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Bashed by a Patient on the Internet: Here’s How to Respond

From: MedScape

The Right and Wrong Way to Handle Internet Criticism

Whether physicians like it or not, patients are checking physicians out online, and they’re focusing more and more on written reviews, not just stars.

Lindsay Neese Burton, healthcare marketing director at Reputation.com, an online reputation management company based in Redwood City, California, says that 80% of consumers not only want to see “star” ratings, they also want to see at least a half dozen written reviews by patients with whom they can identify. “They want to read about what type of care other patients received and what type of interaction they had,” she says. “It feels more real to them.”

Despite the fact that a majority of patient reviews are positive, according to experts, most physicians are uncomfortable with having their services publicly critiqued. A patient’s perception may be unfairly colored by their own personality or outlook; or a patient may have a vendetta against the physician for some other reason, and there’s no way to publicly check out the validity of the complaint.

Additionally, as physicians are aware, while they may provide excellent clinical care, a patient may leave the encounter dissatisfied for any number of reasons, many of which are out of the physician’s control. A receptionist in a bad mood, a long wait, inconvenient parking, a refused request for an unnecessary antibiotic, and more can all result in stinging and “unfair” online reviews to which doctors say they can’t adequately respond because of HIPAA (Health Insurance Portability and Accountability Act of 1996) constraints.

What can a physician do to combat this? Although experts offer different perspectives, their recommendations are all variations on the same theme: the best defense is a good offense. Avoid playing whack-a-mole with negative reviews and focus your attention on cultivating an online presence that reflects your practice.

How to Handle a Stinging Review
Although it may be a challenge to remain calm, there are a few important recommendations:

  • Take a deep breath and stay calm. No one likes criticism, and it’s tempting to fly off the handle when confronted with remarks that may be personal, unfair, or inaccurate. Tempting though it may be to respond to a testy review with an equally testy response, don’t
  • Move the conversation offline. Politely acknowledge the reviewer’s feedback and your regret that they had a negative experience; note that patient privacy considerations constrain your ability to respond online and invite the reviewer to contact you or your office for further conversation. “You want to let people know you’re listening and that this is a place where you are willing to receive feedback,” Burton says
  • Consider the opportunity. Although it’s sometimes hard to see it this way, negative feedback is an opportunity for practice improvement. Is there something to be gleaned from the review? Has a patient raised an actionable concern? When a physician or practice responds to a negative review by addressing a problem, it not only results in practice improvement and a chance to keep the patient, it may also prompt the reviewer to remove the negative remark or post a second post noting that the situation was resolved and highlighting the practice’s responsiveness
  • Forget suing. In the vast majority of situations, suing a patient over online comments is a bad idea, says Eric Goldman, codirector of the High Tech Law Institute at Santa Clara University in California. “Lawsuits are a rarity, and they’re counterproductive. They call attention to the negative comments, and even if the doctor wins, they are not going to be satisfied with the outcome. The vindication will not be worth the cost and effort and it just raises the chances of a counter claim for malpractice”

The Best Defense Is a Good Offense

While some negative reviews are inevitable, experts say doctors need to be much less concerned about the occasional gripe and much more focused on honing their online image. Accept the fact that would-be patients are going to search the Web for physician information—including reviews—and do your best to ensure that the information they see online is accurate across the various sites and that what appears there represents your practice well, says Lee Aase, communications director for the Mayo Clinic’s Social and Digital Innovation Team.

“Do you want to be proactive in taking responsibility for your digital identity or do you just want to be responding to what people are saying?”

“As a physician, you can’t control what people will write, so the question becomes: Do you want to be proactive in taking responsibility for your digital identity or do you just want to be responding to what people are saying?” he asks.

Although the Mayo Clinic has occasionally approached sites like Yelp! about removing physician reviews that the organization felt were grossly unfair and violated terms of service, Aase says his group’s main focus is on helping individual physicians take a proactive approach to social media.

In 2014, Mayo conducted a Google search and found that 102 of the 2148 physicians at its Rochester, Minnesota, campus had at least one negative review over a 3-month period.[1] Mayo offered those physicians social media coaching and encouraged them to enhance their presence on Twitter, LinkedIn, YouTube, and other sites. As a result of the coaching, the doctors increased their social media presence by 66%.[1] That enhanced presence didn’t erase the negative reviews, but it did push them further down the search results list. When Mayo conducted a second Google search about 2 years later, it found that most negative reviews had been pushed off the first page of results.[1]

Develop a Strong and Positive Digital Presence

Some physicians are taking that type of proactive approach a step further and encouraging their patients to write reviews, Burton says. Although that may result in an occasionally dissatisfied patient posting a gripe, the law of averages weighs heavily in doctors’ favor on this one as the vast majority of reviews are favorable. Patients who are well pleased with their doctors are more likely to sit down and type a review than those who are indifferent.

But by far the most proactive strategy—and one that is being employed by a growing number of hospitals and health systems—is to publish institutionally collected Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data on the organization’s website, says Ed Bennett, founder of MarTech.Health Directory. These surveys assess patient experience in various healthcare settings and are part of the Agency for Healthcare Research and Quality. The strategy, first employed by the University of Utah in 2012, has since been adopted by dozens of systems including Geisinger, Cleveland Clinic, Brigham and Women’s, and Vanderbilt.

“Two years ago there were about 60 hospitals doing this,” he says. “I’m sure it’s double that now.”

Although physicians are wary of publishing CAHPS data—a 2017 paper published in the Journal of General Internal Medicine found that only about one in five physicians liked the idea and nearly eight out of 10 (78%) said that posting patients’ narrative comments would increase physician job stress[2]—they’re far more comfortable with the accuracy of those reviews than with reviews appearing on independent websites.[2]

“Nobody wants to be treated like a commodity,” Bennett says. Still, consumers want the best, most accurate information available about their doctors and some of that information is best summed up in a narrative review. What’s more, he says, “physicians and consumers don’t always see reviews the same way. A patient may write that their surgeon didn’t have the greatest bedside manner but they were happy with the results. The doctor may see that as negative, but for a prospective patient looking for a surgeon, bedside manner may not matter one bit.”

While the idea of creating a stronger internet presence and embracing reviews may require a cultural shift for many doctors, Burton thinks most doctors will ultimately accept the trend.

“Physicians respond very well to data and results,” she says. “We show them the data: the more reviews you have, the higher you are going to rank in the search results, the more clicks you are going to get, and the more likely you are to get new patients.”

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