You can find online reviews for everything from house painters to beauty salons to therapists — and there are all sorts of practical and ethical quandaries for organizations when it comes with these online reviews. But the ethics discussion has become especially pertinent at the intersection of online reviews and mental health.
In a recent edition of The Ethicist column in The New York Times, an unnamed mental health clinician wrote, “Discussions with fellow clinicians have revealed that many if not most have ‘primed the pump’ with favorable ‘reviews,’ written by friends or family members or by the therapists themselves” (see Can Therapists Fake Their Own Online Reviews?). The question — is this ethical?
The issue isn’t new, and we’ve covered it before in articles like Before You Respond To That Online Review… and Yelp Comes To Health Care – One More Reason For Online Reputation Management. But where does “priming the pump” sit on the ethical scale? The ethical question I posed to a few colleagues — is this a “necessary action in the online marketplace?” Two of my colleagues provided great perspectives.
OPEN MINDS Senior Associate Sun W. Vega noted two scenarios with two different ethical expectations. She writes:
First, making up fake reviews is lying and therefore an unethical practice. Second, it’s okay for friends, family members, and colleagues to be encouraged to write something especially if you have a positive relationship. Like any other business, one must be prepared to manage the consequences (good or bad) of a public review site and individual responses to reviews. He/she should inform all clients (not selectively) about the review site then they can decide whether or not to write a review and reveal their identity on the site. Regardless, in private practice, clinicians must have the skills to manage a therapeutic relationship when someone is dissatisfied or if a review is bad — whether it’s publicly announced (website, word of mouth, town hall meeting, etc.) or made privately.
Paul Neitman, another OPEN MINDS senior associate, takes a much harder view of clinical professionals who either fake their own online reviews or otherwise participate in anything that could be judged as deception. He writes:
As a Licensed Master Social Worker, I view the issue of “faking one’s own online review” as one that is unethical personally and professionally. Most professional behavioral health codes of ethics may not be entirely updated to reflect all current technological advances, but I believe they do address relevant issues related to “rating oneself.” The first relates to a standard that talks about not asking or using clients to advance oneself or their business. Standard 4.07 in the NASW Code of ethics in part states: “(b) Social workers should not engage in solicitation of testimonial endorsements (including solicitation of consent to use a client’s prior statement as a testimonial endorsement) from current clients or from other people who, because of their particular circumstances, are vulnerable to undue influence.”
So clearly it is true that solicitation of positive ratings is inappropriate. Specific to rating oneself, the Code of Ethics states: “Social workers should not participate in, condone, or be associated with dishonesty, fraud, or deception.”
Clearly (to me) the practice of rating oneself surreptitiously is one of deception and a personal and professional breach of ethics. The argument that one limits access to clients in need if one doesn’t do what everybody else is doing is, to me, a self-serving and thinly veiled rationalization of improper behavior.
There is no doubt that the use of these unregulated public “rating systems” have the potential to harm one’s practice. This is no excuse, however, to engage in “false advertising” in order to positively promote or counter the possibility of negative reviews. Health care, including behavioral health care, is a highly personal “service” that, while no doubt one that can be influenced by internet reviews, also remains one that can be influenced greatly by unsolicited referrals by other health care professionals, family, and friends who have experienced or heard of positive experiences with health care professionals in their community.
From a marketing standpoint, part of your online marketing strategy should be to encourage positive reviews of your organization. But those need to be legitimate reviews, and provider organizations and clinical professionals need to take the time to build the personal relationships with consumers that will lead to those reviews.
In the new era of performance transparency, consumer online reviews cannot be ignored — but they can’t be faked, either. For more, check out Succeeding In The Online Ratings Game. And join me on September 21 at 1 p.m. Eastern, when I host a webinar exploring best practices for tech in a changing market exclusively for OPEN MINDS Circle Elite members — Forecasting The Future: What’s The Impact Of Health Care Technology For Consumers & The Service Delivery System. Not an Elite member? Upgrade your account now to access OPEN MINDS Market Intelligence Reports, the Government RFP & Contract Database, special registrations to all OPEN MINDS institutes, and exclusive online executive education events.