Enterprise Risk Management (ERM) Legal & Regulatory Technology

Handling Negative Internet and Social Media

More and more patients are using healthcare reviews and social media such as Healthgrades, Vitals, RateMDs, Yelp, Google + and Facebook to choose healthcare provider. That makes managing online reviews a key factor in maintaining a professional reputation and growing organizes and practices.

Negative reviews are a fact of life. We are all familiar with people who seem to enjoy complaining. Some patient reviews are sincere criticism, a difference in opinion, laypeople confused about clinical issues as well as comments that are defamatory and untrue. Ideally all reviews should receive a response. Here are suggestions about handling those less than kind comments.

  • Find out if you can make a response. Some social media sites do not allow removal of posts, corrections or rebuttals.
  • Know that if it is posted on your company’s website, Facebook page or any of your business’s social media sites, it can be deleted. But be certain this is your last resort.
  • Post a response. Respond promptly. Back when I was a malpractice claims manager, I always said an indefensible liability case was like a fresh fish: they both started to smell worse the longer they hang around. An unanswered negative review looks as though you don’t care or that the review is true. Try to make a response within a couple of business days.
  • Promote any changes you have made. If the negative review is valid and it drove the organization to make changes, herald that in the response. People sometimes complain or even file malpractice claims in the hopes that changes will be made so that what happened to them will not happen to anyone else. If a change is made, then the patient feels they accomplished something. Read the review and ask yourself if the patient might have a point and find a way to address the issue. In your response, acknowledge the problem and what you did to fix it.
  • Take a deep breath and carefully think before posting a response. It is easy to become unhappy about an unfair review and your first impulse may be to “set the record straight.” The last thing you want to do is get into a social media flame war. You see this happening with restaurants and it rarely reflects positively on the business. You never want your response to become the viral posting of the day or to be mocked on Twitter.
  • Consider consulting a public relations specialist to help craft some basic responses to potential negative social media activity. That way you have verbiage that was created in conjunction with a communication professional at a time when cooler heads prevailed.
  • Recognize that many negative reviews are more about feelings than facts. When someone complains about things such as wait times or fees, think about how to validate those concerns. Citing how your fees are usual and reasonable or your patient cycle time is less than MGMA averages are examples of countering emotion with facts. Instead, validate the concerns with statements such as “We are sorry it took so long for you to be seen.  I would be unhappy if I had to wait that long.”
  • Be aware of healthcare privacy laws. I have seen some situations that I have handled show up on social media and I know the patient’s version of events is untrue. But, unless you have the patient’s permission, you can’t post any protected health information in response. I usually contact the patient for permission, but it is rarely granted.

Unfortunately it has been my experience that a fair number of negative postings involve prescriptions for controlled substances. Complainants claim that providers have discriminated against them as pain patients or that the provider does not care that they are in agony. Often, when I review their charts, I see that the patient was receiving multiple prescriptions from multiple providers and that was the reason the provider declined to write additional prescriptions. Regardless of the patient’s motivation, I usually respond, “Because we respect the privacy of all our patients, I cannot go into the details of a patient’s treatment online. Based on our medical judgment, we were not able to meet the patient’s requests.”

When responding, consider reputation risks. Do you feel the need to get justice? Some providers have sued their patients for defamation based on an online review. There are organizations that providers can hire to manage their social reputation and even file suits against patients.  In some successful claims, the provider expressed a feeling of vindication while in others, the provider lost and had to pay their own legal bills and those of the patient. There is not always a cost-effective remedy to every wrong and sometimes you just have to grit your teeth and move on.

For your consideration, here is a typical response to a negative patient experience review I have used, “We are sorry you did not have a good experience with our practice. We try very hard to do a good job for all of our patients and sometimes we fall short of that goal. Because we respect the privacy of all our patients, we cannot discuss this situation online. Please contact us at (phone) or (email) and we can work together to resolve your concerns.” I have been pleasantly surprised that some patients do call and we have a civil discussion. If we are able to solve their problem, I ask them to modify their original post to reflect this.

Michael G. Lloyd, MBA, CPCU, ARM, CPHRM, with Medex Risk Management, has been involved in healthcare risk management, patient safety, healthcare quality management, professional liability claims, risk financing, compliance, property/liability/casualty insurance program design and administration since 1983 in the Seattle area.

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