When reviews are not true
‘Business Dilemmas’
When reviews are not true
Dr Ed Farnan
Dr Edward Farnan, medico-legal adviser at the MDU, looks at how to deal with a negative online review
Dilemma 1
They have made false allegations
Q I work as a cosmetic surgeon. Yesterday, I discovered that a patient had published a critical post on an online review site.
In the review, the patient made a number of false statements against me and my colleagues.
What can I do?
A Patients are increasingly using social media and online rating sites as a tool to provide feedback about their medical care, which may include negative comments or complaints.
Some of this feedback may seem unjustified, misleading and, on occasion, may be offensive or abusive.
It is worth contacting your defence organisation for advice before considering how to respond.
Remember, should you choose to respond, it is important to do so positively and professionally to the post in a manner which does not breach patient confidentiality.
If you believe your reputation has been damaged online, your options include:
Responding to the comment;
Flagging the comment to the website and/or asking for the offending information to be removed;
Using the ‘right to be forgotten online’ to remove the page from search results.
However, all these approaches can be risky and it is imperative that you do not overlook patient confidentiality.
Responding to critical comments or attempting to have them removed can often be risky, counterproductive and add fuel to the fire.
In Confidentiality: responding to criticism in the media (2017), the GMC acknowledges that it can be frustrating for doctors to see inaccurate or misleading information about their diagnosis, treatment or behaviour, but says this ‘does not relieve you of your duty to respect your patient’s confidentiality’.
Respect confidentiality
Instead, you should respond positively by thanking patients for their comments, apologising if they are not happy with their treatment and asking the person to get in touch directly to raise concerns, while respecting patient confidentiality.
This approach is in line with the NHS complaints procedure, which emphasises the need to be open and honest with complainants and to learn lessons from complaints.
Attempting to have a post removed may inflame the situation and could prompt the person to re-post their comments on another site.
The GMC states: ‘Disputes between patients and doctors conducted in public can also prolong or intensify conflict and may undermine public confidence in the profession, even if they do not involve the disclosure of personal information without consent.’
It is important that colleagues seek to balance an occasional negative comment against positive feedback received.
A helpful response, acknowledging a patient’s concerns and inviting the patient to contact the practice, so that these may be addressed, presents a positive opportunity for the practice to demonstrate its professional approach to patient satisfaction.
Suspicion of abuse
Dr Ellie Mein
Dr Ellie Mein, medico-legal adviser at the MDU, explores medical professionals’ legal and ethical duties to patients who may be experiencing domestic violence
Dilemma 2
My patient may be abuse victim
Q I am a private GP and recently one of my patients came to me complaining of headaches, feeling tired all the time and having palpitations. She was tearful and admitted to feeling anxious and having a low mood.
She confided that she went to the accident and emergency department for a fractured zygoma following a fall down the stairs two weeks ago, and when I took her blood pressure I noticed bruises on her wrists.
How can I establish whether everything is OK within the home?
A It is estimated that one-in-four women in the UK will experience domestic violence. Medical professionals are often in a position to spot the signs, so it is important to be alert to the possibility of domestic abuse, aware of your duty to safeguard patients and to maintain confidentiality in such cases.
Safeguarding patients is especially important, as while GPs may pick up on signs of possible domestic abuse, patients may well be reluctant to confirm this.
In 2012, the Royal College of General Practitioners (RCGP) issued guidance on the development of a practice policy for managing cases of domestic abuse. The guidance recommends electing a senior person within the practice to identify and engage with local domestic violence support services and establishing a care pathway for people to access these services.
Also, remember that all members of the healthcare team have a duty to be alert to the symptoms of possible domestic abuse. Training should be provided to staff on how they should investigate the situation sensitively with patients and the steps that need to be taken in response to a disclosure.
It is important that careful records of such consultations are made, and that information should only be shared with the consent of the patient, unless there are safeguarding and/or child protection concerns.
Although cases should be treated on a case-by-case basis, the advice below is a good starting point:
Be alert to the possibility of domestic abuse in any patient;
Be aware of and follow local and national guidance on the identification and management of patients presenting with signs of possible domestic abuse;
Ensure that you have a clear protocol in place for dealing with domestic abuse;
Liaise with local services who offer support for victims of domestic abuse;
Consider the family as a whole if abuse is, or may be, present in the household;
Be mindful of your duty of confidentiality and seek consent for disclosure unless there is a compelling reason not to do so;
Seek advice if considering disclosure without or contrary to a patient’s consent.