eMerit: A Decade of Helping Doctors Address Online Reviews – Promoting the Positive, Managing the Negative

Jeff Segal | 10.3.20

On October 7th, Legal 123s with ByrdAdatto Season 2 will be launched with Episode 1, Patients: Practice Lifeblood or Practice Threat?.  Michael and Brad are joined by special guest and ByrdAdatto partner Jeff Segal, MD, JD who is also the founder of Medical Justice and eMerit.  This article about eMerit was originally published on the Access+ portal for ByrdAdatto Access+ members.   Enjoy this free access to learn more about eMerit and tune into the podcast to hear more about Jeff’s compelling story.


eMerit: A Decade of Helping Doctors Address Online Reviews – Promoting the Positive, Managing the Negative

Years ago, a doctor only needed to practice the 3 A’s. Be available, be affable, be able. That was the formula for success. A doctor’s reputation flowed from the 3 A’s. Other doctors would refer. Patients and their friends would refer. New patient volume and new patient revenue would rise. Soon, you’d be ready for a partner. Lather, rinse, repeat.

The Internet changed everything in healthcare.

The 3 A’s are still important. But the internet is becoming the dominant means to send that message to new patients. Now patients “know” their doctor before they meet their doctor.

Doctors who practice in underpopulated and isolated areas can safely ignore the internet. For the other 99%, no practice can afford to be without an online strategy.

eMerit was created as a spinoff from Medical Justice. Medical Justice focused on de-escalating doctor-patient conflict. Such conflict can manifest itself as a lawsuit, complaint to the board of Medicine, demands for refunds, and, yes, slamming the doctor online.

eMerit has 3 core features.

Monitor what patients are saying about the doctor online.

Help doctors respond to negative reviews – to the patient, if known, or to the public if anonymous. And do so in a HIPAA compliant way.

Finally, make it easy for a practice to capture feedback at the point of service. Patients are handed an iPad to answer brief survey and provide feedback. The vast majority say yes. With patients’ permission, their reviews are automatically uploaded to the dominant review sites found on page one of a Google search. Easy peazy.

Why be defined by two angry patients with a megaphone? A practice should be defined by the vast majority of its patients. The two angry patients will still be there. But their voices will be buffered by the larger crowd of those who are satisfied. As the old surgical dictum preaches – the solution to pollution is dilution.

Those who dominate the internet will see new patient volume and new patient revenue grow. A lot.

That’s the essence of eMerit.

While most reviews are positive, no practice can make 100% of patients happy. Here’s a primer of how to manage negative reviews.

Let’s start by reviewing the essentials…


The 5 Golden Rules to Follow When Responding to Negative Patient Reviews

Responding to negative patient reviews is a time-consuming process. There are also regulatory landmines doctors must avoid. Some are obvious: Never reveal information about a patient’s treatment without their written authorization. Never identify the author of a review as your patient. Never post billing information online. Others are not as obvious.

When writing a response to a negative patient review, you must remember…

A model response shows the practice is reasonable and isn’t in a debate.
A model response educates the public.
A model response addresses the concerns raised in the review.
A model response takes the conversation offline.
A model response does not address the author directly. 

Write these rules on a piece of paper and share them with your staff. The employee responsible for locating and responding to negative patient reviews should commit these to memory.

The next part of this lesson involves carefully dissecting two real-life examples; an example of a negative review and an example of a model response. Consider how the example response incorporates all five of the principles outlined above.

Disclaimer:  All examples featured in this piece were collected and posted online by Medical Justice’s online reputation management platform, eMerit. The model responses were written by our account managers in collaboration with our clients.  We should mention most of the feedback our clients collect is positive. However, we have never filtered reviews.  We believe the practice of filtering patient reviews is deceptive.

Professional licensing boards regulate advertising and marketing. To such boards, filtering reviews can be perceived as false and deceptive advertising. The penalties can be harsh. You’ve been warned.


So – How Do You Respond to a Negative Patient Review that Resulted from a Medical Complication?

Most medical/surgical procedures are completed without issue. The patient is satisfied with the results and renders payment in a timely fashion. The patient moves on, and so does the doctor. Other times the patient exits the practice feeling dissatisfied either because of objective or subjective concerns. An objective concern is a complication, expected or unexpected. A subjective concern is a mismanaged expectation.  This may spark exchanges like the example depicted below…

Now that you’ve read the exchange, let’s explain why the practice’s reply is a model response. Chiefly, the response demonstrates to the public the practice is rational. When the patient suggests the physician is not board certified, the practice responds:

“While we are sympathetic toward patients who do not see their desired results, we must emphasize that Dr. [BLANK] is board certified through the American Board of Plastic Surgery for plastic and reconstructive surgery in [BLANK], [BLANK]. We hope that readers understand that unfounded allegations like in the above review serve only to start harmful rumors.”

The practice has taken a defensive stance, but it is not an emotional one. They are simply stating facts. The practice acknowledges the patient’s dissatisfaction without divulging unnecessary information. They are content to keep “their side of the story” to themselves.

At a glance, this sounds like a terrible tactic. There are, after all, two sides to every story. Sharing your side of the story may offer the public insight into the clinical aspects of your care. Your side of the story may vindicate you – if not in the eyes of patients, perhaps in the eyes of your fellow physicians.

The temptation to tell all is strong. Still - don’t do this. You’ll get burned.

Imagine a situation where a patient and a doctor are arguing. For the physician to tell his side of the story, what must he do? He must reveal details about the patient’s care. This is a potential HIPAA violation.

Therefore – a physician should never attempt to tell “his side of the story” when responding to an online review  unless  the patient has provided the physician with expressed written consent. Unless his audience is clairvoyant, the surgeon can’t share his thoughts without creating a public record of the patient’s care. Irritating? Absolutely. Can you still demonstrate your clinical expertise to the public? Absolutely. But there’s an optimal way to do it. We’ll explain how – let’s return to the above example.

When the patient calls into question the physician’s qualifications, the practice refutes the claim, as we saw above. But then they take an extra step…

“Additionally, his well-honed skills have earned him much recognition, such as being voted one of ‘America’s Top Surgeons’ in 2014 and 2015 by the Consumers Research Council of America.”

Note, the physician also points to a third party that has criteria for determining specific accolades.

Perhaps this is more information than is necessary to refute the patient, but that’s the point. Use negative reviews as an opportunity to highlight your qualifications. The response also provides the public with some general insight into the medical complication that triggered the negative review.

“Breast implants bottoming out, though uncommon, is serious and does happen from time-to-time. It’s hard to determine one reason why bottoming out occurs, but contributing factors can include weak breast tissue, smoking, large amounts of weight loss, or even exercising without a support bra.”

This is how you demonstrate your clinical expertise to the public. Be general, and do not address the author of the negative review. The practice never refers to the review’s author as “you.” In fact, the practice barely refers to the patient at all. This is by design. When drafting your responses, you must remember: The author of the review will read your response. Your goal is to resolve his/her concerns. But the author of the negative review is not the only patient who will read your reply. It may be seen by hundreds of prospective patients. So, it pays to respond to negative reviews in a genial manner.

We’ll close our analysis by examining the practice’s final remarks:

“Any patient who has experienced their implants bottoming out is encouraged to contact our office so we can discuss a revision surgery.”

The purpose of this closing statement is twofold. For one, it addresses the concerns that inspired the negative review. The patient is unhappy with her results and is seeking a remedy. The remedy the practice offers is a revision surgery. Not a free surgery, or a discounted surgery, but a surgery. Perhaps it will be free. Perhaps it will be discounted. But those are details to be worked out at the practice’s discretion. The point is the patient posted with a problem and presumably left with an answer.


Lastly: the closing statement takes the debate offline. The patient’s instructions are clear. If she wants to schedule a revision, she must contact the office directly. Taking the debate offline puts the practice in control and reduces the likelihood the patient’s personal information will be spilled online.

While the example provided has been dissected in detail, we recognize our analysis is far from exhaustive. Our original publication includes three more real-life examples and analyses. It can be read by visiting us at: https://medicaljustice.com/how-to-respond-negative-patient-reviews/


In sum, eMerit is a full throttle holistic solution to manage a doctor’s most precious asset – his or her reputation. The practice leverage’s the voice of its patients to tell their story to the public. eMerit helps patients find the best doctors. eMerit helps the best doctors be found by patients.


For more information on protecting the patient risk to your practice, schedule a consult with us at info@byrdadatto.com.


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