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How should we respond to negative comments on social media?

Three experts advise a GP in a social media quandary

Our practice has been receiving negative comments on social media. How should we deal with this?

Dr ruth chambers square

Dr Ruth Chambers: Acknowledge the response as genuine feedback

Dealing with negative comments is quite simple. If they are general grumbles then you should accept this is genuine feedback and should respond with a general comment such as ‘Thank you for your feedback, we are sorry to hear you are unhappy as we strive to provide the best service we can’. If the negative comments are constant, you need to examine what the cause is as this will probably reflect a genuine opinion of your quality of service. On Facebook, if the complaint relates to a specific incident then you should privately message the complainant and ask them to make an official complaint at the practice. Then you should remove the complaint from the page. Clearly, if the complaint is offensive, remove it immediately. If a patient continues to be offensive then you can block them from the page. Here is a nice video explaining how people working in health and care should respond to internet trolls.

Bear in mind that patients can create a profile for your practice on Facebook simply by ‘checking in’. If this happens, you have no control over the comments that are then posted by other patients believing this to be an official page. The first bit of advice is check if you have one of these ‘unofficial pages’ and if you do, set up a real one as this will appear first in any searches and can be managed.

Internet trolling can be more of a problem on Twitter as the accounts often give less information about the person so they feel more confident to behave in this way. The approach will always be the same though.

Remember, social media offers the most effective method of engaging with patients and helps raise awareness of issues such as demand pressures and contributing factors such as DNAs, self care and screening programmes. If you are really uneasy then a first step can be to create a private Facebook group for your practice and invite patients to join - that way any negative comments will not be open to the wider public.

Dr Ruth Chambers is a GP in Stoke-on-Trent, Chair of Stoke-on-Trent CCG. This was written with Marc Schmid a digital health consultant. They are authors of ‘Digital Health Care – The Essential Guide’ .

Dr Trevor Thompson

Dr Trevor Thompson: Stay cool and analytical

Consumer feedback on goods and services, on websites like TripAdvisor and Amazon, is part of the fabric of modern living and we learn to discriminate between well-articulated comments and someone ‘going off on one’.

The mood changes however when we ourselves are in receipt of public feedback though forums such as Twitter and NHS Choices. Like every author and hotel in the land, GPs need to accept that negative comments will inevitably appear on social media.

With NHS Choices it is vital to have someone checking the site regularly (normally a practice manager, but could be a member of admin staff) and feeding back where concerns are raised. Stay cool and analytical. What are the issues, are they familiar (appointments), do they relate to a particular individual or particular incident? As appropriate, feed issues into your significant events system.

Respond to all comments. It doesn’t take long to write a balanced and constructive response to even the most seemingly unfair posting. Avoid using stock phrases as this will cause other viewers to doubt your sincerity. Invite the commenter to contact the practice in person. You get the last word.

NHS Choices, unlike some forms of social media, does at least use moderation to weed out defamatory comments and you have the right to report a comment as unsuitable – but not just because it was critical. From the NHS Choices home screen hit the 'For Professionals' link and from there a link entitled 'Managing User Comments FAQ'. This offers excellent guidance.

A barage of negative coverage can hit morale and it may be worth sending a message to all staff offering context, solace and solutions. It is unethical to solicit good reviews from patients, but if a patient spontaneously expresses delight in the service I see no harm in reminding them about NHS Choices.

Dr Trevor Thompson is a GP and reader in health education, University of Bristol 

Dr Naeem Nazem

Dr Nazeem Nazem: Beware of breaching confidentiality

Posts that are malicious in nature, or use racist or discriminatory language, are clearly unacceptable and should never be tolerated. In the first instance, doctors should contact the social media site directly and request that the comments be removed. Facebook, for example, have a set of Community Standards and will remove content that violates its terms.

The best way to react to any negative comments on social media is to respond with a generic statement highlighting that the practice takes all concerns seriously and would request any dissatisfied patient to make contact directly so that any issues can be addressed.

Many comments posted on social media express unhappiness with the clinical care or service provided by an individual doctor or member of staff. It may be tempting to redress the balance, correcting any obvious miscommunication or factual errors. However doctors should be mindful of their ongoing duty of confidentiality to their patients, as well as recognising that not everyone on the internet is who they say they are.

Responding to messages or comments on social media risks compromising patient confidentiality and may call into question a doctor’s professionalism. The GMC guidance Doctors’ use of social media states: ‘you must not use publicly accessible social media to discuss individual patients or their care with those patients or anyone else.’ There is also the possibility of inflaming the situation and encouraging further negative posts.

By asking patients to make contact with the practice directly, doctors can protect patient confidentiality while maintaining their professionalism. Doctors will then have an opportunity to listen to the patient’s concerns and hopefully reach a resolution.

Dr Naeem Nazem is a medico-legal adviser at MDDUS 

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