Thursday, August 3, 2017

HANDS UP! I'm a Yelper!

     It is 2017 and social media is shaping the world we live in. Unfortunately, this is not always positive. We are now living with the ramifications where everyone can give their opinion on anything and act like an expert and anyone can stand to be criticized. And all these opinions are open for the public to see. No where else does this have such a dire impact as in the health care profession. Before we analyze this concept, let's take a look back at three pivotal moments that have shaped the circumstances that we are in now.
    The first event happened in 1975. In that year, the Federal Trade Commission (FTC) allowed doctors to advertise to the public. Before then, doctors self regulated their profession and were disallowed to advertise to the public based on the fact that it violated a notion of ethics and that it might violate the all important doctor to patient relationship. The reason for changing of the law at that time was to make doctors able to legally advertise and the thought was that it would lead to a better and cheaper service via the confines of competition and free trade. What this did, in actuality, was open a can of worms where physicians could openly advertise and market their services just as any other profession could. A confounding factor was that more cosmetic procedures were appearing on the medical market and, thus, they could be more advertisement friendly. The two fit hand in hand. Wanna get more beautiful, then come see Dr. so and so. The following decade of the Eighties witnessed more and more of these campaigns.
     But, no time ever since, did this momentum rev up more than the year of 1992. And that is when we come to the second pivotal moment of this fiasco. That year, Ana Nichole Smith appeared on the cover of Playboy magazine. Soon thereafter, she became a mainstream phenomenon and a household name. But, Ana Nichole Smith's figure, through the eyes of the obvious and by her own admission, was not all real. She was the embodiment of cosmetic breast implants. As her popularity soared, so did the wants of women across America. Other models and entertainers, like Pamela Anderson, followed suite. In 1992, breast augmentation procedures increased by fifty percent. And this trend locked the marriage of cosmetic surgery and physician advertising. So much so that it is omnipresent in the landscape today. In fact, now there are such doctors who have so much exposure that they are celebrities themselves.
     And then there is the third pivotal moment of this debacle. And that is when the world got introduced to Yelp in 2004. Now everyone had a forum to give their opinions on any local business, including the health business. But for doctors, this is one sided as doctors do not have the right to give counter reviews on any negative reviews about them because the are forbidden to do so by HIPPA laws which protect patient confidentiality.
    Three examples represent the disasterous consequences that Yelp has done for the health care profession.
     Let's start with the first example. In the world, there is the power of the almighty dollar. But, in the Yelp world, there is the power of the all mighty review. So this case begins with a young woman who has a non-emergent surgery planned for a certain time. In the preop room, she is told that a more emergent case has arrived and that her procedure will be delayed. The woman gets frustrated by this, so she reeks havoc with the medical staff and the doctor. She does this by also threatening to give the doctor a bad Yelp review. She gets her way. Her surgery is not delayed. What we see here is an example of how patient can usurp the power of this almighty review to their advantage. 
     The second case involves getting away with an all in out case of fraud. A friend of mine who is a dentist and does craftsman work treated a patient of hers with multiple dental crowns and bridges. Before the procedure, the patient was told the price of the procedure in full and he agreed and paid for it. But this patient is a famous "Yelper". To make a long story short, the patient received the full treatment that he paid for but he THREATENED the dentist that if he did not receive all of his money back then he was going to write a disastrous, debilitating review about her and her practice on Yelp. The patient was given all his money back and essentially received thousands of dollars of dental work for free. 
     The final case describes a deeply personal case because it actually happened to me. As an Oral and Maxillofacial Surgeon, I treat Temporomandibular Joint (TMJ) disorders. A friend of mine some time ago had some TMJ issues. One day, I offered to see her at my office for a free consultation and for free x-rays to possibly diagnose and to conservatively treat her condition. Her reply to me was simply, "Well, I will take a look at your Yelp review and let you know". Really? Yelp is more trusted than a personal friendship, even when the services are offered for free? 
     Aside from these examples, it should be noted that Yelp also profits from setting up marketing campaigns for doctors. Thus, the validity of each positive review and the possible cherry picking of each positive review for these paying doctors remains questionable. 
     So here we see, whether by their own fault or not, that Yelp is not good for doctors and can be debilitating to the health care profession. New laws and regulations should be enacted to prevent ANY individual being able to write whatever they want regarding their experiences with their doctor on any social media website.

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