"WORST DOCTOR AND STAFF I HAVE EVER EXPERIENCED!! DO NOT SEE THIS HORRIBLE DOCTOR!!"

"I feel like I was just another number at the office."

"Something everyone reading these has to realize is that the patients who have no complaints about Dr. D (like me) will rarely ever come on this website to rate her. If out of her thousands of patients, she has less than 20 people who are dissatisfied, that is pretty amazing. DR. D IS A PHENOMENAL PHYSICIAN!!!"

Most health plans now offer some form of online quality rating system for physicians. But some of the most damaging criticism can come from the growing number of sites that operate independently of third-party payers.

Even the most competent doctors can be mercilessly berated by a vengeful patient—and for any number of reasons, from long wait times to poor outcomes, from cold stethoscopes to costly bills.

Negative comments might be easy enough to ignore in a typical busy workday, but your patients cruising the net—or potential new patients seeking information about you—might be influenced by them, and that can take a bite out of your bottom line. Online ratings aren't going away, so it may be time you formulated a strategy for dealing with them.

"All of us have to accept the fact that professional life and commerce, the ways of doing business, have changed," says Gerry Niederman, a partner and health-care attorney in the Denver firm Faegre and Benson LLP.

In other words, you won't solve the problem by unplugging your computer. Be proactive: Search the web to see what people are saying about you and your practice.

Numerous companies, such as Reputation Defender, help monitor usage of your name online for a fee. Medical Justice, based in Greensboro, North Carolina, offers physician-patient contracts that forbid the patient from posting information about you or your practice online. Perhaps not surprisingly, this method has its share of critics.

"Patients, hypothetically, might be offended by that and wonder why someone might be trying to gag them," Niederman says. "From the point of view of promoting good patient-physician interaction, I think it might put some patients on the defensive and perhaps be more trouble than it's worth."

OLD-FASHIONED COMMUNICATION

While it may seem obvious, the No. 1 component of a solid cyberstrategy is to recognize that the doctor-patient relationship is more critical than ever in the new world of online rating systems.

"What I tell my clients is to spend an extra minute or two with a [patient]," says Michael Schaff, a health-care attorney with Wilentz, Goldman & Spitzer PA in Woodbridge, New Jersey, and a board member of the American Health Lawyers Association. "Those types of things—creating a better bedside manner—really go a long distance in protecting you from liability and disgruntled patients."

The American Medical Association recommends soliciting feedback from patients to help better meet their needs and increase quality of care. Though negative opinions posted online can be damaging, AMA President Nancy Nielsen, MD, recommends taking them with a grain of salt.

"Some [rating sites] allow postings to be published anonymously, and there is no guarantee that the opinions about a physician even come from that physician's patient," Nielsen says. "People may express dissatisfaction on these forums because they wanted a medication that wasn't medically necessary or because they didn't receive a prescription or service that was delayed or denied by their insurance company."

Put another way: Some patients aren't above lying when you don't give them what they want.