Negative Reviews: the Proactive Online Physician

Negative Reviews and the Proactive Online Physician

Ours is a world of empowered consumers. Whether it’s sloppy service at the department store, or a nasty night of food-poisoning following one too many bad sushi rolls, customers the world over (or at least in the states) know that amidst any unpleasant consumer experience, they’ve got one final respite to make their voice heard: a negative online review.

Granted, a visit to the doctor’s office isn’t exactly the same as a quick trip to the shoe store, but with more and more patients adopt the role of “medical consumers” the lines between the mall and the medical facility, at least in the eyes of patients, are rapidly blurring. It shouldn’t come as any surprise either, that many of the online rating sites available to shoppers have their doppelgänger’s in the medical realm like Vitals, RateMD’s and the near-ubiquitous

What and Why do Patients Post Online?

A recent Medscape article (Top Complaints Posted on Doc Rating Websites) cites the observation of Ken Hertz, a principal with MGMA Health Care Consulting, that whether or not a patient’s complaint is warranted, what drives them online is the fact that their complaints can pull results that “they feel they couldn’t get otherwise.”

Denver-based research company Vanguard Communications scoured 3617 online reviews of 300 internists and OB/GYNs practicing in Austin, Denver, New York City and San Diego, specifically those who had earned the lowest ratings on Vitals, RateMDs and Yelp. Just more than half of the posts (53%) were negative. More precisely though, the study broke down the major complaints of disgruntled patients into three basic categories: 43.1% of these complaints dealt with a physician’s (lack of) bedside manner, 35.3% of these complaints cited poor customer service and 21.5% complained about a physician’s medical skills and/or surgical mistakes.

The Vanguard study works in tandem with research published in the Journal of General Internal Medicine in June 2012, with the general idea culled from the reviews being that a physician’s empathy tends to rank much higher in importance than how knowledgeable or clinically proficient they are.

Characteristics and circumstances that traditionally spur negative reviews are when physicians come off as ego-centric, condescending or uncaring, when they seem indifferent or unresponsive to any patient input or when they get easily frustrated or agitated at patient inquiries. Now, what patients might experience as “condescending” may in fact just be a misinterpretation of the physician’s demeanor, or perhaps an acute moment of stress or weakness in an overwhelming day, but these are the “red flags” that many patients will take online, regardless of the circumstances.

Other experiences that sour patients to the point of keyboard-crusading are long wait times, an unfriendly wait staff or other inconveniences perceived as being unnecessary such as having to come into the office for their test results instead of simply receiving them over the phone.

The reality is that many patients, emboldened by communicative technology and their own consumer-driven experiences. Where they once had to simply shrug off a negative consumer experience, relegating it to dinner time conversation, now they have a worldwide platform through which they can be heard.  

This is certainly not an attempt say that patients are inherently “right” in their reviews though. Just as an overloaded schedule, demanding or unruly patients and any number of unforeseen hiccups can sully a physician’s cheery outlook on the day, so too can patients let their own biases and circumstances discolor the rosy lens through which they write reviews. A routine office visit, punctuated by fussing children, unruly traffic and a crowded waiting room may be the real heart of the matter, and a physician’s minor social foible may be the back-breaking straw.

How Should Physicians Handle Negative Reviews?

Regardless of the thickness of our skins, the things people post online can still hurt. Couple that with the fact that negative reviews can detrimentally impact on business and that sometimes they’re not even really accurate and you’ve got a real nuisance on your hands.

Negative talk online can bring out the worst in people. Some physicians have even taken to suing patients over slanderous reviews. Unfortunately, these types of lawsuits tend to attract more negative attention to the physician than the patient, and the legal fees incurred can be astronomical.

Another strategy that some physicians might take is to have patients sign waivers promising that they won’t post online comments about the doctor. However, this strategy proves less than effective and may come off as needlessly aggressive. Though it may be tempting to answer naysaying patients directly on the online forum, even in a tactful way, these kinds of interactions can have unintended consequences which aren’t good for the physician and get into boundaries of privacy violations.

Proactive not Reactive

Kevin Pho is a board-certified, practicing internal medicine, co-author of the book Online Reputation: A Social Media Guide for Physician and Medical Practices and the creative force behind, one of the internet’s leading online sources for working physician voices.

As an advocate of physicians on social media, Pho encourages doctors to take a proactive stance to managing their presence online. By creating Facebook profiles, LinkedIn profiles and even by utilizing third party reputation management companies (like physicians can control the first few listings that come up when their name is Googled and also send a message to their patients that they have an online presence and they’re willing to engage with it.

What troubles many physicians about making the jump to working online is the time investment involved. How much time a physician chooses to devote to their online presence is completely up to them, but by having something basic, something that will come up when their name or practice is googled, puts them control. In fact, it may even be what can push stray negative reviews further down the listing so that internet seekers can actually get the “full picture” and not just something prompted by an angry patient. Some physicians may even find value in scanning review sites weekly, but setting up their own portals for patient engagement ultimately works in better favor for the physician.

Wary physicians might also put their fears to bed when they realize that for the most part, patient reviews veer to the positive end. Urmimala Sarkar, MD (a San Francisco Primary Care Physician and one of the leading researchers of the Vanguard study) notes that nearly 2/3 of the patient reviews (63%) said they’d recommend their particular physician or internist to a friend.

What makes things difficult for physicians is that often, the patients who do have a pleasant experience don’t take the time to get online and write about it. Instead, online reviews tend to be the domain of those who’ve had a bad experience and wish to grind their axe. In a Physician’s Office Resource Exclusive Interview, Kevin Pho suggested the proactive approach of directing patients to your site. He cites friend of his, a New Orleans Urologist, who literally hands cards out to each and every patient that he sees, and asks them to write a review of the visit on the site of their choice. By giving explicit directions and encouraging them to write, he’s already increasing the chances of positive reviews and actually renders the physician rating sites more useful. Instead of being spammed out repositories of disgruntled patients, they’ll actually show a true spectrum of patient experiences, good and bad.

Consumer-Based Medicine

Many physicians may be perturbed by the level of transparency that online reviews cast on them. If there is an influx of patient complaints regarding the front desk, it may be time to restructure it. If they’re complaining about wait times, there may be some efficiency issues. Regardless, the era of transparency is under way. The internet lends a sounding board to everyone, whether they’ve got anything to say or not. Rather than fighting the development, savvy physicians can use the power of the internet to improve their practices, engage with patients more efficiently and manage their reputation online, all before a negative review has even hit the web.


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