Tag Archives: fake reviews

Fake ratings put good doctors at great risk

Unless you were under a rock, you saw the recent story about Amazon taking legal action against over 1000 individuals who wrote fake reviews on their site.

This bad behavior is not limited to Amazon products. Right now in aesthetic medicine, a handful of website and SEO companies are including fake ratings on doctors’ websites. This puts their clients at risk, potentially damages their reputations, and opens the website and/or the practice up to punitive action by Google or worse. 

How do you know if your ratings are fake?

Example of fake ratings placed on a practice’s website.

If you have a star rating on your website, try clicking on any part of the ratings. Typically, it will not be linked to a source where you can read reviews. There will be no supporting documentation to represent the rating or explain how it was calculated. The number does not automatically increase with new reviews and can be plainly seen by Google or anyone reviewing the source code.

When faked, the number of total ratings shown is typically very large – often 400+ total ratings.  We have rarely seen a plastic surgeon with this many ratings from any legitimate source, other than RealPatientRatings itself which generates ratings in a closed system by including every patient without exception.


How are they doing this?

By including schema tags for aggregate rating and review count, typically in the footer on every page. It is often placed unobtrusively alongside social media items as in the example shown here:

Five reasons why faking your ratings is too risky:

1. Breaking trust with consumers: Nothing makes a potential patient angrier more than being lied to. If someone uses a Google search result and clicks through to your website, they expect to see reviews or ratings. When they discover that there’s really nothing there, this not only frustrates them, but diminishes their trust. If they are looking for real ratings and reviews, they will move on to a practice who meets their needs, and this relationship begins online.

2. Signaling distrust to Google: Google rewards the most trusted sites with higher rankings. Google hates anything fake. Over the years we have seen this pattern repeatedly: fake keywords, fake article sites, fake press releases, fake links, and so on.

Successful and ethical SEO tactics mean behaving like a true brand. Why would you take such a risk and include fake ratings on your site? A quality brand wouldn’t dream of doing this. Google has the smartest engineers in the universe writing algorithms to detect and devalue low quality content and fake backlinks. How could fake ratings not be equally or even more hated by Google? I am already seeing evidence of Google beginning to detect and eliminate these fakes.

3. Ethics: Is it ethical to misrepresent your ratings to get patients to come to your website? Imagine your website being reviewed by your society’s ethics committee…how would that go? Having fake ratings sends a negative message to every colleague in your market that you’re either willing to cheat or have no idea what your SEO provider is doing?

4. FTC’s Truth in Advertising Guidelines: Would the FTC agree with you having phony ratings? Since 2010, they have had a division solely devoted to cracking down on deceptive internet advertising. 

The Federal Trade Commission’s Truth In Advertising rules provide some useful guidelines: reviews must be “truthful and substantiated,” non-deceptive, and any material connection between the reviewer and the business being reviewed must be disclosed.

5. Fraud: While talking with our members at the recent ASPS meeting in Boston, a RPR member with several hundred legitimate ratings showed me how two other surgeons in his market were displaying phony ratings. This doctor is also a lawyer and suggested that misrepresenting one’s rating could be construed as fraud and result in civil action if the patient believed the statistics and was wronged somehow.

Fix it now before the damage is permanent

I expect the fake ratings trend to continue, and that we’ll see a future algorithm update address it. I also expect those websites with fakes to be “dinged” or punished by Google. If you have a fraudulent aggregate rating on your website, we recommend taking it down immediately. If you weren’t aware it was there, you may also rethink your relationship with your web company.

If this is happening to you, whether you’re aware of it or not, it is still your responsibility to manage and monitor the behavior of the website companies or SEO professionals managing your presence. 

My suspicion is that if most the doctors knew what they were risking by having fake ratings on their websites and understood how damaging it was to the patient relationship, they would be very unhappy about it. 

Doctors in leadership positions appear to be suffering from ‘severe ostrich syndrome’

A recent survey published by the American College of Physician Executives (ACPE) suggests that doctors in leadership or executive positions may be suffering from a condition which known as “severe ostrich syndrome” (SOS).


ACPE surveyed 5600 members and received 730 responses. According to the results, a majority of physicians in leadership positions believe that most patients do not look online for ratings.

Ratings and reviews are now an established part of the product evaluation process for everything from books to shoes to electronics. Increasingly, consumers seek out ratings and reviews to evaluate physicians.

  • 32% of consumers would never choose a healthcare provider without reading at least one piece of user-generated content. (Kelton Research/Bazaarvoice, September 2011)
  • 96% of aesthetic consumers say reviews are either “important” or “very important” in choosing a cosmetic doctor. (RealSelf.com)

Although plastic surgeons are recovering from “SOS” faster than their colleagues in other specialties, all physicians share a common problem with traditional rating and review sites: the information available to consumers does not reflect the actual quality of their practices. (Doctors, if you’ve ever looked at your own online reputation, you are likely nodding your head in agreement.)

The ACPE survey reached the same conclusion. Dr. Peter Angood, CEO of the ACPE, says “This important new survey illustrates the strong concern among physician leaders about the quality and integrity of current reporting strategies and the data they are based upon.”

Why are existing patient rating systems so inadequate?

  1. Review sites rarely verify that the reviewer is a real patient of the doctor
  2. They do not prevent reviews by non-patients, most commonly by competitors or angry former staff
  3. The review sites do not consistently generate enough ratings to provide an accurate picture of practice quality
  4. Low numbers of reviews affect validity of conclusions

Because physicians are trained in statistics, they are naturally skeptical of data that isn’t statistically valid. But the general public does not approach ratings and reviews this way, which is why even one negative review can cause serious damage.

happy_ostrichAvoiding SOS “severe ostrich syndrome” (SOS).

Ratings and reviews are part of a new consumer reality. The reviews both validate quality and expose service and care weaknesses. They represent a social media trend that is growing exponentially across both product and service markets.

  1. Seek help from your patients to post reviews on your behalf, but also understand the difficulty, particularly for cosmetic patients, of going public on sites that require them to identify themselves.
  2. Make sure your own site has review content and try to find the issues within your practice that prompt negative postings and fix those proactively.

Additional reading on this subject:

Survey Finds Physicians Very Wary of Doctor Ratings
Physician Executive Journal, Jan/Feb 2013

Publicly Reported Physician Ratings: Here to Stay But Not Yet Ready for Prime Time
Physician Executive Journal, Jan/Feb 2013

By 2014, 15% of reviews will be fake
American Medical News

RPR’s best-in-class patient satisfaction surveys help plastic surgeons take better care of their patients and our highly accurate method of generating online ratings and reviews helps consumers find truly good doctors.

Google+ Business pages now link to Real Patient Ratings reviews

Google Places now includes a link to Real Patient Ratings patient reviews in the “Reviews from around the web” section.

Why is being included in Google+ Business pages so important?

There’s no way to write a fake review on Real Patient Ratings. Having a credible source of ratings and reviews from your real patients included in your Google Places page is an enormous benefit.

To date, Real Patient Ratings has generated over 6500 online reviews for our members.