But even a successful lawsuit may create more negative information for a search engine to find. "It becomes a news event when you file a lawsuit," said Eugene Volokh, a professor specializing in cyberlaw at the University of California–Los Angeles. "The original falsehood then gets magnified and grabs more attention online."

Hiring an internet reputation-management consultant is the alternative. In addition to making positive references to their clients more Google-friendly, they can also create entirely new material, including blogs, Wikipedia entries, YouTube videos, and even entire websites sprinkled with key phrases.

If a client prefers a stealthier approach, reputation managers can look for content about a person or entity with a similar name to their client's, then create links to those sites. That can push those to the top of search results, moving less flattering information well down the list.

"The Google algorithm changes all the time, so it can be tricky and time-consuming," Martin says. He admits to sometimes "tearing his hair out" trying to move negative content off the first page of a Google search. But, he adds, "We figure it out eventually."

Restoring one's reputation costs between $500 and $10,000 per month, depending on how much negative information is floating around on the Web, whether it's on the first page of a Google search, and if the client wants to create new content. It can take anywhere from four months to a year to repair an online reputation. The doctor who hired Campbell will end up spending $30,000.

Some celebrities, C.E.O.'s, and surgeons have begun to hire internet-reputation management companies to constantly monitor the Web and sweep away negative information as it appears. The cost of such vigilance is $1,500 to $7,500 per month.

Even at those prices, internet-reputation management firms say there are some clients they just won't take.

"It's sickening to me that anyone with an ax to grind can go online and destroy people's lives," says Carl Sgro of I.R.M. Consultants in Bloomingdale, New Jersey. But, he added, some people deserve their bad reputations. When they call, he tells them, "I could help you, but I won't."

Also on Porfolio.com:

• Crisis P.R. Firms
  These masters of message make problems disappear.
• Survival Guide: Bad Blogging
  In the digital age, your kids can really embarrass you.
• A-List Blogs for C-Level Execs
  We wouldn’t waste your time. These are must-reads.