___________________________________________ DCA05DE Dental Ethics and the Digital Age, 3rd Edition
CASE STUDY 5 A patient posts a negative comment concerning the post-op pain and slow healing of a dental extraction. The dentist is frustrated and knows that the patient is a heavy smoker, which is most likely the cause of the problem. The dentist must not publicly respond by voicing the opinion that the patient’s heavy smoking is delaying the healing. 1. What strategies can healthcare providers, particularly dentists, use to manage their online presence effectively? 2. How can healthcare providers encourage positive online reviews from satisfied patients? 3. What ethical considerations should guide a provider’s response to negative online reviews? From the provider’s perspective, privacy issues may seem like an uneven playing field, but it is the law. Providers can respond to criticisms with general information about their practices and procedures but may not discuss an individual case (Parr, 2024). Many negative posts are anonymous, but if the provider knows who the patient is, they might consider calling them personally to discuss the concern. Dentists and physicians have had limited success suing for unwarranted negative online reviews despite attempts under defamation law, which covers false statements presented as facts that harm reputations. Written defamation is libel, while spoken is slander (Earle, 2021). Proving defamation is often difficult and costly due to First Amendment protections of opinion and the anonymity of online commenters (Parr, 2024). Legal action can also backfire by drawing more attention to nega- tive remarks. Professionals concerned about their reputations should seek appropriate legal advice. Another ethical issue involving these sites is the practice of posting falsely positive comments. Business owners can hire companies to post falsely positive comments on these websites to promote their businesses. This practice is unprofessional and unethical and should not be allowed to occur. Dentists can certainly encourage happy patients to post positive com- ments. This is ethically permissible and a great way to boost online presence. Since consumer review websites are here to stay, dentists should come to terms with them and use them to their advantage (Parr, 2024). Below are some suggested strategies to help healthcare providers manage online reviews: • Monitor Online Presence: Regularly track what is being posted about providers and the practice using tools like Google Alerts or hiring internet watchdog services. This proactive approach allows for timely responses to negative remarks and helps monitor patient feedback trends. • Build a Positive Online Presence: Create a website showcasing provider credentials, practice philosophy, office details, and more to foster credibility and prepare patients. This can also help counteract any negative comments.
In the pre-Internet world, medical professionals were “reviewed” by word of mouth – positive or negative comments made by existing patients to potential patients concerning their experiences in the office. The potential patient could evaluate the source of the opinion and decide whether to take that person’s comments – good or bad – seriously. Word of mouth is still critical to gaining new patients and building a practice. However, the form “word of mouth” can take has greatly changed. Consumer review websites such as Google, RateMDs, WebMD, Healthgrades, and dozens of others allow patients to post online comments about dental providers and practices quickly and easily. Online reviews may be just as powerful as personal recommendations or disparagements. According to Parr (2024), 84% of patients visit online review sites to evaluate healthcare providers and 73% consider online reviews when selecting a provider. Also, 40% of consumers state that they consult reviews on multiple sites before deciding, while 72% of patients say they would only consider a provider with an average rating of 4 stars or higher. As these website reviews become a mainstay of consumer decision-making, dental professionals cannot ignore them. Even dentists who have resisted the movement to a robust online presence cannot escape the commentary posted on these third-party review sites. Therefore, knowing how to handle negative commentary and protect a provider’s and practice’s reputation is essential. If all the comments posted on these sites were positive, no one would find them cause for concern. Most consumer review websites use a grading system of 1 to 5 or 1 to 10, with the higher number being the higher rating. These sites also accept comments and numerical ratings, and the postings can be anonymous. Although most ratings tend to be positive (Parr 2024), even one negative rating or disparaging comment can hurt a provider’s feelings and, worse, damage their reputa- tion. Imagine how it would feel to see posted on one of these review sites: “Dr. (insert your name) is a QUACK! Avoid him at all costs!” Alternatively, “The office is dirty, and the staff are lazy.” Because the posts can be anonymous, it is not out of the question that a disgruntled employee or a competitor might post something negative. It would be impossible for others who view that post to know the ill intent of such commentary. Physicians and dentists have approached these issues in varying ways and some cases revolving around these websites have made their way into the legal system. One challenge to responding to negative commentary on such sites is HIPAA. As discussed earlier in this course, online patient interaction is a public forum. Patients have the legal right to disclose their protected health information, but health providers cannot disclose it without their consent. Consider the following case.
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