Damage Control: Dealing with Online Patient Complaints

Susan Shepard, MSN, RN, Director, Patient Safety Education, and David O. Hester, FASHRM, CPHRM, Director, Department of Patient Safety and Risk Management.

Although the Internet provides a plethora of useful information, it becomes problematic when patients post unfavorable opinions about physicians and/or their services. It can be difficult to prevent negative comments from being posted to social media sites. It can be equally difficult to obtain a retraction or have a negative comment removed once it has been posted.

Even if you can find the source of the negative comments and persuade the person to stop, existing comments remain in the public domain and might even be perpetuated by others inadvertently or intentionally.

It is not advisable to respond to negative comments in a defensive manner. A defensive response generally solicits another negative comment from the person who posted the initial comment—which creates a war of words that only escalates the situation. In addition, specifically acknowledging that this individual is your patient may conflict with state and federal privacy laws. If you respond to a negative comment, use general, nondefensive language, as in the following example:

In accordance with state and federal privacy laws, Dr._____ is precluded from commenting in public or on social media sites specifically regarding a patient’s treatment. However, Dr._____ is available to discuss concerns directly with the patient in order to achieve a satisfactory resolution. Patients are welcome to contact Dr._____’s office.

No Easy Remedy

The Doctors Company frequently receives requests from members asking for information on how to hold patients accountable for posting negative comments.

If you are considering pursuing a defamation suit, you might need to retain private counsel to assist you. Proving damages and recovering them from a former patient can be a difficult and expensive undertaking.

Keep in mind that many lawyers are not interested in prosecuting these types of claims. Both federal and state courts have repeatedly held that individuals and Internet Service Providers are protected by the First Amendment in exercising their right to free speech.

Some physicians hire reputation management companies. The companies might promise to remove negative posts, but this claim can be misleading. It is more likely that the search engine results will be manipulated to move the posts further down in the result pages, rather than have the negative posts completely removed.

Constructive Feedback

One study indicated that 88 percent of the comments posted about physicians are positive.1 The remaining 12 percent may appear disproportionately hurtful and vindictive, but negative feedback also creates an opportunity for a physician to become a better practitioner or improve the practice.

Consider conducting your own research to determine how the negative comments have affected the practice. Have patients left the practice? Is the patient load decreasing? Do patients call about or comment on the negative posting? Answering these questions will provide reliable evidence to help you determine if there are areas within your practice that could be improved.

Patient Safety Tips to Help You Guard Your Reputation

  • Discuss with all new patients your commitment to answering their questions and keeping them informed.
  • Allow patients to have a voice by conducting patient satisfaction surveys. Discuss the survey results in regular staff meetings, and address any patient concerns.
  • Consider posting in the patient reception area or treatment rooms select survey results and your actions to improve.
  • Ensure that you and your staff communicate with patients and family members in a respectful and friendly manner. When patients have a positive experience with the practice, they are likely to tell others, and when patients in a community are consistently enthusiastic about a physician, negative postings tend to lose their intensity.
  • Consider sending a letter to new patients after their first visit, thanking them for choosing the practice and hoping to see them in the future.
  • Do not respond to a negative post in a defensive manner.
  • If you want to write off all or part of a dissatisfied patient’s fee, contact your patient safety risk manager for help in evaluating the situation from professional liability and compliance standpoints.
  • If there is any demand for money from a dissatisfied patient, contact your claims representative immediately.


  1. Lagu T, Hannon NS, Rothberg MB, Lindenauer PK. Patients’ evaluations of healthcare providers in the era of social networking: an analysis of physician-rating websites. J Gen Intern Med. 2010;25(9):942-6. Accessed September 28, 2011.

Additional Resources

For more about blogs and rating and review sites, read “The Internet: Friend or Foe to Physicians.”

A sample patient satisfaction survey is provided on our Patient Safety page.

Avoid potential liability risks associated with new technologies by visiting our Electronic Health Record and Telemedicine Resource Center.

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

J10098 04/15

Stay in the Know

Sign up for The Doctor’s Practice.

Our e-newsletter features timely articles, videos, and guides on a range of patient safety topics.


Follow The Doctors Company on Twitter Watch The Doctors Company on YouTube The Doctors Company on LinkedIn Like The Doctors Company on Facebook

© ­ The Doctors Company. All rights reserved. Legal Notices and Privacy Policy | Do Not Sell My Info