Managing negative reviews

Most reviews are written in haste and never thought of again, and it is a sad indictment of modern society that a doctor’s reputation can be treated in the same way as a cold burger at a fast food restaurant.

Where do reviews appear?

Reviews can appear in many places, including Google Maps, RateMDS, Whitecoat and Facebook. Some sites allow you to “claim” your profile – but this doesn’t mean you have control over the reviews.

If your practice website or Facebook page allows reviews, you should view our advertising webinar. Positive reviews (or testimonials) under your control breach the AHPRA advertising guidelines and can be more problematic for you than negative reviews.

What can you do?

Your right of response is limited by patient confidentiality and protecting your professional reputation. If the review is sensible and genuine, and the therapeutic relationship can be salvaged, contact the patient in the same way as you would respond to a written complaint to the practice. The best way to address a negative review is for the patient to voluntarily remove the review.

Often the matter can’t be addressed offline because:

• you can’t identify the patient
• the therapeutic relationship is irretrievable
• the review is vitriolic and cannot be addressed sensibly. 

What happens if I respond online?

If the review appears on a website where you can “own” your page (e.g. Google, RateMDs), it is tempting to respond online. If you respond, we recommend any response should be neutral, such as “we take all patient complaints seriously so please contact the practice so we can resolve your concerns.” Anything further may breach patient confidentiality. The patient can talk about their medical problems in an open forum, but you could face an AHPRA or OAIC complaint if you do likewise.

You should never respond to a vitriolic review in kind. Negative reviews can be made worse by a frustrated doctor posting an angry response which harms their reputation more than the negative review.

How do I flag a review?

Each site has its own terms of service (ToS), and this is the best starting point if you intend to flag a review for possible removal. Most review sites won’t remove a review because you don’t like it.

Common ToS include:

• Reviews should be based on your experience and should not be a forum for general political, social commentary, or personal rants.
• Reviews should not contain obscene, profane, offensive language or gestures, or dangerous or derogatory content.
• You shouldn’t post multiple ratings for a single doctor.

ToS are updated regularly, so you should check the site where the review appears. If you mirror the language used in the TOS, you are more likely to have your request taken seriously.

What are the downsides to a written request?

It is important to be aware of services such as Lumen which “collects and analyzes legal complaints and requests for removal of online materials”. If you use inappropriate language, personally disparage the reviewer or disclose personal health information, you could end up on the receiving end of a complaint.

Is the review defamatory?

Defamation as a legal remedy is gaining traction due to some recent high-profile celebrity cases, but aside from being notoriously expensive and very public, there are some defences to defamation which are applicable to on-line reviews being:

• Truth or justification which applies when the comments in question are true or substantially true.
• Fair comment (the comment must be fair) or honest opinion (opinion be held honestly). Either must be made without malice.

Further barriers to an action in defamation include failing to positively identify the author, suing a website which is domiciled in the US or another jurisdiction where the laws differ from Australia, and a $20,000 excess on your policy.

Are there any positives I can take away from this?

Not all reviews are polite or helpful, but if you receive repeated negative comments about communication issues or wait times, the best way to prevent further negative reviews is to address the issue.

If the review is offensive or off topic, most people will simply ignore it. Consumers turn to review sites for genuine reviews which detail the negatives and the positives, so they can determine whether service might be right for them.

We know negative reviews are frustrating, but sometimes it really is better to maintain a dignified silence and focus on all the grateful patients who are happy with your care. Don’t waste your precious time and energy on the vocal minority – most consumers will prefer the opinion of a trusted friend or doctor over an ill-informed review.

Nerissa Ferrie
Medico-legal Adviser, MDA National