Ok. I’ve got this deep, dark secret. Please don’t look away, I assure you most of us have this same secret, and it is safe for work. This secret is that I dream that I “win” by responding to on-line complaints. I boldly respond to an on-line complaint. I throw caution to the wind and unfurl the sails of courage. I relate my reasonable positions, refute lies and misstatements, and the on-line community vindicates our practice. Ah… they will throw laurels of ‘likes’ and ‘smileys’ because they’ll see how ridiculous and untrue the on-line complaint is. The poster apologizes and removes their offending opinions. Additional positive reviews will be driven by my madly successful approach. All is well in the land of five stars and 100% positive ratings.
Ok. Get real. That almost never happens. More often my responses blow up with more negative comments, more people reading what was once a buried, mostly ignored review, and even more frustration for me. People love a good fight or heated argument, particularly if they can watch from the sidelines.
And let me tell you a little known truth… Veterinary practices are at a severe disadvantage in on-line discussions about clients and patients. Client confidentiality rules, public opinion, and a lack of information or interest in what goes on behind the scenes at a clinic, all conspire to tie our hands in responding. Our vets could be disciplined or lose their veterinary license for social media missteps, even falling afoul of unprofessional conduct standards.
Yes, we can get in trouble for social media posts and review responses. There are reasons I don’t share information on the patient or procedure on-line. Some states, like Florida, New Jersey and California, have express confidentiality rules about disclosing patient/procedural information. Some states are more vague and instead have truthfulness and non-deception standards, such as Georgia’s rule 700-8-1 (a) “A licensee or registrant shall not make any false, misleading or deceptive communication….”
Even the ethics on posting information from a patient record is questionable. The AVMA’s ethical code states “The information within veterinary medical records is confidential. It must not be released except as required or allowed by law, or by consent of the owner of the patient.” This isn’t a universal standard, but there is one thing I do know… sharing a treatment record on a complaint forum is likely to get a whole bunch of pet owners bothered about their record confidentiality. So ethically, and in some states legally it I shouldn’t do it; and from a business perspective it’s likely to cause more harm than good to my clinic and the veterinary practice in general.
But in the event that you absolutely have to respond, particularly after you’ve failed to resolve it by communicating directly, there are some ways to do it that will reduce the chances that you risk your livelihood and business. Just set your expectations low and have a clear goal.
My goal when I respond is to convey that “our hospital heard the concern and tried to improve because of it.” That’s it. I don’t need to win the court of complaint forums, I just have to look like I care. The more someone posts, the more unhinged they look, even if it’s reasonable. Think about it, how many long public exchanges have you read in forums and complaint sites where you thought “wow, those people are both so reasonable, I’d love to have them spend time with me….” That’s not what I think. I generally think ‘these two people are idiots, take it somewhere else, please!”
And once I have a goal, I determine what I *can* share, and what I should share. The two are rarely the same. I’ll explain what I do, and when it’s a can vs. a should.
What we can say is very different than what we should say. Veterinary medicine is not pretty, it’s not perfect, but its needed and usually appreciated. I encourage our staff to respond by talking about how we care and are concerned for the pet. Then we talk about how saddened we are for their bad experience, what we are willing to do to help them, and how their feedback has helped us to become a better clinic. This is just about all I recommend you should do.
I don’t share information on the patient or procedures. Some states, like Florida, New Jersey and California, have express confidentiality rules about disclosing patient/procedural information. Some are vague and merely have truthfulness and non-deception standards, such as Georgia’s rule 700-8-1 (a) “A licensee or registrant shall not make any false, misleading or deceptive communication….” The AVMA’s ethical code states “The information within veterinary medical records is confidential. It must not be released except as required or allowed by law, or by consent of the owner of the patient.” There isn’t a universal standard, but there is one thing I do know… sharing a treatment record on a complaint forum is likely to get a whole bunch of pet owners bothered about their record confidentiality. So ethically, and in some states legally it I shouldn’t do it; and it’s likely to cause more harm than good to my clinic.
Is there an obligation of Confidentiality once they post something? Yes and no. Generally they’ve made the information public. But if I dispute something as untrue, I am in effect providing additional confidential information to the public. For example, if they say our clinic didn’t x-ray the leg of their cat, then by my responding “that’s right, because we were treating for a blocked tom, not for leg issues…” it might feel satisfying, but I’ve breached client confidentiality rules. The best thing to do is just let them know you don’t discuss patient treatment on public forums, but would be happy to discuss or provide a copy of the treatment records to the client. That’s all I need to say. A person reading that will at least know that we keep things confidential and have good records on the medicine we perform. It may bring less satisfaction that embarassing the client by exposing their falsehoods, but my goal isn’t to embarass former clients, it’s to manage our practice well and perform good medicine. And while that brings some lost opportunities, our clients can be comfortable in knowing that we won’t engage in negative public spats with any client.
I can share commercial details, ie..if the charges were the topic of the complaint, I can talk about that. Not about the related medical procedure, but about whether the charges were fair, accurate, or the same as for other clients. Ican even mention if we forgave or discounted some of the charges.
If communication was at issue, I can talk about the communication; I just avoid discussing any patient record related content. For example, I can discuss if I called them repeatedly, or if an employee was rude to them. They are likely unhappy or grieving, and you can discuss the feeling and perception they had, and show compassion for their loss. If it’s a smell or cleanliness, you can talk about your cleaning methods and what emergency came in that day that might have delayed it.
I should apologize and talk about what I’ll do better. Even if it’s a complaint about the medical procedure. If they say my clinic botched a spay, I can respond that we’re happy to discuss the case, we are sorry for their poor experience/impression of our medical practices, and we have since directed our veterinarians to review the procedure, check on VIN, and research techniques to see if there is anything we can improve for spays in the future. Look, the answer is usually that we did it right. But we can improve, and perhaps with better follow-up and communication we’d find out why the owner thought it was botched.
Every once in a while, we really could do a better job with a procedure. Everyone can. We don’t have millions of dollars of diagnostic and surgical equipment, we don’t hire AVMA diplomats that specialize in each procedure. We don’t have all day to prep a single animal, evaluate, and then perform a single spay. While it’s possible to do that, the financial costs would be astronomical to attempt to achieve the ‘perfect spay.’
Mark Cuban once said “Perfection is the enemy of profitability.” We’d be out of business, and there would be no vets in the area, if the standard of care was perfection, rather than the standards of acceptable and prevailing veterinary medical practice. And keeping that in mind when I respond is important. I don’t have to be 100% right, I just have to recognize where I can improve and that it concerns me that the client didn’t feel they and their pet were better off after coming to our clinic. If it’s really malpractice, then I should *really* apologize and be prepared to talk to the board, my staff, and my insurance broker.
So I can apologize, and frankly, given that damages are limited to the value of the animal at the time of the procedure, unless there is also a human injury, my admission is not likely to lead to thousands of dollars of potential liability. I don’t want to make this a fear issue, I want to make it a customer experience and clinic quality issue.
I can also truthfully talk about how I tried to resolve it directly. I can wish them well and even recommend some alternative veterinary hospitals. I can tell them you donated their fees to a local rescue foundation (normally better than advertising I refund fees). I can share, broadly, what was going on in the clinic. For example, we had one complaint that we were hurting a person/animal. We had a pot belly pig in treatment that was vocalizing in a way only pet pigs do during treatment. It did sound awful, but the pig was not being harmed in any way. That was easy to explain to the concerned person in the lobby, she even saw the happy, healthy pig leaving later that day.
And I should explain when the poor customer experience was tied to someone else’s critical need and positive experience. We had a puppy come in with maggots, needing immediate medical attention. While we can’t and you shouldn’t share medical details, there’s no doubt our lobby stank for a while afterwards. We explained that we had a very sick animal come in, and that sickness was what the other clients smelled. That we had all hands on deck to help the animal, and thus we weren’t able to do a lobby cleaning until after the animal was taken care of. That post generated more compassion, as every pet owner generally wants immediate care in an emergency. Our clients do not want to be told we will delay their urgent treatment until that awful smell in the lobby is cleaned with Odo-ban. And we did do a thorough cleaning later, and invited the client to come by and check it out.
I don’t ask them to remove their review. If they do, great, if they don’t, I’ve responded and that response has a positive value to our clinic’s reputation. Most negative posts have a short shelf life. Reviews from a couple years ago have little bearing on what we do now, and people who pay attention to reviews know that.
If the review is false, then I will file a complaint with the review site for a falsified review. We’ve gotten reviews removed when done by former employees, by reviewers who never received services, or the reviewer confused our clinic with another clinic.
And I only respond once. I can ask them to contact you if they’d like to discuss it more. Engaging in a hotly contested discussion is not in my businesses best interest.
Finally, I decide when I no longer care about the review. For me, it’s six months, for you it may be two years. But at some point we need to be able to put that comment to bed and be at peace that I’ve gotten all the value I can from the feedback. And that means I have to stop composing my perfect response to a negative review while driving to work. I doubt anyone can avoid thinking, dwelling upon, turning over, and arguing internally, with every line of a negative review. It’s probably unhealthy to bury that response deep down in any event. But the action I take can’t be driven by my feelings, or even by the incredible logic. It’s not about winning an on-line argument with a former customer, it’s about running a successful, constantly improving veterinary clinic. It’s about practicing good medicine on the pet family members of so many people. It’s about avoiding burning out with distracting negative situations. And it’s about becoming better together.
But rest assured, I still secretly dream about that perfect blazing response that causes all our negative reviews to be replaced with positive ones…