pyramid review

The second R strategy is Review – specifically, reviews for your physicians. This is analogous to practice reputation (our first 7R Strategy). Individual physicians also must maintain five-star reviews, but distinct from those for the practice, because patients don’t talk only about your practice; they talk about the doctor.

pyramid review

There are sites specifically designed for rating physicians: Healthgrades, Vitals, RateMDs, to name a few. In addition to including a simple profile or bio, many listing sites have a place for reviews.

The same scientific approach that works for practice reputation also applies to physician reviews.

  • You have to build a five-star reputation.
  • You have to manage and monitor it so that you can address patient concerns.
  • And then you have to market your reviews and your patients’ experience.

And, just as with practice reputation, your process for getting physician reviews needs to include a way to predict whether any request for a review will get you a great review or not. Don't just leave it to a review widget thrown up on your website. What we emphasize with our clients is how they should “read” a patient’s inclination to leave a glowing review rather than a negative one.

Reputation Marketing Machine - Ethically Collecting Great Reviews

We have developed a way to virtually (and ethically) assure that great reviews are captured, using a process that begins by asking one question, “The Ultimate Question” (see below). Based on their answer to this question, patients are automatically directed to an intelligent process where they can voice any concerns regarding their experience (which gives you an opportunity to address those concerns) or, if they are likely to refer you, where they can be asked to provide a review.

The process starts by having the physician ask one simple question to their patient: “Would you be open to giving me feedback on today’s visit?” Patients who say yes are then sent an email that triggers a process designed to capitalize on great experiences and quickly address unpleasant ones. The email directs them to a page with the question “On a scale of 1 to 10, how likely are you to recommend me to your friends and family?”

Net Promoter Score - The Logic Behind The Machine

That last question is famously known as “The Ultimate Question.” Although it sounds simple, it is the basis for what is known as the Net Promoter Score. It was originally put forward by Fred Reichheld of Bain & Company and is used by several Fortune 500 companies (Harvard Business Review, 2003, “One Number You Need to Grow”). The strategy behind this key question is that, based on the number that they answer with, you will decide whether to invite them to leave a review or not.

Studies have shown that people who leave a score of 9 or 10 are highly likely to actively recommend the business to someone else (promoters). A score of 7 or 8 is typically a neutral one. And people who give a score of 6 or less are likely to leave a negative review or to actively recommend against the business (detractors).

net promoter score


The question stands alone. It reveals customers’ loyalty. It is not a satisfaction survey, but it reveals how willing they are to promote you to others. Promoting you is an action. Satisfaction is a feeling that may or may not indicate the likelihood of taking that action. If patients give you a 9 or a 10, you follow up by asking, “Could I trouble you to leave me a review at one of these online sites?” with links to your profile on those review sites.

Managing the Review Building Process

If their answer is 7 or 8 (neutral), you may have some work to do. This means they could give you a three-star review – not a great thing. You might want to ask them, “What would it take for us to move to a 10?” When they answer, you’ll be instantly informed of the process that you need to focus on in your practice to change their experience – maybe the way the phone was answered, or how long they had to wait before seeing the doctor, or the manner in which the doctor dealt with them. When they give a score of 7 or 8, this is an opportunity for you to tweak an experience on your side that may move another patient into the 9 or 10 range.

If you receive a score that is 6 or less (detractor), this almost guarantees a one- or two-star review. To state the obvious, anything less than four stars isn’t usually perceived by prospective patients as a good thing. If you have a response this low, you really have some major corrections to do. It isn’t just enough to say, “What would it take to move us to a 10?” It’s time to drill down into the root cause of their personal reason for giving this score to you.

The reputation system begins with collecting reviews and patient feedback. In our opinion, the separation of reputation and reviews is based on the idea that your practice, as an entity, needs reviews for each location and that individual physician reviews are of equal importance. Each has its own place in the 7R Pyramid. 

In both cases, the process for collecting reviews is the same. What changes is the review site patients who are likely to refer you are asked to visit. Reputation building is as simple as handing out a tablet with a feedback request form to the patient at the end of every visit where they enter their name and email. This captures their contact info into a marketing database. You simply say, “Would you give us/me your feedback?” If they say yes, an email is immediately sent with a link to a page that presents the Net Promoter Score question: “How likely are you to recommend Dr. Jones to a friend or family member?” Once they select their number, there’s branching logic in the system to take them to the next step. If they left a score of 9 or 10, it will direct them to a review site. If it’s a very low score, it will automatically send an email with an apology for such an unhappy, unpleasant, or questionable experience. The system will then forward their information to your designated manager or patient coordinator to reach out to them.

Think about the way that you ask for reviews (if you ask at all). Think about physicians’ reviews being as important as practice reviews, and set up two separate processes for getting reviews for both.

You cannot prevent a dissatisfied patient from leaving a bad review and you cannot ethically remove bad reviews. But with the right review system, it’s like “cutting ’em off at the pass” before a dissatisfied patient has broadcast their thoughts about their experience with your practice. It also encourages satisfied patients to leave positive reviews.

Key Takeaways:

  • Reviews are to physicians what Reputation is to the practice
  • Ask satisfied patients for their feedback to help ensure positive reviews
  • Ask dissatisfied patients for their feedback to help mitigate potentially negative reviews
  • Give patients cards with specific review site links or use technology to automate and leverage the process

Peter J Polack MD FACS

Founder of Emedikon Marketing Systems and a practicing cornea specialist in a large multispecialty practice. Peter specializes in refractive laser and cataract surgery, cornea, and external diseases.

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