How Not to Respond to Bad Patient Reviews Online

I recently attended a lecture advising physicians on how they can use social media more effectively to compete in the marketplace. According to the speaker who cited a Journal of the American Medical Association (JAMA) survey, 20 percent of patients find a physician's ratings on websites very important.  Even more interesting is that 35 percent of patients say they picked a doctor based on good ratings when searching for a physician on the web, and 27 percent of patients reported avoiding those with bad ratings.

As most physicians know, reviews on social media websites and other online platforms are hardly an accurate picture of whether a physician is skilled. More often than not, it is completely unknown how the ratings are generated. However, given that patients do look on websites for information when selecting a physician, social media content can imapct you and your practice and is something of which physicians need to be aware.

First, consider all the ways your practice could use social media to its advantage.  Establishing an onlinepresence in order to project your practice's brand and to share your "message" can be a valuable tool to attract and retain patients, and can counter poor or meaningless ratings.  Practice websites can be augmented with doctor profiles, blogs and video content that informs patients about the expertise of the practice, shares insight into the practice's mission and "vibe" and can help your practice be more attractive to new patients searching for physicians.  Practices can also tailor their content to the patients they are seeking by choosing appropriate social media approaches.  For example, baby boomers are apparently more likely to use Facebook, while younger patients might use Snapchat or Twitter.

The downside to social media is that it invites patient feedback.  According to a 2013 Vanguard Communications study of online reviews, 43.1 percent of patient reviews complained about poor bedside manner and 35.3 percent complained of poor customer service.  Another 21.5 percent complained of poor medical treatment, such as poorly skilled provider and/or office staff, false diagnoses, and surgical mistakes.   Although this may sound like patient reviews are entirely gloomy for physicians, other studies show that, in fact, 88 percent of reviews of physicians are positive. Providers should not be afraid to remind loyal patients who know and trust the practice and its providers that reviews are valuable.  Ask your patients for their feedback in whatever forum makes them comfortable and link it to your social media presence.

Unfortunately, a bad review can be difficult for a provider to resolve.  I spoke with David Adler of the Adler Law Group, a boutique law firm specializing in IP with an emphasis on working with physicians, about how he helps physicians affected by negative reviews.  His advice is that physicians need to be aware that patients have a First Amendment right to share their opinion and cannot be prevented from doing so.  Physicians are also limited by HIPAA restrictions in their response - they cannot respond to comments in a way that reveal whether or not a poster is a patient or otherwise reveal details about the posting individual.  This can make it extremely difficult to respond at all, and replies must be carefully crafted.  Instead, Adler recommends physicians track their reputation online and evaluate all comments and any real risk the comments pose.  Certainly providers can respond legally when a patient's comments constitute defamation or presents another legal issue.  Physicians should seek legal advice when false information is posted and can also engage in self-help by contacting sites like Yelp and Facebook directly, or seeking guidance through the social media platform's guidelines.  This process can be frustrating, but often works.

Here is the advice Adler offers:

1. Don't ignore bad reviews. Create a response strategy in advance.

2. Don't overreact. Zealous and veiled threats of litigation often backfire.

3. Don't lash back. Showing sincerity, sympathy and contrition can often turn a critic into a loyal ally.

4. Don't hire an SEO firm to "astro-turf". Fake reviews are unlawful and the fallout is potentially worse.

As practices strive to remain independent and compete against larger organizations, effective  marketing is key.  Help patients find your practice but be prepared for both the good and the bad that can come from promoting your organization in the digital marketplace.