How to Manage and Prevent Negative Online Patient Reviews

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The reality is, if you have not had a patient post a negative review on one of the online rating websites like Google, Yelp, Facebook, and/or RateMDs, you will. I know that is not news you wanted to hear, but it’s going to happen.  Negative online reviews will usually have some kind of negative impact on your business, so it is important you and your team are prepared for them.  I say “usually”, since if you follow the tips outlined below, you may survive or even come out ahead.

Are online reviews important? The fact is according to Invesp, 90% of consumers read online reviews and 88% of them trust the online reviews as much as personal recommendations.

In this article, I am going to share my “real life” experience with online review sites and the negative reviews that come with them. For the first 5 years of my practice I was not on any review website, but with the proliferation of Facebook’s new “business pages” and “reviews” section, it was a matter of time before that changed. The fact is the demographic that uses Facebook is most likely your clinic’s demographic. If you don’t guide your practices ratings, someone else will! And the first rating may not be good!

If you already have a strategy to proactively get positive reviews about your clinic posted on the most popular review sites, you are way ahead of the game.  Here is how the math of “averages” works: if you only have one 1-star review, your average rating will be 1-star. If you have five, 5-star reviews and one 1-star review, then your average will be 4.3/5-stars (you would think it would be higher, but it’s not).  Luckily, most people discount the most negative reviews and the most positive.  However, we are also going to show you how to turn a negative review into a positive.

As the physician owner or clinic manager, this is your responsibility.  I love the title of Jocko Willink’s book Extreme Ownership, since the title is also the first lesson, and that it is always the leader’s responsibility. You always own the results of your team.

The first step is to find out why you are receiving this negative review. Later, I will discuss a method to prevent any future negative reviews from getting posted before you have a chance to “make it right.”

 

Why Are You Receiving the Negative Review?

There are typically two reasons for receiving a negative review:

(1) You have a problem in the clinic, either with operational procedures and/or your team, or

(2) Your number has come up, and it is your turn to get that “special” patient, where nothing you do seems to make them happy.

You always want to be looking at trends, or early warning signs of trouble; so it’s important to investigate every negative review. Your clinic staff may be doing everything right, but the patient flow at your clinic may not be right. For example, do you send a thank you note or email after each procedure? Are the staff wearing name badges, so the patient identifies with them?  Or simply do you have a process, where you ask the patient about the satisfaction of their procedure?

You may be surprised on what the negative reviews focus on, it could be they don’t like your hours, and wish you were open on Saturdays, or later on Thursdays. These reviews could lead to more business where you did not think there was an opportunity.

On the other hand, maybe the patient did experience horrible customer service at the clinic, and it is a team member’s performance issue that needs to be addressed.  You should have a standard set of values and customer service standards in which every patient should consistently be treated. These may include: calling the patient to confirm an appointment, smiling and calling them by their first name, or booking their next appointment before they leave.

You and your clinic staff need to be prepared and you need to have a SOP (standard operating procedure) in place for all the major procedures or processes in your clinic, including one for handling negative reviews.

 

How to Handle a Negative Review

Now that you have received the negative review, there are some steps you will want to follow so you can try to recover, and make it a win for the clinic.  Review these steps with your entire team beforehand; you want to be prepared ahead of time of the steps that need to be followed.

Step 1 – Breath

I know for me, as the owner of a clinic, when I receive a negative review, it is like they are attacking my child. It hurts, it seems nasty, unfair, and I want to respond in kind. Hold on!  This is the time where you need to understand those feelings are normal, and that is ok; but you now need to take a time-out and accept that you have this negative review. You may be angry with the person who made the review, but you may also be angry with your team. You may think “whose patient was this?”  Did they follow all the procedures?  What did they do that resulted in a negative review!

Your natural instinct may be to respond as soon as possible, but do not.  You have to remember that most reviews were written a few days prior to their actual posting, you do not need to respond to them just because it is now published. I’ve seen reviews written 5 or more days prior to them being posted. It is ok to give yourself a day or two to respond.

Again, this is not the time for action. This is the time to pause, and take 3 big deep breaths.

Step 2 – Stay Positive

Once you are calm, you will now need to accept the fact someone did not like the service they received at your clinic, and you will get to the bottom of the complaint.  Realize that every complaint is an opportunity for you and your team to do better, there are always learning opportunities with each negative review or patient complaint.

A negative review doesn’t mean that something went wrong or broke down, albeit in +95% of the cases it usually does. Some people have a negative outlook on life, and nothing can be done to make them happy. These are the people who have a negative energy, and bring a room down when they enter. When you have the combination of a breakdown of customer service at your clinic and a negative personality, you are going to need to be vigilant in maintaining your positive energy!

I love the best selling book The Four Agreements by Don Miguel Ruiz, in fact, I give it out to all of my employees when they start at the clinic.  The second and third agreements should be kept top of mind during this step: “Don’t Take Anything Personally” and “Don’t Make Assumptions.”

Step 3 – Investigate

I’d like to quote Columbo here, “just the facts ma’am, just the facts” however, I think I would be dating myself!  But that sums up step 3, you need to investigate, take personalities out of it, and get the facts (keep “Don’t make Assumptions” top of mind).  No one is perfect, so you can expect some combination of a clinic team or process breakdown, and a patient who is very angry to be at play here.

It may sound obvious, but in some cases, patients have posted negative reviews about the wrong clinic, so you will want to make sure this is in fact your patient.  As great as this may sound, it doesn’t happen as often as you would like. In other cases, it’s a competitor posting the negative review.

First, find out who the patient is.  They generally do not put their real name on the posting if it is Google, but many do if they post on Yelp or Facebook. Once you know who it is, pull up their chart and find out the procedure and read the notes.  As a side note here, it’s a good idea to take 20-30 minutes a month, and randomly pull up patient charts to make sure your team is charting properly with full notes.

Once you know who the patient is, you should chat with the provider alone, and get their story.  Then I would also chat with the patient care coordinator, receptionist and anyone else who may have interacted with this patient. Get your staff’s side of the story first.

Keep the following in mind, expect your team member, whether they are at fault or not, to be very emotionally invested in the review as well. If they are an engaged team member, it will most likely be devastating to them as well.   Just as you had to pause, breathe, and stay positive, you will need to coach them to do the same.  Also, this is a time to learn about their character, are they a blamer or do they take responsibility?

Step 4 – Make Contact

Now that you have all the facts from the patient’s chart and your staff, you will need to do something that perhaps will be uncomfortable, and that is to contact the patient. It is always best if the physician makes contact, not your team member, but in some rare cases you may have your clinic manager contact the patient.  The fact is most people respect the “white coat,” and if you make contact, it’s like being contacted by the CEO of a big company. People will be impressed, happy, and feel like they are being heard, more so than if the clinic manager contacted them (also it could that person who is part of the problem). It is not a good idea ever for the team member in question to be the one to contact the patient.

Physicians are already trained to listen more than talk, so again, just listen. Whether they are right or wrong, do not judge the patient. The patient needs to be heard, and have their concern acknowledged.  Many years ago, when I worked at Fairmont Hotels (I don’t think this is in the official training manual!), we had a saying “the guest is not always right, but they need to think they are.”  Keep this in mind during your interaction with the patient. Always acknowledge how they feel, it may not make sense to you, but it does to them, for example “I can see why you feel that way, if that happened, I would feel the same way.” And if necessary, you may need to apologize, “I am sincerely sorry for how you were treated, I will speak to the person involved, and we have already made changes to our check-out process to ensure this doesn’t happen again.”

The goal of this all-important step is for the patient to feel heard, have their concerns acknowledged, and have them come to their own conclusion to remove or update the review.   If they don’t offer to remove or revise their review, you may need to encourage them, “I think we had a great conversation, and it sounds like you understand that we have made the necessary changes to prevent this from happening to another patient, may I ask if you could remove or modify your rating?”

Often, the process ends at this step. However, if it does not, then you will need to go to Step 5.

Step 5 – The Response

If you did not do step 4, you need to go back and do it! Trust me, for most situations, contacting the patient will usually resolve the complaint and remove the negative review. If not, you are now going to respond to the negative review, and this will require a plan. Again, you may feel like the clock is ticking, but do not rush this part of the process.

The goal of your response is to show that you acknowledge the situation, apologize and make it right if necessary and you may also want take this opportunity to educate other prospective patients on the procedure.  This often happens with body sculpting procedures, for example, patients seem to forget it can take up to 3 months to see the full results, and that more than one procedure is sometimes necessary (even though they sign that they understand these facts in the consent form).

When apologizing, don’t apologize for a specific procedure or team member; be more general, “I am so sorry to hear about your recent experience at our practice.”  A first sentence that apologizes for the “experience” they receive allows the reader to interpret it in a more positive manner.

The goal is turn lemons into lemonade, not to attack or belittle the writer (even though you may want to!)  When crafting your response, always think about how you can turn the negative into a positive. Here are some tips when writing a response:

Tips for Writing a Response to a Negative Customer Complaint

  • Be positive and upbeat
  • Be understanding
  • Show fairness
  • Apologize when necessary
  • Show a resolution to the problem
  • Do not be accusatory
  • Do not attack the writer
  • Write it, leave it for a few hours, and review it
  • Have someone who does not have a vested interest review it
  • Google has more tips

Here is an example of a review that was posted and a clinic’s response:

1-Star Yelp reviewer, Cynthia:

Everyone in the front office was very nice here but I’m sorry I have to give a poor review. I purchased a Groupon for Laser Hair removal (bikini line). It was incredibly painful – I almost couldn’t endure it. The machine used is not good. I’ve been to another local spa for the same treatment and did not need the numbing cream because it was not painful at all (a breeze in fact). So I didn’t ask for it at #########. The nurse was just okay. Not very sensitive to my painful experience – I probably won’t go back even though I have 4 more sessions included on my Groupon. So I lost money on this too sadly. I cannot recommend Laser Hair Removal.

Owner’s response:

Cynthia, thank you for your comments. The laser we use is actually the newest on the market and the most effective. We offer 3 different numbing applications in case the patient is sensitive. Other lasers might be less painful, but may compromise the results. I recommend using numbing cream, because you don’t want to sacrifice results by using less power. Some places in our area are notorious for using lower power settings so you have to purchase more sessions. Our patients see results very quickly because our protocols are more aggressive, yielding better results without compromising patient safety.

Now, not every response is going to be perfect, there are always going to be some “improvements” that can certainly be made. The point is, don’t beat yourself up, you can always do better next time (or go back and “edit” your response).  A second point to this example is to stay away from daily deal sites like Groupon and Living Social, it is very hard to convert a Groupon customer to become a customer of your clinic.

 

Other Options

If the review written is untrue, potentially libelous, or done by a competitor, then you may contact the review sites and see if you can have them removed. We have found this rarely works. Often the reason is these review website companies have “paid services” to help you remove negative reviews (ie. Yelp), so it conflicts with their revenue model to just remove it without somehow charging you and not taking responsibility for allowing erroneous postings.

Another option is to contact a lawyer, but let me caution you. This can be an expensive option, and I’ve seen the person doing the negative review post the strongly worded letter from the lawyer. This can result in you getting the opposite effect you want, as others may think you are heavy handed and the one being unfair.

 

How To Manage On-Line Reviews

The first step is always to have a well-trained, customer-focused team at the clinic. As the owner or manager of a medical clinic, you want to know if your patients are happy. You need to always know the pulse of your clinic, and what you really want to know is will they come back and will they recommend us to their friends and family?

As I mentioned earlier, the best way to mitigate negative reviews is with a lot of positive reviews.  This is called “reputation management.” The question is how do you get these positive reviews?  And what about the patients who actually did have a negative experience?

There are many ways of doing this survey.  How you send out the survey doesn’t matter, but every patient needs to be surveyed after their procedure. Some of the ways in which you can send out a survey are:

One tip is to keep it simple, just ask one question like “would you recommend our practice to a friend or family member?” The answer is yes or no. If no, you need to follow-up immediately.

When we first started we just used a regular email, but that only went to patients who we thought loved us (the +4-star rating patients).  This certainly added some 4 and 5-star ratings to Facebook and Google, but what it didn’t do is prevent 1-star ratings.  With the recommendation of a physician, we choose a specialized software solution that asks every patient to rate us with 5-stars, and those who rank us highly (4 or 5-stars) get routed to a rating website(s) of our choice. And those who don’t, have an opportunity to “tell us why” and we are emailed the patients response.  The benefit with a dual system is that it allows us to find out issues at the clinic, and fix them, before they result in a series of negative reviews.

reviews-image_0The software I use is called, Reputation Stacker and for $99/m I think it’s a great value (disclosure: I have no financial interest in this software).  However, I am sure there are other software options available, and if you are aware of any, please post them in the comments! One negative aspect of using software like this, is that it does not interact with our EMR, and you will need to have someone at the clinic manually enter the patients name and email (or SMS text number).  It’s a bit time consuming for the staff, but hey, they are probably spending an hour or two a day on Facebook, so they can do this instead!

Whether you have a partially automated solution, utilize survey software, or old-fashioned email, the key to a successful practice of happy patients and a happy team is to have a process to survey every patient.  It is also important to let your team know that every patient will be surveyed, and use the ratings as part of the clinic’s performance numbers. When you tie it to their job or compensation, you will often see an increase in the customer review ratings.

The above section is part of the IAPAM’s Aesthetic Start-up Workshop. I hope these tips will help you with the “reputation management” of your clinic.  If you have any tips on managing negative patient reviews, please add them below!

 

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