As Vice President of Brand Strategy and Marketing at Healthgrades, Lindsey Viscomi oversees Healthgrades brand initiatives across all audiences as well as B2B marketing for health systems. She’s passionate about purpose-driven business and helping millions of Americans make more confident healthcare choices. Lindsey has more than 20 years of experience bridging creativity and strategic thinking to drive results. Since 2011, she has led strategic, creative, and marketing teams at Healthgrades.

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Mariah Tang: Did I say that out loud? Welcome to “Did I Say that Out Loud?”, a podcast where Stu Eddins and Mariah Tang reflect on agency life and answer questions from our higher ed and healthcare clients about the latest in digital marketing, content and SEO.

 

Mariah Tang: All right. Thanks for joining us on another episode of did I say that out loud today, we are joined by Lindsey Viscomi with Healthgrades. Would you like to give us just a quick overview of who you are? Lindsay, for our lovely audience today?

 

Lindsey Viscomi: Sure, thank you for having me. Lindsey Viscomi, I lead brand strategy and marketing at Healthgrades.

 

Mariah: Excellent. And for anybody that’s never heard of health grade since we kind of have a little crossover between healthcare and higher ed here, could you give us just the elevator speech about who Healthgrades is and what they do.

 

Lindsey: Sure, Healthgrades is the leading platform that connects people looking for a doctor with care. So we connect doctors and patients and health systems and patients every day.

 

Mariah: Excellent, excellent. So, Stu, you and I have worked together a long time. We’ve worked in higher ed, we’ve worked in healthcare, and one of the things that we see continuously is reviews, whether that’s out on social, people talking about organizations, people talking about their experiences, or more formal reviews, like what we would see through Healthgrades.

 

So, Stu, before we jump in and start grilling Lindsay here. Could you give me just a couple of highlights? What do you see right now in the trending world of reviews?

 

Stu Eddins: Well, reviews have always been important, particularly when it comes to healthcare, as healthcare became a little more focused on finding a doctor, rather than maintaining a relationship with the same doctor from cradle to grave. We did notice people were making choices based on publicly available reviews of the positions, and our society became more mobile, so it was also not possible to maintain that relationship for as long as may have been traditionally available.

 

The one thing I’ve noticed that’s happening a lot more is as the expertise, the different things, the E at factor about content, has become more important for rankings in search, we’re finding that ratings and such really step into that, into that space, and give some validity to the assumed authority that’s behind the statement one might find in search or on a web page.

 

So in that in that relationship, even when I was doing marketing or content with hospitals and academic medical centers, we really did pay attention to what those ratings were and how aggregating sites that collected doctors together and offered them in ratings, how that behaved and how that played with the audience, always found that to be a critical and important factor in getting discovered, but then also in developing that assurance that if I’ve got 15 doctors to choose from, where do I start so in the scope of work that I did, particularly in healthcare, ratings and rankings were very important, and we would turn to places such as Healthgrades and so on, to find out what the public thought about the doctors, to find out what their engagement level was.

 

Because most of the doctors we worked with were, of course, reputable. They it wasn’t like they were horrible doctors or anything, but the interaction that people are looking for with the position is somewhat intimate, and they like getting that ranking, that rating, to assure them that, yeah, behind all the formality of getting to know somebody, there’s act, there’s more than just competence, there’s an engagement level that that earned that higher rating for them.

 

Mariah: Yeah, absolutely. Lindsey, can you? Could you tell us a little bit about what you’ve seen just in the ebbs and flows, the ups and downs of the role of reviews over the past couple of years.

 

Lindsey: Sure. So, I think if you look back, say over the last 10 to 15 years, the role of physician reviews has gone through a huge transformation, you know, in the early days. So, let’s say, like 2010 there was a lot of skepticism, right? You saw some platforms starting to pop up, but honestly, at that point, only about 16% of doctors even had any reviews. So back then, I think you had providers nervous about, what does this mean? Are people going to come out of the woodworks to ruin my reputation?

 

And consumers were getting used to, at that point, you know, using the internet to shop for a lot of things, but healthcare tends to always lag behind in marketing innovations. And I think it was no different here. You just weren’t used to shopping for a doctor the way you would shop for other things. And so it was really around the mid-2010s or so when two big forces really came together to change that. The first was that by that point, the Internet was really the default starting point for all research. So even though healthcare was late to the party, people by that point were really ready to say, Okay, I feel comfortable that I might look for this online as well.

 

And I think second we saw the rise of dedicated healthcare review platforms. So sites like Healthgrades where I work, which made it easier for people to find reviews and know where to leave reviews. And also, at the same time, you saw big players like Cleveland Clinic and Johns Hopkins start to publish reviews on their own sites. So I think that really started to lend credibility to the idea that patient reviews were here to stay. And now, I think at that point was where you start to say healthcare consumerism, right, started to come into play, that people were shopping, not just taking verbatim the one name they’ve been given.

 

I mean, I think we saw it really escalate this last five years, right? So the pandemic in moving everything online overnight, as people got more comfortable with telehealth, online scheduling, all the things that you had to get used to very quickly, even the people who were kind of lagging and weren’t ready to look at reviews yet, really started to shift at that point into being willing to try it. And in our recent studies, we see that as many as 90% of people use reviews at least occasionally when they are looking for doctors. So it is really pervasive at this point.

 

Mariah: Yeah, I was surprised to hear that it was that many I, you know, being in marketing, you get a little jaded over time, and you’re like, oh, I can see what this is. You know, this this, you know, doctor, whomever it is, they, they’ve really worked hard to get these reviews.

 

But I mean, it’s, like you said, pervasive. It’s, it’s everywhere. No matter if you’re shopping on Amazon for a product, or you’re looking at Netflix and trying to figure out what movie you’re going to watch, there’s reviews everywhere. And I think it’s just part of the inborn decision making process. Now, people expect to see it, and if you don’t have it, it kind of gives you that question of, like, What’s going on over there? Why do they not have this listed? And you know, it’s usually nothing so nefarious.

 

But with reviews being so important and continuing to be so important, what do you see either of you as some of the barriers to collecting those reviews, making sure they’re authentic, just getting out, getting in touch with people, and collecting those reviews in general.

 

Lindsey: So, I feel like there’s three major hurdles that we hear the most, right? The first is that patients themselves often find it a bit of a hassle to leave a review, right? So, they may not be sure where to go when it comes to leaving a review for a doctor, or they might just forget or feel like it’s too much effort. The second is that the frontline staff, the people at your front desk, might feel awkward asking for a review because it feels maybe a little too salesy. And the last, and probably the biggest hurdle, is that the doctors themselves are worried that if they push for reviews, they are going to get swamped by negative feedback.

 

Stu: Yeah, and in the past, I’m talking long ago, we did have hospitals that simply suppressed any ratings for doctors who had a two-star or less. They would show three-star and above, but suppress two stars and one star, their logic, and it was provable at the time, was that these were new doctors who’d only had one or two reviews at that point, and the negative people tend to come out a little more often for review than the positives.

 

Now, I don’t know if this plays out in what you’ve heard, but we tended to notice that you would get a lot of five star reviews without comment, and a lot of two star reviews with a ton of comment. People tended to come back with the with the more voice, when it was the negative, which I think is also what concerned the doctors. Is that something I just noticed in a few hospitals? Or do you think that’s kind of the way it is?

 

Lindsey: Well, I think it’s really interesting, because what the big fear is that reviews are negative, only people who are angry are going to write reviews. And the data we see shows that it’s quite the opposite, right? That the when you look at Healthgrades of doctors on Healthgrades or providers on Healthgrades who have reviews, two thirds of them average 4.0 or above.

 

So overwhelmingly, people like their doctor. And every survey we run, people are really very satisfied with their doctor. So the question is, can you make it really easy for them to share that review? Because yes, I agree that I think the people who are upset are more motivated to go leave it. So if you really focus on making it very frictionless for the people who are happy to write the review. I think you would find that, on average, it actually is positive. And I think that’s why it’s so important to, you know, focus on having it available to patients everywhere, right? It’s on your social media, it’s on your website. It’s a QR code that you hand out when they leave.

And then, of course, you know, training staff to feel comfortable with asking for the review. Because I think, of course, within that 24-hour window of the appointment is going to be your best window to get that feedback. So I think it can be really simple, just like, hey, we’re going to send you a quick text after this appointment. And you know, we appreciate your feedback, because it helps us improve the experience for everyone. And just teeing it up, is something that is going to be easy for them, and is actually going to help other people and improving care, I think, you know, makes it more likely that all that positivity that is already out there is going to come through in the reviews.

 

Mariah: Yeah, I feel like when I get that text, when I’m walking to my car to park. I’m always more inclined to just sit there for 10 seconds and fill it out. And I feel like this is just anecdotal, obviously, but I feel like I’m more inclined to give an authentic review of what happened, instead of, you know, taking two three days to get an email and then I’m like, what did that? What did I do three days ago, first of all, and then, how was that experience? It’s just a great way to get that immediate feedback.

 

Ya know, Stu sent me a quick message right before we jumped on this call, Lindsay, about AI-powered tools, and we’re talking a lot here in the last couple of weeks, and probably for the next several years about AI search and SEO and all of those things, and he mentioned about AI-powered searches pulling in third party data. Stu, did you want to elaborate a bit on that?

 

Stu: Yeah, the question I asked was a pretty simple one. I went to most of the AI answer engines, or however you refer to them, that I use, and I asked the same question it was, do you use position ratings it when deciding on who to cite in your responses? And the response from those search engines was unanimous. The answer is yes, they do look at particularly consumer generated ratings as being a little closer to a source of believable ranking for these for these positions. I imagine that makes Healthgrades very happy. But the thing that we’re trying to figure out with all of this is we don’t often get a citation link that comes along with that recognition, is that something that Healthgrades is perhaps concerned about and working toward to figure out a better way to present those rankings. Is there something that we should look for as far as the way that we display them or make them available?

 

Lindsey: I think that’s a great question. I don’t know if there’s any answer yet, because I imagine that just about everybody who works in digital media in any way is trying to crack the code right now on how to take advantage of being picked up by AI but not get disintermediated from the whole process.

 

So, we have found that thus far, traffic has not been as disrupted for doctor search as it has for maybe more general health information. Right? People are still tending to want to go see all the reviews and dig in to all the detail, versus just the short AI answer, but it’s definitely something that we’re keeping a very close eye on to figure out the right way to play in that world.

 

Stu: Yeah, and by the way, that was a bit of a trick question. Somebody’s going to have the first answer to that. I just got to keep asking you, maybe I’ll find that that one company that solved it. I think that this is going to be very interesting, because when we look at ranking and ratings, it does fit into that very mid funnel decision making stage of the consumers journey, and they’re going to be relying on ranking and doctor aggregation sites, similar to what Healthgrades has, it fits right into the question, show me the best rate rated surgeons for “X” in my neighborhood, and I would imagine that’s going to cause a lot more citation of service such as Healthgrades.

Do you know if perhaps you’re starting to hear from the people who use Healthgrades their concerns about this. Do you know if that’s something that you’re going to be leaning into a little bit more with your or not leading into, but perhaps preparing a little more for with how you’re going to help them understand the value of the rankings and the ratings?

 

Lindsey: Oh, I think, you know, we’re always focused on helping people understand what they need to consider when they look for a doctor. Because I think it’s one of those things that you’re not necessarily ever taught, like, what am I supposed to do when I need to find a doctor? Like, what are the things to consider? And so, you know, we focus a lot on thinking through what are actually the factors that matter most, and patient reviews are just one of them, right? So you know, if you think about the bigger picture of what should you consider when you’re looking for a doctor, right, the first is going to be, are they a good fit for you? Which I think patient reviews is really a great way to look at that, right? You can get that insider knowledge of what to expect, both from the office and from the interaction. But then I think you also, and often overlooked, is taking into account where does that doctor work? So needing to look at the quality of the hospital and the health system they work with. That is less relevant if you’re looking at primary care, but if you need a cardiologist, an orthopedist, and you might need surgery where they work becomes incredibly important.

 

And so I think taking multiple things into consideration, and then the third piece, actually, which can come across in reviews but might not, is the doctor’s specific experience with the condition or procedure that you need them to be an expert at, and that can often be hard to tell right? Bios might kind of dance around it. Reviews, my kind of address it, but I think increasingly people are going to want to see that you’ve got great reviews. Right? People like you. They like your office. You work at a top-quality hospital, and you’re not just an orthopedist, you are a shoulder expert, and I’m coming for shoulder surgery. And like, wanting to be able to see all of that together is really the dream scenario. And I think we’re still in a stage of educating people about that, because still today, right, the typical path is you need a doctor. You might source names from friends neighbors. Maybe your primary care gives you a recommendation, right? You source some names, and then you start Googling, and you start looking at stuff, and in most places you’re going to see maybe some reviews. I mean, there’s, there’s plenty of places you can find reviews, but to be able to see everything in one place, I mean, that’s what Healthgrades has been really focused on is trying to give people the total picture of all the things you need to look at. But I think we’re still not there. I think to ask the average consumer, they think, Oh, well, I looked them up and they got they had five stars, and they might stop there. And so we want to encourage them to go even deeper than that.

 

Mariah: Now I always have to work in a blog mention here, because blog is my favorite thing in the world, but I think you’re spot on. And one of the ways that we’ve been working with and coaching our healthcare clients over the last 10 to 15 years is really dig in with these physicians and these specialists about the things that they’re, you know, most their most niche specialty. So like you said, a rare surgery or a complex condition that they are one of a handful of doctors that they can treat. Write a long form blog article about that, create a video, create some digital ads, or maybe even a landing page, depending on the volume that you’re looking to attract. Pairing it with those, those reviews and the different pieces that you can pull in from third party review sites. I think that’s just a wonderful way to give people that full picture, whether you’re keeping them on one platform or whether it’s multi-platform in the way that AI search, the way that a or, excuse me, SEO works these days. It has to be that, you know, multi-channel approach to really give people the full picture that they’re looking for with that kind of multi-channel omnichannel landscape in mind. Lindsey, what are some of the cool ways that you’re seeing clients out there displaying their physician reviews, either on their site or elsewhere.

 

Lindsey: So I think at this point, having the reviews directly on your own site is really table stakes. It seems to me, nearly everybody has integrated that now. So, you know, a lot of transparency on your site. I think where it gets more interesting is leveraging it for social proof. So for example, that might be just pulling, you know, pull quotes that you’re using in social graphics, and then even taking that further with actual full patient interviews and testimonials and actually spinning these things out into stories that you can put on platforms like YouTube and Instagram.

 

We’ve seen people doing hashtag campaigns to actually encourage any amplified user generated content to share stories. Of course, there’s always inherent risk in that as well, but we are seeing people do that, especially some of the bigger, better known brands, and then I think, also taking it analog, so in the office, having framed, framed reviews and framed quotes from people, from reviews and even digital Review walls that are really, you know, cycling through quotes and new reviews, positive reviews as they come in. And that really kind of builds that quality and trust environment, like right there when the patient is about to see the doctor.

 

Mariah: Yeah, way back when I was a little baby, marketer, before I even met Stu, that was one of my favorite things, was to put together those quotes we worked with a an office here. I worked with an office here in the Cedar Rapids area that had an elevator TV, and one of my jobs was making those cute little slides that go across with the patient quotes. So that’s a fun throwback for me. You’re, yeah, you’re seeing lots of those fun, you know, more traditional types of pieces coming back out. I think the digital fatigue is really getting to people and having that, that approach where you’re touching in the physical world, as well as in the social world and the digital ad world, to just coming in all together. Stu is our analytics guy, and he leads all of our analytics projects here, so tracking is always top of mind. Lindsey, how do you encourage your clients at Healthgrades to track the impact of those physician reviews?

 

Lindsey: I think there’s three main areas that marketers really need to focus on, right the first and the obvious kind of the low hanging fruit is your website and digital metrics, and then connecting the reviews directly back to patient acquisition costs. And then the last part is actually keeping an eye and doing a deep dive on the review platform metrics. So looking out at those third parties and not forgetting to be keeping an eye on those so just to dig in a little more on those, right, what I mean the website and digital metrics, you know, looking, of course, at traffic to provider profiles, but actually looking at which factors are influencing things most. So, I think when it comes to reviews, there’s three pieces of that, right? There’s the actual star rating, right? How good is that? Then there’s how recent they are because people trust more recent reviews more than older ones, and also the volume, right? So we see that when someone has more reviews that has an impact on engagement with their profile and conversion. So looking at, for example, do our four-and-a-half- and five-star doctors see significantly more page traffic, or direct calls to a point, or online appointment scheduling, but say, someone with three stars, and then I think also looking at local search visibility. So we talked about it a little, right? Google loves recency. They love user generated content. So looking at, for example, are your top providers, top-rated ones showing up in the Google local pack when someone searches for specialists in that area.

 

And then, I think, on patient acquisition cost, you know, ideally, right, the better your online reputation is, the lower your patient acquisition cost should be. So actually tracking that and seeing how that changes over time, as you know, as your scores and volume ebb and flow, but I would generally think of it as when you see strong reviews that attracts patient attention and that has the benefit of amplifying everything else you’re doing, right? So you can have all the most beautiful marketing campaigns in the world, and if then people show up and your doctors all have, you know, three stars that is going to detract from the impact of your campaigns. So really keeping an eye on that patient acquisition costs and see how that changes.

 

And then the last piece I mentioned was the third-party platforms, right? So sites like Healthgrades being able to look at your dashboards there to also see what’s going on with reviews. I know I actually just was looking for a doctor for my daughter the other day, and on their, you know, the health system’s website, everyone had amazing scores, and then I checked Healthgrades, and they had some terrible scores. And I have to take all of that in and try to, you know, make sense of what was going on there.

 

But I think looking at tracking there and also making sure that you are responding to reviews there in a HIPAA compliant way, and that you’re not blind to what’s happening on those sites. Because the reality is, as much as everyone would like to think, that the only place people are going to find your doctors is your website, a lot of people prefer a third party. They just find it more objective, and so that’s why sites like Healthgrades have millions of visitors every month, right? So making sure you’re keeping an eye on the full spectrum of it.

 

Stu: Yeah, you’ve just had a couple of interesting things. One of them was something I suspected and tried to test, but I didn’t have a large enough population to do a really good thing, a really good study. I suspected in certain service lines, I’d have enough doctors with the same rating to come up with a guess. But I suspected that if everybody had a four-star rating, the one that had the more four-star ratings got cited more often as a Google search, got more organic traffic, got more page views. And it turned out that in my small sample, that was true. So, it’s not just whether you have the same ranking, it’s how many of those rankings you have. Now my sample size was quite small across several health systems, but it sounds like you’re seeing something similar that in a rating system, somebody that a bunch of people with four stars, the one that gets the most four stars, is probably going to earn the first click.

 

Lindsey: We saw one we saw in a study that we did. This is, this was a couple years old, but that doctors on our site that had seven to 12 reviews got five times more appointment requests. And if it got into that top quintile, it got even bigger. It was almost 10 times more.

 

Stu: Yeah, the way, the way I tried phrasing it, and this does go back a few years, was saying, like, it’s not a popularity content contest at all, but it is certainly more votes of confidence in that particular doctor, because so many said the same thing. And the other thing that you said that was kind of interesting to me was you mentioned about the on site stars being different than from the third party, Healthgrades stars very often on the website, the star rankings may be coming from Epic or from whoever their rating system is built in. And then there’s yours, which tends to be more, of course, consumer-sourced and more publicly available information.

 

One thing I did find interesting, and I’d like to find out if you if you still feel this is true, several years ago, I had a person who’s in charge of marketing for a mid-sized health organization say that they love star ratings, because while the big health guys might have many, many more doctors, a deeper bench doctor for doctor, theirs were just as good, if not better, and the star ratings uncovered that. They didn’t have to have broad a popularity as the system or broad appeal is the system to get their doctors noticed and get their appointment schedules filled. Does that still hold true today? Do you find that there’s some normalization between organization size, that ranking helps pull into play?

 

Lindsey: I think that’s true to some extent, although I do think that larger organizations, if they really put their mind to getting reviews can maybe sometimes dwarf in terms of volume, just because they can put a lot of effort behind it. But I think that absolutely right it, reviews are a great equalizer, and especially if you’re a savvy, savvy small practice who really focuses on making it easy for people to leave reviews, and you can get those really high volumes, I think it can really make you stand out against organizations that aren’t putting in that effort. Yeah, and this gentleman was speaking from the point of view that this is a blue ocean to him, because others of his size were not pursuing this because they felt dwarfed by the larger systems. He thought that this was a good way to equalize between the two. Okay. Very good. Thank you.

 

Mariah: I think our final question for you, Lindsey, is, we always like to ask about what’s next, what’s coming. So what are some of the trends and innovations that you’re seeing in the world of physician reviews that you’d want healthcare marketers to know about or be thinking about?

 

Lindsey: There’s a couple things that I think are really exciting going on that are worth keeping an eye on. So the first is, we talked a little bit about AI, right? AI has now made it possible to go from unstructured comments, right, from those open field reviews, and turn that into structured, actionable data, right? So in the past, it was a really big initiative to try to extract key themes from all of your reviews, and now AI can do that very easily. And so that is letting people, you know, identify key themes that pop up over and over, like great bedside manner or excellent communication or long wait times.

 

By being able to do this at, you know, these things become real business intelligence that you can actually use in a variety of ways. On the marketing front, it lets you go from saying something more generic, like, Oh, Dr. Smith has five stars to, you know, 95% of Dr. Smith’s patients praise her compassionate communication. And so it really gives you a concrete database backed way to influence your marketing.

 

And that also those same kinds of insights, I think, can feed into service recovery and operational change, which I think, you know, moving from thinking of patient reviews as some people might think of this. Oh, it’s a vanity metric. But really, like, first of all, from a service recovery standpoint, right? Meaning, someone had a bad experience, and you can get that feedback and address it. It’s created a feedback loop that just wasn’t there in the past, right? In the past, if someone was unhappy, they didn’t tell the doctor, the doctor didn’t know, and now there’s this immediate feedback loop, and so that gives the doctor a chance to respond. Of course, it’s got to be HIPAA-compliant, protect their privacy and basically take it offline. But in public, you address sorry to hear that. Let’s talk right? And then that gives you a chance to turn someone who was critical, possibly, into a brand advocate.

 

And then the really exciting part is using it for systemic operational change, right? So if you start to see these recurring themes, right, that AI has helped you pull out of your data, you can actually make really meaningful operation changes. So I’ve got a really good example. I heard the other day. We have a client who kept hearing in their reviews that patients didn’t like hearing their name called over the loudspeaker in the waiting room, that it felt invasive, and so they were able to implement a confidential SMS callback system, so instead of your name being called out, you get a text when it’s time for you to go back. And that, to me, felt like a really powerful example of using feedback to drive positive change for your operations. The last thing I just want to mention real fast is also, I feel like really savvy marketers aren’t just looking at their reviews, they’re looking at their competitors’ feedback. Because the same idea, if you can identify that your competitors getting a lot of complaints about poor communication, for example, and you see from your data that that’s one of your strengths. You can actually position around that and use that as you know, as part of your messaging. So you can communicate that you can solve that patient pain point.

 

Mariah: Oh, yeah, I love, I love all of those points that you just made. Lindsay, I feel like maybe this is a little, maybe what I’m about to say is a little philosophical, but in in the society we’re in today, in the state of things with health care, where there’s so much mistrust and there’s so much stress on our providers, and things that transparency, that reviews offer, that social media sometimes offers that you know, the direct patient to provider communication offers is so important in helping not just surface issues, but like you said, surface opportunities, surface ways to make care better in a much easier way than we’ve ever had before, and that transparency matters now more than perhaps it ever has in the past as things were growing.

 

Lindsey: People are increasingly worried that anything they see on the internet is too good to be true, and it actually improves the authenticity. And people trust reviews more when there are a couple bad ones. So you actually don’t want perfect reviews. It makes people be like, I’m not so sure about this.

 

Mariah: I 100% agree with you, and I use that a lot. I’m obviously not very fashion savvy, so when I have to buy clothes online, I’m like, All right, I need to see, I need to see where people like me screwed up and bought the wrong size or whatever. And yeah, I fully agree that not negative necessarily, but not glowing. Ooh. Everything was great. Sometimes those do make you feel a little bit better. So, any final thoughts or any final questions from you, Stu?

 

Stu: No, I thank you very much. Lindsay, this has been great. It’s been enlightening in a lot of ways, because of the seeing it from your point of view, as opposed to where I’ve been, which has been as more of a user of the ratings, it has been very interesting. Thank you very much.

 

Lindsey: Thank you for having me.

 

Mariah Tang: Thanks for listening to “Did I Say That Out Loud?” with Stu Eddins and Mariah Tang. Check out the show notes for more information about today’s episode. And if you have any questions, concerns or comments, hit us up anytime at stamats.com.