Learn rules, risks to manage online critics

Imagine you are attending a local fundraiser. You’re sipping a fine glass of wine while surveying the crowd. You notice a woman heading your way. “Doctor,” she says upon arrival, “I am so glad I ran in to you tonight. I just had to tell you about my recent experience in your office.” Regardless of what comes next, praise or criticism, how should you respond? “With gracious acknowledgement” is the correct answer.

Your response to an online review should be no different: Every review deserves a thoughtful reply.

Your positive, thoughtful response to online reviews can tell the world you’re engaged in the conversation about the service you deliver. It can motivate your cheerleaders to continue singing your praises, encourage conversation that can repair a damaged patient relationship and prove to prospective patients that you care. It might even turn negative reviews into positive ones or make them go away altogether.

This article aims to shed light on the perspective and protocols that will help you and your team confidently respond to a negative online review.


The reputation champion in your practice addresses online reviews. This need not be a dedicated role. You can assign reputation responsibilities to virtually any team member — just ensure these staff members have the trust — and ear — of practice leaders.

For just a few hours each week, this person can:

  • Aid in cultivating positive reviews
  • Monitor patient feedback across multiple channels
  • Provide practice leaders with objective reputation reporting
  • Advocate for operational changes with goals of improving service quality and the practice’s reputation
  • Respond to positive reviews
  • Organize efforts to address negative reviews

Progressive practices may consider giving their reputation champion a regular slot at monthly staff meetings to brief the team on patient opinions shared online.


To respond to critical feedback, you first need to collect it. While most ophthalmology practices already employ an online patient satisfaction survey,* few patrol all the places where patients share reviews online.

Your digital agency can help you select the right software for these needs. Your complement of supporting software should include:

  • A patient satisfaction survey and detailed reporting
  • Software to encourage, aggregate and distribute ratings and reviews online
  • A monitoring application to deliver immediate alerts, and summary reporting, of reviews posted around the web.

These tools will empower your reputation champion with a holistic view, detailed reports and immediate alerts whenever patient complaints arise.


Overreacting to a patient complaint can do as much harm as ignoring it. Before acting, learn what you can about the reviewer, details of the concern and guidelines of the website where the review appears.

After a careful read, decide if: the reviewer shares a legitimate (from the reviewer’s vantage point) criticism; is attempting deception (posts from disgruntled employees are common); or has lost touch with reality. While patients commonly post reviews in their own names, many rating and review websites still permit anonymous reviews.

Sample review brief

Review link:

Reviewer: On Dec. 17, 2017, a one-star review appeared on the Google My Business listing for our practice. The name “A Google User” left the anonymous review. Our receptionist, Maggie, recognized several of the details noted in the review and believes the reviewer to be Marco Billings, seen in our office on Dec. 13 for a follow-up to his cataract surgery.

Content: The reviewer complained of waiting more than an hour before a rushed visit with Dr. Spencer. A review of our records shows that many patients experienced extended wait times last week. This report is consistent with our team’s recollection of Mr. Billings’ experience.

Website guidelines: This review contains no content that violates Google’s guidelines. Google does permit a public, but not a private, response to the review.

Also, triage the content: clarify whether the complaint relates to customer service or clinical care. While you should freely address service complaints, consult your legal counsel or medical malpractice insurance carrier before responding to complaints that may be precursors to a lawsuit.

If you do not have the support of an agency specializing in reputation management, carefully study the review site’s terms of service and guidelines for reviewers. Many sites prohibit inflammatory or threatening reviews, and some require that reviews be based on first-person experience. Also, understand whether the site permits private communications with the reviewer or a public response to the review and whether it has a formal grievance policy. An intimate knowledge of the site’s policies and functionality will help you understand how you can react.

In addition, watch for parity problems between the star rating and the actual text. Happy patients may leave glowing reviews but accidentally click the wrong star-rating value. These reviews are prime targets for correction.

It is the reputation champion’s job to quickly assess the situation and deliver a brief to practice leaders (see Sample review brief, above).

With a detailed assessment in hand, your leadership team and reputation champion can make an informed decision on how to respond to virtually any review.


Some sites allow users to edit or retract their own reviews, but only until another user reacts to the posting. Reactions like giving the review a “thumb’s up,” classifying a review as “useful,” or even your practice’s response can “lock” the review in place. If your goal is to have the author edit or retract the review, you may only have days to connect with that person and achieve a resolution.


No matter how trivial the concerns expressed in a review might seem, they are meaningful to the patient. Even when the patient is culpable in the negative experience or outcome, your practice will never win if you respond with anything other than respect for your patients and prospects.

Also, respect patient privacy. Any member of your team publishing content online in the name of the practice should understand the laws and guidelines protecting patient privacy. So, acknowledge the concern without introducing private health information pertaining to the patient’s care.


If you intend to pursue legal action or suspect that the reviewer could bring legal action on his or her own, consult your legal counsel. In all other instances, you will likely choose one of four courses of action:

  • Request removal. Rating and review websites are reluctant to remove reviews unless they in some way diminish the quality or credibility of the site. If the review violates the site’s guidelines, use its official grievance system to petition for removal. A fair warning: The review site can take weeks to respond (if at all).
  • Work with the reviewer. When circumstances permit you to identify or send the reviewer a private message, you might do so and begin discussing the patient’s concern. The reviewer may be surprised (and impressed) to learn that you monitor your online reputation. Ideally, you can repair the relationship and earn a revision to or retraction of the review.
  • Ignore the review. While we believe that most reviews deserve a public reaction from the practice, your response could antagonize certain reviewers or circumstances. If you suspect the reviewer to be unstable, it may be best to leave the review alone.
  • Respond. Most critical — and all positive — reviews deserve gracious acknowledgement.

In all cases, practices can help their reputation by working to cultivate positive reviews all year long. A majority of positive reviews will dilute the impact of the inevitable negative review.


When it’s time to respond, say “thank you,” even to your critics. Don’t add to, or dispute, the contents of the review. Speak to how you are addressing the concern and ask for a second chance. A senior member of the practice should invite the reviewer to contact the member directly; include contact information.

Tom Seery of RealSelf shared a simple yet elegant model to a negative response:

“Our practice encourages patients to share their experiences. In fact, our greatest source of new referrals is our past patients. We are 100% dedicated to seeing patients achieve safe outcomes and we ask that any past patient with a concern to contact us directly.”

One response is always enough. Avoid debating the reviewer in the public forum.


When responding to online reviews, it’s important that you and your team stay focused on the larger goal: not to “win” but to arrive at a resolution that honors all parties. Your genuine concern and commitment to quality should shine through even as you communicate respect and validation to the reviewer. This considerate approach to negative reviews, paired with active cultivation of positive reviews, will ultimately give prospective patients a glimpse of an exceptional — not perfect — practice that goes the extra mile in its dedication to patient care and satisfaction.

If you aren’t receiving as many reviews as you would like, implement an in-office initiative to encourage patients to leave reviews. Let them know when they leave a review, they will be entered to win a $25 gift card from a retailer of their choosing. OM

*Patient satisfaction surveys such as the one offered by BSM Consulting.

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