The hallmark of the Internet is its ability to increase the free exchange of ideas. The ease with which information is proliferated increases the damage caused by false or harmful information, stretching the bounds of defamation.

The Internet gives the average person an opportunity to express their opinion, anonymously, well-beyond any other venue. An individual now has the ability to publish statements and articles across the world in an instant, without the guidelines or checks and balances of traditional publishing. Thereafter, online erroneous statements may linger for months, or even years, almost impossible to recover, amend and remove. Internet defamation lawsuits are on the rise and the number of people sued over online speech is increasing sharply, according to statistics from the Citizen Media Law Project at Harvard's Berkman Center for Internet and Society.

As a physician, you know that your reputation is one of your most valuable assets. It takes years to cultivate impeccable credentials and positive public perception. Unfortunately, one disgruntled patient can destroy that hard work in minutes with a few clicks of the computer mouse. In these difficult and challenging times, protecting your most valuable assets becomes top-of-mind priority.

Disgruntled patients, or those posing as patients, can easily publish content to the web - regardless of the veracity of that content. Increasingly, physicians are experiencing the damage caused to their hard-earned reputations from these posts, blogs and doctor rating sites.

Below you will find the tips and tools to make it easier to track, control and manage your online reputation.

(1) Be proactive
On the Internet, information flows around the world in seconds. If you are not proactive, millions of people can view a defamatory post before you see it for the first time. Do not wait until you have an issue with your online reputation, stay ahead of the game.

(2) Purchase domain names
Buy iterations of your name and practice name as domain names. Imagine a potential patient going to “your name”.com and reading horrible statements about you posted by a disgruntled patient or competitor. Unfortunately, this happens more than you think. Buying iterations of your name is a simple and inexpensive way to prevent such attacks.

If your name is common and the exact match is unavailable, look for a combination of your name and either a location or a professional title (example: johndoemd.com, www.doctorjohndoe.com or johndoedallas.com). Also, check to see if your name is available with hyphens (example: john-doe-md.com). You can buy a .com domain for as little as $7.95 a year from sites providers as GoDaddy or DreamHost, cheaper if the “.com” extension is not a priority.

(3) Keep a watchful eye
Proactively monitor the Internet. If you wait until someone notifies you of a questionable online post or rating before you begin a proactive monitoring campaign, then you are too late. The damage is already done. Perform monthly (minimum) checks to see if there is any information about you that could be potentially harmful. Search for your name, practice name as well as key staff members.

Medical Justice’s Web Anti-Defamation service includes proprietary technology that proactively monitors the top physician rating websites. The software immediately notifies its members of any new postings or ratings containing member physicians’ name or practice names.

(4) Act fast
If you do find something posted about you online that could be potentially damaging, take action immediately. Whether it is a friend posting photos you do not like or an anonymous person slandering your business, taking care of it sooner rather than later is best. The longer it stays on the web, the more people see it and the more damage it can do. Certain attorneys specialize in cyber-issues and can assist with legal redress if necessary.

(5) Your Google Reputation
Consciously create a clear and positive image of yourself and monitor the Internet for any type of commentary – good, bad, or indifferent. Be contentious while creating and updating content on your practice, professional or social websites. Ambiguous comments or statements can be used misinterpreted. Make sure that your content is clear and unmistakable.

In today’s world, Google is more than a search engine – it is a reputation engine. When a prospective patients, professional partner or investor wants more information about you, they ultimately turn to Google for information. Some individuals, with flawed online reputations, try to manage the situation by creating copious content to “push down” negative information on Google. This tactic can take many weeks – sometimes months – before your new positive image rises up through the ranks of Google.

Do not wait until you are knee-deep in a crisis to decide you need to take charge of your online reputation. A proactive strategy is more effective than reactive tactics.

(6) Assume everything can get on the web
Both in your personal and professional life, what you say online and offline can come back to haunt you. Be safe and assume any emails, conversations, articles or photos may eventually end up on the Web.

If you are blogging, writing editorials, running a website or just have a social media profile, be careful what you post. What you say may cause you problems in the future. If you do want to keep a non-practice affiliated blog or engage on social internet message boards, create a pseudonym for yourself so you cannot be tracked.

(7) Keep Social Networks Private & Actively Monitor
• 30% of online physicians in developed markets report that they use Facebook (Medimix International Report)
Keep your social networking profiles private to all except those you approve. This will keep casual or even malicious viewers from seeing your personal information. Keep in mind that the influence of connections made on the Internet can be much more impactful for high-visibility individuals, such as physicians, than had been previously perceived.

Create custom RSS feeds based on keyword searches: Feedster.com, Technorati.com, IceRocket.com, Google.com/blogsearch, Blogpulse.com, MSN Spaces, Yahoo! News, Google News, MSN News and PubSub. RSS stands for "Really Simple Syndication" -- it's a format for distributing and gathering content from sources across the Web, including newspapers, magazines, and blogs. RSS feeds are an efficient way to monitor and track content that affects your practice.

(8) Put Your Best & Most Accurate Foot Forward
Make sure that your online presence will not be mistaken for someone else’s or used against you. Sign up for social network sites, starting with the most popular like LinkedIn and Facebook.

Complete your social network identities with valid information and data that you want to be "known" about you (e.g. specialty, practice information, credentials, location). Do not forget to link to your own website(s).

While signing up & setting up your identity on these social networks, make sure you pay special attention to the privacy settings. Set certain features, like personal pictures and posts, to private.

(9) Link, Link, Link…
Google sets a high ranking priority to web pages that contain active links. This is an easy way to address the Search Engine Optimization (SEO) for yourself as an individual or your medical practice.

Make it a priority to link your website to your social networking identity links as well as other web pages that you are associated with (e.g. medical societies, alumni organizations, non-profit affiliations).

Anonymity is part of the Internet. Unfortunately, anonymity creates a willingness and boldness to criticize. When online criticism (anonymous or not) strays over the line into libel, questions surrounding freedom of speech arise.

Traditional remedies and approaches do not apply to cases involving physicians. First, physicians are bound by state confidentiality laws and HIPAA. They are forbidden from defending against reputational assaults by posting the medical record as a correction. Second, under traditional legal principles, one who is defamed can sue not only the originator of the libelous comments, but also the distributor- such as a newspaper or a television station. Using that analogy, a natural target would be the digital distributor, the Internet Service Provider. However, in 1996, Congress foreclosed that option by granting broad immunity to Internet Service Providers for the tort of defamation. In general, physicians have few practical after-the-fact remedies against Internet assaults on their reputation.