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Negative Online Patient Reviews

How to respond and what to expect when and if you do.

Oscar Wilde said there is only one thing worse than being talked about, and that is not being talked about. Mr. Wilde was an extrovert and a powerful wit, so it would follow that he enjoyed being in the limelight. If he were still alive, he probably would have reveled in the proliferation of social media despite the fact that almost anyone can publish almost anything about almost anyone without much recourse.

Healthcare providers are encouraged, if not required, to establish some type of online presence. Even if a healthcare provider has not established an online presence, numerous platforms exist for people to post comments and reviews regarding a particular healthcare provider. Unfortunately, not all reviews are positive, and some are downright false, so there is significant interest in learning how to manage those negative online reviews.

There are basically five ways for a healthcare provider to manage online reviews. First, the healthcare provider may choose to do nothing. Second, the healthcare provider may choose to contact the individual or source of the review in an attempt to resolve the issue. Third, the healthcare provider may - but as will be discussed later probably should not - respond online to the negative review. Fourth, the healthcare provider may engage a service to monitor and manage the healthcare provider's online reputation. Fifth, the healthcare provider may file a lawsuit against the individual that posted the negative review, or the website where the review was posted. The actual action a particular healthcare provider should take will depend on the facts and circumstances surrounding the specific negative review.

Healthcare providers may decide to do nothing in response to negative reviews. Never forget that deciding to do nothing is still a legitimate decision. An online review that is petty, nonsensical or irrational probably does not warrant any action. Patients that complain about having to wait when they show up several hours late for their appointments probably do not warrant a response.

Healthcare providers probably should at least attempt to contact an identifiable individual that has posted a negative online review. In fact, healthcare providers should at least attempt to address all legitimate complaints, not only negative online reviews. Most people discuss a negative encounter with their healthcare providers multiple times, and most people listen more intently to negative comments. A healthcare provider that can resolve an issue with a particular individual may convert the negative experience to a positive experience by professionally addressing the issue.

Healthcare providers should avoid responding online to negative reviews for numerous reasons. The most obvious reason should be patient confidentiality. Healthcare providers are required to maintain the privacy of confidential health information including the identity of a patient. Responding to a negative online review by posting an online comment could easily be a breach of confidential information. Additionally, individuals rarely carefully compose their online communications, text messages or emails. Very often, the responses that are sent in the heat of the moment cause more harm than good. A healthcare provider might consider posting a generalized comment, inviting anyone with a complaint to contact the healthcare provider directly so that the healthcare provider can attempt to address the complaint or concern.

Healthcare providers may decide to engage a reputation management company or consultant to scrub the healthcare providers' online reviews. Reputation management companies and consultants cannot actually eliminate negative content. Instead, those companies and consultants are usually able to modify search engine results so that negative information appears lower down in the search result. A reputation management consultant may also function in the same capacity as a public relations firm by assisting a healthcare provider in mitigating the consequences of an extremely egregious incident.

Lastly, healthcare providers may want to file a lawsuit for defamation against the individual that posted the negative review, or the website that provided the platform for the negative review. In reality, the idea of filing a lawsuit is probably the first reaction most healthcare providers have in response to negative online reviews, but filing a lawsuit is generally a bad idea for several reasons.

The elements of a defamation lawsuit are difficult to prove. A healthcare provider would need to show that the negative review was false, maliciously made and caused actual damage to the healthcare provider. Additionally, there are numerous defenses available to the defendant in a defamation case. For example, the websites that only provide a platform for individuals to post reviews are usually immune from any liability unless the website actually created the offending content. The individual that posts a negative online review may also be protected if the review is considered opinion. Even if the lawsuit is successful, the individual responsible for the negative review may be judgement proof.

Defamation lawsuits are fact intensive and difficult to prove, so the expense of the suit can be enormous. Furthermore, many states have enacted anti-SLAPP laws that may backfire on the individual pursuing a defamation lawsuit that is not well founded. SLAPP stands for strategic lawsuit against public participation and describes frivolous lawsuits that are intended to stifle or intimidate critics of a particular individual or issue by overwhelming the critic in expensive litigation. Anti-SLAPP laws allow the victim of a SLAPP lawsuit to seek the early dismissal of the case, and allow the victim to collect reasonable attorney fees.

Healthcare providers should carefully consider what if any response is required for a negative online review. Very often, a healthcare provider is able to resolve a negative online review by contacting the source, and professionally addressing the concerns raised in the review. Hastily responding in kind to a negative online review is almost universally the worst option for responding to a negative online review.

Michael L. Smith, JD, RRT is board certified in health law by The Florida Bar and practices at The Health Law Firm in Altamonte Springs, Fla. This article is for general information only and is not a substitute for formal legal advice.

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