Responding to online practice criticism

Risk adviser Kay Louise Grant offers advice on handling unfavourable online comments.

  • Date: 22 June 2022

SOCIAL media offers many potential benefits for practices, including health education and keeping patients informed about services. However, it is not without some perceived downsides, including potential negative feedback or comments.

People may express dissatisfaction about service provision, posting either directly onto the practice social media page or on their own personal pages. They may also post negative reviews on web-based directories, such as Google reviews, or even official NHS patient resources.

Unfavourable online reviews have become particularly prevalent over the pandemic. Even with restrictions now easing, many GP staff and the practices they work for are subject to ongoing negative comments and even online abuse.

A common public misconception is that practices have been “shying away” from their duties, and often this is down to a lack of awareness of the restrictions to patient access that guidance has placed on practices during the pandemic. Other common complaints include delays or perceived lack of access to their preferred GP, fewer face-to-face appointments and increased use of remote consultations, and delays to treatment or referrals to secondary care.

Regardless of the reason behind such comments, the GPs or staff identified in such posts can be left feeling helpless and unsure of how to respond.

Take time and reflect

A practice may not even be aware of an adverse post until it is brought to their attention by another patient or staff member, or the individual who made the comment, now wondering why there has been no response. It is natural to feel upset or defensive about negative online feedback, and the knee-jerk reaction may be to reply immediately to the post to set the record straight.

However, it is best to take time and reflect. Replying rashly to such posts can risk breaching patient confidentiality, appear unprofessional or indeed confrontational and could be in breach of regulatory guidance.

Embracing feedback

It may also be tempting to simply switch off the ability for patients or followers to make comments or leave reviews on the practice social media page, but this could give the impression that you don’t welcome feedback or suggestions. Remember that patient feedback, even if negative, can be viewed as an opportunity to learn and make positive changes where indicated.

When organisations proactively encourage feedback they often find that positive comments outweigh negative ones. In 2013, the NHS launched the Friends and Family Test (FFT) to help service providers and commissioners in England understand whether patients are happy with the service provided, or where improvements are needed. Patients are asked to provide feedback and organisations are encouraged to submit these comments on a monthly basis to NHS England. Millions of patients have completed the Friends and Family Test and around nine out of 10 comments are positive.

Collecting feedback in this way may deter patients going online to post feedback publicly, leaving you wondering what to do next and whether or not to post a response.

Practical advice

MDDUS often receives calls from GP members seeking advice on how to deal with adverse comments online. Before deciding how to respond, practices must consider the particular circumstances.

No response

If you feel that posting a reply will only make matters worse or spark a wider debate, it might be better to note the comments and leave well alone. A critical comment of you or the practice might also be considered fair and legitimate and that should trigger reflection and possibly a debrief involving the wider practice team. It takes resolve to handle criticism in this way but it should be recognised that in some situations, responding defensively will only make matters worse and cause more issues longer term.

Replying to the original post or comment

This may be the preferred option for practices responding to comments on their own social media profile. Our advice here would be to limit any response to a simple acknowledgement of the concern, providing a link to your practice complaints policy. You should not go into any specific detail about the patient making the comment. You could engage with the patient using a confidential channel, such as a direct conversation, but we advise against contacting the patient via private messaging on their social media page. This will avoid putting your own privacy and boundaries at risk and also prevent any conversation being taken out of context, for example by someone sharing a screenshot that makes it appear as though you are not being transparent.

An example of this type of response might be: “I am sorry to hear you have had a poor experience and I would like to suggest that you contact me to discuss how we may resolve this matter for you.”

Provide the practice contact details and suitable times for them to make contact. Responding in this way helps the patient feel their feedback is valued and that you are prepared to take it seriously. It may also prevent more abusive comments being posted, by demonstrating that you view and respond to patient feedback professionally.

Dealing with online abuse or threats

Comments or feedback that are abusive or threatening are upsetting to read and should be addressed as soon as possible. Either remove the post with an explanation of why (if you have the ability to do so) or contact the relevant platform and request that the post be removed. In extreme circumstances, consider contacting the police to report serious abuse or threats.

Some posts may be anonymous, but if you can identify the patient it may be appropriate to contact them directly in writing to explain why their post is unacceptable and to issue a formal warning.

Regulatory guidance

The GMC has specific guidance regarding social media and reminds doctors that:

When using social media:

36. You must treat colleagues fairly and with respect.

65. You must make sure that your conduct justifies your patients’ trust in you and the public’s trust in the profession.

69. When communicating publicly, including speaking to or writing in the media, you must maintain patient confidentiality. You should remember when using social media that communications intended for friends or family may become more widely available.

70. When advertising your services, you must make sure the information you publish is factual and can be checked, and does not exploit patients’ vulnerability or lack of medical knowledge.

They also have created an area within their ethical hub that provides further practical advice for doctors when using social media and offers guidance doctors should consider in their wider use of social media.

Professional or casual online forums

Another area of social media requiring some caution is online engagement with other healthcare professionals. This may involve sharing ideas and views for educational purposes or for mutual support. Sometimes individuals may share personal views on colleagues or other practices that are not always professional.

Unfair criticism on such sites can leave some professionals feeling bullied or targeted by their peers.

Should you feel it necessary to raise concerns about the conduct of another medical professional, there are specific steps to take as set out in GMC guidance on raising concerns.

Practice policy

GP leads or practice managers are advised to establish and regularly review a policy on social media use that includes guidance on how to deal with online feedback. This will help staff understand their responsibilities in regard to their own personal online presence. Such a policy should specify that any online practice feedback should be raised first with management and not responded to on an individual basis.

In this online, connected world we now live in, it is inevitable that patients will air their views and experiences of personal healthcare. Online criticism may be unfair or not – but it is important to be aware of the options on how to respond.

Follow the regulatory guidance to ensure expected standards are maintained, and if in doubt, do not hesitate to contact MDDUS for advice.

Kay Louise Grant is a risk adviser at MDDUS

This page was correct at the time of publication. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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