It takes years to build a repuation – but that can be destroyed in the blink of a digital eyelid, with just one negative patient review. Find out the latest tips from our medical business consultants and medical marketing consultants, plus all the latest AHPRA advice for 2022 on dealing with negative patient reviews.

 

1 Don’t ignore it

“Firstly, keep in mind the public will also see your reviews and your responses – and they are looking for doctors to respond in a professional, empathetic and prescriptive manner, rather than using canned or one-size-fits-all marketing responses that often only invoke more ire,” says HBN medical practice growth strategist Russell Lee OA.
He says ideally it is important respond to a negative review within 24 to 48 hours.
Not to respond to a negative review may imply that you aren’t concerned about your reputation, or worse, if there’s no response, some readers may conclude the comments are accurate, he says.
“Also keep in mind that smaller businesses don’t get as many reviews generally, so just one or two negative reviews can taint the real picture of the typical customer journey.”

 2 Go to your medical indemnity insurance company

“A good starting point is to seek legal advice from medical indemnity insurance companies, while medical marketing companies who offer reputation management services can also offer practical advice in the first instance,” says Russell.
But he adds that if negative reviews continue, are particularly vicious or and/or appear targeted, it may be worth seeking private legal advice.

 3 Verify the review is “real”

First, find out if the reviewer is a real patient or not.
If you cannot find their profile name on your data base, Russell advises to take a leaf out of this reply a client posted recently, (which can be modified): 
 Dear (insert name),

“Unfortunately, we have no record or recollection of any patient experience fitting this account, nor can we verify anything about your identity in our records. If you were a patient at our practice, we would like to investigate this issue further, so please contact our reception on (insert email and mobile), so that we can address any genuine issues.” 
And he says if it is a real complaint – deal with it privately, not online.
“Other patients do not want to read long, complicated disputes and the patient’s privacy of course must be respected at all costs. So outside of an initial response it is recommended to take the engagement offline,” says Russell.

 4 Walk in the patient’s shoes

Is there a nugget of truth in what has been said? Before getting angry, ask other staff involved what went on, and create a clear timeline of the facts.
And if there was a mistake, aim to make amends by apologising for how the patient felt about their experience. 
Asking a patient to remove a review of a legitimately genuine negative experience not only has possible legal ramifications, but from a branding perspective, patients expect negative reviews and hundreds of “all perfect reviews” may appear suspicious, something known as the Pratfall Effect.
“This suggests that it’s good for brands to show their flaws occasionally and respond professionally, to engender trust,” says HBN’s Hanya Oversby, who is a podcaster for the successful Doctor Diaries podcasts and also has many medical clients in the cosmetic medicine space.
However malicious reviews are another story – again seek legal advice.

 Source: The Pratfall Effect on Brands

  5 Watch out for fake reviews 

“Increasingly fake reviews are penned by competitors, trolls, ex-spouses, previous medical students, or unethical operators and competitors,” says health journalist and marketing manager Jane Worthington from DigiMed Australia.
“These are all among the suspected culprits I have come across dealing with reviews in medical marketing over the years.
She says in some cases, these reviews were not only unfair, but untrue – resulting in devastating psychological consequences for the doctor or health professional.
In other cases, a negative review is written by a legitimate patient but may still raise some legal red flags.
“There may be a kernel of truth in one part the complaint, but much of the complaint might potentially tick the boxes for defamation,” she says.
“Whilst it often takes decades to build a reputation, that can all be destroyed in the blink of a digital eyelid, especially when 80% of patients use the Internet for doctor-finding health searches*

 

 Sources: *   Why doctors need a strong online presence – 80% search rate
Washington post – fake reviews making it hard to seek medical help

6 Understand when a review may be defamatory

“Whilst reporting a negative experience is one thing, defaming during the process is another,” says Jane.
“In one case a plastic surgeon was awarded $530,000 damages by the Supreme Court of NSW after a patient posted two genuine negative reviews.*
“In another case I was made aware of recently, a patient posted a negative review on a doctor’s website, complaining the doctor was late; that she did not get a cup of tea like other patients and that ‘the clinic down the road was 8 x better, cheaper and actually cared about their patients’”.
This potentially ticks the boxes for the major pillars of defamation in a single sentence, says Jane.
1 Firstly, there is a false statement purporting to be fact.  “8x better” is not fact. Nor is “they actually care for their patients.”
2 Secondly, to constitute defamation it must be published which it was.
3 Thirdly, for something to be defamatory the fault must amount to negligence – but being late, is arguably not negligent from the doctor’s perspective.
4 And finally, for something to be defamatory, the plaintiff must identify they have had damage or harm caused, but it could be argued there was no medical damage in this case.

* Source: Landers Legal Insights News

 7 Recognise that more doctors are standing their ground

“Third party review parties not under the doctor’s control are also coming under more scrutiny in recent times, with doctors increasingly looking to keep credibility intact,” says Jane.
Google was in 2020 ordered by an Australian court* to provide details of an IP address, while a Melbourne dentist was awarded significant damages after a patient left negative reviews on Google.

Additional Sources
* Judge allows Melbourne dentist to try new tactic to more quickly unmask negative online reviewer, ABC News
*  Judgment for negative dentist reviews. The Age 2021: $170,000 bad Google review, dentist wins payout

 8 Flag the review with third party sites (e.g., Rate MD or Google My Business)

Although third party sites don’t generally remove negative reviews (the whole point of the site is for patients to report their experiences), there are times when you can flag content as being fake, defamatory, involving impersonation or being “demonstrably inaccurate ” with third party sites.
Links at the bottom of this post include the most asked questions for patients and doctors for RateMD which includes removal of negative reviews along with other useful contact addresses for doctors who may be seeking to remove a negative Google review. 

9 Beware Positive of positive reviews too especially on your own Facebook

Positive reviews can be problematic too and in the past year, Facebook has allowed a disable comments on its settings. This means doctors are now liable for reviews on their own pages which they could not remove in the past.
That’s why the best approach to avoid AHPRA compliance breaches is to disable reviews on Facebook especially if that site is not constantly monitored some legal experts advise.
The upside to this is that while you may lose some positive reviews, damaging negative reviews do not have to be monitored or removed either.

To remove positive reviews on Facebook medical sites.

1 Click on Settings on your Business Page
2 Click on Edit Page
3 Scroll down to “reviews” and click Settings
4 Move the slider from “on” to “off”
5 Save your new settings

A spokesman for AHPRA says the regulator has published national guidance to help registered health practitioners meet their professional and legal obligations and these can be found within the  advertising hub on the AHPRA website.
“Practitioners who are still unsure about what they need to do to ensure they meet advertising requirements of the National Law are advised to contact their professional association or seek independent legal advice,” a spokesperson said.

10 Also be wary of positive reviews on websites you don’t control

Currently you cannot disable reviews on Google My Business or RateMD.
However, if the review states something like: “the results were truly amazing and Dr X made me look 10 years younger,” it is best not to reply.
Why? Because you need to ensure that you do not breach privacy or health practitioner regulations, regardless of what the patient has stated.
Also, if you respond to a review confirming the positive nature of the patient’s experience, you might be breaching the codee in other ways.
AHPRA also has a clear position on this stating that: “Advertisers are not responsible for testimonials published on a third-party website that they do not control.
“However, advertisers should take care if they choose to engage with testimonials on third-party websites as they may be considered using a testimonial to advertise a regulated health service, which is prohibited.”
So will AHPRA be specifically policing thrid party websites anytime soon?
An AHPRA spokesperson said that “resources determine that AHPRA does not currently ‘police’ specific flatforms such as review and ratings website on Google.”
However, the spokesperson adds: “If we receive a complaint and a practitioner is found to be in breach of the National Law’s advertising requirements, we will take the appropriate action.”

Article created by HBN’s Russell Lee and Tanya Oversby at HBN and Jane Worthington DigiMed Australia

Further reading

AMA and Google Reviews legal update
RACGP – Responding to online reviews
AHPRA—Guidelines-for-advertising-regulated-health-services.PDF
AHPRA guidelines about accidentally breaching patient privacy
Contact and support link for Rate MD to request negative review removal 
Google My Business for removal of review 
Most asked questions about removing Google reviews on Rate MD
Google Chat Support 

Disclaimer:  This cannot be taken as legal advice, it is based on many years working as practice strategists and in healthcare organisations with doctors, as well as health marketing and health writing in media and advertising.