They Were Trying To Help
Samson was a 6 year old cat presenting with signs of urethral obstruction. The family attending him, a father, a mother, and an adorable, heartbroken girl of 8, were all in tears. They had been presented with a medical treatment plan that they could not afford.
Negotiations began. CareCredit? They couldn’t get approved. Any kind of deposit? Forget about it. The father practically turned his pockets inside out to prove he had next-to-no cash.
A big reason why the treatment plan was so financially out-of-reach was because it included sedation, urethral catheterization, and three days of hospitalization to ensure the cat didn’t re-block. The family wanted to know if there was any possible way that the hospitalization could be eliminated from the plan. Would it be possible to just sedate the cat, try to unblock him, and send him home?
Both the doctor and practice manager were resistant. They had been down this road before. What if the cat obstructed again later in the day? What if there were additional complications?
The family was positively wracked with anguish. They begged, they pleaded. The little girl wept steadily into her mother’s lap. She was inconsolable.
The doctor caved. Against her better judgement, she had the client sign an Against Medical Advice form, then sedated the cat, passed a catheter, and unblocked the patient. She kept the cat in hospital free-of-charge until he was alert and confirmed that he was patent before he was discharged at the end of the day.
The following morning, the owners called to say that the cat was behaving as though he was blocked again, but because they couldn’t afford any services, the management team referred the family to a shelter.
The medical team followed up with the client three more times, but they only got an answering machine. Then 2 days later, they read this review on Yelp:
“Stay Away!!! This place killed our cat! After making us sign a form that prevents us from suing them and charging us more than 200 dollars, Dr. Montgomery sent our cat home, only for him to re-block again. We took him to another veterinary practice, but it was too late. He died. Never take your animal here. All these people care about is money!”
Are Bad Reviews Are Inevitable?
A 2019 study published in JAMA showed that one-out-of-four physicians had been personally attacked online by a patient. Attacks were related to the care that the individuals had received, but the perpetrators were also angry enough to call out the physicians’ politics, race, or gender. Some received death threats. A 2015 JAVMA paper reported that one-in-five veterinarians also experienced negative online reviews and harassment. A 2017 U.K. survey of 16,000 physicians showed that 85% had been on the receiving side of some kind of intimidating language or behavior. On both the human and animal medicine side, online attacks were most often about patient outcomes, fees, diagnoses, and treatments.
There are hundreds of stories about practices and veterinarians receiving negative, online reviews and comments, a few of which have ‘gone viral’, and many of which have been undeserved. The experience is stressful for everyone involved and can throw the whole practice into crisis management mode for days, weeks or months.
Unfortunately bad online commentary can happen to any practice or any doctor regardless of how many precautionary protocols are in place. As long as you are engaged in the emotionally-fraught work of helping clients and pets in need, you are at risk of getting swatted at by both. When building a strategy to respond to negative online commentary, don’t start the planning with the word if, but when.
Why Do People Write Bad Reviews About Veterinarians?
Well, most don’t, actually. Though there is no clear data for veterinarians, Pew found that only 4% of patients write reviews about their doctors, but 20% of patients are likely to read reviews when choosing a doctor. This sets up a skewed view of practitioners. While a lot of weight is placed on reviews in determining a doctor’s worth, patients are gathering information from a fraction of patients seen, essentially invalidating the credibility of any review, positive or negative. In support of this finding, doctors with negative online reviews were compared with other doctors. Both had the same score on in-house patient surveys regardless of what had been said about them online.
“Numerous studies confirm that very few people actually post reviews or ratings of their doctors online. The JAMA study found that only five percent of adults surveyed had ever posted ratings or reviews of doctors. This means that one disgruntled patient or glowing review can dramatically skew results.”
Smitha Gopal for Rendia.com
But this doesn’t answer why people are inclined to lash out against doctors in public social platforms. According to experts, there are three main reasons why people write bad reviews: To express hurt, to warn others, and to be heard.
Hurt People Want To Hurt
Pet owners love their pets, so it’s only natural that some pet owners are thrown into a complete panic when their loved one is sick. For such individuals, these feelings are as novel as they are overwhelming. They have no experience expressing such sensations, so they resort to lashing out. A therapist friend described it this way, “Imagine that you have never-before-experienced pain in your leg. Because you’ve never felt it before, you are at a loss for how to describe it, so, as a way to ensure your pain is understood, you KICK someone else in their leg.”
Another therapist, Tim Hill described it this way:
“Because we only – hopefully – experience such profound pain rarely, when we do our normal coping mechanisms break down and we often just don’t know how to handle it. We can’t think straight, we can’t do what we can normally do – all we can think about is the pain we are in. Often, we can’t even express the depth and level of our pain; all we can do is show it through uncontrolled outward distress.”
Tim Hill
It’s ironic that in their interest to protect themselves, hurt people wall themselves inside a kind of silent smoldering, yet from the depths of all of that padding, the hurt individual still finds a way to let us know they are raging. Our own anger should be tempered by this perspective. In the same way that we know aggression by most of our feline patients is borne out of fear, we too should recognized that our clients’ nasty behavior is a jumbled way of telegraphing anguish.
Hurt People Want to be Heard
A big reason why pet owners take their grievances about practices or practitioners online is because they are looking for validation. They hope to tell their story to their friends and to the world at large, to be understood, and to be reassured that what happened to them was unjust or undeserved. They also hope that the veterinary office will read their comments. They want to ensure that the veterinarian and the rest of the medical team understand the ramifications of their actions. They want acknowledgement and an apology.
Tips for Navigating an Emotionally Charged Conversation
Emotionally charged conversations are intimidating even for the most experienced. They have the potential to turn loud, reactive, or even violent. Three stumbling blocks regularly confound the ability of participants to reach an accord.
Blame
It’s so commonplace for us to assign blame to a problem before we attempt a fix, that it’s likely you’ll have to give this concept more thought before you act on it or even believe in it. But I’ll give you an experiment that is sure to make a convert of you: The next time something goes down with your spouse or kids, attempt a remedial conversation by first assigning blame. Compare that approach to a second where you agree that something went wrong and sharing how everyone participated in the unfolding event. You’ll find that where the first example encourages entrenchment, the second broadens perspective and thinking.
Not Knowing What You’re Feeling
There’s a reason that you’re keyed up about this meeting. You should explore it in depth. Understanding what you’re really feeling and why will help you identify what you’re experiencing inside the meeting when tensions begin to rise. Having explored these thoughts before you walk into the room will help you manage them better when you’re inside the meeting and facing them again.
Having Your Identity Challenged
Most of us believe (or hope to believe) that we have value; that others believe we are smart, kind, honest, trustworthy, well-intended, skilled, or experienced. This sense of identity, that others think of us a uniquely relevant, good and worthy of respect, is critically important to how we feel about ourselves. If people push on these notions, we push back.
Identity issues are the toughest hurdle to clear in a heated discussion. If others challenge your sense of who you are, or worse, if you challenge the other party’s sense of self, you’re at serious risk of things turning explosive.
Fortunately being aware of this risk may be enough to help you steer clear of such pitfalls. Just trusting that the very best parts of you can’t be eroded by one meeting or one person may be enough. To protect the other individual, avoid words or body language that could be perceived as disrespectful.
Loss of Compassion, Also a Big Risk
The effects of negative online commentary, however awful, always diminish with time. This isn’t to say that you should do nothing, but keep in mind that however explosive the event may appear to be now, the world usually moves quickly on and the negativity fades.
What’s arguably more at risk is your ability to hold onto your compassion when you believe that it has been so thoroughly abused. That’s a big loss. Compassion is vital for all kinds of reasons, some of which might not be obvious to the bottom-line-styled leader:
It’s Great For Business
Compassion pushes employees to find innovative ways to help. It’s usually a major contributor to an employee’s insight into how to go ‘above and beyond’.
Compassion is a Sign of Intelligence
All IQ evaluations assess an individual’s ability to mentally manipulate objects spacialy. This flip of perspective is exactly what compassionate people are doing in your office every day; not just seeing the situation from the hospital’s perspective, but from the clients and the patient’s!
Compassionate People Are Better at Problems Solving
In their interest to ameliorate suffering, compassionate people push themselves to solve client and patient problems.
Compassionate People Strengthen Teams
There are numerous articles on the benefits of compassionate leaders, but having compassionate employees is also important for team health. When compassionate people work for your organization, you improve retention, engagement, and motivation.
Talking to Employees Who Receive Bad Reviews
Show Support, Not Disappointment
Our employee’s ability and interest in helping is important to our business, to our team, and to the employee’s own sense of self worth and identity. Our inclination as leaders is to root out the cause of negative reviews, but if our efforts heap blame on employee and add to his or her humiliation, we risk losing the client and disengaging the team member. Unless the employee’s transgression was willfully malicious, it’s vital to provide support. Use this crisis to learn, to grow trust, and to improve.
Don’t Bad Mouth the Client to Build up the Employee
Remind your team that you are seeing clients at their worst. Just like the patients you treat, clients too can bite. As a group you’re going to be more fulfilled by a compassionate perspective on this kind of a behavior than a spiteful one.
Should You Sue?
Attempted To Make Things Right
In 2014, an Australia pet owner began a social media campaign to smear the reputation of a veterinary practice owner. Her beef? She felt she had been overcharged. Despite numerous attempts on the office side to make things right, the pet owner dug her feet in and escalated her online attacks. Having had enough, the practice owner sued for defamation and won. The downside? The experience broke his spirit and ended up being one of critical factors in his decision to sell. Additionally, the money owned to him (25K and legal fees reported to be in the six figure range) have not yet been paid.
Tried in the Court of Public Opinion
According to a 2020 article in VIN, another vet, this time one living in the U.S., also endured the online wrath of a disgruntled per owner, but unlike her Australian contemporary, her attempts to stop the harassment through lawsuit were not successful. In her case, the client countersued and the online controversy increased. Though her family experienced intimidation and death threats, the authorities failed to intervene. In the end, the practice owner felt as though she had no other recourse but to sell her practice and move outside of the area.
What Attorneys Say
Attorney’s advise that every case must be weighed individually. They also warn that the should-I-or-should-I-not-sue calculus should take into consideration the effects that a lawsuit can have on your existing reputation, on the online commentary, and on your own stress levels. As one of the attorney’s I interviewed said, “It may be important for a professional to be vindicated in a court of law, but that may mean nothing if he or she has already been convicted in the court of public opinion.”
Did you know?
Consumer Reviews Fairness Act (CRFA): The CRFA is a Congressional law passed in 2016 to protect consumers from being intimidated by companies for writing bad reviews. For more on the CRFA, click the hyperlink.
Anti-Slapp Laws: 29 states have laws in place that prevent companies from using threats of legal action to intimidate consumers from writing negative reviews. View the list here.
What To Do
Here are the steps you should take when addressing a negative online comment or review.
Proactively Keep Social Alerts Turned On
The first step in managing online commentary is knowing that it exists. Make sure that you set your social media alerts to warn you of any new written posts or reviews.
Notify the Whole Team
Alert your entire staff that something negative has been written online. Your goal is not to blame them for the commentary, but to alert them that there may be other comments or even calls that are posted or phoned in that relate to it. You want to make sure that all messaging is organized and consistent.
Confirm The The Commentary is Compliant with Community Guidelines and the Law
Social sites have strictly-enforced rules regarding the kind of language that is or is not allowed on their platforms. Use these links to confirm that whatever has been said about you is within guidelines. If it is not, appeal to the site to have the review taken down.
Alternatively, many states have laws regarding online harassment and bullying. See if the online user’s actions are in violation by visiting this site. https://www.findlaw.com/state/criminal-laws/stalking.html
Reach out to the Individual Privately
Remember that a large portion of online abusers want to be heard and validated. Most often review and social sites have ways for you to privately reach out to the individual to see if they would like to discuss the matter. Before engaging in a dialogue with the individual, try rehearsing how you’ll conduct yourself and what you will say on such a call. You’ll want to come across genuinely compassionate towards the individual and interested in learning about their perspective. You should also think about how you plan to discuss fault.
The latter is an important consideration. Many attorneys and insurance agents don’t always encourage their clients to be forthcoming with the truth, though it is important to note that the AVMA code of ethics requires veterinarians to “uphold the standards of professionalism,<and to> be honest in all professional interactions,” and AVMA PLIT “supports full disclosure with an appropriate apology; to tell the whole truth, and tell it quickly.“
You don’t need me to be your moral compass on whether to admit fault, but I’ll tell you a story that may affect your decision making in this area. I have been in situations where employers asked support team members to cover up medical errors. The tactic ‘worked’ in the short term to keep the pet owners in the dark, but subsequent to the event, team members learned that there were some mistakes so shame worthy that they couldn’t be admitted. This ultimately created a culture of secrets and mistrust. Not good.
Respond Online
At this point, we all have enough experience to know when an online beef is reasonable or not, so it is not a given that other consumers will take the side of the ‘injured’ party especially if they see in your response that you are trying to make things right. Take time drafting any public response. Ensure that it is compassionate, mature, and genuine. This is your chance to let the individual, but more importantly the world, know that in the face of disagreements you are ready to be as understanding and accommodating as you can be.
Reach out For Professional Help
AVMA gives all members 30 minutes of FREE consultation through Bernstein Crisis Management. It’s probably best to make an appointment with these experienced individuals before there is an issue so you can ensure that your company has everything in place for a speedy response when something happens online, but the group is also great at responding promptly to any immediate online issues. They can be reached by email or phone.
Have Your Attorney Send The Online Aggressor a Letter
Erik Bernstein of Bernstein Crisis Management believes that a carefully crafted letter from an attorney is sometimes all that is needed to get online aggressors to dial back their behavior. Still, it’s a big gun with the potential for kickback. Speak to Mr. Bernstein or your attorney to see if this is the appropriate response for your situation.
This Too Shall Pass
Online jabs, especially when they are personal, can be humiliating, bewildering, infuriating, and frightening. They can consume all of your mental energy, tie your emotions up in knots, and can distance you from two of your most valuable assets: your team and your compassion.
It took a lot of talent and brain power to get where you are. It also took a lot of soul and humanity.Try not to allow these petty and rash client reactions to distract you from what will likely be a very full life of working, living, loving, and giving.
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