From negative to positive

What should practices do if they are subject to potentially damaging online comments?

Facebook RECEIVING a glowing online review from a satisfied patient can be a welcome boost for hard-pressed practices. But with such positivity comes the inevitable negativity.

The following one-star review (which we’ve anonymised) recently appeared on Google about the treatment of a teenage patient, apparently written by his mother.

"Don’t even think about going to The XXX Dental Practice, shower of money grabbing butchers!! My 15-year-old son Darren just had his braces fitted with that idiot Mr B. He obviously doesn’t care how much pain he causes as long as he funds his Mercedes. Darren left the surgery crying, with braces cutting his cheeks and big bits of wire sticking out the back! Don’t even bother complaining to their sour-faced receptionist Betty. They couldn’t give a TOSS about hurting my son who is now terrified! DO NOT REGISTER HERE!!"

How could, or should, you respond to something like this?

First, it’s important to be aware of the various platforms where dentists and practices can be commented on and rated. Official websites include Care Opinion and NHS Choices, which allow moderated posts and ratings from patients and other interested parties concerning their healthcare experiences – both good and bad. Importantly, the healthcare provider in question has the right to reply to comments, a bit like Tripadviser, but bear in mind these responses will be monitored by the likes of the CQC.

Unofficial health ratings sites such as “I Want Great Care” provide a similar service and are worth regular monitoring. While not specifically healthcare related, social media sites Facebook and Twitter are massively popular and many dental practices have a presence on one or both. These can be useful for communicating important messages to patients but it may be advisable to ensure privacy settings do not allow patients to post comments to the practice feed, or that any comments only appear once moderated by the practice.

While you can take steps to control your own social media feed, you cannot fully control what others might post online about your practice. We have seen plenty of examples of extremely derogatory comments which the practice is often unaware of. A search for your practice or a staff member’s name will often reveal the extent of any problem.

So if you do come across a negative/abusive comment, how should you respond? This depends on the nature of the comment and whether it is substantially inaccurate and could be considered defamatory/libellous.

One option is simply to ignore the comments as the issue may quickly die down. If you do wish to reply, then you must resist the urge to post an angry rebuke, denial or insult as this will merely inflame the situation. Instead, aim for a more considered response which acknowledges the concern and signposts the individual to the practice complaints/ concerns procedure. At all times you must bear in mind patient confidentiality or risk referral to the GDC.

Going back to the scenario, this is a more serious issue as the claims made could be damaging to the practice’s reputation. It is not easy to simply ask for the removal of posts you don’t like, but social media sites such as Google do have processes in place where users can flag a post and request its removal if they believe it breaches the host site’s review policies (e.g. if it is factually inaccurate).

There is also the fact that patient “Darren’s” confidentiality has potentially been breached (albeit by his mother). The practice would have to consider notifying the patient about the breach as Darren is 15 years old and considered competent.

Google’s own rules state that they will consider removing online information which breaches an individual’s confidentiality, but they would be unlikely to respond to the practice as a third party. This means that the practice obligation is to inform the patient about the potential breach and advise them of the process for having the post removed themselves with Google.

So should the practice respond to the comments and allegations made in the review about Darren’s care? One option is to note the content and undertake an internal investigation to establish if there is any truth in the matters raised, i.e. treat it as an actual complaint. There is also a clear duty of care to practice staff as their employer to provide support where appropriate to the receptionist who has been criticised.

If the practice decides to respond directly to the post or contact Darren or his mother, this should be done in a professional manner, noting the causes of concern and directing them to the practice’s complaints process, perhaps with an offer to discuss and investigate the concerns. Again, be mindful of confidentiality and resist the urge to make angry counter accusations which could end up generating even more negative comments.

Alan Frame is a risk adviser at MDDUS