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    Rolling up patient reviews

    If you go to a plastic surgeon’s website and it says online ratings give her an aggregate average of 4.9 points out of 5, you might assume she does a great job and her patients love her.

    In fact, reality may be something else entirely: She may actually have a 3.5 overall rating, perhaps, or even lower. What happened? Most likely, the surgeon hired a tech company who fudged the truth — a decision that could have major consequences.

    “We’re seeing companies bragging that they’re providing a competitive advantage by using technology to manipulate results,” explains Ryan Miller, president of Etna Interactive, a tech consulting firm based in San Luis Obispo, Calif. “If the doctor is unethical and uses this technology to an unethical end, they’ll eventually be called out for it.”

    Benefits of Aggregate Ratings

    Aggregate ratings themselves aren’t the villain. They’re becoming common on physician websites, says Miller, who spoke earlier this year at The Aesthetic Meeting, the annual meeting of the American Society for Aesthetic Plastic Surgery. “They’re a way that a practice can take an active role in leveling the review playing field and share a more representative picture of their reviews,” Miller says.

    Related: Bad Patient Reviews?

    For example, a practice may choose to display an aggregate of online ratings from a variety of sources — Yelp, Google, RealSelf, Healthgrades and more — instead of just displaying ratings from one source. There’s an added bonus: Google detects aggregate ratings and displays them when users find practices during online searches.

    But Beware Legal and Ethical Issues

    The problem: It’s easy for a tech firm to tweak the aggregate rating so negative numbers don’t count. A keystroke here, a keystroke there and voila — A doctor with a 3.2 average overall rating from several sources suddenly has a 4.8 with no one the wiser.

    As an example, Miller points to a Texas plastic surgeon whose aggregate rating is quite impressive, partly because a 1-star rating got thrown out.

    Not surprisingly, this kind of manipulation could pose a legal problem. “In every state, you may not engage in fraudulent, misleading or false advertising,” Miller says. “If you are offering an ‘unbiased’ aggregation of all review content but tossing out any criticism, then it’s our belief that you’re misleading patients.” And, of course, misleading patients is an ethical no-no.

    What should you do? Miller says it’s fine to tout aggregate ratings on your website, but you need to do so in a honest and ethical manner.

    Being up front is actually a time-saver, he says, because “it does take more effort to willfully cut out stuff that’s critical.” And besides, he says, “for the most part, practices are liked and respected by their patients. You don’t need to lie.”

    Randy Dotinga
    Randy Dotinga is a medical writer based in San Diego, Calif.


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