In February of 2014, EMPATHIQ received an email from a doctor who humorously vented, “It would be easier to get an amendment to the Constitution than to have Yelp remove this review.” He had tried to remove the review on his own and ran into the same road block that doctors often face when requesting removal of reviews. That road block comes from the doctor’s own lips; their own words ensure reviews are not removed. In order to understand why, we must revisit the major conflict of interest that exists between websites and doctors.

Removing a Review

Review websites have a vested interest in keeping reviews online, especially ‘sensational’ reviews which attract readers. Websites like RateMDs are beholden to national advertisers who run ads on their websites—not to doctors. Yelp, which makes a grand effort to sell advertising directly to local businesses and doctors does not make special exceptions to their review policy when you pay them. Therefore, an ‘exceptional reason’ must exist for a website to willingly remove a review.

Websites and doctors do not often agree on what constitutes an ‘exceptional reason’ to remove a review. From the website’s perspective, here are the grounds upon which a review would be considered for removal:

Racist or “hate speech”
Spam
Not a patient
The reason why websites remove any reviews at all is to be consistent with their “Terms of Service.” This is a contract between the website and the user which protects the website from becoming legally responsible for the things that people write. Terms of Service typically prohibit racism or hate speech. Hate speech is typically defined as speech against ethnic, religious or sexual minorities. (Ranting about a doctor is not hate speech.) Spam is disallowed for obvious reasons; websites want to stay credible and spam-free. Finally, review websites state that they are not a forum for social commentary and will only accept reviews written by legitimate patients.

The most effective argument for removing a review is usually to claim that it was not left by a patient. Upon hearing that you doubt the review was left by a patient, some websites will promptly remove the review. Others, however, can be more difficult to convince.

Paying the Site Won’t Work

One doctor in Philadelphia had a surprisingly difficult time with a review written by a former employee who was terminated for impersonating his signature to obtain drugs. He tried everything to get it removed including purchasing an advertising plan on the website where the review was posted. After 5 months of paying for $350 / month for advertising, he still could not get the review removed. The former employee claimed she was a patient. The website unquestioningly believed “the patient.”

Why Not Sue?

Several doctors have sued websites like Yelp over the years. Every case has proved futile because of the Communications Decency Act of 1996 which provides a safe harbor to websites who publish user-generated content.10 If a doctor insists on removing a review, he or she would need to sue the patient directly. A lawsuit to the patient could have unintended consequences such as the case of Dr. Tuli v. Fotour or Dr. Gesquiere v. Puttman. In both cases, the doctors sued patients for posting negative comments online. And in both cases, patients talked to the media and headlines like “Doctor Suing Former Patient” emerged on news outlets like CBS and the Boston Globe.11 Now these doctors have much larger reputation problems on their hands.

Search the web for “doctor sues patient” and you will find examples of how lawsuits to suppress negative reviews have resulted in the proliferation of more bad press. This phenomenon is known as the Streisand Effect.

wikipedia reviews

The Streisand effect is the phenomenon whereby an attempt to hide, remove, or censor a piece of information has the unintended consequence of publicizing the information more widely, usually facilitated by the Internet.

It is named after American entertainer Barbra Streisand, whose attempt in 2003 to suppress photographs of her residence in Malibu, California, inadvertently generated further publicity.

As mentioned at the beginning of this lesson—the reason why doctors often fail to remove reviews is they acknowledge reviews were written by patients. Instead of getting angry, EMPATHIQ recommends that doctors politely request reviews be removed on the grounds that they were not conclusively written by patients.

To request removal of a review, send a letter to the website operator where the review is published. State why the review should be removed. State (if you can without being dishonest) that the review was likely not written by a patient and the statements made by the reviewer were designed to harm your reputation instead of share a legitimate consumer experience. About 30% of the time, this results in the removal of an online review across all websites. However, on a particular websites, like Google+, removal success can be as low as 1%.

The outcome of a removal letter depends on where the review was written and what it says. When requesting removal, do not fight with review websites. They are operated by people, who like everybody else, can get emotional and defensive if pushed too hard. The best approach is to act like you don’t care and that you are doing the website a favor by helping them remove content that consumers don’t find useful anyway.

Time to Try Responding

If a polite and reasonable letter does not convince a website to remove a review, you should respond to that review. Many websites prefer a response over a removal request. Responding to a review can neutralize its damage. Public statements are a classic defense tactic for celebrities. They work the same way for doctors, too.

Responding can prevent your detractors from hurting your reputation.12 On occasion, clients call us to report that a new patient walked in because they read the doctor’s response to a negative review. (We’re flattered when we helped write the response.) Sometimes a good response can cause the detractors themselves to change their minds.

Consider Dr. M. who is a specialist at a major university hospital. In 2013, she received an alert from EMPATHIQ about a negative review. The review was left by a patient in agony who could not get an appointment for six months. The same day, the doctor called the patient and scheduled an appointment for the next week. The patient replaced the negative review with a positive one.

Rules of Responding

A rule of thumb when responding to reviews is to keep them compassionate and non-defensive. Responding to a review is not a debate. Speak about procedures in general. If the patient talks about a scar that formed after plastic surgery, talk about why scarring can happen in general (people heal differently or the post-op instructions were not followed). This can cast doubt on your detractors’ credibility without breaking patient privacy. One way to end your response is to encourage the patient to visit and speak with you about their problem. Most patients never do, but making the offer will cast you in a positive light with new patients who are reading your reviews.

One example of a successful response is:

1 STAR REVIEW

I seriously question Dr. XY’s ethics. I feel I was medicated and taken advantage of during my procedure which has had beyond poor results.
DOCTOR’S RESPONSE

I’m sorry you feel that way. At this time, I don’t know who you may be.

You mention that you were medicated. We do medicate patients because most of our patients don’t like to undergo hair restoration surgery without medication. I’m not sure I would have done your surgery if you had told me you didn’t want to be medicated.

Our practice prides itself on the deep, genuine relationships that we build with patients. We always act in the best interest of the client. Additionally, our success rates and patient satisfaction rates are extremely high for our profession.

I am happy to discuss any questions and/or any concerns you have about your experience. Please call our office at xxx-xxx-xxxx. Thanks for taking the time to share your thoughts.
An efficient way to write a response is to start by outlining why the review is wrong. (Bullet points are okay.) Have a staff member turn your outline into a draft. Work together with that staff member to edit the draft until you feel it is ready to post online. Finally, assign a staff member in your office to register and post that response online. If you do not have a full-time staff member dedicated to this function, consider using EMPATHIQ. We handle drafting and posting responses for doctors every day. Our rates start at $1.66 per day, far less than a staff member’s salary.

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