Responding to negative feedback online

Posting reviews about businesses or services on online ratings sites has become common consumer behaviour. This includes patients using these sites to express their satisfaction, or dissatisfaction, with their health treatment. Facing such comments can be a challenging experience.

Dissatisfied patients may go straight to social media and online forums, without ever having raised concerns directly with you or the practice. Being told about online comments by another patient or colleague may be the first time a doctor becomes aware they even have an online profile.

You may be able to deal with it in the same way you would a direct patient complaint. For more information see Responding to a direct patient complaint. Otherwise the information below outlines how to approach reviews and comments posted on online platforms.

There is no legal or professional obligation on you or your practice to monitor comments on sites that are outside your control. If your online presence is not important to your business you may choose not to monitor or engage with any reviews. However, if you are concerned, the information below may be useful.

It is almost always confronting to read an adverse comment in an online forum, particularly if this is the first you have heard about the patient’s concern. However, while negative reviews can feel like a personal attack, they are not necessarily damaging for your personal or practice reputation. While your first instinct might be to act angrily or defensively, it is important to try to take a step back before you decide on any response.

It may seem counter-intuitive, but having some critical reviews may actually be helpful. A majority of consumers report they trust the profile more when they see both good and bad reviews, and are more likely to be suspicious of fake or censored reviews if they don’t see anything negative.

Many people do want to take some action when they find a negative review. There are a number of options, but no single best response, so you do need to consider the particular situation.

If a review is posted by a one-off patient or about an isolated incident, you may be able to resolve or stop it from escalating depending on how you respond. On the other hand, sometimes negative comments do seem to be part of a pattern or sustained program and these may require a different approach.

Talking to someone before you respond can help. Your practice manager or colleagues may have encountered similar situations. Or you may wish to call Avant’s Medico-legal Advisory Service (MLAS) for advice.

Always bear in mind that your legal and professional obligations apply online. Comply with the Medical Board’s Code of Conduct (Good Medical Practice: a Code of Conduct for Doctors in Australia) and take care not to breach patient confidentiality if you respond.

Ignore the comments

While this may be difficult, ignoring the comments is an option.

Sometimes comments seem unreasonable, for example a patient complaining that you declined to provide treatment that you believed was not in their best interests. If you do not think there is actually an issue and other patients are generally happy, you might choose simply to let the comment go. Other patients may respond or post positive reviews and balance out the negative rating.

Even if you choose not to respond it can be worth monitoring the situation for any developments.

Discuss the complaint offline

It is not always possible to identify the author from an online comment but if you do know who has complained, it may be appropriate to contact them offline and discuss their concerns.

You could say how sorry you were to hear that they had concerns, and talk them through. If you can resolve their concerns, the author may offer to update the comments, or have them removed from the website.

Consider whether this approach is appropriate based on your knowledge of the author and the nature of the comments. There is a risk that contacting them could escalate the situation but in other situations this approach can be effective at resolving it quickly.

Administrative complaints – consider replying online

If the review raises administrative issues such as waiting times or parking conditions, your practice manager may wish to reply online.

This approach works best if you can respond in a timely fashion. It can show empathy with the patient and willingness to respond, and can give a positive impression for anyone reading the comment online.

However if the comment was posted months or even years ago, it is usually best not to respond given the time that has passed.

If you do respond, there are some guidelines to bear in mind:

• Take care not to breach patient confidentiality.
• Acknowledge the concerns.
• Take the complaint offline if you can, for example by inviting the author to contact the practice directly.
• Avoid being defensive, even if you don’t agree with the complaint.
• If possible explain what you have done or are doing to address the issue.
• Try to write as you would speak. Stock phrases can sound insincere.
• Follow through on any promises to act on the problem and then communicate what you have done.

Clinical complaints -­ consider acknowledging but do not respond online

If the complaint is about a clinical issue, you or your practice manager may wish to make a general online response apologising and acknowledging the concerns. Keep any online response very general, ensuring you do not breach patient confidentiality.

Request the website host remove the offending comments

If the review breaches the individual platform guidelines you may be able to get it removed. Typically guidelines cover areas such as offensive comments, hate speech, defamation, fake content and other forms of restricted content.

Platforms can vary in terms of how strictly they interpret their guidelines and how willingly they remove comments. Some take the position that consumers are allowed to express their honest opinions.

Generally we advise that you or your practice manager, as representatives of your practice, start the review removal process yourself.

The time a platform takes to review and decide whether to remove a comment can vary.  Please contact Avant’s Medico-legal Advisory Service (MLAS) on 1800 128 268 for further guidance on requesting removal of a review from an online platform.

Consider legal options

Unfortunately some doctors do experience online comments that go well beyond patient complaints. Sustained and co-ordinated attacks or abuse, online stalking or bullying, or other behaviours that make you fear for your safety may constitute cybercrime.

If you experience any of these behaviours there are a number of options available. These might include reporting to ReportCyber , contacting police, or taking out an intervention or protection order.

Online comments may also breach Australian defamation laws. However legal action for defamation can be difficult to win and difficult to enforce. Further, the defamation process will involve airing the negative comments and may actually increase any negative public perceptions. However this is an evolving area of law and always depends on the specific situation.

Dealing with adverse opinions online can be stressful. It is important to take care of yourself and seek support if you need it. Please see Avant’s Health and Wellbeing resources for more information.

For medico-legal advice, please contact us on nca@avant.org.au or call 1800 128 268, 24/7 in emergencies.