When Good Doctors Get Negative Online Reviews

Negative online reviews are often what happens to good doctors when “The operation was a success but the patient died.”

It’s a classic old medical joke about the so-called “Harvard death”.

But in an era of ubiquitous online reviews, it’s not so funny when a doctor or other health care provider does all they can, yet still achieves a less than satisfactory outcome and is left facing the wrath of an outraged Yelper.

Or maybe it was just slow WiFi or old magazines in the waiting room that drew the online ire.

A lot of very good doctors, dentists, and other healthcare professionals are struggling to adapt to a new reality where patients turn to RateMD, Yelp, Vitals, and similar sites to review and rate their caregivers as if they were restaurants.

Yelp Healthcare Provider Reviews

And those reviews do matter.

Research by Thomson Reuters FindLaw reveals that 59% percent of people report using online reviews when choosing a professional service provider such as a lawyer or doctor. Nearly three-quarters (71%) of Millennials and half (49%) of Baby Boomers have used consumer reviews of professional services.

When it comes to online reviews, it’s a confirmed diagnosis of “We have some good news and some bad news.”

Fighting Negative Online Reviews Can Yield Negative Real Life Outcomes

When a caregiver has an online presence, negative comments inevitably pop up, as they will in any type of review stream, and some understandably outraged and frustrated professionals wade into the online fray. But publicly responding to negative reviews can lead healthcare providers onto thin ice.

It’s sad to see a highly educated professional reduced to arguing on the Internet. Worse yet, responding in this way brings a risk of violating HIPAA, the Health Insurance Portability and Accountability Act regulations that protect the privacy and security of patient medical information.

When a patient blamed a Washington State dentist for the loss of a tooth, the dentist fired back with “Due to your clenching and grinding habit, this is not the first molar tooth you have lost due to a fractured root.”

A chiropractor in California answered a mother’s claim that her daughter had received a false diagnosis of scoliosis by reminding her that “You brought your daughter in for the exam in early March 2014. The exam identified one or more of the signs I mentioned above for scoliosis. I absolutely recommended an x-ray to determine if this condition existed; this x-ray was at no additional cost to you.”

While arguably fair, responding like this is a tactic to be avoided. An examination of more than 1.7 million Yelp reviews by the non-profit public interest investigative journalism firm ProPublica revealed over 3,500 1-star reviews that mentioned HIPAA or privacy. In many cases, provider responses to complaints about care evolved into disputes over patient privacy.

The end result can be a HIPAA violation investigation by the U.S. Department of Health and Human Services Office for Civil Rights.

Other efforts to counter the effect of negative reviews are neither productive nor satisfying and also carry the potential for doing more harm than good.

A Seattle doctor ended up suing a woman after she wrote a dramatic Yelp posting claiming she almost died from a blood clot in the leg when her skiing knee injury was misdiagnosed in a Bellevue, WA emergency room. There is some precedent for businesses or service providers prevailing in lawsuits against posters of false and defamatory online reviews. However, as in most doctor versus patient lawsuits, the Seattle case was dismissed. But not before the doctor was dragged into far more financial damage and negative exposure than would have been caused by the original review.

Medice, Cura Te Ipsum

Physician, heal thyself. Doctors are especially vulnerable to negative online reviews. They do not serve customers or consumers. Doctors take care of patients, and are bound by oath to do the best they can to preserve and protect their patients’ health.

Even good doctors often need to do things that can make people unhappy.

Doctors may have to tell people they are too fat, point out poor lifestyle choices, or refuse to prescribe patients the narcotic pain killers they want. All healthcare professionals regularly deal with complicated situations that are difficult for patients to understand and comment accurately on. Caregivers also face the ever-present potential for unfortunate outcomes that are beyond their control.

At the same time, HIPAA restrictions, ethical concerns, and professional standards limit the ability of healthcare professionals to respond to online reviewers.

Nevertheless, as a recent article in Medscape points out, “Today’s Yelpification of doctors and healthcare is here to stay. Websites are proliferating like bacterial spores, enabling anyone—whether you’re a patient or not—to review doctors.”


The Medscape article has an interesting take on the three common types of negative online reviews received by physicians:

  1. “Crazy person”: The review is overly sensitive, over-reactive, and unrealistic, but could influence people.
  2. “Medical competence”: The reviewer complains about a misdiagnosis or medical error, casts doubt on the physician’s medical competence, or believes that he or she did not get the right tests or medication.
  3. “Nuts and bolts”: The review runs the gamut from office décor, staff attentiveness, doctor lateness, bad coffee, loud music, lack of WiFi, outdated magazines, cleanliness of the bathrooms, and more.

A constructive way to approach this list is to think of it as a list of symptoms. When viewed this way, only one of the three review types indicates the possibility of a serious and difficult malady.

Number 1 is a statistical effect that arises from the doctor having contact with the public at large. Any business with a review stream can and usually does suffer from it. The best treatment is to leave this type of review alone. Simply keep it covered with a far greater number of positive reviews.

Number 3 is caused by aspects of the caregiver/patient relationship that are easily controlled by the provider. It is not too difficult to manage the customer service side of healthcare. Look to the efficiency and professionalism of office staff, user-friendliness of appointment management systems and wait times, upkeep of facilities and equipment, and so forth. Putting some effort in here could pay significant dividends on relatively minor investment. In fact, according to Aaron Schur, senior director of litigation at Yelp, most reviews of doctors and dentists don’t concern the actual care delivered. People tend to complain about bedside manner, wait times, office staff, or billing procedures.

Number 4 arises from factors beyond the scope of this generalist overview. It may be an indicator of the layman’s view of proceedings that most patients hold. However, they comprise part of a trend, the ethical healthcare professional should view complaints of this sort as a call for careful reflection on practice.

Good Doctors Use a Minimally Invasive Approach to Handling Negative Reviews

Good doctors encourage their patients to write reviews.

The vast majority of the reviews patients post about their doctors constitute positive public accolades. Reviews also provide good doctors with useful feedback on what is being done right with the practice and what might need some adjustments. The wisdom of the crowd, accumulating over time, is far more credible than any single individual response. Finally, attempts to restrict patients’ freedom to post online reviews are unethical and possibly illegal.

As for the negative reviews that will almost surely appear, a web search quickly uncovers numerous articles that recommend supposedly effective ways to respond. You can find them on reputation management company websites and even on health care specialist sites.

However, a more rigorous analysis supports maintaining professional objectivity and engaging the sources of negative online reviews in a systematic fashion offline, impersonally, and supported by legal advocacy if necessary.

Avoid joining websites to respond to reviews – subscribing to such services may involve agreeing to a legally enforceable contract and/or waiving your rights to sue for defamation or take other courses of action. In any case, resist the urge to engage in defensive online arguments that are undignified often serve only to amplify the reviewer’s complaint.

Lawsuits should only be considered in extremis and in very clear-cut cases of defamation. Litigation takes years, draws increased negative attention, and in the case of doctor vs. patient suits, comes with an increasing body of precedent for failure to favor the plaintiff.

Embrace proactive rather than reactive responses to negative online reviews. Use websites, blogs, and social media sites to disseminate positive information about yourself and your practice. Combine this method with campaigns designed to boost your positive review stream until it buries any negative comments that show up on search engine results pages.

Work to let patients know they are heard and try to keep things in-house by establishing internal complaint/grievance procedures. Make feedback forms available and distribute surveys to provide forums where patients can immediately express their opinions. This may steer them away from posting negative reactions online.

When issues do come up, address the situation directly and compassionately. This has the potential to convert a negative review into a positive effect on your practice by improving your standing with patients. Patients may also edit or delete a negative review when they know their concerns have been heard.

Good Doctors Use Online Reviews to Promote Their Practices

In a recent New England Journal of Medicine article, Vivian Lee, MBA, MD, PhD notes that patient reviews are a source of valuable performance feedback that can help clinicians learn and improve. Reviews are data, and when physicians accept the validity of the data and become receptive to performance feedback, a culture of learning and patient-centeredness is facilitated for the practice.

When the correct strategies are employed, negative reviews can be greatly reduced. The few remaining can be used to produce nearly as much value as positive comments.

Busy healthcare providers seeking to leverage the full power of a strong online review stream will find it far more convenient and efficient to deploy professional review management tools. This is the best way to stay on top of reviews across all of the important review websites while maintaining strong communication links with patients and remaining at a distance from stressful and potentially risky interactions over negative online reviews. It’s the remedy good doctors choose when dealing with negative online reviews.

Handling Negative Online Reviews of Your Employees


Online reviews can be an extremely beneficial component of your marketing strategy. But, as always, the good comes with the bad, and negative online reviews will come in from unhappy customers. Fortunately, there is a wealth of advice and strategy available to help business owners deal with negative reviews.

But what about cases where reviewers direct their ire at specific members of your team, identifying them by name in critical reviews?

As a business owner or manager, you may feel torn between two very real demands: the need to serve the customer and the success of your enterprise versus the equally important imperative to support and develop the human resource backbone of your operation.

We strive to work as if the customer is always right. Yet, without a positive, productive work force, there would be no business to provide products or services and draw the customer in the first place.

It looks like a chicken or egg question. Which one should come first? You cannot fully support one side without alienating the other. What kind of moves will let you come out unscathed and with everyone better off than before?

Handle Negative Online Reviews Like a Boy Scout

Negative online reviews boy scout image.

And that means “Be prepared.” You should be working to respond to every review. Certainly, any type of negative review absolutely requires a response. And that needs to be an authentic, sincere response, not a canned, generic reply.

Once you accept that you are going to be responding to negative online reviews, it makes sense to get organized with a policy and a plan ahead of time.

First, decide who will respond. Maybe you have a dedicated social media person who handles all aspects of the review stream both positive and negative. Or maybe negative reviews get sent up to a manager. What about applying different strategies to various types of negative online reviews? For example, a complaint about cold coffee might be handled on the spot, whereas negative feedback about an employee gets sent “upstairs”.

Next, decide how to respond. You could anticipate potential negative online reviews or use past experience to help in building a response framework that allows for a variety of events including complaints about employees. Sure, no two situations are going to be alike, but having basic procedures in place ahead of time will communicate fairness and help prevent giving the impression of knee-jerking to either side – customer or employee – when the time comes.


Negative online reviews escalator image.

Negative online reviews can stir up a lot of emotion, and it is important to remove that emotion from the mix. You don’t want to make the wrong decision while upset, and you never want any sort of altercation or argument with a customer or employee. If a review has made you angry, take some time to recover. Then consider the situation calmly, review the policies and plans you have in place, and decide on a tentative course of action.

Reach out to the customer with a show of care and concern. Apologize if that is appropriate, make amends if possible. Indicate that the situation is being looked into and things are being changed so the same mistakes will not happen again. Ideally, you can reach a point of closure with one contact, leaving a happy customer who will author no more damaging posts, maybe revise the initial post, and possibly even return to your business.

If the customer or the situation calls for follow-up communication, keep it along the lines of “We have successfully resolved the situation and hope to earn the privilege of your trust again. If you have any other questions or concerns, please contact us at…”

Do not offer more than two public responses to any poster. Although there are customers with valid problems, there are also plenty of trolls and bullies who are simply looking for a public fight. Going to private communication mode should shake most of them off.

Regarding your employee, any complaint or conflict calls for at least making contact by email and indicating your availability to discuss the matter and answer questions. In all likelihood, the employee or employees in question will be aware of the situation before you make contact. Again, have a range of stock procedures and responses in position and be sure that employees are familiar with them. Use your judgment of the situation as a whole to guide you in taking action. Remember, you are trying to communicate fairness and balance in your approach to handling both customers’ and employees’ concerns.

Get to the Heart of the Matter

Continuing the de-escalation process, move from the “who” to the “what” of the situation. We will assume that your customer is making a valid point about their interaction with your employee and is not just a troll or other angry type. In the same vein, if hiring procedures are effective, your employees should be quality people who do their best. It would be rare to find the employee totally at fault.

After responding to the initial fire, you need to find out what the real problem is and correct it. Let’s look at a few common causes of friction between customer and employee.

Missing or unclear procedures. Today’s customers tend to expect instant gratification in most aspects of their lives. Interaction with your business and its customer service personnel is no exception to this rule. If a situation arises that is outside of an employee’s training and experience, they may not be readily able to satisfy the customer’s expectations. Look at this example from the Bellevue, WA Home Depot:

Negative online reviews Home Depot image 1

This negative review resulted from a simple lack of procedural coverage and employee training. The situation could well have been foreseen and prevented, but is easy enough to correct with some clarification of procedures and appropriate training. This example also shows the value that negative reviews can offer as they  highlight situations that have not been accounted for in procedure design. A manager’s proper response is to take responsibility, apologize, and ensure the customer that the omissions in procedure and employee training are being corrected.

Error chains. Giving a customer the impression of insult after injury is a sure way to draw online outbursts of aggression and frustration. The error chain is another variety of procedural failure. It is up to the manager to break the chain before it results in an accumulation of negative review posts.

Negative online reviews Home Depot image 2.

In this case, an initial mishap has resulted in an unsatisfied customer. Instead of ensuring closure of some type when a problem first arises, the employee sets in motion what appears to be an endless daisy chain of unproductive interactions between the customer and the business.

Proper intervention and response to the customer at the first breakdown of service could have broken the error chain and brought closure to the situation. Also note that the problem in this example implies the potential for some type of criminal behavior. The attention of management is certainly called for at this point.

Here again, the emplacement of effective procedure and corresponding employee training is indicated. When multiple employees seem to be failing a customer, structural problems should be considered. Are you understaffed to handle busy periods? Are employees overworked or under-trained? Address the problems, and indicate that you are doing so while apologizing to the customer and doing what you can to make amends.

Unmet service expectations. When customers do not get the level of customer service they expect, you can expect frustration and conflict to arise.

Negative online reviews Home Depot image 3.

Assuming the paint department employee in question is reasonably dedicated and competent, this review points once again to potential failures in procedure and training. Structural problems may also be indicated. Is the department sufficiently staffed with well-trained personnel? Are facilities adequate to handle multiple orders at once? Are the employees overwhelmed during busy periods?

This final review is a good encapsulation of themes that run through all of these and most other negative online reviews involving customer/employee interactions. Customers have certain expectations that need to be met.

Expertise – Customers expect staff and sales team members to be expert and efficient at their work. Particularly at a business like Home Depot where many consumers are looking for technical solutions and advice in implementing them.

Attention – Customers want staff to focus exclusively on their situation and needs without distraction. Service and follow up work should be consistent and complete, ending only when the customer is satisfied.

Caring – Employees must be ready, willing, and able to take sincere interest in customers’ needs. As can be seen in these reviews, if a customer gets the impression of being run in circles, brushed off, or belittled, the online backlash can be fierce.

Customers and Employees Both Want the Same Things

If you set your operation up correctly, negative online reviews can be minimized and there will be no real need to choose between customers and employees.

Customers expect expertise, employees need it and enjoy having it. Being competent removes stress and makes an employee’s job far easier. As an owner or manager, you have the ability to administer the training and development that will empower your staff with expertise.

Employees want to feel that management is attentive to their needs and overall job satisfaction. If you run an operation that is too large to allow personal relationships and communication with your staff members, but not large enough to run a dedicated HR program, consider creating an employee representative or staff liaison designation. Then implement a plan to let employees know that management is willing to listen, be attentive to their needs, and supportive of their search for satisfaction and fulfillment in their work.

When you have the attention piece in place for your employees, it will be generally apparent that a caring workplace is being created. Extras like open and transparent lines of policy-making and communication, recognition and rewards for jobs well done, respect for the honest needs of parents and other caretakers, and the occasional company-wide social get-together will help you earn appreciation and best effort from your staff.

It’s Up to You

As a manager or owner, you must take responsibility for responding skillfully to the needs of both customers and employees.

Giving your employees what they need will position them to meet your customers’ needs more effectively. This will immediately reduce the occurrence of customer/employee conflict and ensuing negative online feedback.

When negative reviews do come in, apply the proper strategies to respond to the customer and remediate the root cause of the problem. Use the opportunity to identify and eliminate the glitches in your operational procedures one by one. This is the sure way to put an end to negative online reviews and build a stellar online reputation for customer service.