[Editor's Note:  This is a guest post from Mike Dolen, who has several years of experience owning, operating, and consulting websites where people share their reviews. His current venture, CreditCardForum, is a website where consumers review reward cards and balance transfer offers. However he also worked with several popular medical review sites during his career.  He and I have no financial relationship.]

Back as a child, I remember when someone in my family had to see a new doctor, we would turn to the phone book for suggestions.  In the internet era, people turn to Google.  Unlike a phonebook, where you can control the information about you, the internet is not much different than the Wild West. People will say things about you and your practice, which may or may not be truthful and accurate. How much is this affecting your business and what can you do about it?

What will people look at?

Regardless of whether a given review about you is positive or negative, the odds of someone actually reading it will largely depend upon where it sits in the rankings:

Source: http://www.seomoz.org/blog/targeting-multiple-keywords-vs-singular-keyword-focus

As you see, just the difference between position #1 and #2 is dramatic. If the information about you is after page 2, there is almost a 99% chance a user will not see it. That data – the most recent available – is a couple years old but I can confirm that it matches my current experience. For example, CreditCardForum’s page for balance transfer cards gets about 2x as many clicks when it’s in the #2 spot versus the #4 spot. That correlates with the 11.9% and 6.1%, respectively, mentioned above.

Conclusion? If there are some unflattering reviews about your practice, don’t be overly concerned if they are found on some obscure review site or message board. Rather, what you should focus on the most is what people are saying about you on page 1 of the results.

How much will online reviews affect you?

Obviously there is no one-size-fits-all answer to this question. With some of the more specialized and/or potentially embarrassing fields of medicine (such as plastic surgery) there’s a good chance a person will be looking online for recommendations, before they ask a friend or relative. However when it comes to finding a general practitioner or local dentist, a person may be more inclined to ask someone they know for recommendations, before resorting to Google.  [Sometimes it's nice to be an emergency doc, who no one looks up before soliciting services.- ed]

If you’re getting customers thru the internet, then that brings us to the question: How much is your business being affected by what people say about you? Ultimately, it’s impossible to know the exact answer, because one can only guess how many potential customers you may have been lost due to a negative review or article.

Let’s dive into a hypothetical scenario to put the potential problem in perspective:

You are a cosmetic surgeon in the San Francisco area who specializes in implants. Due to the private nature of your business, 70% of your customers come thru organic online referrals (that is, customers researching you online). Being that you perform an average of 24 operations per month, this implies that roughly 17 operations per month are the result of your internet presence.

Furthermore, let’s assume that position #2 on the search results is a highly negative review of your practice. Of the people who see it, it persuades one-third of them to not become your patient. If approximately 12% of people click on the #2 spot, this would mean that essentially you are losing 4% of your online customers from that information. This translates into 2.8% of the total number of operations you perform – or in other words – you miss out on one operation every 2 months because of it. If your practice was deriving an average of $8,000 in revenue per operation, it would mean that review was costing you around $48,000 per year.

Now to be clear, all of the above is based on a number of assumptions which are by no means scientific. For example, while it’s true that about 12% of people click on the #2 spot, we do not have the data to determine how many people click on multiple spots. Nor would it be possible to know how many customers are actually deterred from a given review (which I’ll talk about in a moment). The above scenario and its assumptions are merely meant to show you why it’s important to care about what people say.

How can you manage your reputation?

I have quite a bit of experience with consumer review sites – I run one for a living! Currently I run a personal finance site, CreditCardForum, which is the top message board in the credit card niche. In addition, I have previously worked at a company where I helped operate and advise medical message boards and review sites. So I have years of experience dealing with your industry, too.

What follows are the three most valuable tips I can provide you, when it comes to managing your online presence:

1) There’s dirt (true or not) on everyone

First of all, it’s important to accept the fact that you can’t please everyone. If you’ve been in business for a while, it’s inevitable that there will be some negative things said about you. Sometimes they’re said by actual customers, other times they may be comments by outsiders (i.e. “the before and after pictures on Dr. Smith’s website look horrible”).

It is human nature for us to get upset when something bad is said about us, especially if it’s not true. But the bottom line is you shouldn’t be overly concerned regarding comments being negative, if they are in the small minority. Because there’s at least some dirt said about everyone; isolated cases of it are unlikely to discourage a prospective patient. However if there are a lot of people talking badly, then yes, you need to work on how people perceive you.

2) Nice guys finish first

What I mean by that is if there is a nasty review about you on a given site, bullying the webmaster/website owner with legal threats isn’t the solution. Why? Because for starters, the owner of a forum is not legally responsible for what someone else posted about you on their site (the actual person who wrote it is). So you aren’t going to get anywhere by trying to bully them.

Instead, I would recommend killing them with kindness. On both my forum for credit card reviews, as well as various medical websites, I have had to deal with parties who were unhappy regarding something that was said about their service or product. Who was I more eager to help? Those who were nice and polite about it. The ones that tried to just be nasty and tough with subpoenas and the like ended up accomplishing nothing.

3) Play by the rules

I have come across doctors who have tried to counter negative reviews, by posing as patients (or paying others to) and writing positive reviews, which were obviously false. Not only is this morally wrong, but it’s also illegal since the FTC enacted some rules a couple years ago (they require the disclosure of financial relationships).

The best way to counter negative reviews is to simply encourage your patients to write about their experiences online. When patients are happy about the treatment they have received, they are usually more than happy to share that with the world. Having plenty of good stuff said about you will likely overshadow the bad.

What do you think?  Does your online reputation matter to your practice?  What have you done to manage it?