Dealing with a negative online review on a physician rating site

Dealing with a negative online review on a physician rating siteWhenever I speak about social media to doctors across the country, I often get asked, “How do I deal with a negative online review?”

Here’s one way not to handle it: sue the patient writing the review.

There’s a well publicized case in Minnesota, where a resident posted a screenshot of the situation on Reddit, and wrote: “This dickface doctor from my hometown is suing a WWII veteran’s family for $50,000 for rating him poorly on the Internet.  Perhaps he deserves a few more poor ratings …”

Reddit, for those who don’t know, is a social news service, and receives millions of page views daily.  As a testament to its visibility, that screenshot shows the link received 635 comments.

The exposure on Reddit triggered scores of clearly fabricated negative reviews on the physician’s Google Places page, Healthgrades, and Vitals.com.

So, if the doctor was so worried about negative reviews before, the situation is much worse now.

Doctors shouldn’t try to remove negative online ratings.  Previous attempts have failed, and in this case, suing the patient has compounded an already bad situation.

Instead, look at a recent study from the Journal of General Internal Medicine last year that showed that close to 90% of online physician ratings were, in fact, positive.

Doctors should use that fact to their advantage.  How? Provide patients with clear, written instructions to rate them online. Do not coerce or “suggest” that they write a positive review. Simply ask them to go online and rate their doctor.

Chances are, their review will be better than most doctors think, and will make the more vicious statements appear more like outliers.

Kevin Pho is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on FacebookTwitter, and LinkedIn.

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  • Muddy Waters

    In my opinion, negative reviews are irrelevant. As the saying goes, “you can’t please everyone.” In fact, most people that take the time to complain about something on the Internet are usually neurotic and have unrealistic expectations. For example, if a doctor cannot provide a diagnosis for vague or unusual symptoms or complaints, the doctor will probably be viewed in a negative light.

    • http://Www.twitter.com/alicearobertson Alice

      They aren’t irrelevant when they are true. Even one negative restaurant review causes me to pause, so how much more when your health is at stake?

      I have only posted one fabulous review about the doctor we love. He got a kick out of it (it was my usual dramatics to entertain him and show gratitude).

      What is problematic to me (beyond doctors behaving badly..which is a site that does exist) is patients being labeled as scorners. I have a bad review rolling around my head I could put online and document with medical records. I have waited for an apology (he was cited by his employer) that isn’t arriving and, in truth, I am going to consider it a public service…not irrelevant.

      • http://www.dialdoctors.com Dial Doctors

        I agree that negative reviews aren’t irrelevant but I can certainly see the point Muddy Waters was trying to make. What’s the easiest way to get a negative review? Don’t do something irrational your patients want you to do. One example is remembering the blue pill with the pretty sign that you sent to that pharmacy on the West side of town. Yes this is a real request and if you don’t believe me check out similar cases by a different doctor http://drgrumpyinthehouse.blogspot.com Whenever you read an unflattering review keep in mind that it might be a fake. A good way to spot them is evaluate how many details it has. If all it says is ‘that doctor is so inconsiderate,’ then it’s most likely not true.

  • http://www.healthcaremarketingcoe.com/health_care_social_media/ Simon Sikorski, M.D. Twitter @medmarketingcoe

    Really great stuff Kevin!

    Kevin Pho, M.D. recommends (When dealing with a negative online review): Encourage your other patients to review you online… The positive reviews will drown out the negative reviews.

    Best recommendation I heard a doctor speak yet!

  • http://www.faircaremd.com Alex Fair

    Even the best doctors can get a 10% negative review rate, it is to be expected – and patients know this too. Not everyone can be happy, especially when it is medical care we are talking about – where the outcome is not always what we would wish. 100% positive smacks of manipulation and is not credible either. I know most of us in healthcare are over-achievers who always got 100%, but the court of public opinion, like actual medicine, is different than the board exams.

    What to do?
    1. Monitor with a google automated search on your name.(1) This will scour the internet for references to you and come back to keep you informed about any changes on a daily, weekly, or less frequent basis – right to your in box (it’s free too!)
    2. Respond as needed and request sites to remove bad reviews. Many review sites allow you to moderate up to 25%.
    3. Only Participate in sites that respect your requests and treat you fairly. If there are 9 good reviews and one bad review, don’t upload your photo to the one that publishes the negative one first intentionally.
    4. Drown out the noise, similar to Dr. Pho’s suggestion. In this case, I recommend an approach like Dr. Gafanovich has used on our site (2). She aggregated all the positive stuff out there about her and now a search on her name shows our site first and foremost.

    Good luck!
    -Alex

    Link references:
    (1) http://www.google.com/alerts
    (2) http://www.faircaremd.com/public/providers/Marina-Gafanovich-MD

  • http://www.drmartinyoung.com Martin Young

    It’s human nature to accentuate bad news, and, coupled with an egotistical patient, a perceived ‘bad’ medical experience is great fodder for social engagement. A review site for doctors is such a person’s dream come true.

    Bad news in medical circles travels ten times further and faster than good news.

    There’s nothing we can do, except be gracious under pressure. Luckily, the truth will come out eventually. One lonely negative voice amongst many says more about the complainant than the doctor.

    • ninguem

      “……McKee told the Laurions that 44 percent of hemorrhagic stroke victims die within 30 days…..”

      I do believe that’s a fact.

      I have a feeling the doctor was straight with the family and they didn’t like it. I say that as a doctor who has, on many occasions, encountered such families with grossly unrealistic expectations when mom has her stroke at age 84. No, we’ve done two CT scans during this hospitalization, we’re not doing a third. That sort of thing.

      Of course, that’s right. There’s nothing we can do.

      Seems the bar associations fight back….hard…..against the lawyer rating sites.

      • Noah Vale
        • http://Www.twitter.com/alicearobertson Alice

          This is interesting to read firsthand experiences.

          Defamation is hard to win, but cease snd exist orders are scary and becoming the Internet item of the day (some people post them at their blog with a resounding message). I posted as a witness on an expose blog and an Internet lawyer sent a 37 page threat…even had dates of his supposed upcoming filing…names of those who were in collusion. At first it was scary. One lady caved and ripped everything they requested down…one stood her ground (no filing of a lawsuit happened).

          The ACLU may have to get involved with what is our First Amendment rights…actually they did win a hefty settlement for a blog owner who exposed a big business. Nice precedent. Interesting though….doctors will hire lawyers and sue for malpractice, defamation…while decrying that lawyers are so inanely evil.

          I hope these sites stand their ground…although Britain does contain free speech moreso than here (the citizens there have certainly turned speech into a form of art….but the court system is different).

          Eventually, these sites may move overseas via servers, because suing in a different country is expensive and wildly difficult….now that the casinos are experiencing difficulty (but that involves fraud). Those who feel the need to post can do so by surfing anonymously (different from just posting anonymously…I was told if they have to get court orders judges get mad..it is better to post under your real name and take accountability for your words…something about the law and intent)….your ISP is protected, but the owner of the site may be in trouble.

          Most defamation (and slander) suits are more like the lion with a thorn it’s paw roaring about in agony. But some people become terrified at loud roars and run, while others will stay and recognize the empty threat and stand their ground.

          Even if you disagree with an opinion….go to the mat….because free speech is worth fighting for. You do not want to suppress the right to express your opinion.

  • http://www.alertpresence.com Brett Pollard

    Thanks for the mention in your article, Kevin. Typically physician reviews don’t pose a problem for doctors. However, I do think it’s important to be informed on these matters if some issue does arise.

    I’m in agreement with encouraging patients to post their own reviews. A good place to request that is through any existing social media channels where they are already connected to advocates.

  • http://drsamgirgis.com Dr Sam Girgis

    There are companies that provide services that will allow you to have these negative remarks removed. One such company is reputation defender… Has anyone ever used them before?

    Dr Sam Girgis
    drsamgirgis.com

  • ninguem

    “This dickface doctor from my hometown is suing a WWII veteran’s family for $50,000 for rating him poorly on the Internet. Perhaps he deserves a few more poor ratings …”

    That “dickface doctor” is likely the son, or grandson, of a WW-2 veteran’s family as well. What does that have to do with anything?

    “…..Perhaps he deserves a few more poor ratings …”
    In other words, a deliberate attempt to spam the site with bad ratings, by people who have never been treated by him, with the deliberate intent to ruin his reputation.

    http://www.duluthnewstribune.com/event/article/id/171193/publisher_ID/36/
    This is one of the family’s complaints:
    “……McKee told the Laurions that 44 percent of hemorrhagic stroke victims die within 30 days…..”

    I do believe that’s true, though I’m not a neurologist. That’s a complaint?

    I have a feeling the family did a lot to contribute to the problem.

    I recommend readers add some positive spam on the rating site, to make up for the negative spam he’s already received.

  • http://Www.twitter.com/alicearobertson Alice

    Why aren’t more doctors encouraging surveys? They could deal with the patient directly instead of publicly? Isn’t that why you call a manager over if you find a dead fly on your spaghetti?

    Doctors are good at preservation of reputation, but often terrible at customer service.

    Why not a sign next to the one that says payment is expected at time of service? A sign stating if you are unhappy talk to Ms. Fixer, or email them? Like the bumper sticker on the truck that just cut you off on the highway has? A way for the patient to vent privately?

    It is an absolute that doctors will mess up…why not extend an olive branch that you care? Far easier than picking up the pieces from an angry patient posting online.

    • ninguem

      Read the doctor rating sites’ listings for the Minnesota doctor in question.

      His rating is filled with obviously spammed slander.

      And you want to make that the doctor’s fault?

      • http://Www.twitter.com/alicearobertson Alice

        No, I am not saying it is the doctor’s fault. I think doctors are running a business, not a charitable organization…not an impersonal type of business though. You need public relations skills to deal with patients who feel offended. Far better to head it off at the pass than to let them stew in their juices and post online. There are reasons to post online….it could be spam….but why? It could be a real doctor did screw up. The age of hiding behind the white coat, doctored records, and colleague’s covering needs to be over. And, yes, I admit some patients are out of control also.

        My understanding is if you are going to sue you do not talk about it. So, I do not think doctors should make blanket statements about posters…I think many of the supposed offends want to rant….that could be accomplished…but fluffing them off will lead to online rants. I do not think an anonymous post carries much weight though. It can be illuminating, but usually not so. That said my friends check doctors out online…I rarely do…I think meeting the doctor in person is the most reveling. That said two of my doctors were chosen as patient favorites from surveys.

  • http://www.mdwrites.com MD

    You can not please everyone. If a doctor only has positive ratings, I would start thinking that he got all his friends and office staff to rate him. As long as all the reviews are not negative, this would not influence my decision to see him.

  • http://www.mx.com Su

    The classic PR strategy to handle bad press is to address it head-on and change the “narrative.”

    Any thoughts on how that might that work for physicians who don’t want to lend anymore credence e to anonymous gripes?

  • Alice

    Ninguem…what I am saying is…..an ounce of prevention is worth a pound of cure. It is not a cure all….but it is preventative medicine..not foolproof.

  • Alix

    I sell on Ebay. The few bad reviews I’ve gotten (while sometimes blown out of proportion) helped me be a better seller. If a doctor gets a bad review s/he should probably think it through; if the patient was upset enough to post a negative review, then possibly changes need to be made in that physician’s practice.

  • VikkiA

    Online reviews aren’t used as a definite resource for me, but they do tend to carry enough weight to help influence my decision.

    When I moved to a new town, I cancelled a veterinary appointment with a new vet when I googled his practice after arranging the appointment—I mistakenly did post-research. The reviews were about 50% positive and 50% negative which made it too uncomfortable for me to accept him as my cat’s new doctor. The vet wasn’t happy about the reason for my cancellation and called me to ask on which site I had read the reviews.

    I don’t usually reject a doctor for one or two negative reviews, rather I allow for about a 20% disappointment factor. Anyone who can please 80% of the demanding general public is doing a good job.

    The problem, as MuddyWaters wrote, is that “most people that take the time to complain about something on the Internet are usually neurotic and have unrealistic expectations.” Although I disagree that people who complain online are neurotic, I do believe that many people online and in ‘real time,” can have unrealistic expectations about services, can be difficult to please or will use minor issues for an opportunity to complain. People like myself can try to weed through the tangles and attempt to determine the proximity of truth, but the vast lot of people will read a few reviews, see some bad ones and immediately discard that doctor.

    Then there’s the fake reviews from other physicians to look out for. Since fake negative reviews are known to happen in the restaurant business, why not from competing practices in medical services?

  • VikkiA

    Additionally, a recent online search for a specialist uncovered that most of the complaints weren’t about the individual doctors. The complaints were about the office personnel, such as the staff was ‘rude’, ‘unprofessional’, left patients holding on the phone for unreasonable lengths of time.

    A doctor’s negative grade can be the result of an unfriendly staff.

  • http://www.DocRate.net Angela N. Vance

    Kevin,
    I couldn’t have said it better. Review sites that doctors request feedback on, like DocRate.net, can actually be used as a free quality control tool. Most patients like (or even adore) their doctor, or they wouldn’t keep going to them, and the act of asking the patients opinion will nurture the doctor/patient trust. You are saying to the patient, “I value your opinion, and intend on giving you the best possible care”. The negative comments come and go, but some may actually give you an insight on areas of improvement that you may not have considered.
    You can’t win them all, but you can blow the few negative comments out of the water with all of the resoundingly satisfied patients.

  • Ron MD

    My solution to a bad review from a pissed off patient ? Open 10 gmail accounts and give myself 10 awesome reviews to dilute out the crap. If the site provides no oversight and no proof that the review is reliable, I have no ethical obligation to do anything but play the game.

    • Alice

      I think this is a funny way to deal with it…it did give me a chuckle. I think posters should not be allowed anonimity when so much is at stake. The doctors who post under their real names have more credibility….and so it is with rating sites.

      Yet…one wonders…do doctors use rating sites like Amazon? Restaurant, hotels, or even colleagues? Is it only useless when it is bad info about you?

  • Ron MD

    By the way, these sites are about making money for the owners, not as a public service. Most sell insurance Even Healthgrades is there to make money by charging hospitals to use their “award” status. Pure greed.

    • http://www.faircaremd.com Alex Fair

      Let’s face it, Quality in Healthcare lacks a great online metric. I recall when I went shopping for new doctors for my kids I could never get a real feel for who was good at what or the right kind of person. They are a poor substitute for outcomes data or such, but the best we have for now.

      Healthgrades and other patient feedback sites have their uses and they should be allowed to sell ad space, that’s what keeps them free. Calling it unfettered greed is a bit like saying TV shouldn’t have commercials.

      Second generation ratings sites don’t let you do a rating unless you have made an appointment or, in our case, have a signed, sealed, and delivered contract for care. We will only actually publish the review if the doctor verifies the visit happened. After that he or she can review and decide if they want to use one of their moderation chits which keep the stars, but suppress the comments. Once people exceed too many chits their account is deactivated because bad care is not Fair to anyone. This system was designed by discussing how to do it right by doctors. It does require the Physician’s or their team’s active participation, but one great testimonial does wonders for your reputation. Tweet or share it and expand your reach asap. We reinvented the online review as a patient relations tool that can help you generate great publicity.

      Yes, we integrate all the other reviews you want, but people take such unverified data with a grain of salt generally and are well aware of the flooding technique you describe. So are we and it is something our system is designed to prevent as well.

      See sample here if you are interested: http://www.faircaremd.com/public/providers/Karl-Hussman-MD

      We also are working on a third generation review tool if you would like to review it. Why so much about patient reviews? They are most certainly an imperfect metric of quality. As soon as better exists, we will adopt them. Quality is king in care and this, unfortunately, is the best data available. Only by looking at all of it at once can we get actionable data, imho.

      Great conversation Dr. Pho, as always.

      • http://Www.twitter.com/alicearobertson Alice

        I often post from my cell phone, so it is messy…but today I have a bit more time and wanted to ask Alex why is the doctor verifying the visit when the patient could just email you their bill, or proof of payment. I find it curious…. and time consuming…it is probably losing you posts because some patients will feel you are not timely and siding with doctors (the source of income dilemma that frustrates patients). What doctor would verify a visit if they think a possible negative review is forthcoming?

        Patients can go to the county court records the doctor lives or works in and see if they have been sued. Interesting stuff comes up that way if the doctor is not displaying integrity in their personal or professional life. I know I saw some civil cases that made me do a double
        take, yet I rarely use health grades.

        Once as a joke a person who was dealing with a team of doctors played a made up game of who owned the nicest house. They used the auditor site to get the info. Their assumptions were right on…..an arrogant doctor was living in a penthouse then sued for non payment. All from public records, not health grade sites. All free….and they never went back to that doctor.

        • http://www.faircaremd.com Alex Fair

          Hi Alice,
          Thanks for your question.

          My website (FairCareMD) is all about making connections between doctors and prospective patients. After you make a “deal” or contract for care through the system we will ask you to do a review, so it is all automated and easy.

          People use it because they save a great deal on care, getting much better prices than are easy to find otherwise. Doctors love it because they are paid fairly and directly without any hassles.

          To date no reviews have been suppressed, but it is nice for the doctors to know that they can if they want to. As in relativity, there may also be an observer effect too. The review system may actually improve care too since they know that this is an engaged patient and they will be more likely to do a review.

          I agree, there is a great deal of info out there about docs, but if you want to research a dozen of them it is hard, that is why we allow links to so many sources. We didn’t get invasive about their credit or home addresses as they don’t relate much to care.

          We would love to hear what you think here or on our new feedback form on our home page. Orange tab at right. Thank You!

  • Reddit Reader

    The judge’s summary judgment order is posted online as a .pdf image.

    http://www.onpointnews.com/docs/Mckee-v-Laurion.pdf