Shaking off outlier patient review

[faelivrin]

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First job out of fellowship and I recently happened on a VERY personal (almost vicious in its detail) negative review which really shook me. There were kernels of truth to it which makes it hurt more but honestly, I chalk the whole thing down to my inexperience, poor support staff, and the patient's personality. The patient had no actual adverse outcome.

This was posted almost 2 years ago but I can't stop thinking about it... especially when I feel that this profession has consumed me. I'm embarrassed to think that colleagues, future patients, and even my family might happen on it one day. I try to think of the far more numerous grateful patients that I have but I still can't.stop.thinking.about this goddamn review.

 

[ShuperNewbie]

Dude same. You're not alone on that one. That said, in this line of work, you can straight up save a patient's life twice over and receive a horrible review for bad clinic parking and poor support staff lol.

I think this kind of unhealthy response (and again, no shade - I'm definitely guilty of this myself) was conditioned into us from med school. We were constantly being evaluated (*cough* judged fiercely - I once had an attending in med school straight up just say "I don't know why but I just don't like you very much" lol. Very constructive) and we learned to internalize this because our futures depended on these evaluations (from med school all the way up to fellowship). Now that we're big boys (and girls) this whole thing has become maladaptive.

Honestly I still struggle with this myself (you're FOR SURE not alone in this) but when stuff like this happens, I often take solace in the other parts of my being that bring me value and have nothing at all to do with medicine. I'll often think "well that patient might think xyz of me but they have no idea that I can paint a kickass bowl of fruit" or "pssh that person has no idea how much I serve my local community doing -xyz- and they love me" or "well my partner loves me dearly and that's way more important than what some rando thinks" and if you don't got something like that, then this is a sign to start detaching a bit and finding something like that. And if all else fails, I find a little guided CBT works wonders for stuff like this ;-)

 

[anonperson]

First job out of fellowship and I recently happened on a VERY personal (almost vicious in its detail) negative review which really shook me. There were kernels of truth to it which makes it hurt more but honestly, I chalk the whole thing down to my inexperience, poor support staff, and the patient's personality. The patient had no actual adverse outcome.

This was posted almost 2 years ago but I can't stop thinking about it... especially when I feel that this profession has consumed me. I'm embarrassed to think that colleagues, future patients, and even my family might happen on it one day. I try to think of the far more numerous grateful patients that I have but I still can't.stop.thinking.about this goddamn review.

It's normal to feel this way after getting a negative review. Who wants to see their name getting bad mouthed?

But you have to let it go.

There are so many patients with personality defects who can hardly function and use these negative reviews as a weapon for any perceived slight.

There are plenty of patients you have helped but generally satisfied patients don't leave reviews unless requested. If you want to solicit patients to leave positive reviews, you can but that's a different discussion.

My employer uses patient satisfaction surveys for some of the bonuses. The main question is based on whether you would recommend this doctor.

Usually I score fine but this last month I got only 66%. The sample size is ridiculously small because usually disgruntled patients like to make their feelings known.

Provide good care and move on with your life.

 

[onconconconconc]

I'm replying mostly in support - I don't have the perfect answer for how to deal with this. I also recently received a very bad review, so I can relate. It has made me question whether I want to change jobs or even continue in clinical medicine (in the context of many other challenges related to my workplace - more of a "last straw" sort of thing).

It is painful for many reasons:

• It is naturally difficult to hear negative feedback
• Generally, we as oncologists put a great deal of mental and emotional labor into our work. It is often underappreciated and it is not always obvious to our patients due to time limitations and system constraints.
• Due to the nature of cancer, bad outcomes are inevitable in many cases. We do our best to prepare patients and families, but everyone processes this differently. It feels unfair that we become the target of vitriol for people who have maladaptive strategies to cope with grief.
• In a world where reputations are important, it is disheartening that our patients, colleagues, friends, and family can now go online and read the negative feedback which may or may not be justified.

Unfortunately, most of us will have to deal with this if we practice long enough.
Things that have been helpful for me are similar to what others have mentioned:

• Not reading my Press-Ganey reports. I know I am far from perfect and I think feedback can be helpful, but I find that reading this random mailbag of complaints is bad for my mental health and resilience.
• CBT strategies/putting things into perspective. Only I can control my feelings and actions. I am just one person on a big planet in a vast universe and I will eventually die. In 1, 5, 10 years this is unlikely to have an impact on my life. Eventually it will all be forgotten.
• Leaning into life outside of work including relationships with friends, spouse, and family; reminding myself that my worth as a person is intrinsic and not tied to my work.
• Exploring job listings and thinking about my next move...

Hang in there!

 

[VA Hopeful Dr]

Don't go looking for reviews. If your job doesn't make you review bad ones, just don't read them. Out of sight out of mind is really handy for these things.

 

[gutonc]

Don't go looking for reviews. If your job doesn't make you review bad ones, just don't read them. Out of sight out of mind is really handy for these things.

100% this. I no longer get my PG reviews sent to me for review and I couldn't be happier. I have never sought out my own reviews. I know that I do good work and I'm also well aware that I both make mistakes from time to time and can't please everyone all the time, especially those with personality disorders.

 

[faelivrin]

Thank you all for taking the time to reply. I've been feeling so hollow inside but this too shall pass.

 

[dozitgetchahi]

I don’t read patient reviews, and I’ve gotten to the point where I actively avoid patient feedback.

At least in rheumatology, we encounter a buttload of pts with bizarre or nasty personalities, personality disorders, severe anxiety, etc. On top of this, we get a ton of inappropriate referrals for OA, fibro etc, and nobody likes to hear “I can’t really help you” or “I’m not sure why your doctor sent you here, I’m not really the doctor for this” - no matter how nicely you try to say it. And the happy pts are much less likely to leave a review.

A vicious review with lots of personal details is almost certainly an ad hominem attack from a pt with an ax to grind. I remember getting a nasty review like this early on which included details like “the doctor’s pants were too tight” etc. Just ridiculous and silly stuff which had no real basis in reality, but was intended to sound embarrassing.

I definitely try to deliver a good experience to pts. However, there have been years where my satisfaction scores haven’t been that hot. I no longer care about this and have moved on with my life. (Fortunately, I don’t work at a place where bonuses etc are tied to these scores.)

 

[bobsmith]

I agree with others - after all this training where we are used to getting nearly daily feedback from our attendings, we then go to getting minimal feedback when we become attendings so it's tempting to look to reviews to find something useful, but there often isn't

Unless you think there's truth to what the patient said, or if there's some recurring complaint or something that you actually think you could have done differently, I would also try to ignore it

I recently had a patient fire me after 2 years of me / my staff bending over backwards for increasingly burdensome asks / requests. He had previously fired 2 other oncologists so this was not surprising, but the straw that broke the camel's back was that I used the word "probably" in one of my patient messages to him instead of something more definitive

Some people are just unreasonable and you (probably!) can't win