Dealing with negative online comments

Dr Bobby Nicholas
Medicolegal Consultant
Medical Protection Society (MPS)
28 Jun 2021

The increasing use of social media and online reviews has made it easier for patients to comment publicly—on Facebook and Google reviews, for instance—on the care they receive. Positive comments are heartening for any healthcare professional to read.

Feedback in general can be useful in helping a doctor or a service improve. However, receiving negative comments can be challenging in any circumstance. Seeing unfair criticism online, in view of colleagues, patients and friends, can be even more challenging—especially if it is felt that there is no right of reply.

The use of social media is often associated with the use of emotive and confrontational language that is not usually expected in the course of normal spoken dialogue. This, together with the fact that there are limited safeguards to prevent patients from making unpleasant or factually inaccurate posts on social media, makes it understandable as to why doctors and practices are concerned.

In a recent Medical Protection Society (MPS) survey, a few doctors shared that following COVID-19 outbreaks in a hospital and a clinic, patients spread false stories online which led to fewer patients attending their appointments.1

MPS is often asked to provide support and advice for doctors who feel that they are being unfairly portrayed in online comments.

How a doctor responds to negative feedback can be an important factor in whether matters escalate. Some types of comments may warrant reporting to the website, although this does not prevent the person from simply posting the comments elsewhere.

Doctors sometimes feel that some negative feedback amounts to defamation. However, taking legal action over a comment needs to be considered very carefully, as this can risk inviting more attention and publicity in respect of the comments.

Duty of confidentiality
When receiving such negative feedback, it is tempting to defend one’s reputation by engaging in a war of words with the patient. However, doctors need to be mindful of their duty of confidentiality when responding to feedback on public forums. When writing in haste, in particular, it is possible that comments may inadvertently breach doctor-patient confidentiality.

It can also be tempting to become defensive and respond by saying that many other patients are happy with the service provided, or to try and provide a more balanced picture through evidencing positive feedback.

A calm and professional response helps
Doctors and practices need to be ready to deal with online criticism and should use it as an opportunity to demonstrate that they take concerns seriously and want to improve the care they provide patients. A good response will reflect well on the practice and will help counterbalance the negative remarks that have been made.

Becoming aggressive or defensive is generally an unhelpful approach and often leads to more confrontation. A more effective response can be to express disappointment that the patient did not have a positive experience and offer the opportunity to discuss the concerns in more detail. By resolving the complaint, the person posting the negative comments may choose to remove the comments themselves.

Bear in mind that if you think a comment is unreasonable or unfair, others may see it that way too. Informal patients’ surveys in the US found that 65 percent of patients tended to ignore negative reviews that seemed unreasonable or exaggerated.2

Similar US surveys found that almost one-in-five patients will disregard a negative review if the provider has responded in a thoughtful manner.3

A calm and professional response will come across well to others who may read comments and is the best way to try to resolve the patient’s concerns. Here are five steps that will help you provide a good response:
1. Although a prompt response is important, try to make sure the reply is calm, measured and not written in haste.
2. Thank the patient for his/her comments, acknowledge concerns he/she has raised, and apologize if appropriate.
3. Explain that you take all concerns very seriously, and that you will investigate the matter further.
4. Invite the patient to contact you, giving him/her specific contact details to arrange a telephone call or meeting. Consider using your complaints procedure to resolve any expressions of dissatisfaction.
5. Bear in mind your duty of confidentiality and do not disclose any personal information.

Finally, you should contact MPS or your medical defence organization for further advice if you are unsure of how to proceed upon receiving a negative online comment.

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