Responding to online criticism: Best practices for doctors

Ms Sinead Lay provides advice about how to handle negative reviews and outlines the risks of online engagement 

In an era where online reviews significantly influence public perception, doctors often find themselves scrutinised on digital platforms. Negative reviews can impact a doctor’s professional reputation, financial stability, and overall wellbeing while also affecting patient trust.

Unlike other sectors, where businesses can openly address criticism, doctors must navigate strict professional, ethical, and legal constraints that limit their ability to respond. This often leads to frustration and a sense of helplessness among healthcare practitioners.

Earlier this year, a doctor was alleged to have breached patient confidentiality in response to a negative online review, leading to a Medical Council fitness to practise inquiry. It was claimed that the doctor disclosed private and sensitive medical information while making derogatory comments about the patient. This case served as a stark reminder of the challenges posed by online criticism and the potential professional consequences of engaging with it.

Best practices for handling negative reviews

1. Review the feedback

Carefully analyse the review to identify the key concerns. Some reviewers may highlight positive aspects of their experience at the hospital or practice alongside criticisms, making it important to consider both perspectives.

2. Investigate the concerns

If the reviewer is identifiable, review their medical records, 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 friend or family member of a patient, the concerns should still be investigated thoroughly. However, without explicit consent from a 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.

3. Reflect on the findings

Following the investigation, reflect on any identified deficiencies in care and consider what improvements could potentially be implemented to prevent a recurrence.

4. 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/hospital 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 reach out, 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.

5. 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.

Avoid engaging directly with reviewers online

Publicly engaging with or challenging a reviewer’s comments carries significant risk, particularly concerning patient confidentiality and data protection laws. The Medical Council’s Guide to Professional Conduct and Ethics for Registered Medical Practitioners (ninth edition) underscores the importance of maintaining confidentiality, stating:

5.2 “Confidentiality is essential to maintaining patient trust and encouraging full disclosure about their health.

20.1 Professional standards must be upheld on social media, just as they are in other forms of communication.

29.1 Patient confidentiality is a core element of the doctor-patient relationship….”

Any unauthorised disclosure of patient information – even writing something which confirms that an individual is a patient at the practice or hospital – 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.

Unlike other sectors, where businesses can openly address criticism, doctors must navigate strict professional, ethical, and legal constraints that limit their ability to respond

Considerations for requesting review removal

Requesting that the platform remove a negative review may seem like a straightforward solution, but several factors should be considered before attempting this:

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.

Potential confidentiality risks: Seeking removal may necessitate identifying the reviewer or confirming their patient status, and this could potentially breach patient confidentiality.

The ‘Streisand effect’: Attempts to suppress a 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, and violates the platform’s content policies, removal may be requested. However, any communication with the platform should avoid disclosing identifiable patient 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, doctors must prioritise patient confidentiality 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 enhance 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 Medical Protection (or your indemnity provider) before taking action. By adhering to best practices, doctors can navigate online criticism while safeguarding their professional integrity and maintaining strong patient relationships.