Dr. X’s review went something like this:

1 STAR Rating: “If I could leave a negative star review, I would. Avoid Dr X. My mom was on vacation when she fell.  Unfortunately, she was “cared” for by Dr. X.  Dr. X said, ‘unless my mom wanted to play professional sports, she did not need surgery’. My mom was in a lot of pain and when she returned home, she saw another doctor that said my mom needed surgery right away or she would lose mobility!  The HELPFUL doctor couldn’t believe that Dr. X didn’t even change the bandages…. Dr. X, bring light and good health to the world by retiring.”

Like anyone who receives a review like this, the doctor was upset and completely disagreed with the reviewer’s account of the visit. He immediately instructed the staff to post a response with the “facts”, and then began to pressure his team to have Google delete the reviewer’s comment. As you can imagine, even if the reviewer isn’t responding, the outcome is not positive for the practice or the doctor; and if the reviewer is responding, the outcome likely only gets worse.

So, we know that bad reviews happen, even to the very best of providers.  How should we handle them, and how can we manage the conversations within the clinic and with the providers?

Step One: Consider your options.

The first rule of Review Club: work the plan. It’s easy to allow any review, especially a not-so-great-one, to feel very personal.  The key to success is the consistent, long game. Just like managing any situation that isn’t going perfectly within the business, the goal should be to consider your options and work the plan. This is the very reason there is a Customer Review Strategy in place to begin with; it is the clinic’s time to shine.  An emotional response, particularly a direct response including any details around the patient visit, may not only validate the patient’s identity and easily be a HIPAA/privacy violation, but it often fuels the fire. Consider the options and work the plan; but what is the plan?

Step Two: Remove.

Does the review qualify as inappropriate in Google’s eyes? Getting rid of a Google review is not necessarily simple, but it isn’t impossible either.  Google only removes reviews if the reviewer breaks one of Google’s user policies. 

Google Review Policies:

1. Spam and fake content that is posted to manipulate ratings. This includes posting multiple times, including from different accounts.
2. Off-topic posts that are general in nature, such as political commentary or personal rants.
3. Promoting actions be taken or items purchased that fail to comply with local legal regulations. Such restricted content includes promoting alcohol, gambling, guns, pharmaceuticals, adult services, and more. 
4. Illegal or depict illegal activity, such as copyrighted content, endangered animal products, graphic violence, human trafficking, etc.
5. Terrorist in nature.
6. Sexually explicit or in any way sexually exploits children.
7. Offensive, obscene, or profane.
8. Dangerous, considered harassment or intimidating, or that incite hatred.
9. Impersonating others or having false representation.
10. Dishonest or biased. This includes posting reviews of your own business (or having a current or former employee do it for you) and trying to manipulate a competitor’s ratings.

So, does this review qualify for deletion under any of these policies? In this instance, our review does not qualify for removal.  If you believe, after reviewing the policies, your business can prove the reviewer broke one of Google’s policies, you have a chance to present your case. I’ve included an abbreviated overview of how to contact Google support below.

To contact Google’s support for small businesses:

1. Go to Small Business Support
2. Scroll down and select “contact us”
3. Select “customer reviews and photos,” and then “manage customer reviews”
4. Choose to receive help via phone, web chat, or email

Using any of these methods, one can expect help within 24 hours. If the practice chooses to contact Google via email or chat, it is helpful to have a screenshot of the review in question ready to go.

When the Google support team reaches out, it is up to the practice to explain why the review should be removed. Be ready to explain why the review is in violation of policy and defend your request to get it removed.

CLICK THIS LINK to request to delete a review from Google.

Step Three: Respond

If having Google remove the review isn’t going to work for the practice, the easiest way to have a review removed is having the patient remove it themself.  Typically, this is accomplished by contacting the patient offline with hopes to better understand what happened and find a way to resolve the issue.  Where this approach can become risky is when a well-meaning practice representative accidentally validates a patient’s claim during the casual phone conversation, for instance, by apologizing for the incident or mishap.  Apologizing opens the door, if only a crack, to admission in a malpractice action and trying to have the patient see it “your way” may inflame the patient instead of inspiring them to remove a post. 

Additionally, engaging with the reviewer may prompt more online discussion.  There is nothing stopping a patient from replicating their comments on multiple online platforms.  Businesses that have the most success responding to poor reviews utilize only their most experienced, skilled and disciplined staff, and those team members stay within a very defined framework.  Additionally, having some sort of fix readymade that directly addresses the patient concern is imperative.  The caller must have a plan to resolve the issue going into the conversation.

Step Four: Move On.

Sometimes time is the best healer. When a practice has an active reputation program in place, one bad review won’t be disruptive in the bigger picture; and confronting the reviewer is most often, not worth the risk.  If the practice has an active program to solicit reviews, in a few weeks this review will be buried by an overwhelming number of other reviews that for the most part, should be very good.  If this is a one-off, the manager or clinical supervisor can make note and move on.  If there seems to be a trend within the practice, this time is a great opportunity to meet with the provider or team to realign, fix a process or define a new approach. 

Overall, having an active reputation program in place, understanding your Customer Review Strategy and working your plan to consider, remove, respond or move on will improve the online reputation of your practice and the providers that work within it.

Second of three articles.   Following the implementation of a successful virtual patient management pilot, QM2 moved forward with lessons learned and developed patient engagement strategies focusing on the right patient, the right intervention, at the right time, through the RIGHT channel.

“When something really great happens, what do you do?  You share it,”  said James Benson, President and Founder of QM2 Solutions as he reviewed the results of its early virtual visit programs.  “In the spring of 2020, we had virtual visit pilot programs at ENT Hearing Associates of Florida, Colorado ENT and Allergy of Colorado Springs, and South Carolina ENT in Columbia South Carolina.  Each group had different needs and patient types, but the volume and value of the patient engagement was clear.  How could QM2 easily adapt and share the successful programs with others in the hearing industry?

First, the basics.  QM2’s approach to virtual care focuses on asynchronous ‘e-visit’ and ‘check-in’ technology for patients to complete virtual visits, then driving other patient engagement through in person visits, telemedicine, remote programing and testing.  QM2’s technology includes patient outreach using text or email providing notifications and encrypted links for patients to connect to their clinicians.  The ability for patients to simply connect with their provider when they have an issue, and the ability for the professional clinician to triage responses based on the patient’s relative need, satisfied two seeming incongruent objectives: 1) Increase the number of quality patient engagements; and 2) Save time through a focus on triage and automatic connections.

Next, QM2 created targeted hearing outreach programs around three patient types, 1) Acute- Connecting to hearing aid patients with current technology or care needs; 2) Chronic follow-up: Directing on-going engagements to diagnosed, but untreated hearing loss, and on-going conditions like dizziness and imbalance issues with fall risk; And 3) patients who are seeking answers or help with non-diagnosis hearing issues or concerns.

In the start of the fourth quarter of 2020 QM2 launched the hearing aid virtual patient management program at groups in Alabama, California, Florida, Texas, and Wisconsin.  The results of these implementations drove significant patient interactions and ongoing care.

On average, 50% of hearing aid patients open and read virtual visit messages from the practices (emails or texts announcing the program and providing a link into the SEngage portal), while 20% of patients completed hearing aid virtual visits when provided the connection.  That means, for every 2000 SEngage patient engagements, over 400 patients completed virtual visits.

The data is instructive.  43% of hearing aid patients completing virtual visits report a change (or suspected change) in their hearing and a declining ability to communicate.  50% of hearing aid patients have identified features and functions they wish worked better (or were included in their hearing aids.)

As QM2 began to help clinicians prioritize responses, we found that “somewhat happy” patients report a 49% change in hearing, and that 76% of “somewhat unhappy” patients report changes in their ability to hear and communicate.  Working with clinicians we found that “somewhat” patients often not been seen for years, not attending clean and fit appointments, been re-tested or attended product “events”.  Yet, re-engaging these patients through virtual channels, making it easy for them to communicate their needs, drives impact.  These two-way engagements pointed to additional testing, adjustments, and sometimes, new technology or treatments.  Audiologists are surprised when they note the number of patients re-engaging the patient and the impact, they are having by re-connecting to these patients.

To determine the impact of this type of care on the business of audiology, QM2 looked at its customers’ ratio of experienced hearing aid patients beyond three years of use to the number of units sold to experienced users.  What have they discovered?  Most selling hearing aids to less than 5% of the eligible patients in their database per year and that implementing a virtual patient management program can increase the number of units sold by 30% year over year.

The final article in this series will speak to clinician techniques, what is next for virtual patient management to drive better care and increased business.

Don’t want to wait for the final article? Learn more today!

What started as an approach helping an audiology practice stay in business last spring, has become a beacon for expanded patient engagement and growing sales.

It happened to almost everyone.   Patients stopped calling, aware that ‘non-essential’ services were shut down.  And, while patients were still suffering, practices were furloughing staff and struggling to get ahold of patients.

“We developed our application, SEngage, to engage patients on behalf of their healthcare providers,” said James Benson, President and Founder of QM2 Solutions. “Before COVID we were using our system to deliver patient experience surveys and build online reputation.  Then COVID hit and we needed to do more for our customers.”

QM2 Solutions reached out to Dr. Patricia Ramos to talk about how they could help. Patricia Ramos is the Director of Audiology and Rehabilitative Services at ENT and Allergy Associates of Florida and oversees their audiology division, ENT Hearing Associates of Florida.

ENTAAF and their ENTHAF Audiology division is a large ENT and audiology practice with greater than 25 offices throughout Florida.  They were seeing decreasing volumes and were managing locations with decreased in office staffing and providers.

“We came together with QM2 through online meetings on evenings and weekends and laid out a plan for engaging our audiology patients,” Dr. Ramos said.

It was important for ENTHAF to test how virtual visits would work with hearing aid patients.  “Would our older demographic respond?  I needed to review clinical approaches and measure results.  It was all new to our providers and patients,” She said.

ENTHAF launched with a small group of patients.  Within the first week, 146 patients-initiated HIPAA compliant asynchronous visits with the practice.

The patient responses were prioritized and fit into the following categories: (1) I’m fine, thanks for giving me a way to connect, (2) I need supplies or batteries, (3) My hearing aids seem broken, (4) I would like to buy new hearing aids, and (5) I have an illness/condition requiring a physician evaluation.

Within three weeks, the practice collected $18,000 through the newly created remote service delivery channels.  The provider team scheduled 256 additional follow-up visits between the audiologists and physicians at a direct value of $25,000.  Medium term follow-up revenue from the limited program generated $32,000.  Overall, ENT Hearing Associates of Florida E-visit program initiated $75,000.  And it was just the beginning.

“The results of E-visits were real. We proved that we could improve hearing aid patients’ lives while generating revenue through virtual delivery channels,” Ramos said.

“In that first six weeks we showed that by focusing on the right patient, at the right time, through the right communication channel, our customers would serve more patients and generate significant revenue,” Benson said.

The next two articles will focus on the growth of the program, lessons learned, and the impact of new, approaches to engaging patients.

During the Florida Combined Otolaryngology Meeting in November 2020, I presented an overview on trends in audiology virtual visits.  Check it out on the MedAudPro YouTube Channel HERE!

Love this article? Check out Virtual Visits by the same author.

Why new Virtual Visit channels are important?

• A well-planned virtual visit program eliminates visit barriers. No-show research and studies on patient visit patterns highlight that patients often do not call when they have a need.   Phone trees, visit anxiety, long wait times, hurried providers, uncertainty about the reasons for their visit, limit patient driven engagement.  Lack of action by patients who need it delay key treatments that impact health and the cost of care.
• COVID fears, rules, and corresponding changes in consumer choice are reducing patients calling or coming into the office.  While in-clinic volumes are increasing, they will not return to pre-covid rates for some time. Virtual visits give providers a simple and secure way to begin or continue care.
• New clinical channels for delivery with more effective methods for patient triage, allow practitioners to make the best use of clinic time and space.
• Virtual visits create connection for both billable and non-billable e-visits and check-ins increase patient access to your practice.

What are the key ingredients to a virtual visit program?

• Build virtual channels by evaluating visit types and technology, then mapping patient type and services to each channel(s).
• Create a wide virtual funnel by reaching out to many patients.
• Utilize emails and/or texts to create virtual connections.  Secure patient messaging educates patients about virtual visit options and open the door to direct interaction.
• Develop diagnosis, visit-type content to streamline a patient’s virtual visit.  By helping patients efficiently communicate their needs, symptoms, and concerns, providers identify specific care opportunities.
• Cultivate virtual visit, clinical pathways around specific diagnoses.   Focus on chronic conditions and develop internal clinical guidelines to make sure you are quickly addressing patient needs.

Now Act!

Virtual visit programs are dependent on a clinic’s most valuable resource, the clinician, and their professional judgement, expertise, and clinic management.  New virtual approaches that open the door to thousands of patients highlight a clinic’s workflow and ability to respond to patient needs.   Asynchronous visit technology, not requiring real time response, allows for greater reach, but underscores the need to act fast on a patient’s needs.  The good news is that technology, supplemented with internal expertise, allows for more efficient triage.  These approaches, along with consideration to use the most efficient delivery channel, magnify a clinic’s capacity.

What a virtual visit program is NOT.

A Virtual visit program is not telemedicine software.  It is not emailing or texting patients. It is not having a portal. 

It is a comprehensive approach that focuses on the right patient, at the right time, with the right care, through the right channel.

Groups who have implemented virtual approaches create an impressive magnitude of “other” service opportunities realized through virtual visits.  Increased clinic site visits, surgeries, increased curbside services, and home-based services.  In the hearing aid industry, there is a significant increase in remote programming of hearing aids, and hearing aid purchases as a direct result of patient requests.

Maybe the most important way to describe the impact of virtual visits program is to talk about real life examples and the real-life results.   Today we highlight the journey of an hearing aid practice, ENT Hearing Associates of Florida.  On April 6, 2020 they identified the desire to develop a virtual visit program with established hearing aid patients.  The group started small, identifying care pathways.  They contracted with QM2 Solutions to implement an asynchronous portal and messaging system.

The group then began announcing the program and connecting remotely to patients.  As patients responded, they were brought to a customized, patient virtual visit where they answered four questions about their hearing needs.   Patients completed their visit on their smartphone, their computer screen, iPad, or tablet.  

It didn’t take long for ENT Hearing Associates of Florida to realize an impact. Within a week a hundred and forty-six different patients completed audiology E-visits. The patient response ranged from everything from, “thanks for giving me a way to connect,” to, “my hearing aids are broken.” Some stated they would like to purchase supplies and others requested to buy new hearing aids!

While engagement of a hundred and forty-six different patients is impressive, the 256 additional patient engagements within three weeks of the initial virtual visit are maybe more important to share.  Additional engagements included: curbside pickups, telephone calls, and more than 90 face-to-face audiology appointments.  The practice then focused on using telemed software to assist in both hearing aid sales and hearing aid adjustments.   Finally, triaging audiology virtual visits led to face-to-face ENT and Telemed visits.  The impact to the number of visits was real.

ENT Hearing Associates of Florida expanded their clinical reach and deepened patient engagement.  They took time to develop a well-organized virtual visit program and found it deepened connection with patients.  As the program matures and outcomes are measured, they are seeing better outcomes and greater patient satisfaction.  Ultimately, this approach had a significant revenue impact for the practice and has been expanded to address the needs of other patient groups.

Find out if a virtual patient management program is right for your practice. Click here for a Free Strategic Virtual Patient Management Assessment.

About James Benson

QM2 Solutions, CEO & Founder

James Benson is the President and Founder of QM2 Solution. QM2 Solutions, with headquarters in Elkhart Lake, Wisconsin, provides solutions that generate practice growth and clinical improvement through patient feedback.

Before QM2 solutions, James worked as a practice administrator and management consultant to surgical subspecialty groups including 12 years working with Otolaryngologists. James served executive leadership roles within the Association of Otolaryngology Administrators (currently known as ASCENT), as consultant to the AAO-HNS Board of Governors and is a co-founder of the Large Group Executive Forum for Otolaryngology Practices.

James speaks nationally on areas of healthcare quality, outcomes, experience, benchmarking, and business development. James has a BS from the University of Wisconsin-Madison (1994) and a Master of Science from the University of Wisconsin-Green Bay (Quality and Systems Design (2000).

Connect with Jamie on LinkedIn