In the wake of a story about a California dentist who sued two patients because of bad reviews they posted on Yelp, I thought it was time to bring my internet guru Glenn Lombardi back for another Chairside^® interview. The French Laundry, located in the Napa Valley town of Yountville, California, is widely acknowledged to be the best restaurant in the U.S., yet it has some three-star reviews among its plethora of five-star reviews. If this legendary restaurant with its commitment to perfection can disappoint people, any of us can. Glenn discusses this and more in this issue’s One-on-One. Enjoy!

Dr. Michael DiTolla: Glenn, I like to bring you back at least once a year, sometimes more often, because in addition to doing websites for dentists, you now help them with their online presence and social media needs. This is an area that is changing so rapidly that I feel like I need to check in with you every couple months to find out what we, as dentists, should be doing. Talk to me about how social media has changed, and what you’d like to see dental offices doing.

Glenn Lombardi: Well, it has progressed quite a bit in the last year. While most dentists are familiar with Facebook and Twitter, which are continually growing and evolving, there are now new social sites emerging like Google+ and location-based social platforms. We’ve also seen a rise in the influence of online reviews, which have become an essential piece of the whole social media aspect. It’s now more important than ever that dentists are aware of what is being said about them online, and that they are also being proactive in trying to interact with and influence positive dialog.

MD: It seems like, despite your best intentions and attempts to treat every patient right, there are going to be times when you disappoint somebody, whether it’s clinically or whether it’s estimating what the insurance is going to pay. You just can’t hit it right on the head every time. And if the patient happens to be one of the people who spends a lot of time online, I think it’s fair to say that, even as a great dentist trying to do everything right, you can end up with a bad online review. I don’t think you have to kill a patient for that to happen, right?

GL: Right. Just look at your favorite restaurant around the corner. You can go online and find 100 good reviews, but for every 100 positive reviews, there will inevitably be an additional five or 10 negative reviews. And, unfortunately, the people who are typically most apt to give a review are those who are unhappy with a service. As a dentist, you can’t possibly satisfy every patient who walks through your door, but you can, in combination with great customer service, encourage your most loyal patients to give you a good review online on the major review sites, such as Yelp, Yahoo and Google.

Just look at your favorite restaurant around the corner. You can go online and find 100 good reviews, but for every 100 positive reviews, there will inevitably be an additional five or 10 negative reviews. And, unfortunately, the people who are typically most apt to give a review are those who are unhappy with a service.

A dentist can do a couple things to make that happen. There are a handful of services out there that send patients an email following their appointment that asks: How was the process? How was the service? Can you review us? At Officite, we offer a more hands-on approach. We provide our clients with simple instruction cards for giving a review that can be given to the patient as they leave the office. The patient can then give the dentist a positive review from their home computer. We also offer an in-office review solution, which allows a patient to review the dentist right there in the office, directly from their mobile device. While a dentist might get three, four or five negative reviews over time, if they’re encouraging patients throughout the year to leave positive reviews, by the end of the year they will have garnered enough positive reviews to offset a handful of negative ones.

MD: Are dentists comfortable with this? For example, we’ve been hearing at practice management seminars for the last 15 years that we should be asking for referrals from our patient base, especially from the satisfied patients who we know get along with us and the staff. Also, we’ve always been told that, as the dentist, we should ask for the referral personally because that’s really powerful. But the reality is, a lot of dentists are uncomfortable asking for that type of referral. Are most of the dentists you’re working with comfortable asking for positive reviews, or are they done up front by the staff?

GL: It’s really been a staff process. A dentist needs to train the staff on who to ask and what makes a patient a good candidate for a positive review. Some of the things you want to identify as a patient comes through are: Did they have a positive, outgoing personality? Are they consistently pleased with your services? Do they already have accounts set up on Google or Yahoo? Once you narrow down the “right” patient to ask, the process becomes a lot easier and more effective. You’re just asking a select few patients for reviews, not necessarily everyone who comes through the office.

MD: That makes sense. I can see dentists being much more comfortable with your approach.

You mentioned smartphones and iPads. My mom and I were sitting at one of my son’s hockey games, and I asked her a question about a book she was reading. She whipped an iPad out of her purse, and I was at once really proud of my mom and also horrified to see her with a piece of high technology because it made my iPad seem slightly less cool. But I realize that for some people who are intimidated by computers, the iPad is actually a solution that doesn’t feel as intimidating as maybe the keyboard and the mouse did because you get to interact with it on a different level. Are you finding with these different platforms, like the computer, the iPad and the smartphone, that there are things that need to be optimized for the dental practice?

GL: Most definitely. While a lot of people still use their home computers, there are now more than 250 million mobile phone users. Ninety million of those are using the internet on those devices. There are some incredible stats out there on what is happening with smartphones, iPads and other portable devices. The number one thing you want to do is make sure your website is compatible with those devices. So if someone searches for your practice via an iPad, a Droid or an iPhone, you want to make sure that when they pull it up they get a mobile- or iPad-friendly version of the site. If someone is looking at your website via smartphone, they’re probably looking to call you, get directions, those sorts of things. They’re probably not looking to read up about flossing. You want to make sure the navigation is presented clearly, so that while they’re on that device they can get to the information they are looking for with a touch of a finger.

In fact, last week I was at Google’s campus in California for a meeting, and they stated that there will be more local searches on mobile devices at some point in 2013 than there will be on personal computers. So this shift is happening fast. If more searches are being done on a smartphone or tablet device, then you need to make the necessary changes to ensure that your website is accessible from those devices because that’s where your patients are.

MD: That makes sense, and I think that might actually be true for me as well. I have a nice computer at home, but it’s easy for my smartphone to get on the internet and it’s easy to do searches. Plus, my phone is always right there with me.

GL: Exactly. Think about all the patients that you communicate with in the office that then go and refer people back to you, be it their friends or acquaintances at work. If they’re sitting there talking to someone and they say: “Hey, you really need to see Dr. DiTolla. He’s great.” And the person says: “Wow, I’m looking for a new dentist. How can I reach him?” If they are sitting at a restaurant or wherever they might be, they might go straight to their iPhone or their Droid and pull up the information to read about that dentist and even make an appointment. So it’s a very simple concept that all these patients who are being referred to you, in most cases, are probably searching for you online before they come into your office or even contact you. So, again, not knowing what device they’re going to be on, you want to make sure you’ve optimized your website for that potential new patient, whether they’re accessing you on a tablet, a work computer or an iPhone.

MD: I agree with what you’re saying about the significance of a website. Recently I had to go see a physical therapist for an injury, and the first thing I did was pull him up online. I just wanted to see a picture of what he and his staff looked like. I don’t know if I expected them to look evil so I would know not to go there, but there was just something that made me feel more comfortable seeing who they were and what they looked like before I went. You know what I mean?

GL: Yes, I understand that. It’s just a comfort level. Whether you’re being referred to a urologist or a dentist, it’s just human nature to search for them online. That is a big change from the traditional phone book. Just because your site may not be iPad-compatible today, it’s OK; it’s part of the process. So if you don’t have a website and are going to get one, it’s important to make sure the vendor you’re considering also offers a mobile solution. And if you already have a site, go back and revisit this with your provider and talk about how you can move, over the next couple months, from just a computer-centric website to one that can be accessed from any mobile device.

MD: I guess at some point most of these things will be designed mainly for mobile devices and computers might be kind of an afterthought.

GL: Yep. In fact, I was at a BIA/Kelsey conference last week, and they stated that less than 2% of the websites out there today are mobile-friendly. So while mobile is where we are headed, many people still need to take the next step to make their sites mobile-ready.

MD: Yeah, I absolutely agree. In fact, our site, glidewelldental.com, has been entirely redone to be easily accessible from mobile devices. We’re big believers in what you’re saying.

Going back to my physical therapist example, not only did I want to see what he and his staff looked like, I wanted to find their hours and see where they were located because I didn’t recognize the address. So it made it really simple for me to get there. And I can almost honestly say that, even though the referral was from a friend of mine, if they hadn’t had a website, I would have been a little bit leery about going over there. If a doctor doesn’t have a website, I guess it says to me that they’re just not trying hard enough; that they don’t care enough to help out their patients. Maybe he’s the best physical therapist in the world, but if he’s not willing to take that effort to make it a little bit easier for me to do business with him, I almost don’t want to deal with someone like that. On one hand, that sounds kind of lame, but on the other hand, I think a lot of people feel that way.

A woman told me the other day she’s switching her dentist because his office still calls her home voicemail to confirm appointments instead of texting her. She doesn’t want to go home and check her messages or check them remotely. She just wants to get a text message to see whether she has an appointment and what her appointment time is.

GL: (laughs) Well, there you go.

MD: Do you have any idea what percent of dental offices have a website today?

GL: There are varying numbers out there. I think we can estimate that somewhere between 30% and 40% of all practices have what I would call a “functional” website. There’s probably another 20% to 30% that have something very simple or brochure-like that they might have put up four or five years ago that’s probably not functional at this point or visually appealing. But even here at Officite, half of the clients coming to us for new websites already have one. If you bought a site three, four or five years ago, it is also part of the process that you need to refresh and update it, both from a technology standpoint and from a look-and-feel standpoint. Your site is oftentimes the first impression a patient has of your practice. You don’t want your outdated site to send the message that your practice isn’t up to speed.

MD: What do you think is keeping the other 40% from getting a website?

GL: I think the biggest issue is fear of the process; that it’s going to be too involved and too difficult. In a lot of cases, it might be somebody who is not technology savvy. Someone might be a great dentist, but when it comes to the internet and computers, they’re still hesitant. Building a website can be a simple process, and if you pick the right provider, they will hold your hand through the whole process. They’ll walk you through all the things they need from you, and in some cases can have a site up and live on the internet, within an hour of your time. So I think the biggest fear is of the process, and what dentists need to know is that it’s easy, and the longer they wait, the further behind they get.

MD: So it’s not a money issue for most of the doctors you talk to? As it’s really not all that expensive, it seems like it wouldn’t be a money issue like investing in an expensive piece of technology would be.

GL: No, it should not be a money issue because the return on investment is very clear and very simple, and you can measure it monthly, if not daily. If you just get one new patient a month, you’ve paid for the site in six to eight months. So it’s really not an investment issue, it’s an ease-of-process issue.

When speaking with dentists without a website, I’ll often recommend that they do a search on Google for their name or practice name. In many cases, the search will show 10 to 12 results from various directory listings, all with varying information on the dentist including patient reviews. So on the first page of the search results you’ve got 12 different sites telling everybody who you are and what other patients are saying about you. But if you have a site and you Google your name, your website is going to come up, and below it will be the directions to your practice, contact info, any articles you might have written, your blog. So the top half of the page is going to be links to your website where you are now telling your story. The patient won’t have to sort through directory listings that may or may not have accurate information about you because your website pages will be the first to appear. So not only is it important to have a website, but more importantly, you want to take control of your online presence. That’s just one of the things you have to look at. Every time someone refers a patient to you, they’re going to search your name online. Do you want a handful of directory sites telling your story, or do you want to tell your own story with your website?

MD: It’s funny you mention that because I sometimes get emails from dentists who I want to call because they’ve asked a question that requires a longer answer. I’ll Google their names, and you’re exactly right, I get healthdirectory.net, doctoroogle.com, and all this other stuff that are not official pages by them. You wonder if the information or phone number is accurate. There are even friends of mine who don’t have a website. I’ll search their name, and you’ll see a review or two of them and it’s completely uncontrolled.

When you talk about dentists not doing a website because of the work that is involved, do you think there’s a perception among dentists that if they do a website they’re going to have to start blogging? Is blogging one of the things where they think: I can’t write, I don’t take clinical photographs, this is going to be a big problem, I don’t want to get invested in this?

GL: You’re right, that is probably another fear they have. Obviously, you don’t have to blog, but it is a great educational tool. But even here at Officite, we will actually do the blogging for you, if you’d like.

MD: Really?

GL: Yeah, we think it’s a helpful service because blogging is an important part of taking control of your online identity.

To take control of your online presence, you first want to have a website, so when someone searches for your name, your information comes up. If someone is on Facebook talking to their friend and their friend just had teeth whitening or new veneers and posted a picture, you want them to be able to link back to another Facebook page when they ask their friend who their dentist is. If they’re driving to your office and looking for directions and they pull up your site on an iPhone, you want to be able to give them directions quickly off that iPhone. So no matter where they’re looking or what they’re doing, you want to make sure you’re telling your story and you’re communicating with them on whatever device they’re using to look for you. Again, people go to Yelp. Have you gone onto Yelp and claimed your page for your practice and updated the information? Those are the things you need to do. If it’s too much for you, there are providers out there who can manage all of that. They can set up your Google Places page, set up your Yahoo page, complete your profile on Insider Pages, Citysearch, wherever it might be. You have no idea where the patient is going to look for you online, but you want to make sure when they do, you’re telling your story. You want to take control of your entire internet presence. By having a provider do that, you take all the guesswork out of it because they’re doing it for hundreds of other dentists. Anywhere a patient looks for you, your story is going to be told and it’s going to be told by you.

MD: That’s a great point. For somebody who has been out of school a little more than 20 years now, I don’t think it was ever part of the deal when I graduated that one day what you did as a dentist would be rated online by non-professionals — not by other dentists, but by patients — and written up on a site like Yelp. It almost boggles the mind that dentists are being subjected to this scrutiny on a site like Yelp, but on the other hand, it probably has some positive benefits as well because it’s going to force dentists to try to be a little better. Or, it will force them to do at least what you’re saying and take control of that online presence. It’s a brave new world here when all of a sudden dentists are being subjected to online reviews on Yelp, as though they were the local dry cleaner down on the corner.

GL: I agree. I don’t think it’s necessarily fair, but it’s no different than if that patient walks out of your office and tells the next 10 friends they see that they had a horrible experience. It’s really the same concept, except it’s online. Sometimes you don’t know that a patient left your office and said all those negative things about you, so the good news is an online presence allows you to improve yourself because you can always be monitoring what’s being said about your practice. You need to monitor your online reputation, and when there are negative reviews, maybe there is something to be learned from them. Maybe there is something you’re doing wrong or some way you are communicating improperly. Maybe a staff member is not communicating in front the way you think they are when you’re back working in the operatory. So from one aspect, it’s a great way to learn about your practice and maybe improve it, but secondly, you do want to take control of that online presence. While you might get some negative reviews, you want to make sure all those people who had positive reviews get online, so that it goes out to the community online.

Sometimes you don’t know that a patient left your office and said all those negative things about you, so the good news is an online presence allows you to improve yourself because you can always be monitoring what’s being said about your practice. You need to monitor your online reputation, and when there are negative reviews, maybe there is something to be learned from them.

MD: You know, there might be a disgruntled patient who leaves your practice and tells 10 people. I guess it could come up 10 times in conversation — they’d have to have a pretty strong vendetta against you — but 38 when you put it online and there’s the potential for thousands of people to see it, including your family members, friends and other people, it seems like it has the potential to be a lot more damaging. So there is an absolute need to control this because one patient telling a few of their friends seems like a lot less of a big deal than somebody going online and saying it, where it has the potential to really spread. It’s unfortunate, I guess, for some dentists that they are going to have to take control of this, but they’re probably going to be reviewed online whether they want to be or not. Some might say, “Hey, I never signed up for this.” Well, you don’t have to, right?

GL: Right, you don’t have to sign up, it just happens. That’s why you want to put together some sort of plan to get positive reviews online because you can have the same positive experience happening to offset that negative. When talking about additional ways of communicating with the community, another great idea is getting your patients to “Like” your Facebook page and integrating the blog from your website into your Facebook page, so every time you or your service provider updates content on your blog and one of your patients “Likes” it, it’s going to show on their Facebook page and to their 250 friends. If you’re putting out good content, or if the provider is writing the blog for you and it’s quality, interesting content that patients are going to find helpful, what ends up happening when they “Like” those things on their Facebook page is that it then spreads exponentially to all their friends. So another great way to communicate positive things and educate your community is by using a simple blog and Facebook page. It’s not rocket science, but it’s a great way to maintain that positive presence about you and your practice.

MD: I actually didn’t know that it worked that way. That’s really interesting. It sounds like your company will do the blogging for the dentists if they want you to, but can they also set up something where you guys would do the blogging for them for three months? And then if the doctor has an interesting case and takes some photos, or he wants to write something, could he write something for one month and then you guys could do the next three months? I mean, is it possible for the dentists to be able to intermittently blog and have you guys provide the content the rest of the time?

GL: That’s exactly how our blog management program works. We’ve actually partnered with a company called Dear Doctor, publisher of Dear Doctor – Dentistry & Oral Health, a quarterly dentistry magazine written exclusively by dental healthcare professionals for the education and well-being of the general public. Articles they have written for their magazine can be posted to our clients’ blogs every week. It’s an automated process, so it requires little to no effort from the practice, but they are still getting highly educational and credible posts. If the dentist chooses, we can also craft personalized articles for the practice to give the dentist more input into each article without having to write them.

MD: I had no idea you guys offered that second option. So if a dentist goes to a course and learns how to start delivering sleep apnea devices or snoring appliances, he can request blog entries from you guys on those topics and you will write something and put it on his site to help attract those new patients?

GL: Exactly. We’ll actually write the content for them based on different topic areas. It’s a great service and a great way to educate your patients on a regular basis while populating your website and social media sites with new, valuable information. Again, it’s all about making it easy and simple for the dentist. Most dentists have barely enough time in the day to see their patients, so it’s not always possible for them to write a blog post as well. That’s where Officite can really help out.

MD: That’s a great idea. I don’t want to sound jaded, but for 20 years we’ve told many people about brushing and flossing, and I’m not sure the message is getting through — at least not to males — so I can see a lot of dentists thinking: Hey, let’s blog on something other than brushing and flossing. Let’s do something on bleaching! I’ve got a bunch of bleach here that’s going to expire in three months. Or let’s do something on snoring, or let’s talk about this new all-ceramic crown. For them to be able to pick the topics and have you guys come up with information sounds like a great idea.

To recap, it sounds like you certainly encourage dentists — almost say it’s mandatory — to have a website. It just doesn’t seem like there’s anything you can do for your practice that will give you as much bang for your buck as getting involved with a nice, up-to-date website and some active blogging.

GL: Right. Today’s patients expect you to have a website that is current and educational. It’s not that expensive or difficult to launch a professional website, and the return on investment is very high. Nowadays, not having a website speaks louder than having one.

Glenn Lombardi is president of Officite LLC, a leading national provider of premier websites and turnkey internet marketing solutions for the dental community. Contact him at 800-908-2483, officite.com or glombardi@officite.com.