How to Respond to Negative Reviews

Even though most online reviews are likely to be positive, remember that they also reflect the patient’s overall experience in your care. These reviews often focus on nonclinical issues not directly related to the doctor. But those comments are no less important to your reputation.

Yet, you’re a physician. Your profession has different standards from other types of businesses that are reviewed online. Some rules for reputation management don’t apply to you. For instance, in the past Yelp encouraged businesses to “create a Yelp Deal” by offering discounts to customers who find the business on their site, to “turn Yelp visitors into paying customers.” They also advise business owners to message customers, and “join the conversation regarding a business.” Obviously, these guidelines cannot be used by medical practitioners to manage their online reputations on any review site.

Online reputation companies often try to bury bad reviews by creating more positive information to improve the search rankings of a business. Some of their strategies include publishing numerous press releases with positive news about the business or individual, and creating multiple websites about various products and services of a business as a way to divert attention away from the negative reviews and give the business more positive visibility in search results. Most medical practices do not lend themselves to these types of solutions.

Doctors actually have numerous options for responding to patient reviews, according to Eric Goldman, professor of law at Santa Clara University School of Law. He has written extensively on legal issues relating to online rating sites:

Respond generally. Most negative reviews relate to nonclinical aspects of the practice such as parking, wait times, out-of-date magazines, or staff attitude. Doctors can respond to those issues directly in the review site without violating privacy laws. Explain these aspects of your practice without confirming or denying that the reviewer was your patient. Explain how you run your practice in general terms, but refrain from publicly talking about the specifics of any one patient’s experience.

Address individuals offline. Responding to negative reviews that criticize bedside manner or question medical judgment should never be done in a public forum. Some sites, allow providers to privately respond to patient reviews. You may take the opportunity to do so. But it’s better to take this conversation offline. A standard response to call the office to further discuss the concern is appropriate.

Ask for permission to reply. Finally, you can ask patients for their permission to publicly reply to their reviews or post an apology. Once you have their written consent, a public response or apology can show others in the forum that you are listening to patients and taking steps to address their concerns. Doing this potentially turns the negative situation of a bad review into a more constructive experience.

In a New England Journal of Medicine perspective piece published in October 2012, “Why Doctors Prescribe Opioids to Known Opioid Abusers,” Stanford psychiatrist Anna Lembke, MD, explains the various pressures doctors face when patients ask them to prescribe controlled substances. One is patient ratings:

The prioritization of the subjective experience of pain has been reinforced by the modern practice of regularly assessing patient satisfaction. Patients fill out surveys about the care they receive, which commonly include questions about how adequately their providers have addressed their pain. Doctors’ clinical skills may also be evaluated on for-profit doctor-grading websites for the world to see.

Doctors who refuse to prescribe opioids to certain patients out of concern about abuse are likely to get a poor rating from those patients . . .

. . . When I asked a physician colleague who regularly treats pain how he deals with the problem of using opioids in patients who he knows are abusing them, he said, “Sometimes I just have to do the right thing and refuse to prescribe them, even if I know they’re going to go on Yelp and give me a bad rating.”

Online ratings should never get in the way of practicing good medicine. If a physician gets a bad review because he was “doing the right thing” by refusing an inappropriate request for a controlled substance, use the principles described above.

Take the conversation offline by using a standard response to call the office. Do so without confirming or denying that the reviewer is your patient. If the patient is known to you, you may ask for his or her written permission to respond publicly, where you can then address the patient’s concerns and perhaps explain your motive to stem the epidemic of prescription drug abuse.

Obviously, posting responses is reactive and shouldn’t be your only strategy for combating negative reviews. Those reviews will live a long time online, and could become fodder for malpractice attorneys or could impact your ability to sell your practice. In other words, they can haunt you for a long time.

Be proactive instead. Consider the patient’s experience and make sure that the customer service aspects of your practice meet acceptable standards as part of the new definition of professionalism in medicine. Once you excel in service, encourage more patients to review you online. In the end, any negative reviews will appear to be outliers.

Excerpted from: Establishing and Managing Your Online Reputation: A Social Media Guide for Physicians and Medical Practices , by Kevin Pho, MD.