A few years after family physician Gus Geraci left a full-time practice in Camp Hill, Pa., he was online one day and -- out of curiosity -- Googled his name.
What popped up on the screen was a single anonymous posting by a former patient: "He made me wait way too long, and then I felt rushed."
After years of practicing medicine and treating hundreds of patients, his career had been capsulized in one damaging sentence.
"No glowing comments about the time I paid a late-night visit to an inpatient who had taken a turn for the worse," Dr. Geraci later noted in writing about the episode for the medical society's blog. "Nothing about the patient I asked to come to the office on a Sunday afternoon for stitches to save them hours of waiting in the ER. Not a single mention about the time I spent with the family of a dying patient."
His initial reaction, he acknowledged, was anger. "You want to say, 'That can't be right.' But the reality is, I'm sure I caught this patient on a bad day."
He also couldn't help but wonder: When potential patients read that online posting, would they still come to his office?
Dr. Geraci never followed up on the posting; by that time, he'd moved on to his current position as chief medical officer of the Pennsylvania Medical Society, the physicians' statewide professional association.
But he does have a message for the society's 17,230 members: Establish and manage your online presence before someone else does it for you.
His advice: Send out surveys. Poll your patients. Then post the results. "You can't make every patient happy. But the way to battle a negative review is to get a positive one." One starkly critical comment can be harmful, he said, but "one negative review out of 100 is nothing."
More and more, physicians are finding their care being reviewed online, much like a restaurant or a movie. Among respondents to a late December state medical society survey, nearly one in five physicians said they'd had a negative online review while only 5 percent said their employer had a policy in place on how to respond to such reviews.
"In the world of employed physicians, it's certainly on their mind" because of the possible implications for their compensation or even job security, said Dr. Geraci. "For independent physicians, they're starting to look at it and think about it."
There are several websites, such as Yelp.com, where people can make comments and that has spawned an entire cottage industry, said McMurray-based plastic surgeon Amelia Pare. In her specialty, professional journals carry ads promising to buff up a physician's online image and she knows physicians who have hired full-time media consultants.
"We're kind of missing the mark on what medicine is about," she said.
The emergence of online comments has also spawned a new front for litigators.
Last year, the Digital Media Project at Harvard University noted at least seven lawsuits in five years filed by physicians against patients over negative online comments. While some patients backed down when threatened by a suit, the court ruled in the patients' favor in other cases, saying the comments were protected free speech.
In an infamous New York case, a dentist insisted patients sign an agreement promising not to make disparaging online comments about their care before receiving treatment. When a patient put critical remarks online anyway, both the dentist and the patient ended up filing suits against each other.
Ultimately, posting anonymous, negative comments online "doesn't benefit anybody. It doesn't help the person who's taking the potshot and it doesn't do anything for the potential patient, quite frankly," Dr. Pare said.
Instead, she suggests saying something directly to the doctor or the office staff, an approach she believes can bring real and often immediate results.
Steve Twedt: firstname.lastname@example.org or 412-263-1963.