Managing negative patient reviews

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I recently read Gloria Kim, MD’s excellent essay “How Yelp made me a better doctor,” a runner-up in the Medical Economics 2018 Physician Writing Contest. Kim, an OB/GYN, was devastated when a patient wrote a scathing review of her on Yelp. Kim had provided thorough, caring service for a patient and had certainly done nothing to warrant the fury that emanated from the review, “skewering everything about me and my office with vehement gusto.”

Kim spent a great deal of time thinking about this negative review. She pored over the patient’s chart. She perseverated on the review for months. The review devastated Kim. A consciousness and caring physician, she writes in her essay that “I really wanted [my patients] to like me.”

As I read this essay, my heart ached for Kim, and for every physician who faces the dilemma of “asymmetrical rewards.” In other words, all the hard work and effort put into 99 percent of your day can completely fade away in response to one single negative response or complaint.

In the case of Kim, the good work that she did “spending sometimes over an hour with a distressed patient…telling me of her disintegrating marriage” or “another patient [telling me] of her teenage son’s horrific and tragic death” was meaningless compared to one patient who was dissatisfied with her, for no obvious reason.

While Kim was able to make the best of her situation, using the negative review as an opportunity to make improvements in her work flow, other physicians may find themselves feeling burned out when they face angry patient reviews.

But what if I told you that the occasional negative patient complaint online could actually turn out to be a good thing for your reputation?

Guess what? It can!

Pratfall effect

When I say a negative online complaint can help a physician’s reputation, I’m not talking about a doctor with a page full of one-star reviews but rather a Gloria Kim-type of physician with many four- and five-star reviews. Think a high-quality, caring physician who just has an off day, or runs across a difficult patient that even TV’s Marcus Welby couldn’t make happy and ends up with a less-than-stellar review.

You see, there’s this interesting little concept in psychology called “pratfall effect.” It turns out that we like people who have a few flaws much better than we like people who seem “perfect” or invincible. So, if a physician has nothing but five-star reviews, they may seem intimidating and be perceived as less likeable than the doctor that has mostly five stars and one or two one-star reviews. So, believe it or not, having a bad review from time-to-time can actually gain you patients!

Bad reviews bring out your champions

The other positive thing that can happen when we get a negative review is that the occasional detractor can bring out our champions. Most of the time people who really like us don’t take the time to write us reviews. But when patients who like their doctor see a vicious review of a doctor that they care about, then look out! Patients will often rush to that doctor’s defense, and you will then see a string of positive reviews that quickly neutralize a negative review.

Although this may happen organically, we can always improve our online reviews by asking our patients to write reviews of our practice. There is nothing wrong with this – “the solution to pollution,” after all, “is dilution." The more positive reviews that you have online, the less likely that a negative review will be noticed.

Take control

Another way to negate unwanted comments on review sites is to take control of your social media and web presence. Marjorie Stiegler, MD, an expert on social media for physicians and the author of The Social Prescription: How Savvy Doctors can Leverage Digital Platforms for Professional Success points out that the more web presence you have, the more likely it is that when someone searches for your name or practice, your own sites thatyou control show up ahead of doctor rating review sites.

It’s much easier to do this than you might think. Start by making a Google page for yourself and for your business, as well as a Facebook page. You can add a Twitter account or Instagram if you feel ambitious. Create a website using an online service that makes it easy to do yourself (which can be remarkably affordable) or hire a professional website developer to help you. Many online websites even offer free SEO (search-engine optimization) services that allow search engines like Google to find your website when people are searching for keywords that you have linked to your site (“family physician” or “general surgeon” for example).

Acknowledge your feelings

Finally, remember that although negative reviews are inevitable and are unlikely to actually hurt your practice, they do cause physicians emotional distress. When we get a negative review or an angry letter from a patient, we need to acknowledge our feelings – it can hurt. We all want to be liked, and we work hard for our patients.

Usually patient complaints are related to some type of misunderstanding or confusion, but they are rarely something that the patients are willing to work on if they are at the point of firing off angry letters or reviews. As physicians, we mustreconcile ourselves to this – it is impossible to please everyone, no matter how hard we try. Perfectionism is an impossible ideal, and if we expect perfection from ourselves, we will inevitably fail. Seeing ourselves as failures, or inadequate as physicians, is one of the major hallmarks of burnout.

All the more reason that psychology can help! Kim suggests in her essay that residency training should include a psychology and indeed, psychology is something that can truly benefit all physicians. We can learn how to cope with the powerful emotions that patients can elicit in us and learn how to process them in a healthy way. We can also use psychology to help our patients more effectively, and hopefully mitigate their urge to write those negative reviews that we hate so much.

In the next article in this series, we will discuss using psychology to try to prevent bad reviews – by using deep listening and emotional mirroring to show empathy and create a more efficient yet satisfying patient visit.

Rebekah Bernard is a family physician and the author of Physician Wellness: The Rock Star Doctor’s Guide. Change Your Thinking, Improve Your Life. She can be reached at her self-titled site, Rebekah Bernard, MD.