Dentists caught in rating game

By Laird Harrison, Senior Editor

October 10, 2007 -- "I felt more like a meal ticket than a patient."

"Simply the nicest, most knowledgeable dentist you ever want to meet."

"Very root canal-happy doctor. Get a second opinion!!!"

Such chatter about dentists is common at dinner parties and water coolers. But with the growth of online forums and "top dentist" scorecards in magazines, dentists are more and more likely to find themselves reviewed in public. Such ratings have the potential to affect patients' choice of practitioners.

Paul Dean Douglas, DDS, of Scottsdale, Arizona, was happy when he was named a top dentist by Phoenix Magazine, but he was surprised about the "meal ticket" comment on the DR.Oogle site. "My crown was botched and I had a lot of pain w/ no response to my emergency calls," the reviewer went on. Since the criticism was posted anonymously, Dr. Douglas has no way of talking to the patient about his or her concerns.

Such rating services can sometimes trump a dentist's online marketing efforts. If you go to the trouble of building a web site for your practice, you'd like it to be the first hit when someone searches the Internet for your name. Instead, what popped to the top in a recent Google search for Nathan Kaufman, DDS, was a review on DR.Oogle.

The Albany, California-based dentist had no beef with the reviews -- he's the dentist called, "Simply the nicest." But he does have serious qualms about the usefulness of a system that gave him four gold stars based on two patient reviews. "Sites like this can have a huge impact on people," he said. "But information on the Internet is not as accurate as it is perceived to be."

My brother, the dentist

In fact, dental review sites use wildly different criteria. On some sites, such as DR.Oogle or Yelp, anyone can post a review -- a disgruntled patient or a loyal one, a relative, your angry ex or your best friend from college. In addition to displaying anonymous comments, the sites automatically average the number of stars the reviewers have awarded, a la Amazon. If only one reviewer has logged on and given you one star, then one star is what you get.

Even less rigorous are various local listservs and bulletin boards where participants poll each other informally. On the surface, such chatter seems to echo water cooler conversations. But unlike quips made over a cup of java, comments posted on a web site can fester there indefinitely.

On the other hand, Kevin Brasler, managing editor of Consumer Checkbook, thinks the cloak of anonymity makes for more candid reviews. "On the phone, people are much more likely to give positive information," he said. "Face to face, they are even more likely." Only in writing do they comfortably unload on the person who just screwed up a filling or made them wait two hours for an appointment.

But anonymity isn't enough, Brasler said. He argued that his publication is more rigorous than many other rating services; it sends out 100,000 surveys to its subscribers and 400,000 to subscribers of Consumer Reports, asking them to rate practitioners in seven metropolitan areas. It then lists roughly the top half -- those dentists who got better-than-average ratings. The dentists are rated according to such criteria as "producing the results you expect," "being gentle," "asking about symptoms or problems," "instructing on prevention," and "keeping down time in the waiting room."

Checkbook also provides information to help readers understand the results. There are articles about common dental problems and treatments, the range of prices charged for various dental procedures, as well as a description of the magazine's survey methods and what differences are statistically significant. No dentist is listed unless at least ten patients responded to the survey.

'We want your ad'

Dental ratings also crop up frequently in many city magazines. Instead of surveying patients, many of these magazines ask dentists to recommend the best dentists. On one hand, dentists might be expected to bring some expertise to the evaluation of their peers. But as the DC-based Washingtonian Magazine admits in describing its method for reviewing dentists, this approach can be something of a popularity contest, with newer and less sociable dentists left out regardless of their abilities.

The magazine also notes, "Dentists can judge a colleague’s skill but, unless they get feedback from patients, do not always know if the dentist has a good chairside manner, if the office staff is pleasant and efficient, and if prices are reasonable."

The practice of some magazines selling advertising to dentists to coincide with their "top dentists" features has raised eyebrows as well. "They never pick the same guys," said Irvin G. Lubis, DMD, a former Boonton, New Jersey periodontist who now works as a marketing consultant for dentists. "They pick 12 dentists one year and 12 different dentists the next year. The message is, 'We want you to place an ad,'" he told (He advises against placing such ads because his clients have not found them cost effective.) Other services that connect patients with dentists, such as 1-800-DENTIST, are more direct in their approach: dentists get listed by paying, period.

Knowing these criteria can help dentists tweak their marketing campaigns, or at least respond to patients' questions, said Dr. Lubis. "Explain to your patients what these rating may mean and what they may not mean," he recommended.

But what can a dentist do about unfair (and anonymous) public criticism? Many reviewing sites will remove such reviews under pressure. According to DR.Oogle's Frequently Asked Questions (FAQ) page, if a dentist complains, the company will contact the reviewer to ask for more information and edit the review if necessary. If a dentist still isn't happy, DR.Oogle will remove the review. DR.Oogle will even remove dentists altogether if they don't want to be listed on the site. (That's what the FAQ promises. The site's owners declined to be interviewed by about what sort of complaints they had received.)

The site also warns users that it may disclose their identities if required by law -- and mentions that it has sometimes heard from dentists' lawyers. Although courts have excused Web sites from liability related to the comments users post, the users have no such immunity. Defamation about one's profession or occupation is actionable, says Michael L. Rustad, PhD, JD, LLM, a Sufflolk University expert in Internet law told DrBicuspid in an email. "The [victimized] dentist need not even prove special damages."

Fortunately, few dentists have to resort to such measures. DR.Oogle estimates that only 11 percent of its 73,297 reviews are critical, and negative reviews of many dentists are balanced by positives.

Even if you can't get harsh words removed from the web, they won't necessarily kill your practice, Jim Gray, a dental marketing consultant based in Reno, Nevada said. Nor will a positive review help much. "Patients are completely hip to bogus rating systems," he said. "It doesn't even register with them."

Patients do pay attention to reviews -- but mainly from people they know. Finding a dentist who accepts their insurance and is located nearby matters more than an anonymous review posted on a Web site, said Gray.

Instead of putting time and money into influencing such reviews, Gray advised, dentists should focus on good conventional advertising campaigns, attractive offers such as low introductory prices, and above all, giving patients a good experience when they come in the door.

The reviews should take care of themselves.

Copyright © 2007

To read this and get access to all of the exclusive content on create a free account or sign-in now.

Member Sign In:
MemberID or email address:  
Do you have a password?
No, I want a free membership.
Yes, I have a password:  
Forgot your password?
Sign in using your social networking account:
Sign in using your social networking