If you’ve been practicing for any length of time, you’ve almost certainly run into a situation like the one recently reported by a doctor after reading a patient review on RealSelf.
The review, it turns out, was quite positive — the patient rated the surgery as “Worth It” and had given the doctor 4 out of a possible 5 stars — but it also included the patient’s opinions about the non-care aspects of her experience, which were not quite as glowing.
While happy with the outcome of my surgery, I found the doctor’s staff to be rude and disorganized, she wrote.
The doctor, in turn, wanted to post a rebuttal to clarify that his staff was well-trained and it was, in fact, the patient who was difficult to deal with, a course of action that raises two crucial questions:
Should a patient’s experience outside the medical care received be a factor in online reviews, and more important, what’s the appropriate course of action when you disagree with that patient’s perspective on their experience?
Given the complexities of the issue — the power of social media, the viral nature of the Internet, issues of patient confidentiality and free speech — there is no one-size-fits-all answer. However, if there’s a single takeaway from the above scenario, it’s the fact that patients and doctors often view their interactions through two very different lenses.
From a medical point of view, it’s all about the procedure and ensuring a successful outcome. From the patient’s point of view, the procedure is just one part — the most important part, to be sure, but still just one part — of an ongoing experience that starts with the initial contact and continues through any required follow up and the resolution of any issues.
In fact, according to a 2007 paper, “What Patients Want,” patient satisfaction is influenced by 7 key factors:
- Access to the physician
- Communication with and by the provider
- Personality and demeanor of the provider
- Quality of care
- Care continuity/follow-up
- Quality of facilities
- Office staff
Not only that but most complaints don’t have anything to do with the medical care provided. According to one recent study, “unhappy patients who post negative reviews of their doctors on the Internet complain about poor customer service and bedside manner four times more often than cite misdiagnoses and inadequate medical skills as cause for their dissatisfaction.”
Among the reasons unhappy patients cited for their dissatisfaction:
- 43.1% of complaints related to doctor indifference and bedside manner
- 35.3% were customer-service gripes
- 21.5% related to physician skill
In other words, the majority of negative patient reviews have nothing to do with the medical aspects of the care received. In such cases, it’s clear that doctors can respond without fear of violating patient privacy but the larger issue of whether they should respond remains an open question. And let’s face it, when a “difficult” patient makes claims that cry out to be countered, it can be hard to resist.
The fact is that whether non-care elements should or shouldn’t be part of online reviews is a moot point. They are and will continue to be so. The real issue isn’t what’s in a review but, rather, whether you should respond and, if so, how.
Consider the scenario cited above and 3 possible responses:
- Respond as proposed, pointing out that your staff is well-trained and it was, in fact, the patient who was difficult?
- Respond in a way that thanks the patient for their input and expresses regret for their dissatisfaction with their experience (even if you disagree with their comments)?
- Let sleeping dogs lie and not respond at all?
What would you do if the reviewer above was your patient?