Review confrontation

[SommeRiver]

I am set to do an injxn on a pt this week...I think it is this week.

He left a really bad review about me and my staff during the only clinic visit we've had, and the entire review is a lie.

It is completely outrageous, and none of it is true.

Should I confront him over that? If so, before the injxn or after?

It is a 35 yo M with severe L5-S1 disk collapse and moderate foraminal stenosis.

I do an entire visit with him and his husband, tell them both I have no idea if the shot will help (bc I can't predict the future), but since he's failed PT and this is a many yr problem let's try it.

The review is F'd. They even complain that I didn't knock before entering the room.

I've never confronted someone over a review, but maybe I should?

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[SommeRiver]

I had a long NPV with this dude and we got along very well. No issues. I was stunned by the review.

 

[callmeanesthesia]

Wait, why is he even coming back if he left with that terrible of an impression? Did you refuse opioids or something? I’d say if he even shows up for the injection, yes you should confront him and ask him to remove it. Have someone else in the room though.

 

[Ronin1]

I am set to do an injxn on a pt this week...I think it is this week.

He left a really bad review about me and my staff during the only clinic visit we've had, and the entire review is a lie.

It is completely outrageous, and none of it is true.

Should I confront him over that? If so, before the injxn or after?

It is a 35 yo M with severe L5-S1 disk collapse and moderate foraminal stenosis.

I do an entire visit with him and his husband, tell them both I have no idea if the shot will help (bc I can't predict the future), but since he's failed PT and this is a many yr problem let's try it.

The review is F'd. They even complain that I didn't knock before entering the room.

I've never confronted someone over a review, but maybe I should?

Well I would be hesitant to stick a needle in a bad reviewer.... I would have my nurse give them a call to see why they were truly dissatisfied and if necessary give them the competitions number

 

[paindoc007]

I second the above. A young person with discogenic disease who’s unhappy to begin with? Won’t be happy after “so painful injection that didn’t help”

That’s balls though. To rip someone online and still show up for their procedure

 

[lobelsteve]

NSS instead of local.
Contrast to show needle placement.
Place a bandaid.

He is jot coming back for an injection.

What kind of p...y are you to put up with this bs?

Do the same to the plumber or auto mechanic and what do you think they will do?

 

[deleted480308]

Notice of termination for irreparable damage to physician/patient relationship. I apologize that your opinion of my care has been so damaged, I wish you well with your next provider. I am offering you a list of providers in the area and a 30day refill of all meds I have been writing for you.

 

[Laryngospasm]

Nothing good will come from doing a procedure in this case. This person most likely has some kind of personality disorder. Although in my experience they don’t usually come back for the procedures. As my grandfather used to say “never wrestle with pigs, they enjoy it and you get dirty”

 

[SommeRiver]

We had a completely normal visit.

It was polite and we discussed all options. I simply told him epidurals aren't that effective for discogenic pain but I think it is reasonable to try it at this point.

That L5-S1 disk is bad, and he's got a protrusion with herniation and foraminal stenosis, but his pain is lumbosacral jxn and groin.

He has an acetabular cyst in the hip, maybe some hip impingement too.

Pain for years, failed PT, let's try the shot.

I found out yesterday about his review and I was stunned.

He never asked for opiates.

It simply has to be on the side of better judgment to cancel that injxn.

Next thing I know I stick him and any number of things occur.

 

[willabeast]

Think if this person is a borderline or not. If yes, a procedure is not going to work. This is not a theory. Procedures do not work on borderline PD.

 

[Agast]

I don’t think you have to worry about him coming back for the injection. And he sounds ****oo crazy in his review. I’ve had a few one star reviews where the patient claims they greeted me, thanked me, something something insert pleasantry here - and I barreled past them like an autistic person. Usually a good sign they have a personality disorder.

 

[callmeanesthesia]

Is he even a veteran or was that a lie too? Normal pleasant encounter to u-turn into that does suggest borderline. Definitely avoid injection. Could just wait for him to no-show the appt and bill him for it...

 

[Gauss]

Notice of termination for irreparable damage to physician/patient relationship. I apologize that your opinion of my care has been so damaged, I wish you well with your next provider. I am offering you a list of providers in the area and a 30day refill of all meds I have been writing for you.

This is probably your best route - follow your state's medical board guidelines for termination of relationship. Expect another rave review if you do this. Far too often attempts to repair this relationship fail unless you are a skilled psychologist/psychiatrist

 

[au bon pain]

We had a completely normal visit.

It was polite and we discussed all options. I simply told him epidurals aren't that effective for discogenic pain but I think it is reasonable to try it at this point.

That L5-S1 disk is bad, and he's got a protrusion with herniation and foraminal stenosis, but his pain is lumbosacral jxn and groin.

He has an acetabular cyst in the hip, maybe some hip impingement too.

Pain for years, failed PT, let's try the shot.

I found out yesterday about his review and I was stunned.

He never asked for opiates.

It simply has to be on the side of better judgment to cancel that injxn.

Next thing I know I stick him and any number of things occur.

This guy served in the mil for over a decade and your office visit was his “worst experience ever”!?!

If the army ever finds out about this review they’ll probably seek you out to contract for a npv for each new recruit in an effort to boost morale. After experiencing your clinic, soldiers will surely view their work/duty stations in a comparatively more favorable light.

 

[Ronin1]

That’s not too horrible of a review lol I’ve had plenty of worse ones back when I used to read them

 

[Ligament]

Do not treat this patient. He obviously does not trust you, and is looking to sue you. Offer him a referral to another pain clinic and cite that a trusting doctor/patient relationship could not be established.

 

[paindoctor2014]

It’s a tough spot. I wouldn’t want to treat him either. I had a similar situation and I continued to treat the patient bc the online review was “anonymous”. I didn’t do any injections and didn’t write opioids fwiw

 

[MD87]

Not worth worsening the headache he’s already given you. I agree to have someone from your staff, or you, call him before the injection. If some sort of peace can’t be made, send him elsewhere.

My top pick would be to not inject. Likely won’t help him, especially if he doesn’t trust you at this point... his perception will be the injection didn’t go well even if it did.

Second pick would be an interlam. God forbid you do a TFESI and give him a Tinel’s and have him say you made him worse.

 

[myrandom2003]

Cancel procedure. Discharge patient officially.

Future headache not worth the $100.

They will complain to insurance so they don’t have to pay and possibly consult a lawyer to get money.

 

[Disciple]

As it pertains to the derm thread, the personality disorders/psyche overlap is what separates Derm/Pain.

 

[Baron Samedi]

An important part of treating pain is maintaining a therapeutic relationship. Nothing wrong with terminating if that is not achievable.

 

[Yo GabbaPentin]

Immediately terminate. I disagree with referring anywhere else. You’ve already wasted too much time on them.

 

[SommeRiver]

Tomorrow AM I'm going to DC this nitwit.

 

[myrandom2003]

Just be careful as to what you say in the discharge letter. As you already know, this person may just screen shot your letter and post it online. I would be very vague and PC

 

[SommeRiver]

So, here's what is happening (if any of you care)...

The reason I wasn't sure if that injxn was this week or not is bc HE canceled it (thanks).

So my staff does a good job of protecting me from bickering and nickel and diming...

We have our visit (normal visit...no problems AT ALL). He goes to check out, and when he gets to the front desk he starts an argument with out front desk staff about procedural sedation.

They tell him I don't do that, so he just left and refused to schedule.

He isn't my problem any longer, and I guess he's just borderline in all likelihood. So bizarre.

Online reviews should place an asterisk on HIPAA.

Not saying a physician should divulge private health information online but damn dude...I should be able to be like, "Yo bruh...Since there may be ppl reading this, you're FoS. Here are the facts..."

A high school buddy owns a butcher shop and he debates ppl on his reviews all the time. Hilarious BTW.

 

[SommeRiver]

At least with this sociopath I can see why he was mad at me - Tragically low IQ, confused, life in utter disarray and without meaning, seeking opiates, can't remember who his doctors are and who does what...A low individual seeking gain (opiates).

I get why he was pissed.

 

[deleted480308]

Fwiw, i might delete the actual screenshotd as they could be misconstrued as identifying

 

[paindoc007]

Add a personality disorder plus a rough life. These type of people are looking to blame someone for all of their problems. And after your “so painful inj that makes him worse”, you’d be the target. That’s a blessing he ripped you before inj vs after. Be happy on that

 

[SommeRiver]

Fwiw, i might delete the actual screenshotd as they could be misconstrued as identifying

Those were all posted publicly on social media and Google.

 

[Ducttape]

Fwiw, i might delete the actual screenshotd as they could be misconstrued as identifying

he has gotten rid of the actual data...

another idea, post these on the private forum.

 

[deleted480308]

Do what you want with it but it seems like a liability that isn’t necessary. Maybe i’m overly cautious but i’m just looking out for you

 

[SommeRiver]

Private forum?

 

[SSdoc33]

Those were all posted publicly on social media and Google.

but your comments in regard to the posts could be seen as "insensitive" by a jury.

 

[lobelsteve]

Not identifying anybody. Insensitive is not a crime. Stop being babies. It is why people treat you poorly.

 

[lobelsteve]

I do not think sexual orientation correlates with quality of patient. And epidurals do not make people gay. Nor will it make them not gay. 15 yrs in and no needle sticks, but on the 5-10 gay men I have implanted, the techs, nurses, and Anes team felt need to mention it every time I touched a sharp.

 

[SommeRiver]

I've had several HIV positive pts that everyone feels the need to remind me again and again they've got HIV.

These are like, undetectable viral load pts.

 

[myrandom2003]

HIV is like diabetes now. No one wants it. And there is truvada and medications such as that for exposure.

Hawkeye is old school. May have been not as cringe-worthy a decade or two ago but times are changing. Not to excuse the comment or anything like that.

Maybe the OP should put the link to a mental health clinic as the reply to the comment/bad review. No commentary or response, but just the link.

 

[SSdoc33]

How do u get it removed?

the comment shouldnt be removed. it should serve as a beacon of what NOT to do. in the 70's it would be just as hateful and abhorrent to say (or even think) this way, but it would have been tolerated. it is nice to know that we have grown as a society

i will remind anyone reading this thread that homophobia is specifically not tolerated via the SDN terms of service.

1. Members do not tolerate racism, sexism, homophobia, antisemitism or other forms of oppression. We promote and celebrate diversity of people and ideas. Negative prejudgements purposely marginalize one group in an effort to establish a defined norm for another group; this kind of thinking is antithetical to the delivery of medical care. If you find an old thread that contains such ideology, please report it.

 

[cowboydoc]

the comment shouldnt be removed. it should serve as a beacon of what NOT to do. in the 70's it would be just as hateful and abhorrent to say (or even think) this way, but it would have been tolerated. it is nice to know that we have grown as a society

i will remind anyone reading this thread that homophobia is specifically not tolerated via the SDN terms of service.

1. Members do not tolerate racism, sexism, homophobia, antisemitism or other forms of oppression. We promote and celebrate diversity of people and ideas. Negative prejudgements purposely marginalize one group in an effort to establish a defined norm for another group; this kind of thinking is antithetical to the delivery of medical care. If you find an old thread that contains such ideology, please report it.

He was talking about the Google review, not the forum comment. Agree with your point on the forum comment.

 

[Baron Samedi]

Imagine being so pre-occupied with a patient's sexual orientation that you judge them as a human being before they even walk in the door.

What an awful way to live, Hawkeye. Get help.

 

[callmeanesthesia]

Separating sexual orientation from this though, I have had nothing but trouble from people who bring their spouse along as an “advocate” for them.

 

[deleted993114]

Imagine being so pre-occupied with a patient's sexual orientation that you judge them as a human being before they even walk in the door.

What an awful way to live, Hawkeye. Get help.

My younger brother is gay. My wife's younger brother is gay.

I do not harbor any ill feelings towards gays at all. The points I made (which is 100% factual):

1. is that gays tend to have a higher incidence of psychiatric and affective disorders. One would assume that this comes with the internal struggles they faced with accepting their sexuality as well as external persecution as kids.That was the salient point that everyone completely overlooked and immediately went on the attack. I have had many "good" patients who are gay, yet one must understand the associated medical conditions/pathology associated with that lifestyle and be objective.

2. I view with suspicion anyone who brings in their spouse for "support" in a medical visit. It implies a degree of dependency and an inability to personally deal with a medical issue.

I find it interesting, yet not surprising, that there is a chord of attacks. The world has turned PC and I find most of the PC police to be very hateful, angry people who are quick to attack others when they percieve the "PC laws" have been violated. The lynch mob immediately cries "homophobe" and goes on the attack, as people today have been conditioned to do so. It is the impulsive, thin skinned nature of people today that makes them so unpleasant.

The world is turning into Orwell's "1984". Kick me off here for being a "homophobe" if you like- that is okay with me. I am far from it, yet am not shocked by the impulsive and angry statements.

I asked that the moderators delete my account, as I really do not want to be associated with angry, impulsive individuals. I am a very positive person and find negativity to be corrosive and infectious. Life is too short for that. Adios.

 

[SSdoc33]

My younger brother is gay. My wife's younger brother is gay.

I do not harbor any ill feelings towards gays at all. The points I made (which is 100% factual):

1. is that gays tend to have a higher incidence of psychiatric and affective disorders. One would assume that this comes with the internal struggles they faced with accepting their sexuality as well as external persecution as kids.That was the salient point that everyone completely overlooked and immediately went on the attack. I have had many "good" patients who are gay, yet one must understand the associated medical conditions/pathology associated with that lifestyle and be objective.

2. I view with suspicion anyone who brings in their spouse for "support" in a medical visit. It implies a degree of dependency and an inability to personally deal with a medical issue.

I find it interesting, yet not surprising, that there is a chord of attacks. The world has turned PC and I find most of the PC police to be very hateful, angry people who are quick to attack others when they percieve the "PC laws" have been violated. The lynch mob immediately cries "homophobe" and goes on the attack, as people today have been conditioned to do so. It is the impulsive, thin skinned nature of people today that makes them so unpleasant.

The world is turning into Orwell's "1984". Kick me off here for being a "homophobe" if you like- that is okay with me. I am far from it, yet am not shocked by the impulsive and angry statements.

wrong, dude. wrong.

the correct response would be to admit that your comment was inappropriate, apologize, and to try to work on being more inclusive and less homophobic, frankly.

i dont think you should be kicked off, or banned, but you clearly can't teach old dogs new tricks.

if one happens to be be gay (some studies estimate the LGBTQ population to be around 20%), then you are immediate offending them. why do that?

 

[BobBarker]

My younger brother is gay. My wife's younger brother is gay.

I do not harbor any ill feelings towards gays at all. The points I made (which is 100% factual):

1. is that gays tend to have a higher incidence of psychiatric and affective disorders. One would assume that this comes with the internal struggles they faced with accepting their sexuality as well as external persecution as kids.That was the salient point that everyone completely overlooked and immediately went on the attack. I have had many "good" patients who are gay, yet one must understand the associated medical conditions/pathology associated with that lifestyle and be objective.

2. I view with suspicion anyone who brings in their spouse for "support" in a medical visit. It implies a degree of dependency and an inability to personally deal with a medical issue.

I find it interesting, yet not surprising, that there is a chord of attacks. The world has turned PC and I find most of the PC police to be very hateful, angry people who are quick to attack others when they percieve the "PC laws" have been violated. The lynch mob immediately cries "homophobe" and goes on the attack, as people today have been conditioned to do so. It is the impulsive, thin skinned nature of people today that makes them so unpleasant.

The world is turning into Orwell's "1984". Kick me off here for being a "homophobe" if you like- that is okay with me. I am far from it, yet am not shocked by the impulsive and angry statements.

I asked that the moderators delete my account, as I really do not want to be associated with angry, impulsive individuals. I am a very positive person and find negativity to be corrosive and infectious. Life is too short for that. Adios.

Whoa, you don’t need to leave! Don’t worry about it and move along.

 

[au bon pain]

I have had nothing but trouble from people who bring their spouse along as an “advocate” for them.

The best way I've found to deal with this is to fully embrace the spouse. These folks tend to want to come out guns a'blazing to validate their presence so I thank them for coming and act pleased about having them in the room. It tends to disarm them very quickly and make things go much more smoothly. Sometimes they can prove to be a good ally to help motivate the patient.

If they prove to be disruptive they are invited to remain silent, exit the room, or the visit can end. Their choice.

 

[Matthew9Thirtyfive]

A post was removed along with several posts quoting it, as they violated our TOS. Whatever the intention behind them, homophobic comments have no place on SDN.

 

[Baron Samedi]

Often the spouse is the more reasonable one and can improve compliance and understanding of treatment plans.

With the amount of times people have come for a follow-up and forgotten to get labwork or an imaging study despite getting a written checkout sheet, I should start requesting spouses come along.

 

[Baron Samedi]

Classic strategy.

1. Say something offensive
2. Claim that you aren't homophobic/racist/bigoted because you know someone in that group. "My best friend is black.."
3. Double down on offensive comment
4. Blame "PC culture"

 

[VA Hopeful Dr]

Classic strategy.

1. Say something offensive
2. Claim that you aren't homophobic/racist/bigoted because you know someone in that group. "My best friend is black.."
3. Double down on offensive comment
4. Blame "PC culture"

There's a world of difference between "best friend is X" and "sibling is X". Not saying it can't still be a convenient excuse, but not the same at all.

Have y'all ever considered not immediately jumping to being as harsh as you were when faced with someone like this? We actually have pretty good evidence that says shaming doesn't work. Reasoned conversation, on the other hand, does.

I obviously can't see the responses anymore, but when I read this thread yesterday my two initial thoughts were "Damn, I can't believe Hawkeye just said that" followed shortly by "Man, these responses are brutal".

 

[deleted480308]

There's a world of difference between "best friend is X" and "sibling is X". Not saying it can't still be a convenient excuse, but not the same at all.

Have y'all ever considered not immediately jumping to being as harsh as you were when faced with someone like this? We actually have pretty good evidence that says shaming doesn't work. Reasoned conversation, on the other hand, does.

I obviously can't see the responses anymore, but when I read this thread yesterday my two initial thoughts were "Damn, I can't believe Hawkeye just said that" followed shortly by "Man, these responses are brutal".

There was a pretty hard dogpile. My response must have quoted theirs because it’s now gone. Admittedly I’m biased but I thought I was pretty reasonable

having had to work around many open racists in the past, i agree that a direct conversation works better (anecdotally)