Inappropriately Slanderous Social Media Review? “No Thank You, You’re Fired as My Patient”

Yes, I use Yelp and Google reviews to find good restaurants, and love reading reviews, and I yes have business Yelp and Google pages to help patients find me. Unlike HealthGrades, Vitals, RateMD, and the traditional physician reputation scores, these physician profiles are voluntarily put on the same forum as a coffee house, nail salon or lawn irrigation by us, the physician. The Yelp/Google consumers are quick to give you a high five 5-star review but equally quick to give you a scathing review.  I’m not getting into whether Google is better than Yelp for reviews; that’s for another post. I’m also not talking about Press-Ganey which is solicited by hospital systems to garner rating for themselves. Those are made public as the hospital sees fit. 

So, Yelp/Google reviews create a new problem for us physicians (by our own doing… remember we set up our own SEO business pages to compete in the local market). Do we need to stay their doctor if we feel like we have been unjustly or wrongly judged in the public eye, publicly humiliated, called names, or called a thief? (Even if reportable and comment taken down) I feel like this is a resounding “Hell No”. 

You want authentic medicine? 

It’s not really about the public humiliation, it is more about the personality of the patient, the consumerism of heath care, and the demands and entitlement mentality. 

You want physicians who are true to themselves, happy, and not burned out? Well, we are imperfect humans trying our best. We have good days and bad. We are tracked, credentialed, analyzed, scrutinized by payers, hospital systems, and the government. We try to anticipate patient needs. We have personal lives. We have pets that get sick, kids we stay up with all night if need be. We don’t call in sick, we come in tired and weary, and see patients in clinic (because that’s better than cancelling clinic, right?).

We are practicing medicine and saving lives and hoping to make a difference. We want to build a healthy therapeutic physician-patient relationship. What we are not doing is thinking in the back of our minds whether patients are going to write a scathing review because we didn’t return their call, or didn’t send in the prescription on time, or other infractions they come up with. I’m not talking about those dangerous doctors who the public needs protecting from.

Under what circumstances do you fire a patient? 

 My mantra is “it’s easier to find a good new patient than find good new staff.” There is a formal code of ethicsthe AMA has defined for physcian-patient relationships. Here is my code of ethics: Abusive demanding patients- no thank you. If you are making my staff cry, no thank you, even if my staff are at fault. Even if they didn’t give me a message. Be civil, don’t use expletives. Backing my staff up is probably the top reason I fire a patient. If a patient has something to say, say it to the doctor (most won’t, they are all smiles when we walk in) but instead they growl at the staff. Negative social media reviews irreversibly break down the physician-patient relationship. We can’t come back from those and keep you as a patient. 

A close second is the drug seeking patient, patients who abuse medication I’m prescribing, or lies about other prescribers.  Other reasons to fire a patient are breaking the contract they sign regarding chronic unremedied nonpayment, chronic no shows, making threats, groping, and now you can add negative social media reviews to the list. 

To the kind, tolerant patient

We love you, thank you for the kindness you show us and our staff. Thank you for the homemade gifts, Christmas cards, treats from your travels, and dog shampoo you’ve dropped off for my pup.  Thank you for allowing me to reschedule you so I could attend my daughters 5th grade talent show. Thank you for bringing me gardenias that you grew in your garden, and the quilt you made me after your knee replacement. For the wine labeled “paranoia” you brought in to make me laugh about your somatic complaints. Thank you for the updates about your kids, graduation and wedding invitations, tolerating that I run late sometimes, and asking me how my day is. Thank you for caring that I’m ok and allowing me to be human. You make it worth it, don’t change! 

To the disgruntled patient

If you live in a small town, or are uninsured/underinsured with only a few options, burning that doctor bridge will make things harder for you. If you ask for medical records to be transferred, we have our own internal patient review system.  We like to include the reasons a patient has been dismissed from our practice. It becomes part of your medical record. We are more than happy to let your new doctor know they need to watch their back with you. 

This is not a box that has wrapping which is too hard to open warranting a one-star review on Amazon, this isn’t a cold meal or a bad manicure. This is healthcare. It’s messy and real. 

References 

Tayma Shaya MD

Tayma S. Shaya M.D. FAAFP is a Kuwaiti-American board certified family physician living and practicing in Sugar Land, Texas. She went to University of Texas at Austin to obtain a B.S. in Nutrition, received her medical degree of University of Texas Health Science Center in San Antonio, TX. After medical school, Dr. Shaya completed three years of Family Medicine training back in Houston at Southwest Memorial Hermann Family Medicine Residency, acting as a chief resident in her final year. After being employed for 14 years by hospital systems, Dr. Shaya became an entrepreneur opening her clinic Shaya Precision Health PLLC in January 2016. Practicing with authenticity and heart, Dr. Shaya is known for her diagnostic skills, down to earth personality, and pairing a holistic approach to an allopathically managed patients. An early adopter of virtual medicine, she has been able to extend the reach of her practice to an international audience. A lifetime learner, she is currently working on her functional medicine certification through Institute of Functional Medicine. In her spare time she loves spending time with her husband and their combined 5 children, three cats and two dogs. In addition to travel, she is a voracious reader, sometimes tv binge watcher and volunteers with the Houston Livestock Show and Rodeo every season in the Health Booth. For stress management, she loves working with leather to make personal use leather items, belts and accessories. She is passionate about prevention of physician burnout, and helping manage that vulnerability. You can learn more at http://www.shayahealth.com/, or follow her on facebook https://www.facebook.com/shayahealth/ 

  5 comments for “Inappropriately Slanderous Social Media Review? “No Thank You, You’re Fired as My Patient”

  1. Leigh Ann
    July 10, 2019 at 3:56 pm

    Bravo! I just adore you. As a pharma rep and a patient who has known you for at least 10 years, kindness and respect have always been appreciated. No matter how busy you were, you always had time to treat all with kindness. I wish more of the medical community cared as much as you!!! Over the years I have witnessed many doctors treat their staff, patients and reps with disrespect.. but never you. It only makes sense that you expect the same from all. Thanks for all you do to make the world a better place!

  2. stuart
    July 10, 2019 at 10:25 am

    The one thing I will not tolerate is patients blaming my staff for problems caused by their insurance.

    “These kind people are trying to help you. Either apologize now or leave and never come back.”

    10
  3. Ken
    July 10, 2019 at 10:09 am

    Obnoxious patients are still the most stressful part of practicing medicine. Worse than the EMR, greedy admins, and sleazy insurance companies.

  4. Steve O'
    July 10, 2019 at 9:02 am

    The problem is not medical care, but the Snitch’n’Bitch culture of America. “I’m tellin!” is the threat of the eternal High School. “Woo you’re in trouble!” is the next step; “Busted!” is the consequence.
    When adults disagree, they confront each other to resolve the problem, not the hurt feelings involved. This has long disappeared from our culture, and “I’m Telling Mom!” has replaced it.
    I received a sulky e-mail from a patient whose telephone visit was canceled. He claims he did not know that it was canceled, but he insisted that it was really not canceled, and it was my fault for not fulfilling it, as our office had apparently called to confirm at an earlier date, and then called him to cancel it. He was hurt, bitter and offended, and wanted another primary care provider to comfort his trauma. Best of luck!
    The world is filled with five-star ratings about crap, and one-star ratings about mediocre service. An objective reviewer must be mature; that’s missing from our “I’m Telling Mom!” culture.

  5. Thomas David Guastavino
    July 10, 2019 at 6:53 am

    Here are my methods for handling disgruntled patients:
    1) Appointment running late because you that to respond to an emergency-
    -Stop covering the emergency room
    2) Patient demanding medically inappropriate test or procedure:
    -Say that it is their insurance company not approving the test, not you
    3) Complicated patients unhappy because they have multiple problems
    -Stop taking care of complex patients
    4) Unhappy patient because your treatments are not working
    -Become a super sub-specialist so you are at the end of the line, not the beginning
    And, of course, get rid of any complex, difficult, demanding or uncooperative patients. Its nit worth it anymore.

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