They say that the only thing worse than being talked about is not being talked about, but does this truism apply to dental practice, and how do we cope with a negative online review?
As the digital world expands to fill every aspect of our lives, and consumers become increasingly empowered to give feedback, more and more members are contacting Dental Protection to request assistance in managing on-line reviews.
Unfortunately, more and more patients are turning to the privacy of their keyboard to make their displeasure known publicly through a negative review, rather than sharing their concerns directly with the dental practice. Unfortunately, online reviews are made anonymously, which means you cannot even begin to resolve the concern with the patient.
Receiving an online complaint is distressing. Many practitioners are concerned that they will suffer not only with reputational damage, but also that the mere allegation of poor performance may trigger the principal dentist to dismiss them. While there is some legitimacy to these concerns, they may not be as absolute as you first think.
We asked experts, as well as dentists who have been the subject of negative reviews, for their advice.
Casey Bryan, owner and SEO specialist at Grand Cru Digital, recommends bookmarking the following links:
She recommends alongside reporting false reviews directly to Google, to also contact Google’s support team on Twitter to try to get the review removed faster: @GoogleMyBiz.
“Their support team on Twitter is pretty good and they typically get back to you much quicker than when you approach them on email,” Casey says.
Casey advises that responding to all good and bad reviews is best practice for businesses to get into. “When you are responding to a review you are not only responding to that person but to many potential customers who are also going to read that response,” she explains. “So, if you are responding to a negative review, a lot of people who might be considering going to that dentist are going to read how you have responded to that. Like the guidelines say, you need to keep the response professional and keep it polite. One thing I suggest to my clients to say is: ‘If you wish to discuss this further feel free to call or email me,” so then you are taking that discussion offline and out of the public eye.”
She says it is case-by-case working out if a review is fake, and points out that Google has an automated spam-detection system. “Hopefully, fake reviews will be filtered out, in some cases even before they are publicly shown,” she says. “If they are shown, you can respond to the review by saying: ‘We cannot find your details in our system. Can you please provide us with more information as we’d like to address your concerns as soon as possible? Feel free to call or email us and we can discuss this further’.”
She adds the time it takes for a fake review to be removed can differ. “Sometimes the review can be taken down in a couple of days, but sometimes it can take longer,” she says.
“The reviews get checked manually if you flag that they are inappropriate, so you have to realise it is a support team who is actually going through and reading them. Therefore, if there are public holidays it will take longer for them to be reviewed.”
It is important to note that a review must violate one of the review policies in order for it to be removed. This includes content that is offensive, sexually explicit, illegal and dangerous. You can check out the full policy here.
NOTE: Google will not remove a review just because you disagree with it. It must violate their policy to be removed. Casey says if Google doesn’t remove a review, then that’s where a well-constructed response would be advised.
If the review definitely violates on of these policies and it still hasn’t been removed after several days, Casey suggests getting in touch with Google again, preferably through Twitter.
It’s never nice to see something unfavourable about you online; and if this comes in the form of a Google Review, it can be a knee-jerk reaction to want it to disappear. However, Enore Panetta, principal at Panetta McGrath, points out there is a difference between a negative review and a false review.
“Negative reviews can be an inevitable part of doing any type of business,” he says. “Some would regard it as an opportunity to receive feedback and to improve on patient experience. Some negative reviews can also reflect a legitimate grievance and shouldn’t be dismissed.
“On the other hand, false reviews are different,” he adds. “False reviews or reviews where inappropriate language has been used can carry legal consequences for whoever has posted the review.”
If a review has been posted that you believe is false, Enore recommends seeking legal advice or advice from ADAWA. “If the review is false it is worthwhile checking the guidelines of the platform,” he advises. “These platforms generally have content guidelines and you can flag the inappropriate reviews for the platform to review or remove it.
“ADAWA and their legal advisers or your personal lawyer may be able to help you draft a letter to the platform asking for the false review to be removed. If the reviewer is able to be identified, a letter could be sent to them privately asking them to remove or change the review. Generally, you should seek advice from ADAWA or your lawyer just to check those letters and that they are sent in the right tone. Sometimes they can only serve to escalate matters.”
Although tempting to respond to a hostile review, Enore advises caution. “If you are going to respond, a comment in very general terms is probably the best approach,” he says. “This should be limited to something along the lines of not considering the comments to be accurate and that any concerns regarding the services provided should be addressed to the practice or the dentist directly.
“You don’t want to be responding when you’re angry,” he adds. “If you are able to respond in a measured way and in a way where you demonstrate some willingness to take on feedback, then that would be the best way to respond. You also want to be careful not to inadvertently breach patient confidentiality or privacy. Again, you probably want to seek some legal advice or have ADAWA or the WA Dental Cases Panel review what is going to be posted in reply.”
He says there is also the option of not responding. “Sometimes I think, as difficult as it is, to not take it personally and try to rise above it.” he says.
Does the review classify as defamation? Enore says for a Google Review to be classified as ‘defamatory’ the comments have to published to at least one other person and has to harm the reputation of the dentist or business in the eyes of the public.
However, he does not recommend jumping to sue.
“Defamation proceedings are a very big step. They are a complex, time consuming and expensive matter. Before you take this step, you should seek legal advice to understand what is involved, and the benefits and risks.”
Enore adds there is a risk that by launching an action in defamation, you bring even more attention to the negative review, particularly if there is media coverage.
“There was a case reported in The Age newspaper where a Melbourne dentist took defamation action against a patient who had posted a scathing online review about the quote he received for a filling and gave the practice a 1-star Google Review rating,” he says.
“The post said something along the lines of: ‘The greedy owner drives a Bentley, brags about his private box at the footy, yet his motto is we see things from the patient’s perspective.’ It went on to say, ‘The only thing this guy sees is the size of your wallet.’
“The dentist claimed that as a result of the review, he had suffered damage to his reputation. However, the media attention that the dentist received probably ended up bringing far more attention to these comments than they otherwise would have received. In other words, suing for defamation might actually increase the damage caused by the review.”
When Dr Smithson* discovered one of her staff had committed fraud, the staff member was dismissed, on the basis of misconduct.
“It wasn’t amicable,” Dr Smithson says. “She let us know she was going to seek legal advice for unfair dismissal but nothing came of it. We then got a very defamatory Google Review. The content was defamatory, written by an alias, with a very personal attack on me.”
Dr Smithson contacted Google to request the review was taken down. “I think in this day and age, people read reviews before they go to a practice or go to any retail or customer-based place,” she says.
Dr Smithson says to some extent it was upsetting, but she knew not to take the review personally. “It is best to report it and seek advice from the ADA and request Google to take it down,” she says. “I think that is the most you can do. I can see if someone was in a fragile state it could impact them a lot more and it would be advisable to seek some counselling. Even if you are thick-skinned, it can impact how you feel.”
Dr Smithson adds her experience highlights the importance of seeking advice regarding begrudged staff members. “It is useful to seek advice from ADA and have any incident recorded with them to cover your bases at every step if anything unfortunate does arise,” she says.
*name changed
Sandeep* is a practice owner who is active in managing the online reputation of the practice. When a patient presented with a toothache, he seemed friendly and gave no indication that he was unhappy with his appointment. However, soon negative reviews started popping up about the dentist who treated him.
“He posted on our Google Reviews, on our Facebook page and other sources,” Sandeep says. “At the time, he posted a total of six reviews under different accounts, all very targeted at the dentist who treated him. I managed to identify him based on what he was describing in his various complaints, and the first thing we did was try to reach out to him offline. If we can identify the patient, we always try to touch base to see if it is just a misunderstanding and something we can sort out.”
Sandeep, who has a background in IT, managed to compile a list of the patient’s accounts and personas based on the information he was able to find from Facebook and Google. He also flagged the reviews with Google. “I responded to the reviews as well,” he says. “You are not necessarily responding to the person who feels they had a bad experience. Equally important, you are being seen to provide great customer service. Negative reviews will happen from time to time. I feel people are more understanding of negative reviews in dentistry compared with other service industries, as a large percentage of the population still have a base fear or dislike of dentistry. Having a 5-star or 100% service record can even appear fake (and generally is).”
Eventually, Sandeep was able to reach the patient, who said nothing was wrong, but continued to post more reviews stating the next dentist he saw said the previous dentist had done many things wrong.
“I feel that getting legal involved to cease and desist can be a mistake,” Sandeep says. “The internet is a soapbox for people with issues, with an unpoliceable number of avenues for a single person to misrepresent themselves as a larger view. You can also become their sole focus for a long period of time.”
Google removed the reviews because they breached Google policy, however the patient still pops up online from time-to-time, posting about 40 times since 2018.
For the dentist targeted, it was a stressful experience. “Most dentists do not realise this was one person pretending to be many, so her peers were noticing these reviews and thinking her patients were constantly complaining about her,” Sandeep says.
To other practices, Sandeep recommends having an agency or IT savvy person actively managing the practice’s online reputation.
“People see online reviews as a trusted authority, of a similar level to word of mouth,” he says. “If you move into a new area, the first thing you do is go online for reviews about local businesses.”
*Name changed.
When Dr Barbagello* treated a patient, the denture the patient received was not up to his expectations. “He wasn’t happy with the denture and missed his appointment that was allocated to him for the review and adjustment of the denture, and then posted a negative review.”
Dr Barbagello sought legal advice but says the advice was of no help. She says the review was frustrating because the patient had a good quality denture but was not open to communication. “Try to ignore it,” she advises other dentists who receive negative Google review. “It is hard to do because we always try to do our best for our patients.
“When the patient came in for treatment, he spoke badly about two other dentists. I gave him options about tooth replacement and he chose dentures, but he expected the dentures would be like implants. I am not happy about the review, but I have moved on. It is disappointing when people hide behind their keyboards because they don’t want to face someone in person.”
*name changed
If you receive negative reviews, it might be tempting to encourage loyal patients to post positive testimonials in an attempt to drown out the bad, but it is advisable to be mindful of AHRPA guidelines.
“Under section 133(1)(c) of the National Law,[1] a person must not advertise a regulated health service in a way that uses a testimonial or purported testimonial,” says a spokesperson from AHPRA. “This means the National Law does not allow the use of testimonials to advertise regulated health services or a business that provides a regulated health service.
“Testimonial means a statement, review, view or feedback about a service received or provided. In the context of the National Law, a testimonial involves recommendations or positive statements about clinical aspects of a regulated health service.
“The Dental Board of Australia is one of the 15 National Boards that have published Guidelines for advertising regulated health services as well as a testimonial tool to help all advertisers, including registered dental practitioners, meet their legal obligations when advertising.”
These guidelines, together with other resources and support materials, are available on the website for each National Board, and are also available on the AHPRA website.
Practitioners are not responsible for removing (or trying to have removed) unsolicited testimonials published on review platforms or on social media they do not control or on sites that are not advertising a regulated health service.
However, if a health service provider engages with a reviewer on such a site, for example, by responding to a positive or negative review on a booking site or review platform in a way that promotes their service, the response might be considered to represent advertising, and might therefore be considered a breach of National Law. For example, if a practitioner responds to a positive patient review that contains information about the clinical aspects of a regulated health service, the patient review may then be considered a testimonial used by the practitioner in their advertising.
To avoid this, service providers should refrain from responding to reviews in a way that is promoting or advertising their health service. Practitioners should also not direct or encourage clients to place reviews.
[1] The Health Practitioner Regulation National Law, as in force in each state and territory (National Law).
We asked patients if seeing a 1-star Google Review would impact their decision on being treated by the dentist in question:
“I personally find all online review sites highly unreliable and, while I may give a cursory glance to them, I will never base my assessment of any health professional or other establishment on them. They are far too easy to be ‘gamed’ by both the business themselves and disgruntled customers or even the business’ competitors. In short, a 1-star review on any online review site will never prevent me from engaging with that professional, nor will a 5-star review encourage me to do so, because online reviews are akin to playground name calling.” (Matt)
“I would want the bad comments to be very low compared to good reviews. Reviews are subjective obviously so it would be natural for there to be a mix. If there was only a bad one, I’d scroll past.” (Alison)
“I tend to look for consistent mentions of the same issue. Any business can have a bad day, but when more than one person has the same specific issue, it’s more likely to be a frequent issue.” (Mel)
“I think a lot of people who write reviews do so if they have had a negative experience. I am 100 percent sure that the good experiences far outweigh the bad but yes, I do read the reviews and did write a glowing one for my dentist, who I would and do recommend to anyone that asks.” (Natalie)
“Having seen how quickly you can drown a negative comment in ingenuine positive comments I don’t trust Google Reviews at all. I will go word of mouth all the way.” (Dan)
There are a few practical steps to take, starting with taking a deep breath and not succumbing to panic or fury. Verify if the patient is of your practice, and then reach out to ADA or Dental Cases Panel to seek some impartial, professional advice.
If the decision is taken to respond to the review, your adviser can help you craft this response. The key is that the response to the clinical issue at hand is not publically given, as to do so would be a breach of the patient’s privacy. Instead, consider a generic response, inviting the patient to contact you to discuss their concerns directly. This will serve
the purpose of responding to genuine concerns, whilst reassuring any other readers of that review that you do take complaints seriously, without inadvertently breaching any legislations.
It is regrettable that reviews, both good and bad, are a natural consequence of the modern world. While it is helpful to have strategies in place for those which are false or defamatory, it is equally as helpful to develop some internal coping mechanisms, as reading critical reviews can be harsh and hurtful. You then need to make the decision to “respond, not react”.
Reacting can be unhelpful as it comes from an emotional place of hurt. Responding in a measured way can take the sting out of the review, and gives you the legitimate opportunity to invite a disgruntled patient back to discuss their concerns, before the matter potentially escalates to a formal complaint to the regulator.
Ah, Facebook – the stomping ground of trolls and keyboard warriors, just waiting to dish out negative reviews and brutal feedback. What on earth do we do about Facebook? In much the same as Google reviews, Facebook reviews should be responded to respectfully – remember, potential clients are far more interested to see how you respond than they are in the initial review. Express your disappointment that the reviewer is unhappy, and ask if you can take the conversation offline in order to help them. This applies not just to reviews, but also to negative comments on your Facebook Page.
If a Facebook review violates community standards, you do have the option of reporting it. Simply click “report”, then sit and wait for the Facebook Gods to decide if you have a case and the review should be deleted.
Comments on Facebook posts are easier to handle, as you have the option of deleting or hiding. Deleting comments is risky, as it looks as though you have something to hide. The “hide” option is much better, as the comment remains visible to the writer and their family and friends, but hidden to everyone else. Crisis averted!
If the mere thought of a review on your Facebook page makes you break out in a cold sweat, then you also have the option of switching off reviews all together. Simply head to “Settings” and then disable reviews.
First published in the Western Articulator June 2019
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