Reputation: At once trivial and important

It takes 20 years to build a reputation and 5 minutes to ruin it. If you think about that, you’ll do things differently.” Warren Buffet, Ameri­can business magnate and philanthropist, and one of the most successful investors in the world, would certainly know a thing or two about the value of a good reputation. 

Generally speaking physicians, as a profession, are held in fairly high regard among the public and other professions, and individually are revered by their patients. The main drivers of physician reputation are provision of services, innovation, and ethics. But as Mr Buffet notes, reputation is a fragile thing and what took years to build can come crumbling down in a matter of moments. Why does a good reputation matter? 

Reputation represents the way others look at us and as such is both utterly trivial and critically important. Trivial because many of us don’t care what others may think of us, but important because a good reputation can be beneficial and a bad one can be devastating.

As physicians our successful practice depends on maintaining a good reputation. In the case of physicians, reputation equals trust. We have work­ed hard for years to build a thriving practice, be respected by our colleagues, and be revered by our pa­tients. Because of the nature of the profession, we work directly with the most precious possession our clients have—their health. It makes what we do very special, and it also makes our liability higher than almost any other profession. 

The many hundreds of happy patients we have rarely say anything publicly, but when a patient is disgruntled, whether the problem is perceived or real, they needn’t look very far to say so. Websites such as RatemyMD.ca, RateMDs.com and doctorscorecard.com offer Canadian patients, and others, a place to vent with anonymity. 

Unfortunately, since happy posters are rare, negative res­ponses accumulate, and doctors have to bear the brunt and live with the general belief that a section of patients believe they aren’t receiving good health care. Since these websites are open to everyone, patients, potential patients, colleagues, hospital staff, friends, and family members can all see what others think of us. It might be a good idea for each of us to check our ratings once in a while, if only to make ourselves aware.

At the end of last year, both Gallup in the US and Ipsos here in Canada conducted their annual surveys on honesty and ethical standards among different professions. As in past surveys, physicians are always included in the top three spots, along with nurses and pharmacists. 
As is the case with all things external to use, we really only have influence over our reputation, not necessarily control over it. 

Long wait lists for diagnostics or specialist consults, lack of access to family doctors, and patients being treated in ERD hallways each contribute to how Canadians view doctors. And sometimes it only takes one or two physicians to mar the reputation of the profession as a whole. 

Two stories have recently been covered in the national media: first, two Montreal cardiologists are being investigated by the Quebec College for supposedly accepting bribes to move patients up the waiting list for surgery, and second, a former Canadian physician now practising in Texas has been charged with bilking the US government millions of Medicare dollars by inventing phony patients. 

Although reputation is an intangible concept, it is generally understood that a good reputation demonstrably increases the profession’s worth and will provide a sustained competitive advantage. A good reputation will bolster advocacy efforts, ensure inclusion in change management, and provide support in times of controversy. However, reputation is a fragile thing and at an individual level—which contributes to the whole—we should all take consistent action that embodies the characteristics we would like others to associate with us. 

I will leave you with one final quote, this one from the great philosopher and teacher Socrates, who said, “The way to gain a good reputation is to endeavor to be what you desire to appear.”
—Nasir Jetha, MD
BCMA President