Insurance companies are beginning to provide patient reviews of physicians to their members. For example, Zagat has assisted WellPoint Insurance in creating online reviews of physicians available to WellPoint customers, including Blue Cross plan members.
The quality and frequency of rating are becoming popular areas of research, but very few studies are currently available. Khadry et al.1 reviewed more than 4999 individual online ratings of physicians, and researchers concluded that most patients give favorable online physician reviews. One in six of the participating American physicians were rated online by patients. Gao et al.3 concluded that a strong correlation exists between online ratings and offline reputation. This conclusion is limited by the fact that "quality" was never defined in the study; the researchers simply suggest that "quality" is a judgment made by patients that is based on factors including physician’s bedside manner, timeliness, and communication skills. Notably, the structure of many rating sites would permit persons who are not even patients, but disgruntled acquaintances, contractors, or staff, to submit fictitious reviews. However, reviews may provide important information to the larger community about a patient's experience, and this information can be used to identify weaknesses, like timeliness, in a physician’s practice.
Physician-to-physician websites
Physicians can also network and collaborate with one another on websites such as OrthoMind.com and Sermo.com. These sites allow for new forms of collaboration such as informally sharing experiences about the success of new surgical techniques. However, the sites require the same level of care that a physician would use when interacting with fellow colleagues in real life, such as not using patient identifiers to nontreating clinicians.
Text messaging
A text message is an electronic message, generally up to 160 characters in length, sent between two mobile phones. Patients are generally receptive to the idea of texting with their physicians. Patients who use phones paid for by their employers, especially senior management and board members, may be concerned about their employer having access to sensitive health care information. Some physicians believe texting is an ideal form of communication because it permits both patients as well as physicians to respond in an efficient manner when it is most convenient for each party. Some physicians and their offices have begun text messaging patients as a means to remind patients about appointments, and others use it to more closely monitor patients with chronic conditions such as diabetes. Physicians also find it convenient to text sign-out lists to colleagues.
The primary concern for patients, and physicians as well, is ensuring privacy and patient confidentiality when texting. Texting does not provide any way to ensure that only the patient and not someone with access to the phone receives the text message. Physicians who intend to text with patients should work with legal counsel to establish a texting policy that explains how messages will be recorded in a patient’s chart, how quickly the physician will respond to texts, the types of concerns that can be dealt with through texting, and a common vocabulary to be used in the texts. Patients who wish to text with physicians should sign a written informed consent acknowledging that they understand the texting policy as well as any privacy risks and texting charges associated with its use before any texting begins. Physicians can best be able to limit the risk of a third party obtaining confidential health information by only using texting to confirm appointments. Private companies may soon develop software that permits a physician and patient to send secure text messages that protect a patient’s privacy and confidentiality. At this time, the Joint Commission Frequently Asked Questions on Texting Orders notes that it is not acceptable for physicians to text orders for patients to the hospital because "this method provides no ability to verify the identity (of MD) [and] no way to keep the original message as validation ...".4
Protecting a physician’s reputation
Physicians should safeguard their professional reputation online because it may impact relationships with patients, staff, and fellow physicians as well as affect physicians’ future opportunities and the public’s trust in the medical community. Bad reviews, even if completely false, can be detrimental to a physician’s reputation. This is especially true if the negative review is the first one listed after an Internet search of the physician’s name. Nonetheless, a physician still has substantial control over his or her reputation as described below.
Provide quality patient care
First and foremost, physicians can best protect their reputations by providing – and ensuring that their staff who interact with patients are providing – excellent patient care. Physicians and their staff should strive to make patients feel welcome and respected by actively listening to the patients’ concerns.
