React in haste and you’ll repent at leisure

The increasing use of social media and prevalence of online review or comparison sites has provided patients with various platforms to comment on the care or treatment they have received at a private clinic.

We like to see positive comments from patients, but negative comments can be challenging. Dr Bobby Nicholas discusses how best to handle these.

Feedback in general can be useful in helping a doctor make improvements to the service they provide. 

But receiving negative comments can be challenging and even more so if unfair criticism has been published online in view of colleagues, patients and friends. 

And it can also be particularly frustrating if it is felt that there is no right of reply. 

The language used on social media and review sites can often be emotive and confrontational and is not what we usually expect in the course of spoken dialogue. 

This, together with limited safeguards to prevent patients from making unpleasant or factually inaccurate posts, makes it understandable that private practitioners are concerned. 

We at Medical Protection are often asked to provide support and advice for private doctors who feel 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 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 around the comments or issue.

When receiving such negative feedback, it is tempting to defend one’s reputation by engaging in a war of words with the patient via social media or website. 

Duty of confidentiality

But 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.  

Becoming aggressive or defensive is, however, generally an unhelpful approach, as it can often lead to more confrontation. Attempting to evidence positive comments or feedback may also backfire and instead engage other patients who were unhappy with some aspect of the service they received.

Doctors and clinic staff need to be ready to deal with online criticism and should use it as an opportunity to demonstrate they take concerns seriously and want to improve the care they provide patients. 

Good response

A good response will reflect well on the practice and will help to counterbalance the negative remarks that have been made.

For example, an effective response would express genuine disappointment that the patient did not have a positive experience and offer the opportunity to discuss the concerns in more detail offline. 

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% of patients tended to ignore negative reviews that seemed unreasonable or exaggerated. 

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

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.

Dr Bobby Nicholas (right) is a medico-legal adviser at Medical Protection