Up for Review: Five Keys to Managing Online Criticism

Kevin Pho, MD, Founder and Editor, KevinMD.com

Patients have more avenues than ever to express themselves online, whether on social media or through physician rating sites like RateMDs, Vitals, and Healthgrades. No matter how professional and caring a doctor you may be, eventually you will face criticism on the web. No doctor will receive universally positive reviews. So when a patient posts critical comments about you, it’s important to know how to respond. Here are five keys to managing that criticism.

  1. Listen to the criticism. Patients may leave online reviews because they feel this is the only way they can have a voice. After patients leave your exam room, often you don’t know what they thought about you or your practice. The criticism might not even be about you. You don’t know what patients thought about the nurses or medical assistants, or if they were concerned about the parking or whether the waiting room magazines were up to date. These are issues you may not be aware of—but they matter to patients. By listening to online criticism, you can identify and fix easily correctable situations and improve patients’ satisfaction scores.
  2. Take critical conversations offline. Whenever you see criticism on the web, there’s a strong temptation to respond to it immediately. You want to set the record straight and clear the air. Instead, take the conversation offline. An online argument is unlikely to result in anything productive. Post a standard reply thanking the patient for the comment and asking him or her to call the clinic. Be careful not to reveal any private patient information. If you can resolve the dispute over the phone or in person, the patient may take down the comment or even add an addendum stating, “You know what? This office is actually listening to what I have to say.” That can turn a negative situation into a more constructive one. Take the same approach whether the patient’s comment is on a ratings site or on social media. If you’re employed by a hospital or healthcare system, coordinate your efforts with your marketing or public relations team, who are likely to see an offline conversation as the most beneficial solution for both you and the organization.
  3. Read the fine print. If you believe any online comments are suspicious, contact the rating site to see if the comments violate the terms of service agreement. For example, a patient left my practice a little disgruntled. Shortly after that encounter, dozens of negative ratings appeared on a rating site that could have conceivably come from this one patient. I reported the comments because the rating site has a terms of service agreement that prohibits anyone from posting multiple ratings on a single doctor. The company investigated and found that all of the ratings came from a single computer. The site then removed the comments. Always read the terms of service agreement and report any possible violations.
  4. Ask more patients to rate you online. Most patients generally like their doctors, and dozens of studies show that a majority of online ratings are positive. By asking more patients to rate you online, you can make negative ratings look more like outliers. In the surgical world, there’s a saying about irrigating an abscess: “The solution to pollution is dilution.” The same principle applies to physician rating sites. If you ask more patients to rate you online, the positive comments can dilute the negative ratings by placing them lower in search results and making them less visible. Your patients just need to be encouraged to write reviews. Ask your patients to post a review if there’s something they like about you or what your practice is doing, or if they have any suggestions for your practice. Don’t cherry-pick patients or pressure them to say something positive about your practice, but ask for a rating from every single patient in a low-key and low-pressure way. Many practices even hand out cards with specific instructions on how to rate their doctors online. On the whole, the reviews will be positive.
  5. Resist the urge to sue. Only rarely have doctors successfully sued rating sites, which may argue that removing negative ratings is an infringement of a patient’s right to free speech. Also, suing patients for bad reviews may backfire. A doctor once sued a patient for a negative review and made front-page headlines in a newspaper. Now whenever you search online for that doctor’s name, the newspaper story comes up as the first result. By suing patients over criticism, you will only bring more attention to it and highlight the negative reviews.

Final Thoughts

Doctors by nature take all patient interactions very seriously—and often take criticism personally. We are trained to take a one-on-one approach to patient care and to make sacrifices for our patients. That makes negativity especially hard to hear. It may be difficult to regard online criticism as an inevitable part of the job, but that’s what it is. Patients don’t expect us to be 100 percent perfect, and patients are more likely to see an 89 percent positive rating on a website as more authentic than a 100 percent rating. Try to manage your patients’ expectations—and also try to manage your expectations for yourself. Recognize that you may not be the right fit for every patient, and that sometimes a patient simply has different expectations than you do.

We now live in a world where doctors are rated like professionals in many other industries, a trend that will continue to grow. Many doctors dislike being rated at all, but to succeed in the online world you shouldn’t ignore reviews. Instead, approach online ratings proactively. You’ll find yourself better able to influence the online conversation about you, fix any shortcomings in your practice, and engage critical patients in a positive, constructive way.

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.