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Ionizing Your Online Reputation: Shifting Negative Reviews to Positive


What your patients are saying about you on the Internet can be critical to your success as a doctor in the 21st Century. Last year, the Pew Internet & American Life Project reported that 44 percent of Internet users look for information about physicians and other healthcare professionals online. That number was even higher (51 percent) for Internet users between 34 and 45 years of age.

Google your name. The first results will likely be physician finder sites like, Health Grades or Vitals, or broad-based service finders like Yelp or InsiderPages. You might be amazed by the patient reviews on those sites–both good and bad, true and false–about you and your practice.

These reviews constitute but one part of your overall online reputation–I’ll discuss the other parts in an upcoming article–but they’re an important one. A recent study published in the Journal of General Internal Medicine analyzed the reviews on Yelp and RateMDs for family and internal medicine practices in four cities. 37 percent of the reviews were negative. Since visitors tend to focus on the bad reviews more than the good, it’s important to look at all the feedback and address it appropriately.

To get a handle on the dos and don’ts of managing negative reviews in the healthcare field, I talked to Deborah C. Hiser, a specialist in HIPAA and Partner at law firm Brown McCarroll, and Joey McGirr, an online marketing expert with McGirr Interactive Communications.

What You Can’t Do

Never publicly discuss patient specifics. Although a patient can post anything they want about their visit with you, it is a major HIPAA violation for you to respond by saying anything about them. According to Ms. Hiser, you cannot publicly confirm or deny that they’re a patient of yours, much less share anything about their medical diagnosis or treatment. Most doctors choose to err on the side of caution and not respond at all, but if you do choose to respond publicly, be very cautious not to break this rule.

Never email patients without their consent. You might feel that a patient’s negative online comments warrant direct follow-up and want to contact them by email. But in many states, doctors need a patient’s written consent to communicate with them electronically. Unless you’re certain you’re not in one of those states or have consent, use the telephone instead.

What You Shouldn’t Do

Don’t respond when you’re upset. You take your business personally, so it’s easy to react defensively. But McGirr cautions you first to follow the 24-hour rule: “Doctors tend to surround themselves with smart people, so let it sit for a day and seek the counsel of others who can view the situation more objectively than you can.” A day later is the time to take any of the actions listed below, not immediately when the wound is still fresh.

Don’t get into drawn-out he-said/she-said discussions. There are several reasons for this. First, no one wins a back and forth battle about who did what to whom, and that’s especially true on the Internet where these dialogues are preserved forever. Second, search engines and review sites generally give more weight to newer content, making them more prominent in search results. This means that every time you reply to a comment you’re drawing more attention to the negative review. Finally, a response from the owner of the business validates the original comment in the eyes of the review site, making it much harder to have that review removed if that’s what you want to do. Let your advocates come to your defense for you. That’s more effective than defending yourself.

What You Can and Should Do

Pick your battles. The rest of this article suggests a few best practices, but the first thing you need to do is determine whether the review is worth responding to. McGirr points out that there are two kinds of negative reviews: “ones where the person doesn’t have a clue and sounds crazy because they probably are, and ones where the person has a genuine complaint.” Once you’ve let the criticism rest for 24 hours and talked it over with someone else, figure out how valid the person’s concern is and take the appropriate action, below.

Use the feedback to improve your practice. According to the Journal of General Internal Medicine article referenced above, most negative feedback has nothing to do with the doctor’s technical competence but rather the management of the practice itself. Criticism about the office staff, appointment access, and appointment wait times were very common, with 61 percent of comments about wait times being negative (compared to 75 percent of comments about time spent with the doctor being positive). Use these comments as a catalyst to improve your practice, coming from a place of genuinely wanting to do your best, rather than trying to game the system.

Craft a response that demonstrates a commitment to improvement. As mentioned previously, doctors need to tread carefully to avoid violating HIPAA. But one good reason to respond would be to update patients on changes you’ve made to the practice in response to their feedback. For example:

Because of privacy regulations, we can’t discuss any specifics about your comments. However, we want you to know that we are committed to providing high quality care and we take your feedback very seriously. Reducing wait times is one of the most challenging aspects of our practice, so we recently hired a consultant to help us improve our scheduling methods and avoid these kinds of problems in the future.

By posting a reply like that, you communicate to patients that you are listening, and are working to address their needs.

Reach out to the patient who posted the negative review. If you can identify the patient based on their comments, you can absolutely reach out to them by phone, says Ms. Hiser. And if you can’t identify the patient, feel free to post a public comment inviting the reviewer to contact you:

We apologize that you had that experience, criticalreviewer2012. We’re committed to providing the best experience possible for people, so please call our office and Dr. Smith will personally make this right.

If this is done appropriately, many reviewers will go back and change their reviews. Yelp reports “lots of success stories from business owners who were polite to their reviewers and were accordingly given a second chance.”

Get libelous reviews removed. Libel is defamation through the use of untrue words or pictures. If the defamation is severe enough to impact your practice, it’s worth your time to get it removed. Most sites will remove libelous posts if there’s evidence that the posted information is untrue; check the site’s Terms and Conditions section for contact information and procedures to do this. If that fails, discuss your options with a lawyer.

Encourage happy patients to post reviews. There’s no rule against asking patients to write an online review. Just don’t cherry-pick who you ask. McGirr points out that if all you have are 5-star reviews, people think you’re gaming the system, and most sites now have algorithms to remove suspicious reviews. Unfortunately, this can end up with valid reviews getting deleted as well, so rather than only ask the patients you suspect will write a positive review, contact patients (through their preferred, HIPAA-approved method) 48 hours after their visit and encourage them to let you know how you’re doing.

Online reputation management is an ongoing process. If you continuously monitor what patients are saying about you, and come from a place of genuinely wanting to know how you’re doing, it should be no problem to make the necessary adjustments to make sure your online reputation continues to be a positive one.

Blog thumbnail image created by Jennifer Morrow.

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About the Author

David Kassin Fried has been a freelance writer since 2006, specializing in corporate communications, business growth and development, technical documentation and more. In addition to his work as a business writer, David is a published author, a produced screenwriter and playwright, and an accomplished actor.

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