Thoughts on a Bad Review

IMG_1474It’s a Monday. Drinking my coffee and in my email is the weekly update from There is a new listing on one of the MD rating sites. I groan inwardly. By working hard to maintain patient-physician partnerships it’s easy to fall into the trap of believing it’s possible to please everyone. When staying abreast of new developments in one’s profession and practicing evidence-based medicine where it is appropriate, one thinks the bases are covered. Staying on time in order to avoid wasting my patients’ time is a priority. Encouraging patients to use exercise and dietary changes to control and reduce the development of life-threatening illnesses isn’t what every patient wants to hear though. And let’s face it, I am human. Sometimes when I see patients, it’s with exhaustion. Sometimes it’s necessary for me to get to a meeting or go home in time to take care of something. None-the-less I try very hard not to allow my impatience to show in the exam room, that’s unprofessional. But this morning there is the knowledge that patients generally don’t post online reviews unless they are unhappy gnawing in my brain. Sometimes I ask patients to review us, but I haven’t done that recently. Indeed the review is terrible. I recognize the name of the individual who posted it and am somewhat surprised. They’ve  been a patient for 10 years. It is a sad commentary on our medical relationship that after knowing someone for 10 years there isn’t enough of a comfort level to yelp (1)bring concerns to me instead of writing it in public. I look at the interaction in the EHR. Nothing jumps out at me, it was not a day I was rushed, there was discussion about an unexpected medication cost. What am I missing? How did the interaction go badly and I missed it? My office manager will reach out to the patient and ask questions. Hopefully this will improve our care (the staff was rude too, according to the review, so that may have set the stage for my failure).

Intellectually I know that the great majority of my patients are satisfied with my care (we’ve done a variety of surveys that tell me that). As written above, it’s important to me to deliver competent care that includes partnering with patients to ensure that their questions and needs are addressed. I think I’m doing the best that is humanly possible and recognize that the human element ensures that I will sometimes fail—despite knowing all this my sleep will be interrupted tonight.

And I guess that’s OK. That’s how we improve our skills.

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7 thoughts on “Thoughts on a Bad Review

  1. If only the happy patients would be as vocal, right Kathy? At least you’re one step ahead of some because you’re following up. Don’t be afraid to post a heartfelt response online if able (you didn’t say where the review was posted) because sometimes a response can be more impactful than a negative review.

    Do you have a way for patients to complain directly to you without going through the front staff? I know I’ve dealt with some people who were clearly not on the doctor’s radar and I never found a way to let’m know because the difficult people were the ones controlling the communication.

      • You have been my learned physician for over ten years. During that time you have gotten me through multiple illnesses. You are sharp, knowledgeable, witty, and a wonderful diagnostician.
        AND you staff have never been rude. Too bad that patient is not
        adult enough to deal head on with a problem area. I am confident you would have worked out her problem with her. I thank God for
        you on a regular basis!!

  2. I agree that patients should talk to their doctor about problems instead of blasting him// her online. It’s hard to say what prompts people to do something like this, especially someone who has been a patient for ten years. Perhaps the patient was having a bad day for other reasons, and the doctor was the place to dump it all. But doctors aren’t mind readers any more than everybody else. So there is only one way to tell your doctor if you’re unhappy about the office staff, the nurse, a tech, or even his/her treatment of you, and that is to be upfront about it. I couldn’t criticize a doctor online, unless he did something grossly unprofessional or incompetent, and even then I think the proper channel is through the office. I’m a former high school teacher, and trying to do my level best every day sometimes slapped me in the face, too. When a student or parent misunderstood something, or took offense at something I did or didn’t do, I was sometimes blissfully unaware until that call from the front office or another parent or teacher told me something that was being said about me. It didn’t happen often, but the few times it did, it cut me to the quick and I felt almost betrayed. It did cost me some sleep. Why not talk to me about it first? Sometimes people would rather take the easy way out, by complaining to others. This approach doesn’t really help, and the bottom line is that it has to come back to the teacher or the doctor anyway. And most likely there will still be a discussion, so if the person felt awkward talking about it upfront in the first place, they will still have to deal with it by speaking with the maligned person. Then it could be even more awkward.

    • It always amazing me that of all the professions out there, when I am speaking with patients who are teachers they often have the same professional experiences. If the patient returns to me, there was enough information that I know who it is, so you are right, the individual is going to have to deal with the post in a more personal way.

      • Doctors and teachers share many of the same work related aggravations: patients who don’t follow directions and get sicker/ kids who won’t follow directions and flunk, (then sometimes patients and students get mad as if it is the Dr’s /teacher’s fault), intervening caregivers / parents who know better than the doctor / teacher, or on the flip side, caregivers / parents who don’t care and don’t assist with administering medicine correctly or helping kids study, administration demands that make it difficult to do a quality job with the patient / student (taking up so much of our time with lots of OTHER things to do), throwing new technology at us continually, and then completely ditching a whole system to convert to another, standing at work all day, dealing with many patients / students during a workday and needing to remember little details about them, dealing with some very sad life situations with some of our patients / students, workdays that go far beyond the “8-5” that most people think it is, dealing with sometimes wonderful and sometime prickly staff members, who can make your day easier or harder, and then the big perk: patients / students who truly appreciate what you do and return to tell you so, and success stories… the ones you bring through a crisis, and see overcome it and get better. I will say that of course the crises that doctors face are far different from the one the teachers deal with: failing grades, irate parents, discipline problems, dramatic “I won’t be able to play football,etc.”. And anything that doctors deal with is so much more serious than what we face in education, although sometimes kids and parents will try to convince us that it’s life and death! I’ve often thought of my doctors when faced with things that I know must frustrate doctors, also. And now, with all of the insurance changes, and re- focused accountability, it reminds me of the Common Core Curriculum that is being forced on school districts across the nation, teacher / district accountability, and questions that we face when kids fail: what did you do to teach this student differently? if he /she wouldn’t engage, pay attention in class, why not? What could you have done about it? Why didn’t you? Out of 180 students this semester, 15 failed your class: that is unacceptable, you must be doing something wrong. But when it comes down to it: doctors have the ultimate responsibility, our health… which trumps anything that any other profession has to face. Truly, doctors are the most dedicated, caring, and brave people on the planet.

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