Online reputations: The Internet’s dirty little secrets and how they can kill your dental practice

As an avid marketer of my dental practice, I sometimes Google my name and specific keywords to see what comes up and where I rank. Over the last few weeks, I noticed two negative reviews on consumer rating sites. In the past, when a patient had left a negative review, my staff and I would quickly go through the schedule and charts to see if we could identify the patient. However, our last two were somewhat different, in that the reviewer was very specific about his experience and alleged that our positive reviews were “fake.” Immediately, I had our staff go through all of the charts over the last few months and try to recall the patient and the situation. I wanted to ensure that if we had done something wrong or did not handle the situation to the patient’s satisfaction, that we are at least able to take corrective action; if not for that specific patient, then for our future patients.

As many businesses do, we invest a lot of time and money into our marketing and provide the best service that we can. But the irony is that the more we expose our business to the market, the more susceptible we become to these types of reviews which can be counteractive and, personally, quite bothersome. The unfortunate part is that once it is up online, it is there permanently.

It was not until a few days ago that things appeared much clearer to me. I was on my way to a meeting in New Orleans and had a stop-over in Atlanta where I ran into an old friend who owns multiple brand name hotels all over the United States. We started talking about his business and how the hotel industry has become a very competitive and saturated market just like dentistry.

He shared with me that he recently hired a new director of communications, who came from another hotel chain. Since hiring him, sales had gone up. His job was to stay on top of hotel review sites, thank people for posting their positive experiences, and address any negative experiences from the management side. He informed me that by having more postings and responses, the major search engines started to rank the hotel higher in consumer searches, making it easier for people to find his hotels over others. What he told me next blew me away. His new director of communications was also responsible for leaving negative comments for competitor hotels. I was stunned and could not believe that he would be involved in such an unethical and deceptive practice. His response was that he did not even know about it until his director of communications explained it to him and that it is a very common practice in his industry. Recently, Peter Hook, who describes himself on Twitter as “director of propaganda” for Accor hotels in Asia and the Pacific, was caught publishing a number of critical reviews about the company’s rivals. Now things started to make sense to me. I decided to do some more research on the topic, specifically in the dental industry.

Reviews on most sites are unverified, meaning anyone can create an identity and post an experience. Amazon.com is such a massive e-commerce player where anyone can leave a review on any product. Some popular sites say that suspicious reviews are investigated, while others claim they have software to detect automatic postings. RateMD.com claims that they track IP addresses so that the same user is unable to continuously post positive or negative reviews. Regardless of any anti-fraud measures, there are many ways around it. People can stoop to using multiple user names and can post from different locations to prevent using the same IP.

Studies have shown that a one-point increase on a five-point scale can command up to 9 percent increase in revenues for businesses (Harvard Business Review). However, in this new world of online marketing and the “power consumer reviews,” it has resulted in a new kind of business around reputation management. Some of these companies offer to pay people $5 for every fake review they write, while others just have a team of writers overseas that churn out fake consumer reviews. The latest being caught and fined in this practice are a number of companies in New York. A total of 19 firms collectively agreed to pay more than $350,000 in fines and stop posting bogus online reviews touting clients using a Bangladesh company to write fake reviews, being paid from $1-$10 per review (USA TODAY). On Freelancer.com, there are more than 200 ads for people to produce fake reviews for sites.

Georgios Zervas, co-author of a recent study, “Fake It Till You Make It: Reputation, Competition, and Yelp Review Fraud,” concluded that at least 16 percent of the reviews are fake.

Most people are not aware that posting false reviews is against the law. It is also very difficult to track and has become a new type of crime where “reputation” companies can make millions driven by corporations who want to increase their bottom line. According to Scheiderman Edward Telmany, US Coachways' chief executive, "We get bashed online, we are losing money from this." Telmany told his employees to write favorable reviews and posted a five-star review himself on Yelp that began, "US Coachways does a great job!"

Another misleading practice that has come up in the dental industry is one where a company has set up an online review site for practitioners in which mainly negative reviews are posted.  If you contact the company for verification of these reviews, you likely will not get a response back. However, an online reputation management company may contact you, offering to have the comments removed for a fee. It has come to light that most of these management companies are owned by the online review sites that have posted the negative reviews and will have those postings removed but for a price. Sounds a lot like extortion in the digital age, right? Kathleen Richards investigated this practice and has written an article called “Yelp and the Business of Extortion 2.0,” where owners say Yelp offers to hide negative customer reviews on its website for a price.

In a 2012 Ipsos MediaCT study commissioned by Google, 69 percent of business travellers researched a trip online and 54% read reviews from other travellers. A similar trend is growing in the medical and dental field as more people check for reviews when choosing a practitioner for themselves and for their children. My wife did the same when we were expecting our first and second child by researching every OB and pediatrician.

So what can be done so as to not fall a victim to this fraud?

Educating the public about these practices is the first step. I am sure you will never look at an online review the same way after reading this article and the same goes for our patients. If they understand that not all what is written is true, they will use that information more carefully or may not at all.

This is not to say that all sites are bad. Many are credible and give verifiable information to consumers by having reviewers log on and provide their information before posting.

Another tactic to combat bad reviews is to encourage satisfied patients to leave good reviews. Many offices do this by having monthly draws for free gifts like electric toothbrushes for those who have liked them on Facebook or have posted an online review of the office.

One approach that some American dentists have tried is having their patients sign a non-publish agreement along with the patient intake forms. Some practitioners have even sued patients for posting to online sites about their experiences. Dr. Stacy Makhnevich was a New York City dentist who made use of a bizarre form provided by a company called "Medical Justice." Her patients were expected to sign this form, through which they assigned copyright in all their reviews of the dental practice and the doctor to the doctor herself, enabling her to use copyright notices to censor any criticism of her that appeared online.

In a day where every dentist is trying to get on the front page or the first result in an online search, many have resorted to paying search engines to be in that top search. The problem is that other dentists are learning to instruct their staff to click the competitor’s link in the morning multiple times to use up their daily budgets and have them no longer appear at the top. Yes, it’s another deceptive practice, but all seems to be fair in love, war, and dentistry.

The good news is that as online sites strive to deliver accurate information to become a trusted and credible source for their users, they themselves are engaging in practices to ensure the reviews are from actual clients. In addition to setting up a client profile, some are working with companies like hotels, airlines, and restaurants to send out e-mails requesting reviews from existing customers. It’s a win-win for all parties involved as it prevents fraudulent emails from non-clients, and keeps the website credible while encouraging more reviews and higher rankings for the business. Eventually, as the number of posts increase via smartphones, you will only be able to post reviews of places you actually have visited.

There is a whole science dedicated to identifying false reviews, like the overuse of superlatives or “I” and “we,” or the fact that most fake reviewers spend less than a minute to write their reviews. Real reviews, however, will often have photos uploaded by the user which shows that the reviewer was actually there. But, just as more information is published on fake reviews, these reviewers change their patterns to blend in and it once again it becomes a cat-and-mouse game.

As we move into the future and digital age, a new level of fraud will continue to emerge. When arming your security system and locking your front door, be advised that this is no longer the only method to protect your assets. There is a whole world of cybercrime that can cost you more than a laptop or a tablet. Stay current and employ Internet safety measures that keep you and your business safe.