Google Yourself, Your Oncology Center, Your Doctors—A Smart Practice Management Strategy

Dawn Holcombe, MBA, FACMPE, ACHE

October 2016, Vol 6, No 10 - From the Editor


We are all busy and carefully guard our time and that of our staff. We may often block access at work to social media, such as Facebook or various websites that are grading physicians, but you do not want to forget about those sites; they should be an important part of your administrative duties, for several reasons.

The movement toward value-based care by Medicare and by private payers affects every physician in the country, not only those participating in specific models, such as the Centers for Medicare & Medicaid Services Oncology Care Model (OCM). Accountable care organizations, employers, health plans, and even pharmacy benefit managers are looking at their networks to build relationships with physicians who can best help them to meet their own quality care and financial goals.

Your Patients Can Influence Your Reimbursement

Patients, regardless of age, are increasingly tuned into social media. A 75-year-old member of my family just asked me for advice about investigating an oncologist. Despite his living in a remote area of Maine with limited Internet access, as soon as I started naming names and making recommendations, he was on the Internet looking up their backgrounds, reviews from other patients, and even looked deeply into where they had trained and whether their specialization matched his diagnosis.

You often rely on happy patients to make strong referrals to friends and family, but you cannot lose sight of the presence of so many sources of information—good and bad, valid or not.

Medicare is gearing up to send an 82-question survey to its beneficiaries about the quality of care they receive from OCM-participating groups. Oncology practices will not be allowed to send those surveys out, but their performance on the surveys will affect their reimbursement rates.

Knowing what your patients are saying to anyone who asks is very useful and can often be found online. I Googled the name of a physician friend today, and found that his own web page from his practice was listed first (very good work on the part of the practice); I also found links to 5 physician comparison sites, in addition to the links from his own practice and affiliated hospitals.

Overall, 5 patients had rated him on one commercial comparison site, based on the following deliberations:

  • It was easy to get an appointment
  • The wait time was short during my visit
  • The staff was professional and friendly
  • My problem was accurately diagnosed
  • The doctor spent enough time with me
  • There was appropriate follow-up after my visit.
These are not unreasonable criteria for rating healthcare providers, and they are not unreasonable comparators. This specific information obviously represents a very limited, self-­selected respondent population, but those 5 reviews led to a rating of 3.5 of 5 stars. Would that rating make a difference to a possible patient or to someone who contracts with the physician? Maybe not. But it is important to be aware of what is out there. This physician only had 10 of the 12 options on the Google first page relevant to him, so it was not an onerous process to quickly review each of them for information and accuracy.

Patients’ Reviews Are No Laughing Matter

Another good investigation is to Google each of your physicians and add the word “reviews” to the search function. The challenge for physicians and practice administrators is that when anything is posted about them on these sites, it can have ramifications far beyond a single set of eyes. It is wise to assume that just as patients can find these postings, so can lawyers, referral sources, community resources providing advice to patients, and healthcare networks (eg, payers, hospitals, pharmacies) with which the physician is participating or would like to be involved, and, most scary, federal and state enforcement agencies.

One patient posted a scathing review of a well-established oncologist earlier this summer, on a page with 11 other comments received over several years, most of which were high praise. This review involved an allegation by the patient who claimed to having been affected by mold related to the chemotherapy medications. This review was posted on June 22, 2016. Just 6 days later, inspectors from the FDA showed up at the practice door for a surprise 2-day inspection on June 28 and 29, resulting in an issuance of Form 483, listing observations related to the practice’s handling of chemotherapy and the facilities of the practice.

Based on FDA inspection filing (while preserving the confidentiality of the physician involved), the inspectors’ observations classified the private oncology office as a “producer of sterile drug products,” not as a physician practice. This shows that the inspectors were looking at the medical practice as a handler of sterile drugs rather than a provider. The standards for those handling sterile drugs are set in the US Pharmacopeial Convention “General Chapter <797> Pharmaceutical Compounding—Sterile Preparations.”1

Forewarned Is Forearmed

When the FDA has teams monitoring social media and other websites looking for reasons to inspect and protect the public health, then medical practices themselves should monitor those sites to be aware of any potential adverse postings.

Strong practices may also develop a proactive social media and other online presence and conduct their own patient satisfaction surveys, or collect patient comments to catch concerns before they escalate to random public sites.




Reference

  1. US Pharmacopeial Convention. General Chapter 797 Pharmaceutical Compounding—Sterile Preparations. September 15, 2015. www.usp.org/usp-nf/notices/general-chapter-797-proposed-revision. Accessed September 15, 2016.