■ Duties and responsibilities:

Expectations of physicians in practice

Online physician reviews: What’s to be done?

Originally published September 2014 / Revised May 2016

Doctors are increasingly rated and evaluated on Internet sites. While some physicians would rather wish these sites away, online physician reviews are likely here to stay. Rather than turn a blind eye to these ratings, doctors should consider monitoring what is being said about them, and take measured steps to deal with these reviews.

Online consumer reviews continue to expand and now include a number of websites dedicated to rating physicians. These sites enable patients to view physician profiles, share patient experiences, rate doctors across a number of different factors, and comment on individual doctors and their medical practices. While physician review sites have limitations, patients may use the sites to comment on their physicians' communication skills, timeliness, and follow up of test results. Online reviews can also include information about office staff, with comments on attitudes, and office processes and management. The posted information can be used by patients to share information about their experiences with a particular physician, prepare for a referral visit to a different doctor, or learn more when seeking a new physician.

Strategies to monitor online reviews

While many physicians may be reluctant to search for comments about themselves by using search engines such as Google or Bing, doing so can be valuable. Physicians may want to occasionally monitor what is written about them on the web, and pay particular attention to physician rating sites. These sites are generally not intended to harm physicians' reputations. In fact, most physician rating sites allow doctors to update and correct their profile information, and many sites have terms of use requiring only truthful, non-libelous, and relevant postings. Some sites also allow physicians to respond to comments if they choose.

When a physician's online reviews are largely positive — and most are — this is a sign patients are generally satisfied with the care and service received. In these situations, physicians should reflect on the feedback, build upon what works well in their practice, and continue to provide quality care to patients. Physicians should place less emphasis on numerical ratings, since these may not be statistically sound. When negative online reviews and comments are encountered, it may be appropriate to pause and assess the feedback as objectively as possible. Online reviews may provide important insights for doctors. Physicians should generally not publicly reply online to specific patients, even if they feel certain about which patient provided the comment or review, nor should they publicly post any specific comments online.

"I feel very fortunate to have Dr. X as my physician. She is knowledgeable and experienced and truly listens. She always follows up."

 "…this doctor is amazing…. He sure knows his medicine…. He listens, cares and makes you feel comfortable. Unfortunately there is one super sour personality amongst his reception staff who takes pleasure in being difficult and making life miserable whenever you deal with her…. Rather than being  pleasant, she always makes you feel like you are interrupting and bothering her…."

 "…not to be recommended…. Dr. Y is always in a frenzy and is inattentive…. I always feel rushed and intimidated to ask questions because he seems so hurried….

 "…incredible doctor. She's always cheerful, open, knowledgeable, and caring. She really takes the time to get to know her patients personally, and is not thrown by anything. She can separate myths from facts and offers lots of resources for information. She is punctual, and accurate, and I definitely recommend her…."


How to monitor your online reputation: 6 steps to take

    1. Foster a positive patient experience in your medical office or practice. Many online complaints relate to medical office issues such as wait times, staff friendliness and interaction with patients, continuity of care (including follow up of test results), and technology (including electronic medical records). Physicians should review these complaints with an eye to improving patient experience and satisfaction.

    2. Encourage an open dialogue with patients. Ideally, patients should feel comfortable discussing their concerns directly with physicians. Fostering honest and open communication can have a positive effect on the physician-patient relationship, improve patient satisfaction, and reduce the potential for negative Internet comments.

    3. Develop formal mechanisms to obtain and measure patient feedback. Formal feedback or complaint mechanisms can be an effective way for physicians to hear from patients. Patient satisfaction surveys can help physicians identify areas for improvement within their practice. Doctors seeking patient feedback through this mechanism should attempt to act on relevant suggestions.

    4. Identify and make improvements based on online comments. Similar comments from multiple patients may be indicative of a problem that needs to be addressed. For example, a physician who receives multiple complaints about rushing patients may wish to examine the factors that may be contributing to this perception.

    5. Respond in an appropriate manner. While the source of online comments may be apparent, physicians should never assume a specific patient made a posting. Similarly, physicians should not ask patients to provide positive online reviews or to sign agreements indicating they will not write negative Internet reviews.

      Other methods to gather feedback from patients, such as anonymous surveys, are considered more appropriate and professional.

    6. Protect privacy of patients. Physicians must always be aware of their obligation to patient confidentiality and privacy. Given how passionate physicians are about the high-quality care they provide, it is understandable doctors may take negative online comments personally. However, responding quickly in anger may escalate a situation unnecessarily or create additional medico-legal issues, such as breaches of physician-patient confidentiality.

Advice from the CMPA

Members with concerns or questions about online reviews would benefit from speaking in confidence with an experienced CMPA medical officer.

For physicians faced with negative Internet reviews, the CMPA will not generally extend assistance to members wishing to bring a civil action against a ratings website or an individual who has posted comments on a ratings website. However, the Association may assist members in preparing a request to a ratings website to have defamatory comments about a physician's practice removed. Doctors can also contact their own legal counsel for advice about other steps that could be taken. Physicians should be aware limitation periods in defamation actions may be relatively short, especially when compared to negligence actions.

DISCLAIMER: The information contained in this learning material is for general educational purposes only and is not intended to provide specific professional medical or legal advice, nor to constitute a "standard of care" for Canadian healthcare professionals. The use of CMPA learning resources is subject to the foregoing as well as the CMPA's Terms of Use.