Consumers have reviewed restaurants, hotels, and retail stores in online platforms regularly for years. Now, they are adding clinicians and hospitals to the mix as well.

Even Yelp has gotten into the health care review business, joining sites such as RateMDs, DrScore.com, HealthGrades, and Vitals.

It's understandable for a clinician to take exception to the opinions of patients expressed online, particularly when the comments take a negative turn.  “We take pride in ourselves and our work,” Dr. Steve Nichols, Chief of Clinical Operations Performance for Schumacher Clinical Partners, said. “So it is natural to want to react when someone says something negative about it.  This is important since mishandling a situation like this can result in damage to your reputation, and even legal actions, which can be far more damaging to your career.”

You may think, "We're already subject to values-based health care where even the way we get paid is determined by patient satisfaction. Why should we concern ourselves with what somebody says on Facebook, Twitter, or Yelp?"

Like it or not, the Internet, and social media in particular, has enabled patients to speak their minds. What they have to say isn't always complimentary, but it does influence the opinions of others.

The logical question to ask is, how do we respond to criticisms in public forums such as those described?

Here are our best practices for our clinicians who may want to respond to patient reviews.  

1. First, and Foremost, Contact SCP

Many folks forget that once something is posted online, it is forever available on the Internet, and down the road, may end up being used against them.  So while it can be tempting to refute a complaint written by a patient online, think twice before responding and get some helpful advice first. In fact, SCP has many resources available to you to assist, so please contact our Compliance Department at 800-893-9698, extension 1117.

2. Protect Your Online Reputation

Once you build a positive reputation online, you have to maintain it. That includes being thoughtful about what you post. 

Don't publish inappropriate content, as it could come back to haunt you. Also, watch how you respond to criticism, should you decide to do so publicly. When it comes to sharing information involving patients, refer to HIPAA as the standard. Absolutely no Protected Health Information (“PHI”) can be shared online. And don’t forget that what is considered PHI is rather broad. The best approach is to take any discussion offline. (If you want to review HIPAA and acquire some CME for doing so, there is a module available on SCP University through the Provider Portal.)

It’s also useful to ask if a patient types your name or the name of the hospital where you work into Google, what results will he see? Outdated practice information or negative reviews on physician-rating sites? Or, will he see a blog post you wrote or links to the social networks where you maintain a presence?

Either you will build, maintain, and protect your online presence or someone else will do it for you.  And yet, consider the person who posted the comment:  Is it someone that is likely to be held in esteem?  If not, then know that their comments are not likely to carry much weight in the realm of public opinion of those who matter.

3. Monitor your Online Reputation

Part of protecting your online reputation involves monitoring what patients are saying and where they are saying it.

Online reputation monitoring tools like Social Mention, Reputology, or Review Trackers can help. (Social Mention is free to use, while the others are affordably priced.) Also, set up Google Alerts for your name or the name of the hospital. Monitor Twitter as well, using sites such as Mention or TalkWalker. You should know that many malpractice lawyers will look for your social media to potentially use it against you—even many years later, so any indiscretion could come back to plague you in a different context.

4. Address Negative Comments Promptly

Quickly addressing negative reviews shows the patient that you care and value their opinion. It may also be the catalyst that results in a person who had a bad experience with you changing their mind and either taking down or revising the review.  Since a patient who complains online could end up filing a complaint against you, it is best to coordinate communications with the patient through SCP and the hospital administration, and to consider whether a response is even warranted.

5. Take the Issue Offline

Depending on the nature of the problem, rather than respond to an adverse review by leaving a public comment, it's often best to reply privately via phone.

If you can resolve the matter to the patients’ satisfaction, they might post a favorable update. On the other hand, if it too is unpleasant, then refrain from further contact with the patient and contact us at SCP again. If they threaten legal action, let us know immediately so we can become involved and help to avoid further escalation.

6. Be Preemptive

A negative review, particularly one that expresses a strong opinion, may stimulate emotions that could lead to a sterner response than necessary.

If a patient or family interaction becomes emotional and negative, then take the time to collect your thoughts and correct the situation quickly, before it becomes more public.  Have someone be a neutral witness and perhaps even facilitate a better resolution at the time.  Hospitals have Administrators on call, Charge Nurses, and/or House Supervisors who are often good sources for this purpose too.

If, after talking with the person, you find there is merit to the comments, then reassure them and take proactive steps to remedy the situation.

7. Understand How Rating and Review Sites Work

Each consumer rating and review site has a particular way of filtering and ranking reviews. Familiarize yourself with them.

For example, Yelp uses an algorithm to recommend reviews it thinks will be the most helpful to the Yelp community based on three factors: quality, reliability, and the reviewer’s activity on the site.

8. Take Negative Reviews Seriously

In most cases, people who leave negative reviews aren’t out to defame you. They merely want to express their opinion about the experience. One reason that patients leave reviews is that they feel it's the only way to get their voice heard.

Listen to the criticism and take such reviews on their merits, as they may reveal an area of your practice or facility that could benefit from improvement.

9. See the Good in a Bad Review

Negative reviews can benefit your practice or facility. If every review is positive and abounds with four- and five-star ratings, patients could become suspicious, feeling that the reviews are “manufactured.” As paradoxical as it sounds, the fact that negative reviews appear can contribute to building trust, rather than diminishing it.

10. Share Reviews with Fellow Staff Members

Make sure everyone in your ED or hospital is aware of reviews you’ve received, both positive and negative. Not only will that help to ensure you prevent similar problems in the future, but it also builds a patient-satisfaction mindset among staff members that can contribute to improving Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores.

11. Claim Your Profile on Patient Review Sites

Most rating and review sites will allow you to claim your profile. Consider doing so, since it enables you to correct any erroneous information and bring the profile to 100 percent completion, but learn the rules that they follow.

Start by claiming your profile on physician-rating sites such as HealthGrades, Yelp, and RateMDs. Then ensure all the information is correct, including your name, contact information, board certification status, and hospital affiliation. Consider that incorrect information may actually diminish the validity of the reviews, so know that this can be tricky.

12. Whatever You Do, Avoid Legal Actions AT ALL COSTS

Avoid the courts at all costs. There are very few documented cases where a jury sided with the clinician. Also, suing a patient for a defamatory remark could result in calling more attention to the issue than is warranted (or a counterclaim for alleged malpractice!). And, it will all show up on Google or Facebook (or both) eventually. 

Conclusion

These best practices for addressing negative comments will help, but you don’t need to try them all at once. Take the one-by-one approach, starting with proactively building your online presence and being very careful with it throughout your life because it will live on forever. And, know that plaintiff’s attorneys will almost always seek out your online presence in any case that arises, so keep that in mind as you post information about yourself.  Ask yourself how this would look if presented in court.

If you keep your patients’ needs top of mind, it will be reflected online in the content you create and the way you respond to comments. And, don’t think patients won’t notice, because they will –which could lead to more positive ratings and reviews.