MD reviews: encouraging or enraging?

“Dr. Smith is the absolute best doctor ever! I am so lucky I found him; he takes care of me and my family, he takes the time to listen to us and he is always so caring.’“Stay away from Dr. Smith—he does not know a thing about medicine. I had a cough that wouldn’t go away and he refused to give me anything; he told me to go home and drink fluid! I will never go back to see him ever again!”Read over those two comments again—would a patient actually know anything about the fictitious Dr. Smith and his competence as a physician? Would they feel that they would like him to see them and their family as patients, or would they be worried that he will not be helpful? What kinds of feelings would these comments bring up if you replaced Dr. Smith’s name in the comments with your own name? How would you feel? How would Dr. Smith feel reading the comments? Reading the first comment might make him feel validated that the hard work he does in clinic is evident to his patients; he might be thankful that he is a family physician and this may motivate him to keep doing the good work he is doing. But when he reads the second comment, all of this goes out the door: he now feels angry, sad and frustrated. He may or may not remember this particular patient—if it happened at all (more about that later). Read: Dr. Marina Malak: Privacy perils: protection or pestering?Online doctor reviews are everywhere—from sites like RateMDs, to the individual clinic name on Google, to people’s social media feeds. There is no escaping society’s view of our care and identities as physicians. While positive reviews can be encouraging and boost our self-esteem, negative reviews can take quite a toll on our mental health, joy in work and overall attitudes toward our careers and patients.Why do patients leave reviews in general? There are patients who are truly grateful for the hard work that their doctors do—and this need not be a “miracle or life-saving story” (although certainly these exist and should be shared!). Sometimes, all it takes is for a physician to take an extra five minutes to empathize with a patient; to comfort a crying child before a vaccine; to explain discharge instructions adequately; to advocate for a referral—these are all heroic and noble aspects of our profession. And though many times these actions and gestures go unnoticed, sometimes we have patients who decide that doctors need recognition and gratitude—and they offer this by leaving a comment for the whole world to see, thanking us for our work. These positive comments can go a long way for physicians! Receiving recognition and grateful feedback from patients in the form of an online review is one way that patients can give back to their doctors. But what about the negative reviews, the seemingly horrific stories and sometimes barraging comments about physicians that are shared? First, let’s remember that not all reviews are real; patients, family members, random strangers—anyone can make up a story and leave a comment online. Recall that most sites don’t require identification to leave a comment, and even if they do, people can make up identities. Unfortunately, this can lead to harmful comments being written; indeed, many physicians say that some reviews have impacted their reputations, have contributed to feelings of burnout and depression, etc. At other times, perhaps a patient really did have a negative experience with a physician; whether their depiction in the comment is accurate is another story. We know that one’s memory or depiction of any encounter is influenced by one’s emotions and expectations. Even a small misunderstanding or miscommunication can be exaggerated into a comment that is inflammatory. Hence, it is unfortunately common that a comment left on a physician’s profile is exaggerated, emotional or contains inaccurate or distorted information. Importantly, of course, these reviews also neglect to reflect the physician’s perspective of the situation.Let’s remember, though, doctors do make mistakes, and sometimes we don’t always see eye to eye with patients. A patient’s negative review may very well be accurate—whether that means a physician truly made an error diagnosing a condition, did not take the time to thoroughly listen to the patient, etc. If left anonymously, the physicians may spend time wondering who that particular patient was. At other times, physicians may know exactly who the patient is—and then must make the difficult decision of whether to bring it up with that patient at some point. Whether or not “Dr. Smith” decides to read his patients’ reviews depends on his reaction them in general. Does he spend time ruminating on the negative reviews, reading them repeatedly and trying to discover who wrote which comment? Certainly, it can be helpful for Dr. Smith to read the grateful comments and feel how appreciated he is. It may even be useful, at times, to use the negative comments to see how Dr. Smith can improve his own practice. But it is most definitely not conducive to his mental health for Dr. Smith to scroll through the reviews weekly, scanning to see if any new comments have been posted or who has taken the time to leave a review.Open access and advances in technology have made information-sharing easier than ever—and online patient reviews are no different. If Dr. Smith happens to stumble on his reviews and read negative ones, my advice would be to remember that not all comments are real, and that patient reviews are influenced by their own biases and experiences. Dr. Smith would do well to approach the reviews with a desire to improve where possible and he most certainly ought to revel in the positive comments where patients express gratitude and appreciation for him.In the words of American speaker and author Lysa TerKeurst: “Don’t let compliments get to your head and don’t let criticisms get to your heart.”Dr. Marina Malak is a family physician in Mississauga, Ont.

MD reviews: encouraging or enraging?

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