Should practices respond or ignore patient reviews that are unfavourable? Medicolegal expert Sinead Lay advises on the best action to take
Online reviews posted about a practice that are negative can have a harmful effect on its professional reputation, patient trust and can be upsetting for practice staff.
In other industries, businesses can address criticism more directly and are not bound by the same professional, ethical, and legal constraints with regards to patient confidentiality. Not being able to challenge a review and put the practice’s side of the story forward can lead to a sense of helplessness.
In my role supporting healthcare staff with medicolegal matters, I have seen cases where the healthcare professional was alleged to have breached patient confidentiality when responding to a negative online review, resulting in a regulatory investigation. When such cases arise, they serve as a reminder of the challenges posed by online criticism and the potential consequences of engaging with it.
Below are some steps for handling negative online reviews in a measured and professional way, which may reduce risk.
Consider the feedback
First things first, it is important to carefully analyse the review to identify the key concerns. Some reviewers may highlight positive aspects of their experience at the practice alongside criticisms, making it important to consider both perspectives.
Investigate
If the reviewer is identifiable, review their call logs, and any relevant communications. Engage with staff members who have been involved in their care, particularly those mentioned in the review.
In cases where the reviewer is a relative of a patient, the concerns should still be investigated thoroughly. However, without explicit consent from a mentally competent patient, direct engagement with the reviewer should be avoided. If the reviewer remains anonymous, you should consider conducting an internal review in good faith to identify and assess any potential shortcomings.
Reflect
Following the investigation on the concerns raised, reflect on any identified deficiencies in care and consider if any improvements could potentially be implemented to prevent a recurrence.
Respond professionally
A professional, standardised response to any negative reviews can sometimes be an effective approach. It should acknowledge the review while maintaining patient confidentiality and offering an opportunity for direct communication. An example response could be:
‘At [practice name], we are committed to providing the highest standard of care. While we cannot discuss patient matters on public forums, we encourage anyone with concerns to contact us directly.‘
If the reviewer then chooses to get in touch, their concerns should be handled as a formal complaint in accordance with the practice’s complaints policy. If the patient is identifiable, consider following up via phone or in writing, acknowledging their concerns and outlining any steps taken to address them. A sincere apology for any identified shortcomings may also help rebuild trust. If matters are resolved, the patient may be asked to consider updating or removing the review, though it is important to note that they are under no obligation to do so.
Document the process
As with any complaint, it is advisable to maintain detailed records of the review, investigation, and any actions taken. Documentation should also be kept in a separate complaint file, distinct from the patient’s medical record. Keeping screenshots of the original review can be valuable for tracking and audit purposes.
Think carefully before engaging directly
Publicly challenging a reviewer’s comments is tempting, however it carries significant risk, particularly concerning patient confidentiality and data protection laws.
Any unauthorised disclosure of patient information – even writing something that confirms that an individual is a patient at the practice – without consent, legal obligation, or a compelling public interest justification, could constitute a breach of confidentiality. Responding to a negative review in a public forum may inadvertently reveal a patient’s identity or confirm their attendance, leading to potentially serious professional consequences.
Requesting a review to be removed
Requesting that the platform removes a negative review may seem like a straightforward solution, but several factors should be considered before attempting this:
1.Freedom of expression: Many platforms prioritise free speech and are unlikely to remove reviews unless they violate their content policies. Subjective opinions, such as ‘The doctor seemed rushed’ or ‘Avoid this clinic,’ typically do not meet the criteria for removal.
2. Potential confidentiality risks: Seeking removal may necessitate identifying the reviewer or confirming their patient status, and this could potentially breach patient confidentiality.
3. The ‘Streisand Effect’: This is where attempts to suppress information result in making it more widespread. In this case, the review may be perceived as an effort to silence criticism, prompting the reviewer to escalate their complaints across multiple platforms with increased severity.
If a review is inaccurate or misleading, in line with the platforms content policies, removal may be requested. However, any communication with the platform should avoid disclosing patient-identifiable information. Instead, emphasise the potential impact on patient care, such as deterring individuals from seeking necessary medical attention, as well as the business or financial implications for the practice.
Conclusion
While negative reviews are an unavoidable and frustrating aspect of modern medical practice, patient confidentiality must be considered above all else. Thoughtful investigation, professional response strategies, and meticulous documentation can help manage online criticism effectively.
Negative reviews can be distressing, but they also present an opportunity for reflection and improvement. A well-handled response can demonstrate a commitment to patient care, professionalism, and continuous development. Ensuring that each complaint or criticism is approached constructively can foster trust and credibility within the practice.
Furthermore, consistently delivering high-quality care and maintaining open, effective communication with patients can help mitigate the likelihood of negative feedback in the first place.
If in doubt, seek guidance from your indemnity provider, before taking action.
Sinead Lay is a case manager at indemnity provider, Medical Protection
