Can they really say that? GPs and online reviews

Amanda Lyons

28/12/2018 1:01:18 PM

Dr Steven Kaye talks about helping GPs on the thorny question of how to respond – or not – to patients’ online comments.

While it will always be difficult for practitioners to alter or remove negative online reviews, a new RACGP factsheet is designed to help GPs navigate how best to deal with them.
While it will always be difficult for practitioners to alter or remove negative online reviews, a new RACGP factsheet is designed to help GPs navigate how best to deal with them.

‘The worst GP I have ever seen. I took my daughter to see him when she was very sick. He missed the diagnosis and was deliberately rough with her. It was like we were imposing on his time. I’d ask a taxi driver for medical advice before seeing this GP. Never see him if you are ill – or well.’
This review, which the GP found by googling his own name, was used as a case-study by medico-legal expert Dr Sara Bird in a previous article in Australian Family Physician.
Not only can this kind of online feedback can be personally distressing, it can also pose a threat to a doctor’s business. But as the number of online review platforms has grown – seemingly by the day –so has the likelihood of doctors receiving online comments from patients.
‘There are many online interactive sites where doctor reviews might appear – Google, Facebook, Yelp, RateMDs,’ Dr Steven Kaye, Deputy Chair of the RACGP Expert Committee – Practice Technology and Management, told newsGP.
‘In the majority of cases, the review is of a negative nature, potentially causing reputational damage for the doctor or practice.
‘These reviews are usually unvetted and can be posted by any member of the community, and as there is no “right of reply” the accuracy of the information and complaint cannot be verified.’
Many GPs in this situation understandably want to do something, from responding with their own comment to trying to get the review deleted.
But Dr Kaye warns there is usually little recourse available to doctors in the case of online reviews, and that trying to take action can often result in making a bad situation even worse.
‘While the temptation to respond to negative comments is very strong, it should be avoided,’ he said. ‘Inevitably, reputational damage will only be heightened by ongoing open debate and discussions.’

Dr-Steven-Kaye-text.jpgAlthough the compulsion is strong to reply to negative online reviews, Dr Steven Kaye advises that it is best to avoid doing so.
Part of the reason doctors have such limited recourse is that many online reviews are posted anonymously. In cases where the author of the review is identifiable, there may be some more positive options – but these can have their own drawbacks.
‘If the author of the negative comments can be accurately identified, there is always the potential to legally attend to the reputational damage,’ Dr Kaye said.
‘However, the cost and inconvenience of doing so would rarely be rewarded with a legal victory in whatever form – financial compensation, retraction, etcetera.’
If comments or reviews have a significantly negative effect on a doctor’s business and the complainant is identifiable, mediation may be a possible avenue.
‘Offline discussion with a complainant in a calm and controlled manner to work through issues appropriately is preferable [to online discussion],’ Dr Kaye said.
Of course, not all reviews are negative – and positive ones come with their own temptations, as a potential way to boost business. But Dr Kaye very firmly emphasises that going down this path is also best avoided.
‘Usage of positive reviews is unacceptable. Testimonials are not legally allowed to be used for medical practitioner advertising,’ he said.
Under the definition of The Health Practitioner Regulation National Law, the term ‘testimonials’ includes reviews that make positive statements about clinical aspects of a doctor’s service.
Therefore, reviews can be used in advertising, but only if they are focused strictly on non-clinical aspects, such as car parking or the ambience of the waiting room. It is also important to remember that permission for use is required from the reviewer themselves and the website on which the review was originally published.
Finally, reviews can be edited but not to the point where they become deceptive or misleading. As a broad example, if the review stated ‘exceptionally long waiting times at this practice’, this could not be changed to read, ‘exceptional … waiting times’.
Navigating these issues can be difficult, distressing and can even have legal consequences for doctors. The RACGP has created an online resource to assist GPs in these situations, the Responding to online reviews factsheet.
‘It allows clarity to be developed with regard to response options for medical practitioners,’ Dr Kaye said.
The factsheet gathers information from relevant sources, including the Australian Health Practitioner Regulation Agency (AHPRA), and provides advice for a range of questions from GPs, such as ‘How should I respond to a review?’ and ‘Do I need to keep track of online reviews that might breach the law?’
There are two points in particular that Dr Kaye is especially keen to drive home.
‘The obvious temptation to respond to reviews should be avoided, and there is unlikely to be any way to alter online review comments,’ he said.
It seems that online reviews are something GPs will have to accept, to some extent, but the factsheet is designed help them do so with more clarity about how – or how not – to respond.

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John   7/12/2018 7:19:21 AM

Disagree with most of what is written here. Medical indemnity insurers and advisers who work for them have hardly any experience defending defamation. Even MDA National who claim to cover 'defamation' in their Practice Indemnity Policy don't cover defamation that another party does to you.
I speak from personal experience. Few years ago, I was slandered online by a Naturopath. The indemnity provider argued against doing anything at all(too convenient for them) using the reasoning in the article. I didn't realise at the time that this, exactly, is the agenda of indemnity insurers; i.e. minimise their headache.
Two years later, having studied the law, I decided to change approach and take on the online defamers.
All it took was just one email threatening legal action. The offending slander was removed within half an hour! Also able to get two slanderous reviews removed by Google through persistent and maintaining serious intent of taking legal action, both against the unknown reviewers whose identities were protected by Google and Google itself. If all of us change our approach, people will think twice before deliberately making a false statement publicly with intent to sully our reputations.

Rosalie Schultz   7/12/2018 11:03:39 AM

Great response John, I'm glad you protected yourself and sorry your indemnity organisation was so unhelpful.
Not only can legal action lead to removal of inaccurate and unfair reviews, it can also deter others from slander and bullying, creating a more friendly online environment.

Vanessa Elliott   12/12/2018 7:44:35 PM

Why on earth would any self-respecting individual or business NOT defend themselves and call out the kinds of inexcusable behaviour that our medico-legal and professional bodies seem to be blithely recommending we simply ignore? One cannot help but ask, "In whose interest is it, for Doctors to remain passive and silent in the face of willfully deliberate and malicious online behaviour?" Patients and/or others who choose to behave in a manner that potentially causes distress, hardship and/or brings a Doctor or their business into disrepute, surely must be called to account like any other member of society? No individual citizen has the right to post a inaccurate restaurant, accommodation or product review without the possibility of threat of defamation, recourse or redress. Doctors, time to stand up strong and proud and dare to defy the ridiculous, ill-conceived advice of those who must surely have no other agenda, than for you to remain constrained, silent, dis-empowered and compliant. I can conceive of no other justifiable reason for keeping the medical profession on the boundaries of society. May more of you follow John and study law - and start to live in freedom more than fear!

Dr Mark Jeffries   26/11/2019 11:37:55 PM

As a lawyer and a doctor I find most of this article inaccurate.

I would defend against any defamation. Plenty of solicitors and case law to support you. Starting to worry about some of our ‘medical experts’..