The biggest resistance to developing an online presence
among dental practices has been the fear of negative publicity,
comments and reviews. The reality is that having a strong web
presence and knowing how to play the game is the best way dentists
can ensure that the image of their practice portrayed online
is accurate and positive. For many years dentists were able to
ignore aspects of their practice and policies toward patients and
staff that were less than friendly but the Internet has changed all
that. Anyone who feels wronged now has the ability to broadcast
their displeasure, whether on the office social media page or via a
review on Google, Yelp or any number of other places online.
One of the major influences the Internet has had on our lives
today is the ability it gives people to share their experiences with
not only their friends, but also complete strangers. It makes us
accountable in a way we have never been before. Yet not only do
dental practices need to be wary of negative publicity, they need
to learn how to harness the power of the sharing economy1 to
their advantage, to emphasize the positive things they do, to
encourage satisfied customers to be missionaries for the growth
of the business, and generally to make sure the online image or
electronic reputation of the business mirrors or enhances the
vision and goals the business has created.
In a perfect world, the Internet would reflect reality, so the
challenge for business owners is to make sure that ideal exists as
it pertains to their businesses. The biggest problem that dentists
face is that the largest preponderance of reviews about businesses
online are for the nightlife and hospitality industries (restaurants,
movies, music, etc.). References to dentistry, both online and in
the real world, have always emphasized the negative experience,
with having a tooth pulled or a root canal performed being cateby gorized as among the worst experiences in life. The few who have
bad experiences are known to complain or discuss it publicly,
whereas no one has ever heard anyone say, “I just had a great root
canal!” Likewise, a dental patient is more apt to write a negative
or bashing review on a website than one that praises his dentist
or positive experience at a dental office.
For that reason, dentists must be proactive by encouraging
(hopefully satisfied) patients to place reviews of their office.
Accomplishing this is harder than one might think. Attempts to
game the system by encouragement of overly positive reviews and
thus creating a bloated positive image run the risk of being
rejected by review sites. I was recently researching an orthopedic
surgeon and found that he only had an average rating of oneand-
a-half stars on Yelp with eight reviews. On closer inspection
I found another 90 reviews that were hidden by Yelp as being
non-recommended and the preponderance of those were five star
reviews. I followed up with Yelp to discuss this matter as well as
reports that up to 25 percent of all reviews online were bogus.2
Craigslist is one place where people are solicited to write
reviews without ever knowing a business, for a fee, of course.
There are even reports of businesses incentivizing individuals to
write negative reviews about competitors. The Yelp representative
acknowledged the issue but explained that Yelp has developed
a sophisticated algorithm to weed out bogus reviews and
that 75 percent of reviews make “recommended” status.
A review can also be labeled as non-recommended if the
algorithm detects a pattern that would indicate that the review
was forced or unnaturally coerced. If a dental office all of a sudden
starts asking their patients to write positive reviews on Yelp,
even if the reviews are genuine and heartfelt, the Yelp algorithm
will note for example, that in one week Dr. Smith’s office got
five Yelp reviews where they previously had only one or two in
the preceding six months. Yelp wants the reviews to be consumer
driven and random, without coercion.
Another example of how its algorithm detects bogus reviews
is through a computer’s identification or IP address, which is unique for each computer. A professional review writer might
set up multiple Yelp accounts on the same computer to disguise
his identity when he attempts to write multiple reviews
for the same business. Since the different accounts would
come from the same IP address, any reviews from that computer
would be rejected.
There was recently a scandal around a survey conducted by
an Orlando newspaper about CNN’s “Blackfish,” a documentary
about an orca held in captivity at SeaWorld. The results of
the poll indicated that an overwhelming number of the participants
had not changed their perception of the theme park, but
an audit showed that 180 of the 300+ votes in the poll came
from the same IP address, which was registered to Sea World!3
So, how should a dentist use Yelp properly? The Yelp
spokesperson who I recently interviewed recommended that
offices place a decal that is visible at their place of business
encouraging consumers to “find us on Yelp.” In so doing, more
patients will notice the decal and consider writing a review on
Yelp. This should create an evenly spaced submission pattern and
shouldn’t be rejected by the algorithm. Another suggestion Yelp
has is to run a check-in promotion at the office in which a patient
gets some sort of product incentive to let Yelp know they have visited
your office. Yelp would then follow up by asking them to rate
the business with a high likelihood of being published.
Facebook has also started a review system based on a star rating
that appears prominently below the cover photo on a business
page. Businesses can encourage their fans to post a review
and the posters can select a privacy rating of friends, public or
complete privacy to determine if the rating and any comments
are viewable. The star rating is factored into that pages’ rating on
Facebook. Like Yelp, Facebook will also message users who have
checked in to a business and ask them to rate the business. On
Facebook, businesses do have the ability to remove a review from
being viewed in the review box, but cannot delete the rating
imparted by the user.
Google may offer the biggest incentive for a business to
request reviews from a Google+ page. The limitation of asking
patients to review your business on Google is that they must have
a Google+ account to do so. Google+ also prohibits anonymous
reviews to encourage authenticity and publishes a business’
Google+ star rating on their search results page. Since Google is
far and away the most popular search engine, having a fouror
five-star rating viewable on search results will increase the likelihood
of potential customers clicking on the link to that business.
Conversely, having a lower rating is a reputation disaster.
There are a large number of other dental review sites that
consumers can both post to and review ratings of dentists on.
Healthgrades, Vitals, Doctoroogle, Citysearch, Angie’s List,
Rankmydentist and RateMDs are just some of the many sites.
Some are free services that rely on advertising for their funding,
while others require paid membership from providers, members
or both. A dentist’s reputation can be attacked with negative
reviews from any of these sites and if the idea of monitoring
them all seems daunting, relax knowing that there is help available
from some fine products in the marketplace.
Reputation.com has two products: Reputation Defender and
Reputation for Business. I learned about this company in 2010
when I had a personal battle with identity theft and have found
the services invaluable. Reputation for Business is a fully managed
personal service that monitors all known review sites and
responds quickly to any negative reviews to preserve a dentists’
reputation. They recently became integrated with Henry Schein
via the Dentrix Developer Program and are sold through the
Dentrix Marketplace. They offer a unique kiosk program that
integrates with Dentrix — tablets are provided to patients in the
office while the experience is still fresh. Negative reviews are
routed back to the office for review while positive ones are posted
directly online. The platform uses the Dentrix integration to
solicit patients to review the practice online and then routes the reviews to the sites that require reputation enhancement the
most. They also provide a place for dentists to view all their
reviews in one location and get notified when a new review is
placed on any of the major review sites. The software is also available
as a stand-alone system and has plans to integrate soon with
Eaglesoft and other practice management systems.
Another valuable tool is the Social Beacon offered by
Einstein Medical. Einstein has been around since 1995 as a leading
provider of Internet marketing for cash-pay health-care practices.
Their proprietary DocShop directory connects patients to
specialty medical and dental offices and they also create exceptional
websites (including mine, www.painlessdrz.com). Their
newly rolled out Social Beacon allows a dentists’ patients to
review the practice right on the office website. The application
then takes four- and five-star reviews and allows the office to
select which review site to post it to.
Monitoring all the review sites allows an office to determine
which sites might need a boost in ratings and the office can
alternate or pick the sites they wish reviews to post to. In the
event that a user places a review of three stars or less, something
very interesting happens. A pop up questionnaire asks about
the user experience including a field for additional comments.
After submitting the review and receiving an acknowledgement,
the review is then sent to the office instead of being published
online. The office personnel can then view the middling
to negative review and use the information to attempt to
improve the relationship with the patient or to evaluate systems
in place for improvement. Those screened reviews never get
published online. This is a handy little tool that can help
improve the care and customer service offered, as often the dentist
and staff do not realize the behaviors and policies that tick
off some patients.
There are valuable lessons learned from less-than-positive
reviews and often these situations present an opportunity to salvage
a potentially lost patient relationship. I often get asked at
my lectures how to respond to negative posts on my office
Facebook Page. This is a unique type of negative review or comment
because Facebook permits the administrator to delete any
comments posted to their page. But in most cases I believe this
is a missed opportunity. A negative post by a known individual
who is not hiding behind a fictitious name is a cry for justice by
someone who feels wronged.
I cite an example of a patient who complained about having
to wait more than 30 minutes for an appointment in a post on
my Facebook Page. I examined the schedule for the day and
recalled that we were set behind with an avulsed tooth emergency
requiring immediate re-implantation. I addressed the negative
post right on Facebook disclosing the reason for the unexpected
wait and apologized that we had not been diligent in informing
him the reason for the delay and offering to reschedule. What
happened next surprised even me. Many other patients who were
Facebook fans of the page chirped in with comments ranging
from testimonials to many years as a patient and not having to
ever wait more than five or 10 minutes to patients commenting
on how amazing it is that we can re-implant an avulsed tooth.
The end result was a very positive chain and a salvaged patient.
This example shows how a dental office can and should be
proactive with reviews, both positive and negative. Thank
patients for positive ones and address the negatives where appropriate.
It takes many years of hard work to establish a positive
reputation. It’s worth the time and expense to preserve it when
the Internet has made it so easy for alienated patients and staff
members to gripe. The Internet is not going away so dentists are
wise to embrace it, learn as much as they can about it and utilize
the services of professionals to support our reputations.