Urologists: Proactive stance helps head off online slams

Question:

Is your handling of dissatisfied patients affected by their ability to give vent to their feelings online?

Respondents:

Vernon M. Pais, MD
Lebanon, NH

Sanford L. Polse, MD
Burbank, CA

Stuart M. Polsky, MD
Mooresville, NC

Neal J. Prendergast, MD
Louisville, KY

Word of mouth is one of the best means of advertising a medical practice can have. In the past, it meant that your patients recommended your practice to their friends, family, co-workers, and acquaintances, but since the advent of the Internet, word-of-mouth travels at the speed of light. That's great when patients are happy, but an unhappy patient commenting online about a physician can be disastrous, even if the claims are untrue or inaccurate.

Urology Times asked urologists around the country whether the ability of a dissatisfied patient to broadcast his discontent on the Internet has changed the way they deal with those patients and whether additional measures are needed to prevent those patients from trashing a physician's reputation online.

Whether they sound off to their family or blast the doctor on an Internet blog, the need to defuse angry patients is a matter of concern to all of the urologists interviewed.

Neal Prendergast, MD, who is in a group of 17 physicians in Louisville, KY, says that misunderstandings frequently light the fuse of dissatisfaction in patients.

"My first approach is not to let that happen," he explained. "I make sure I answer their questions, that they understand their problem and what my impression of their problem is, and what our plan is to take care of it."

Good communication from the initial contact with the patient is the key to heading off discord, agrees Vernon M. Pais, MD. Dr. Pais is one of eight urologists at the Hitchcock Medical Center in Lebanon, NH.

"In all honesty, I take a proactive approach and try to spend a lot of time with my patients so we don't have that problem very often," he said.

"I'm a second-generation urologist," Dr. Pais explained. "As I grew up, I watched my dad and I had the privilege of working with him for a few years. He was that classic small-town physician, and he just put so much stress on open communication, hearing what the patient was actually saying, and addressing their concerns. [The importance of communicating with patients] was drilled into me since before the beginning of time. As a younger physician I grew up with that older approach."

Dr. Pais, an assistant professor of surgery at Dartmouth University Medical School, maintains that while the method of sharing information may be different today, it is an issue that predates the Internet, and computers.

"If you're not a good physician to your patient, that word gets around," he said. "I don't do anything differently because of an Internet blog. If I get the sense a patient is unhappy, I really try to take the time to say, 'You don't look satisfied. Tell us what we're doing or not doing.' Much of the time, it's just a communication issue."

On the other hand, Dr. Pais concedes, it's not always possible to keep everyone happy. Then other action is needed.

"If they want something I really don't think is indicated, I'll explain why. If they feel strongly, I will try to get them in touch with one of my partners or another urologist who might take a different approach, but I don't think folks leave the office upset on any routine basis," he said.

Patient satisfaction begins by creating an office culture of patient care, Mooresville, NC, urologist Stuart M. Polsky, MD, maintains.