November 17, 2017

The tricky question of how doctors should respond to bad online reviews

Daily Briefing

    As health care consumers increasingly post doctor ratings online, hospitals and physicians have adopted a wide variety of strategies to address negative reviews, ranging from suing commentators for defamation to soliciting additional feedback, Casey Ross writes for STAT News.

    A thorny issue

    According to Ross, some doctors oppose the idea of patients publicly posting reviews, arguing that doctors—who are limited by federal patient privacy laws—are unable to fairly respond to negative reviews.

    Seeking out reviews

    To navigate such concerns—and in response to a wave of third-party review websites, such as Healthgrades or RateMDs—some hospitals solicit patient reviews as a way to put potentially negative reviews in context and encourage their doctors to improve, Ross reports.

    Hospitals that have adopted the practice include the University of Utah, which was the first hospital to post unedited patient reviews online in 2012, as well as Brigham and Women's Hospital, the Cleveland Clinic, Duke Health, and Geisinger. According to Ross, many health care systems allow doctors to look over the reviews and file an appeal with an internal committee to get the comments removed if they are unreasonable or unjust.

    Those who litigate

    Meanwhile, some providers have opted to sue individual reviewers for libel, Ross reports.

    Ross explains that while third-party websites are protected from liability for comments posted on their sites, reviewers themselves are not. For instance, Aaron Schur, senior director of litigation at Yelp, last year testified before Congress seeking greater protections for reviewers, explaining how his company regularly receives subpoenas from plaintiffs seeking the personal information of a Yelp user to press charges.

    For example, two freestanding EDs in Texas recently filed a legal petition to make Google provide the identities of 22 commentators linked to negative reviews of the EDs' services. In another case in Cleveland, a plastic surgeon has filed a lawsuit against a patient for negative reviews the patient posted online.

    According to Ross, the majority of such suits are settled out of court—the Cleveland lawsuit, which appears to be heading to trial, may be a rare exception—and in some cases, the threat of litigation is enough to get the reviewers to take down their comments. In his congressional testimony, Schur highlighted a letter from a Yelp user who deleted his negative comment about a dentist after the dentist sued him for $100,000—even though the user maintains the comment was accurate.

    'Reputation management'

    But Jeffrey Segal—CEO of eMerit, a company that helps collect and post patient reviews for doctors—said there are better ways to respond to negative comments than litigation, which can be expensive and risky.

    Segal advises providers to seek out comments rather than discourage them. "I call it the denominator problem," he said, pointing out that doctors who feel as if their reputation is being undermined should encourage all variety of comments. According to Ross, many other industries engage in this kind of "reputation management"—essentially hiring third-party firms like Segal's to solicit positive reviews and address negative ones. 

    Segal—who also founded Medical Justice, a firm to help physicians avoid frivolous litigation—said while lawsuits will likely continue, doctors should be careful. "Litigation is probably something that should be used sparingly, infrequently, and with full eyes open," he said. "There probably are occasional circumstances where it probably is (warranted), particularly if your practice is clearly damaged. But those are the exception. They're not the rule" (Ross, STAT News, 11/13).

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