1st Real Patient Review

[SpoiledMilk]

Mixed emotions with 1st ever real patient review of my performance in clinic. Paraphrasing the pt's comments with synonyms as to preserve privacy from google searches.

M.A. asked pt if they were ok with seeing Dr AND MS together. Yes. But MS arrived alone.
Pt agreed to have MS examine/speak to them after being asked permission by MS, followed by should not have agreed.
Next, MS did well and bedside manners were awesome.
Last, MS will do fine going forward but won't if gets ruined by Doc.
Rating was single star out of five stars.

Huh???

Do you still read your patient reviews?

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[anonperson]

Mixed emotions with 1st ever real patient review of my performance in clinic. Paraphrasing the pt's comments with synonyms as to preserve privacy from google searches.

M.A. asked pt if they were ok with seeing Dr AND MS together. Yes. But MS arrived alone.
Pt agreed to have MS examine/speak to them after being asked permission by MS, followed by should not have agreed.
Next, MS did well and bedside manners were awesome.
Last, MS will do fine going forward but won't if gets ruined by Doc.
Rating was single star out of five stars.

Huh???

Do you still read your patient reviews?

Patients are typically dumb. You can get a five star review by doing anything they want even if it's not indicated or prescribe a bunch of narcotics for back pain etc.

I'll keep an eye out on my reviews to look for anything that really trashes me. I've had one that did but the patient used an alias on Google review so I was able to get it deleted.

But it was stupid stuff. I didn't prescribe vit b6 to the patient and told them to get it over the counter. This was enough to elicit a one star review.

Another patient was seeing me for OB care. Saw the PCP in our clinic for a URTI and wasn't happy with that care. She left a scathing review about how the clinic was terrible and she wanted to switch out etc. I was going to do a planned c section on her but didn't want to now because of this review (liability risk). I had the office manager reach out to the patient and address the review. Told her we can transfer your care easily so you can be happy with your care. She refuses and I continue to see her. I did her c section and she was happy with the care but still hasn't taken down the review.

But I do actively solicit patients who are happy with their care to write positive reviews. It's the new reality that these reviews can color a new patients perception.

 

[Splenda88]

Patients are typically dumb. You can get a five star review by doing anything they want even if it's not indicated or prescribe a bunch of narcotics for back pain etc.

I'll keep an eye out on my reviews to look for anything that really trashes me. I've had one that did but the patient used an alias on Google review so I was able to get it deleted.

But it was stupid stuff. I didn't prescribe vit b6 to the patient and told them to get it over the counter. This was enough to elicit a one star review.

Another patient was seeing me for OB care. Saw the PCP in our clinic for a URTI and wasn't happy with that care. She left a scathing review about how the clinic was terrible and she wanted to switch out etc. I was going to do a planned c section on her but didn't want to now because of this review (liability risk). I had the office manager reach out to the patient and address the review. Told her we can transfer your care easily so you can be happy with your care. She refuses and I continue to see her. I did her c section and she was happy with the care but still hasn't taken down the review.

But I do actively solicit patients who are happy with their care to write positive reviews. It's the new reality that these reviews can color a new patients perception.

These are things that are pushing me to get out of medicine ASAP. Physicians are treated as people who a selling products on Amazon.

 

[cabinbuilder]

Patient's are hateful and are used to "the customer is always right" and get pissed when they don't get what they want even if it's not medically sound. I NEVER read patient reviews and NEVER read PRESS GANEY reviews because those who review are petty, bitchy, and pouty about not getting what they think they deserve because their cereal box degree is better than yours. I know who my fan club is, I don't have to read about it.

 

[hallowmann]

I remember one of my first Press Ganeys was from a patient whom I saw, and listened and talked to extensively about viral illnesses and antibiotics, made sure she was heard, responded appropriately, and ultimately it seemed reasonable to prescribe an antibiotic. Patient still chewed me out in Press Ganey because I didn't "listen to her from the beginning" and automatically say she needed the antibiotic when she suggested it at the very start of the visit. I was instead "condescending" by asking her more questions because she "knows her body and knew she needed an antibiotic". And this was someone I actually prescribed antibiotics to, and who absolutely did not voice any annoyance or concerns during the visit.

After that I said F-it and don't care nearly as much about the reviews. The many patients that like me for being straightforward with my explanatioms and reasonable with prescribing are enough for me, if I don't see them again, it's for the best for them and me.

 

[goldsummer]

I've gotten bad reviews. a few were basically due to:

- patient not wanting to come into a visit for an evaluation and wanting me to just send in antibiotics. i denied this and required a visit. they got angry with me at the visit telling me about how uncaring a doctor i am because they had to take off work to come and drive here, they mention how expensive gas was. I politely defended myself. In hindsight, I shoulda told them to get down off their pedestal and follow the process like everyone else or find another clinic.

- patient switching to me from another provider (at an outside clinic) and has a future visit called in requesting i fill their oxycodone before the visit. I reply with i dont do chronic pain meds and wont prescribe until seeing the patient anyways and put in a referral to pain management. They didnt schedule with pain management and show up to establish care visit angry and im a horrible doctor etc. I still go through the visit with them and take care of other needs. I get a terrible review after.

These are just a few. These experiences along with everything else sort of make me a bit jaded about the job...

Patients are typically dumb. You can get a five star review by doing anything they want even if it's not indicated or prescribe a bunch of narcotics for back pain etc.

I'll keep an eye out on my reviews to look for anything that really trashes me. I've had one that did but the patient used an alias on Google review so I was able to get it deleted.

What is the process to get it deleted? I have one I feel is purposed just to bash me and they used an alias.

 

[anonperson]

I've gotten bad reviews. a few were basically due to:

- patient not wanting to come into a visit for an evaluation and wanting me to just send in antibiotics. i denied this and required a visit. they got angry with me at the visit telling me about how uncaring a doctor i am because they had to take off work to come and drive here, they mention how expensive gas was. I politely defended myself. In hindsight, I shoulda told them to get down off their pedestal and follow the process like everyone else or find another clinic.

- patient switching to me from another provider (at an outside clinic) and has a future visit called in requesting i fill their oxycodone before the visit. I reply with i dont do chronic pain meds and wont prescribe until seeing the patient anyways and put in a referral to pain management. They didnt schedule with pain management and show up to establish care visit angry and im a horrible doctor etc. I still go through the visit with them and take care of other needs. I get a terrible review after.

These are just a few. These experiences along with everything else sort of make me a bit jaded about the job...




What is the process to get it deleted? I have one I feel is purposed just to bash me and they used an alias.

You can report reviews and give a reason.

I wasn't sure it was going to work but the review eventually came down.

Sorry to hear about your experiences. The pain patients are the worst.

 

[Ironspy]

You can report reviews and give a reason.

I wasn't sure it was going to work but the review eventually came down.

Sorry to hear about your experiences. The pain patients are the worst.

Psych here but I had a deranged lady leave the same 1 star review on multiple sites. I asked my friends and family to flag them as not helpful/inappropriate and it took a few months but they were all eventually removed

 

[Sleepingdoc]

Dont worry about reviews... this whole system of reviews are just stupid.
So you are asking bunch of sick people if you had great service???? Really

We are not serving cookies or fried chicken here. No one really cares about reviews except the admins who bring this nonsense up during committee evaluation for yearly reviews. I just tell them, i dont care about reviews, please dont ever bring it up or i will quit and you would have to hire a brand new physician to see all my panel. That fixes things.

 

[VA Hopeful Dr]

Dont worry about reviews... this whole system of reviews are just stupid.
So you are asking bunch of sick people if you had great service???? Really

We are not serving cookies or fried chicken here. No one really cares about reviews except the admins who bring this nonsense up during committee evaluation for yearly reviews. I just tell them, i dont care about reviews, please dont ever bring it up or i will quit and you would have to hire a brand new physician to see all my panel. That fixes things.

I would urge caution with this approach. Most places won't fire you over it, but they can make life difficult for you.

 

[bronx43]

I would urge caution with this approach. Most places won't fire you over it, but they can make life difficult for you.

That’s why people should and are simplifying their lifestyle and trying to FIRE.

 

[VA Hopeful Dr]

That’s why people should and are simplifying their lifestyle and trying to FIRE.

That is of course an option, but its not for everyone.

 

[bronx43]

That is of course an option, but its not for everyone.

Of course. Though there are really only two options for most people: pander to base instincts of patients while taking it from admin or FIRE.

If one needs the cash flow to keep a lifestyle then there really isn’t a choice.

 

[VA Hopeful Dr]

Of course. Though there are really only two options for most people: pander to base instincts of patients while taking it from admin or FIRE.

If one needs the cash flow to keep a lifestyle then there really isn’t a choice.

Its not quite so black and white.

 

[bronx43]

Its not quite so black and white.

Sometimes it is and other times it’s not. Just depends on practice location and environment. My previous big city job in a large institution was more often than not pandering to all parties involved. At my current gig, not so much.

 

[Sleepingdoc]

I would urge caution with this approach. Most places won't fire you over it, but they can make life difficult for you.

There are so many options as a physician, so much work out there. I am getting calls every week asking me to work for them, few just begging.. These are options for everyone breathing with a license to practice. Admin's are aware of that too. If they make life difficult, i just give them my notice.

 

[VA Hopeful Dr]

There are so many options as a physician, so much work out there. I am getting calls every week asking me to work for them, few just begging.. These are options for everyone breathing with a license to practice. Admin's are aware of that too. If they make life difficult, i just give them my notice.

Again, not a great option for everyone. If you have the flexibility to do that, great. I mean that sincerely as it's the main power we still have.

 

[scharnhorst]

Judging a doctor by patient reviews is like asking cadets in a military academy to grade their drill sergeant !

 

[SLC]

My favorite are the people you inherit from another provider who’ve been totally mismanaged and who expect to continue to be mismanaged because they like what they’re getting out of it.

I’m strict about controlled substances, when people find out I’m not as loose with the Xanax as the last doc that worked here, they have taken to google reviews to trash me.

No luck getting any of them taken down either.

 

[FrustratedFamDoc]

A review is all about how a patient felt when they walked out the door. It is NOTHING to do about the actual care rendered.

With this being understood, the psychological component of the visit is literally, everything in this regard.

Were you confident but not arrogant? Did you steer the conversation correctly, letting them finish what they had to say, without making it feel like you were butting in? Was eye contact appropriate, but not creepy? Did you come off as dismissive of their concerns? Did you translate doctor speak in to English without sounding condescending?

Most non medical people have no clue how to tell a bad doc from a good one, but they sure do know when they’re being treated like a nobody. Unfortunately, we all have colleagues who are very guilty of this, who hurt it for the rest of us.

To me, learning and understanding the ability and style in which I communicate with my patients has been the most challenging part of what I do, but it is far and away the #1 reason for my referrals.

Most of the time It’s not that you told them you weren’t doing xyz, it’s HOW you told them. Yes, of course there are exceptions, but as a rule it holds true.

No, I’m not writing Xanax, you’ll have to find someone else.

Or

Xanax? Aren’t you tired of being a slave to that ish? Let’s talk homie. I’m going to take 5 minutes of your time, then I’ll let you get out of here.

They came in loaded for bear. You flipped the script while at the same time coming across as not another a-hole doctor.

The vibe is now ‘I won’t write it because I care about you’ instead of ‘I won’t write it so stop asking.’

 

[scharnhorst]

also lower expectations I cannot stress that enough
I have seen over the yrs lots of young docs esp FP/IM start off thinking they are hot $hit and then when they can't satisfy patients demands get frustrated

 

[scharnhorst]

My favorite are the people you inherit from another provider who’ve been totally mismanaged and who expect to continue to be mismanaged because they like what they’re getting out of it.

I’m strict about controlled substances, when people find out I’m not as loose with the Xanax as the last doc that worked here, they have taken to google reviews to trash me.

No luck getting any of them taken down either.

oh yes dealt with a LOT of that
3 options
1-steer the course if no harm is done or expected [rarely]
2 -be a total a$$ and tell them how it is [10%]
3- show little interest in following previous doc recs and I can only do so much as thats how I'm trained.You are welcome to a 2nd opinion [90%]

 

[scharnhorst]

Xanax? Aren’t you tired of being a slave to that ish? Let’s talk homie. I’m going to take 5 minutes of your time, then I’ll let you get out of here.

They came in loaded for bear. You flipped the script while at the same time coming across as not another a-hole doctor.

The vibe is now ‘I won’t write it because I care about you’ instead of ‘I won’t write it so stop asking.’

great point but this takes time and effort
and yield is not that great
I've done it many a times but its a judgement call

 

[allantois]

Reviews saying you don’t give out controls, are good reviews even if they are 1 star

 

[Ubba]

1. My understanding is that waiting lists to see PCPs are very long. And most patients won't bother to look at WebMD. Your appointments will probably fill regardless.

2. No other physician will judge you negatively for negative patient reviews. We all know how it is. Frankly, it is absurd that HIPAA prohibits us from responding to patient reviews. If they start it, we should be allowed to respond. Maybe it's for the best, though. Forces us to not diminish ourselves by getting into the muck with them.

 

[allantois]

I know lots of people who respond to their reviews in a pretty nasty way lol

 

[dozitgetchahi]

My personal feeling is that if any doctor gets universally “good” reviews, they’re almost certainly doing something wrong. Lots of patients are poor advocates for themselves and their health and will want things that are harmful for them. Part of your job as a doctor is to say “no” when patients ask for something stupid. If you “satisfy” each and every patient, you’re often doing harm. Even putting this aside, you won’t make everyone happy no matter how hard you try.

**** the reviews, and **** the institutions that worship them. My current job is really good in a lot of ways, but they care about “patient satisfaction” scores like no job I’ve had previously and it’s definitely irritating to have to hear about it over and over. Especially when toxic patients are filing nonsense complaints over the stupidest things.

 

[dozitgetchahi]

oh yes dealt with a LOT of that
3 options
1-steer the course if no harm is done or expected [rarely]
2 -be a total a$$ and tell them how it is [10%]
3- show little interest in following previous doc recs and I can only do so much as thats how I'm trained.You are welcome to a 2nd opinion [90%]

Fourth option: filter these patients out before they ever hit your door.

I’m rheumatology and I often decline a referral if a ****load of controlled substances are on the med list, or if I get even a vague sense that the patient is on a drug seeking expedition. The local PCPs seem to do the same.

 

[dozitgetchahi]

A review is all about how a patient felt when they walked out the door. It is NOTHING to do about the actual care rendered.

With this being understood, the psychological component of the visit is literally, everything in this regard.

Were you confident but not arrogant? Did you steer the conversation correctly, letting them finish what they had to say, without making it feel like you were butting in? Was eye contact appropriate, but not creepy? Did you come off as dismissive of their concerns? Did you translate doctor speak in to English without sounding condescending?

Most non medical people have no clue how to tell a bad doc from a good one, but they sure do know when they’re being treated like a nobody. Unfortunately, we all have colleagues who are very guilty of this, who hurt it for the rest of us.

To me, learning and understanding the ability and style in which I communicate with my patients has been the most challenging part of what I do, but it is far and away the #1 reason for my referrals.

Most of the time It’s not that you told them you weren’t doing xyz, it’s HOW you told them. Yes, of course there are exceptions, but as a rule it holds true.

No, I’m not writing Xanax, you’ll have to find someone else.

Or

Xanax? Aren’t you tired of being a slave to that ish? Let’s talk homie. I’m going to take 5 minutes of your time, then I’ll let you get out of here.

They came in loaded for bear. You flipped the script while at the same time coming across as not another a-hole doctor.

The vibe is now ‘I won’t write it because I care about you’ instead of ‘I won’t write it so stop asking.’

Yeah, all that is nice in theory. As a rheumatologist, I make a great big effort towards that.

It often makes no difference.

There are some (many?) patients who appreciate it. There are also a larger than expected fraction where they don’t want to hear why you won’t give them opioids etc. In rheumatology, there are also a fair few patients who expect to be able to talk your ear off for an hour about every silly ass stupid somatic complaint and issue they’re having, and you simply don’t have the time to accommodate this. It’s one thing when one patient does this in a day, but when half your clinic panel does, it’s just absurd, and you have to be able to “cut and run”. You have a schedule in clinic, and while I'm happy to go over to take care of an actual super sick lupus patient, I’m really not happy to do so for yet another bored middle aged woman who passionately thinks she has SLE but doesn’t. I’m often very reasonable and (perhaps excessively) accommodating, but at some point as the patient you need to hear that this is my opinion and arguing with me about it for half an hour 1) isn’t going to change anything and 2) is just a waste of time for you, me, and all the patients in the queue behind you.

Unsurprisingly, setting basic boundaries in clinic yields negative reviews. But consistently running an hour behind to accommodate every last patient’s trifles and “needs” also yields negative reviews from all the other patients who had to wait. After about 5 years of doing this, I’m firmly in the camp of “set boundaries and piss a few people off”. And like I said above, I actually think that a good doctor should be pissing some patients off. A good doctor should set “bright line” boundaries that they won’t cross, not indulge patients’ silly fantasies about what is wrong with them, not tolerate ostriches who want to bury their heads in the sand while their health disintegrates, etc. A surprising fraction of the doctors I hear of who “everyone adores” are actually charlatans, horrible clinicians, have a super loose script pad and are contributing to the opioid disaster in this country, or some combination of the above.

 

[VA Hopeful Dr]

My personal feeling is that if any doctor gets universally “good” reviews, they’re almost certainly doing something wrong. Lots of patients are poor advocates for themselves and their health and will want things that are harmful for them. Part of your job as a doctor is to say “no” when patients ask for something stupid. If you “satisfy” each and every patient, you’re often doing harm. Even putting this aside, you won’t make everyone happy no matter how hard you try.

**** the reviews, and **** the institutions that worship them. My current job is really good in a lot of ways, but they care about “patient satisfaction” scores like no job I’ve had previously and it’s definitely irritating to have to hear about it over and over. Especially when toxic patients are filing nonsense complaints over the stupidest things.

As much as I'd like to blame hospitals for it, this is a CMS measure.

Fourth option: filter these patients out before they ever hit your door.

I’m rheumatology and I often decline a referral if a ****load of controlled substances are on the med list, or if I get even a vague sense that the patient is on a drug seeking expedition. The local PCPs seem to do the same.

Employed PCPs can't really do this most of the time.

 

[dozitgetchahi]

As much as I'd like to blame hospitals for it, this is a CMS measure.


Employed PCPs can't really do this most of the time.

Several local PCP clinics are now doing criminal background checks on patients before they take them, as well as reviewing charts etc. I don’t know how/why they’re able to get away with this, but they are.

Also, CMS measure or not, some institutions seem to care about all of this way more than others. As I mentioned earlier, my current PP is simply obsessed with “patient satisfaction” scores to an extent that I’ve never had to deal with before - not even at previous horrible hospital jobs.

 

[VA Hopeful Dr]

Several local PCP clinics are now doing criminal background checks on patients before they take them, as well as reviewing charts etc. I don’t know how/why they’re able to get away with this, but they are.

Also, CMS measure or not, some institutions seem to care about all of this way more than others. As I mentioned earlier, my current PP is simply obsessed with “patient satisfaction” scores to an extent that I’ve never had to deal with before - not even at previous horrible hospital jobs.

That tells me they had some really bad problems with patients in the recent past.

Private practice is naturally going to care more, they don't have built in referral bases and advertising like hospital systems do.

 

[90sportsfan]

I was talking to an attending about this, and she told me that at first the patient reviews were hurtful, but after the initial shock of a bad one, they lose their sting. As others said, many of the 1-star/low reviews are not about actual clinical care; they are often about "length of time to get an appointment," "receptionist attitude," "certain office policies," etc. Some of them can actually be constructive (i.e. if there is a receptionist who many are complaining about, messages not getting returned, scheduling challenges, etc.). Also, while it can be difficult to read, sometimes our body language, mannerisms, or communication during patient interactions could inadvertently be perceived differently by patients. So if there are consistent comments, it could be constructive feedback for ways to improve during patient interactions that we never realized.

The worst are the downright rude and hurtful comments some patients make questioning your competence, calling you the "worst doctor ever," etc (luckily these seem to be more rare). Those are hurtful because if your friends, family, son/daughter, boyfriend/girlfriend, potential dating partner, or former classmates Google your name, they will see it. There are some senior faculty who I really respect and I kinda cringe when I read some of the nasty patient comments they have received, and worry if my future residents/fellows/students will see similar comments if they Google my name (I'm a resident but want to go into academics). I guess it's just comes with the territory.

 

[VA Hopeful Dr]

I was talking to an attending about this, and she told me that at first the patient reviews were hurtful, but after the initial shock of a bad one, they lose their sting. As others said, many of the 1-star/low reviews are not about actual clinical care; they are often about "length of time to get an appointment," "receptionist attitude," "certain office policies," etc. Some of them can actually be constructive (i.e. if there is a receptionist who many are complaining about, messages not getting returned, scheduling challenges, etc.). Also, while it can be difficult to read, sometimes our body language, mannerisms, or communication during patient interactions could inadvertently be perceived differently by patients. So if there are consistent comments, it could be constructive feedback for ways to improve during patient interactions that we never realized.

The worst are the downright rude and hurtful comments some patients make questioning your competence, calling you the "worst doctor ever," etc (luckily these seem to be more rare). Those are hurtful because if your friends, family, son/daughter, boyfriend/girlfriend, potential dating partner, or former classmates Google your name, they will see it. There are some senior faculty who I really respect and I kinda cringe when I read some of the nasty patient comments they have received, and worry if my future residents/fellows/students will see similar comments if they Google my name (I'm a resident but want to go into academics). I guess it's just comes with the territory.

No one in your personal life cares at all about your online patient reviews.

The only people in your professional life who would care are your employers.

 

[HemeOncHopeful19]

There are some senior faculty who I really respect and I kinda cringe when I read some of the nasty patient comments they have received, and worry if my future residents/fellows/students will see similar comments if they Google my name (I'm a resident but want to go into academics).

This is the most Academic MD post I might’ve ever seen on this forum, lol.

The only people googling your patient reviews are potential future patients (ok… and maybe your grandma), nobody else gives a hoot about your “reputation”

 

[Ironheme]

Also, a lot of us also have the problem of having too many patients rather than too few. So a couple of bad reviews when I have to choose between good medicine and patient satisfaction is not an issue.

I'm the one that has to live with myself at the end of the day and I'd rather not be known as the local candyman.

 

[sloh]

This is the most Academic MD post I might’ve ever seen on this forum, lol.

The only people googling your patient reviews are potential future patients (ok… and maybe your grandma), nobody else gives a hoot about your “reputation”

That’s why he’s going into academics lmao