Facebook and Twitter: How to deal with patient complaints

As anyone who's ever worked with the public knows, it's no fun dealing with an angry customer who chooses to express his or her dissatisfaction as loudly and publicly as possible. In a medical practice, not only do you have an irate patient to try to please, but often a waiting room full of perked ears, eager to take in every detail of a fellow patient's temper tantrum and how you respond.

As unpleasant as they are, however, these kinds of situations don't happen too often; and there's an established history of best practices for such embattled employees to follow.

But imagine you're the Cleveland Clinic, and an unhappy patient uses Twitter to broadcast a nasty complaint about one of your doctors to your 11,000-plus followers. Then a handful, say 500, of that person's followers retweet the gripe to their followers, and so on. If Twitter is indeed akin to word-of-mouth marketing on steroids, this has the makings of a monstrous problem.

Fortunately, healthcare organizations of all sizes have been quick to come up with effective solutions.

At its Patient Experience: Innovation and Empathy Summit this past Sunday, Cleveland Clinic senior public relations manager Joe Milicia revealed that while the majority of @ClevelandClinic mentions from patients are positive, as many as one or two out of 10 may be unfavorable.

'Twitter duty'

How the organization responds to such communications has evolved over time, Milicia said, but one hard and fast rule is that it's a priority to respond quickly. In fact, its goal is to respond to any patient complaint made via Twitter within just two hours (or 24 hours for Facebook). To accomplish this, a team of five communications employees, including Milicia, take turns alternating 'Twitter duty' for a week at a time.

Whenever possible, the team member sends the patient who wrote the tweet a direct message (a private, 140-character message between two Twitter users who are following each other) requesting a phone number for a Clinic representative to call the patient to discuss the matter further.

Patients respond very well to this approach, Milicia said, because their concerns not only are being acknowledged, but the follow-up is convenient and personal. Very often, the original tweet turns out to be somewhat of a nonsense complaint, such as a person venting about an experience from several years ago. Sometimes the author isn't even a patient of the Cleveland Clinic, said Shelley Frost, director of the Cleveland Clinic's consumer affairs and ombudsman office.

But if the complaint is found to have merit, it would next be investigated just as though it were made through other channels. The investigation and all information and correspondence related to it become part of a confidential database and are resolved completely offline, Frost said.

When it comes to social media and the handling of all sorts of sensitive issues, the rules are still being written. But I think Cleveland Clinic's approach is spot on, even for practices who may not have a dedicated Twitter team. Few healthcare organizations have even close to that kind of volume of online followers, for that matter, so the effort to keep up is relative.

Dealing with Facebook

As for Facebook, you might approach complaints slightly differently. For starters, keep in mind that because of the popularity of Facebook, more of your patients are likely to view the complaint.

If the comment is abusive or from a non-patient, the best approach may be to delete the post and block that user. If it is a patient, go back to imagining someone screaming at your receptionist over the front desk. Then be grateful you have time to compose a thoughtful response.

When a patient posted on Salud Pediatrics' Facebook page that he was considering finding a new practice due to some physician turnover and longer wait times to get an appointment, for example, physicians and staff initially took offense to the comment, the group's administrator, Brandon Betancourt, told me recently.

But after some time mulling it over, they realized that the patient was right.

Here's the gist of what Betancourt ultimately posted on the practice's Facebook page in response:

We understand if your child is sick and you can't get in to see a pediatrician, that is a problem. For what it's worth, we don't like the situation any more than you do. We've always prided ourselves in having an open schedule. But unfortunately there are situations that are beyond our control. Although the hiring process has taken longer than we'd hoped, please understand that we're taking precautions to find the right person so that we don't find ourselves in the same situation a year from now. In the meantime, we do have a nurse practitioner on staff who may be able to help accommodate some of your needs. Thank you for your comment. We like to know the good and the bad, so we can work more with the good and improve on the bad.

Note that this was a public response. Part of Betancourt's rationale in responding right on the practice's page was so that other patients could see the whole story. His hope was that they'd detect some rudeness in the man's initial comment and see from the response that the one remaining physician was doing the best she could to keep up with the patient load of three. "I wanted to say, 'You're being very unfair,' but I left it to the other readers to come to that conclusion on their own," Betancourt said.

Even though this approach is so different from Cleveland's, it seems appropriate for the situation. There probably are dozens of right ways to respond--but even more wrong ways. What would you do or recommend? - Deb