Gone are the paternalistic days when patients revered doctors. A bad review can create the fear that your patients and referring clinicians will start to doubt you. But all is not lost. You can look at patient reviews strategically.
Bad reviews are not always bad, and most of the time, they reveal an opportunity to course-correct rather than a scathing personal indictment. Further, there are some that you (and would-be patients) can generally dismiss off the bat, like those with grammar and spelling errors.
The reason bad reviews can be damaging is that they can significantly lower your overall clinician rating. However, this matters only if you don’t have that many reviews to begin with. Later on in this piece, I explain how to get your reviews up and your ratio corrected. Note that once this correction occurs, a bad review may actually legitimize the good ones. The more real your reviews look, the more believable they are.
Where do bad reviews come from? Typically, they stem from a lack of communication, or a misunderstanding on the part of the patient. This means they can send useful messages to both you and the patients reading them. For example, “Dr. X won’t refill my pain medicine,” or “Dr. X’s office expected me to pay up front.”
Bad reviews can also alert you to a problem you need to fix. If they note a long wait, it’s time to track your wait times. If they mention rude staff, it could be an opportunity to educate and retrain your staff. Complaints about payments and no-show fees may reveal unclear policies.
Are you a bad doctor if you receive a bad review? Not necessarily. There is a story about two patients sharing a room. One patient had a complication, and the doctor caring for them was in the room and visiting often. The other patient had an uncomplicated surgery, and the doctor only visited once. The latter patient wondered if they had a good doctor, since they weren’t getting as much attention as the former patient. Clearly, this wasn’t the case. Context matters — and patients aren’t always privy to it.
Fortunately, there are many strategies that can help with patient reviews.
1) Trust yourself to read these reviews. Reading bad reviews can trigger shame when we make the bad review mean something about us. To combat this shame, bear in mind that you are seeking legitimacy from a source you don’t control. Bad reviews, like complications, are statistical possibilities. Words in a review are a neutral event until you add the emotional layers on top of it. You can delegate reading reviews to a trusted source, but not reading reviews means you will miss the things you are doing right, too.
2) Increase the good reviews. We might be telling ourselves that’s not what a doctor is “supposed” to do. It may even feel like a conflict — after all, we have power over the patient because we obtain personal information and provide access to medication and treatment. Services are available to remove reviews for a fee, but their worth is debatable compared to other strategies. Making reviewing easy for patients with cell phone prompts, EMR links, and help from office staff is worth the time. Reviews have the potential to boost your SEO ratings, so even bad reviews could count for those numbers, too.
3) Focus on policies. It can be tempting to play to the reviews and prescribe more medicines or refund money. This can be confusing to patients and a source of frustration for your staff. You are better served by having strong policies in place that are available for both patients and staff. Consistency will allow your staff to explain your policies to the patient and help them feel supported. Refunding money can convey guilt, and it sends the message that your reputation is for sale.
4) Be careful in your responses to reviews. Any response to a review runs the risk of a HIPAA violation. Acknowledging that the reviewer is a patient is thought to violate their rights. It may be worth responding to a review with “If you are a patient in our office, please call the office to help resolve this issue” or “We cannot confirm you are a patient because of privacy, but we can respond with our policy which is to collect money based on insurance contracts.” You may find it best to not comment at all to avoid any issues. Tone is difficult to control, and your response could hurt you more than the original comment. “Feeding the internet trolls” is rarely worth the time it takes to worry about it or respond.
5) Prevention is worth a pound of cure. If you get a bad vibe, you can be upfront. “It sounds like we are not a good fit, can I help you find another doctor?” Your office manager could be proactive and call the patient after the review, especially if it appears to be a misunderstanding that you can fix. Showing support to the patient, communicating your policy, and asking them to remove the review might work.
6) Your reputation is your responsibility. You may think it is the administration’s job to help you. You may even have a marketing expert on standby. But you are the person most invested in your reputation. Taking good care of your patients and focusing on your referral base is a great strategy.
7) When to be concerned: Some patients trigger warning signs. Documenting exchanges, or having a scribe or medical assistant present, can help protect you from accusations. If a situation escalates, a formal dismissal letter by certified mail is appropriate (make sure to document that you offered referrals and are available for 30 days for emergencies). Don’t hesitate to call your malpractice insurer for advice, the police for protection, and a lawyer if the reviewer crosses the line to slander. Clinicians are not punching bags for our patients, and speaking up and protecting ourselves is justified. The safety for you and your staff is much more important than the worry that you are overreacting.
Finally, do you want the patient who would/would not pick you on reviews alone? Give your patients some credit.
How do you handle bad patient reviews? Have you ever deployed any of these suggestions? Share your strategies and experiences in the comments below.
Amy Vertrees, MD is the Founder of the BOSS Business of Surgery Series. She can be found at www.BOSSsurgery.com.
Illustration by Jennifer Bogartz
