Discussions

patient responses and follow-up process

Posted by Megan Rowe @MeganRowe, May 20, 2016

We have had other conversations around responding to negative social media posts from patients, and I think everyone participating agreed that these concerns ultimately end up in their hospital’s patient relations office.

When you guys reply to these patients on social media, do you give them patient relations’ contact info? Or do you try to get them to contact you (or private message the account) first, and then ask PR to follow up?

The reason I’m asking…we used to reply to the comments with something like “We’re so sorry to hear this, and we’ll share your feedback with the departments involved” (if we have enough information to ID them) “If you would like us to look into it more and follow up with you, please contact our Patient Relations office at phone number/email.”

I never liked this because I thought it came across like we were telling an already-frustrated patient to take another step. So a few months ago, Patient Relations and I agreed that I would instead try to get the patient to message me contact info, which I would then pass onto PR for their follow-up.

But this is also proving to result in more steps and hand-offs for the patient, who often sends me a lengthy message about their care, which I then I have to pass onto PR. And PR prefers to have a phone number, and sometimes they don’t give me that. And some patients, I suspect, still just want to vent and know that they were heard, not to talk on the phone with someone from PR.

So one Patient Relations employee encouraged me to start saying something more like “We’re very sorry to hear about this. We appreciate you sharing this with us on Facebook. We have a department, Patient Relations, that investigates patient concerns, and if you would like, they can speak with you and look into this more. If you would like contact them, their email address is…”

What do you all think about this kind of response?

Great post Megan! This was covered pretty extensively at this weeks member conference at Mayo in Rochester. Jay Baer did a presentation on responding to negative posts/reviews. He has written a book “Hug Your Haters” which I have started to read, and to this point would highly recommend.

I followed the same path as you mentioned above and actually have a meeting coming up with our patient relations team to discuss how we can best approach this. It will be a bit of a challenge on my part though because they are recommending that we give them a the same response you mentioned above: “We’re so sorry to hear this, and we’ll share your feedback with the departments involved” (if we have enough information to ID them) “If you would like us to look into it more and follow up with you, please contact our Patient Relations office at phone number/email.”

I do not like this reply and agree with your points as to why. I would much prefer, “We apologize for the experience you had. We strive to deliver the best possible patient care, and it appears we have fallen short. Please send me a private message so we can discuss further in private.”

Then when they message me (they usually do) I will ask them if they would like me to share this with the departments involved along with the directors, or if you provide me with your contact info, I will have our (name), our patient relations person to reach out to you.

They usually would like someone to reach out to them, but occasionally they just want to be heard and for me to pass the conversation along.

REPLY

I think this highlights something else that was brought up at the Member Meeting…that we need to break down the barriers with Patient Relations (or Office of Patient Experience as Mayo calls it.) From the Patient’s perspective, they don’t care about our institutional organization charts. We shouldn’t make an already frustrated patient take more steps, and we in PR/Public Affairs aren’t in position to give them meaningful help ourselves.

REPLY
@LeeAase

I think this highlights something else that was brought up at the Member Meeting…that we need to break down the barriers with Patient Relations (or Office of Patient Experience as Mayo calls it.) From the Patient’s perspective, they don’t care about our institutional organization charts. We shouldn’t make an already frustrated patient take more steps, and we in PR/Public Affairs aren’t in position to give them meaningful help ourselves.

Jump to this post

Thanks for the feedback. It sounds like we’re all on the same page.

After discussing more with my manager and colleagues who do social media backup when I’m out, I think we’re going to try offering the poster options: We’ll give them the Patient Relations contact info, but we’ll also offer up the option of them DM’ing us a phone number, which we could then pass along to PR.

In our experience, regardless of response, only maybe 1/4 of patients actually end up taking any further steps.

REPLY

HI All, was there a more updated thread on responding to Facebook posts/comments and triaging to Patient Experience?

REPLY

I know nearly everyone will disagree we me, and I know in theory we can learn from frustrated patients, but consider at least the possibility we put way to much energy and focus on these things. There is an opportunity cost with these efforts, and although it’s not a zero sum game, and we can walk and chew bubblegum at the same time, I suggest that preventing one fatal car accident (by a distracted driving campaign) or getting a 5% increase in Vaccination rate, or having a person call 1 hour earlier for a stroke and saving years of functionality is a much more important use of marketing SocMed time.

REPLY

Great thread, BTW. The presentation mentioned ("Hug Your Haters") is one I'd be interested in hearing more about or connecting to. Could anyone recommend a link to that?

Facebook, twitter, etc. are all public sites and so how health care providers respond to 'hate', 'dislike' or 'complaint' says a lot about the recipient's values. Recently, I have been managing offensive tweets on Twitter rather than complaints about my services.

I am a solo practitioner (Clinical/Health Psychologist), so there are many issues (privacy laws!) related to the management of a complaint about my services on my social media site. My social media policy contains a section on the options available to persons who feel they have been injured by my professional services and I would likely refer them to that policy, whilst acknowledging their dissatisfaction.

Worthwhile to read this thread!

REPLY

Hi Dr. Marceli @drpaulam – welcome to our discussion forum! Thank you for your comments. The Hug Your Haters presentation referred to was by Jay Baer at our 2016 annual conference. Unfortunately, we didn't record that presentation. However, here's a link to a YouTube video of Jay presenting on the subject at a different conference

.

What have you found to be the most challenging as you respond to offensive tweets?

Liked by Dr Paula Miceli

REPLY
@DanHinmon

Hi Dr. Marceli @drpaulam – welcome to our discussion forum! Thank you for your comments. The Hug Your Haters presentation referred to was by Jay Baer at our 2016 annual conference. Unfortunately, we didn't record that presentation. However, here's a link to a YouTube video of Jay presenting on the subject at a different conference

.

What have you found to be the most challenging as you respond to offensive tweets?

Jump to this post

Thanks for the link! A oouple of things. It takes effort and time to monitor the account and its content. Sometimes I wrestle with the decision of not responding to an offensive tweet vs. reporting/deleting it (reporting a tweet automatically deletes it). The latter choice (deleting the user) clears my account, but it runs the risk of evoking an even greater response from the writer. None of that response will end up on my account, but it will mean that someone in the twitter community is writing things (negative) about me. Typically I make a post about ethical guidelines and inform readers of my account that a tweet/user has been deleted.

In my ideal world, I could indicate disagreement with a tweet more effectively. Some things absolutely need to be reported as offensive. I feel limited about how to communicate different experiences – displeasure, disgust, disagreement, and dis-association with a user. Sometimes I just want to delete a tweet, but in order to do that, I have to delete a user. That user might only be having a 'bad moment'. I'm trying to figure that out.

REPLY

We adopted the "Hug Your Haters" approach and try to respond to every comment on every social media platform. We have a general public comment explaining that we welcome all feedback from patients but that we cannot handle patient information publicly and then we include a contact number for the manager of whatever department or office they are complaining about. I then also private message them with similar information explaining who the manager is that they can reach out to, with the phone number again. I then, send a copy of the review and a link to the social media site where it is posted. That email is copied to our "Reputation Management Team" which includes our CEO, president and all the vice presidents. The manager who handles the outreach to the patient is then directed to "reply to all" when they are able to resolve the matter.
We are having some success, with even a few people who have come back to delete or update their reviews.
Of course not everyone is going to be "won over" but even if they don't change their review, anyone who reads it in the future will see that we are a health care organization that cares and responds. As Mr. Baer says, not responding is a response. It's a response that says you don't care.

REPLY
@drpaulam

Thanks for the link! A oouple of things. It takes effort and time to monitor the account and its content. Sometimes I wrestle with the decision of not responding to an offensive tweet vs. reporting/deleting it (reporting a tweet automatically deletes it). The latter choice (deleting the user) clears my account, but it runs the risk of evoking an even greater response from the writer. None of that response will end up on my account, but it will mean that someone in the twitter community is writing things (negative) about me. Typically I make a post about ethical guidelines and inform readers of my account that a tweet/user has been deleted.

In my ideal world, I could indicate disagreement with a tweet more effectively. Some things absolutely need to be reported as offensive. I feel limited about how to communicate different experiences – displeasure, disgust, disagreement, and dis-association with a user. Sometimes I just want to delete a tweet, but in order to do that, I have to delete a user. That user might only be having a 'bad moment'. I'm trying to figure that out.

Jump to this post

I think a lot of our members are still trying to figure this out. I'm going to tag @stacytheobald who handles most of the social media response for Mayo Clinic's enterprise accounts. Stacy – how do you make the decision about whether to ignore, respond, or delete?

REPLY

@drpaulam Thank you for your questions. Our situation is a little different being we have many Mayo accounts and physician twitter accounts. We have guidelines that help us determine if a post needs to be removed/reported. These can be found in the "Resources" tab at the top then select Mayo Clinic Resources. We delete/ban/hide when comments negatively call out a physician or provider by name and we will let that poster know that we have the right to remove based on our statement in the about section on Facebook "Relevant, respectful discussion, questions and feedback encouraged. Posts we deem offensive, defamatory, spam, ads, violate Facebook's terms of service, inaccurate or otherwise objectionable may be deleted. No solicitation."

Tweets are not automatically deleted when they are reported, Twitter reviews the tweet and then determines if it will be removed on a case by case basis. So we rarely report tweets except when we received the tweet from Dr. Nifkin(spam) account. https://www.thedailybeast.com/far-right-twitter-keeps-falling-for-the-same-liberal-troll Typically, we check to see how many followers the poster has and if our response will make it worse than just ignoring them, which is generally the case for Twitter. I hope this helped, if you have additional questions, please let me know.

REPLY

When considering such things as Reputation Management Teams and Hugging your Haters, I think everyone should consider at least the possibility of how these efforts could worsen care and increase patient mortality. (As a starting point read the HBR article on The Feedback Fallacy): https://hbr.org/2019/03/the-feedback-fallacy

One simple example. Say a physician is seeing 40 patients a day, 4 days a week, gets a negative comment from a patient, which was bounced up to the Reputation Management team or some other Hugging Your Haters approach. Fair or not ( but especially if not), elevating this complaint to the level of the CEO may upset that physician for the next several weeks, subtly affecting the care of hundreds of patients. If it was an unfair complaint and was not handled perfectly, it may result in a highly experienced physician leaving the clinic, which can have a dramatic impact on an entire patient panel.

I am very wary of systemic approaches which can impact care, and, as a general rule, I start off with the assumption that administrative changes or software changes will negatively affect the very delicate interaction between physician and patient in the room until proven otherwise. One simple check – consider an email to every provider in your clinic describing the protocol for how you handle social media complaints and ask one question: Do they think this will this improve or worsen patient outcome?

REPLY

Thanks for sharing that article, @matthewrehrl. I skimmed it and look forward to reading more closely. We do pass along the positive comments, too, which are encouraging and affirming. I think we all tend to be more deeply affected by negative comments than by positive. Even if comments are 99% positive, it's really easy to get fixated on the negative. I agree it's likely not helpful to pass along an isolated negative comment, and we don't forward those to leadership. We're more interested in proactive/prophylactic reputation management by encouraging staff to take charge of their online identity through their own social media accounts, which will tend to be prioritized in search. It's more important to reach out and see if we can resolve the issue for the patient if we can, and the provider may not be involved in that discussion, at least at first.

REPLY
@stacytheobald

@drpaulam Thank you for your questions. Our situation is a little different being we have many Mayo accounts and physician twitter accounts. We have guidelines that help us determine if a post needs to be removed/reported. These can be found in the "Resources" tab at the top then select Mayo Clinic Resources. We delete/ban/hide when comments negatively call out a physician or provider by name and we will let that poster know that we have the right to remove based on our statement in the about section on Facebook "Relevant, respectful discussion, questions and feedback encouraged. Posts we deem offensive, defamatory, spam, ads, violate Facebook's terms of service, inaccurate or otherwise objectionable may be deleted. No solicitation."

Tweets are not automatically deleted when they are reported, Twitter reviews the tweet and then determines if it will be removed on a case by case basis. So we rarely report tweets except when we received the tweet from Dr. Nifkin(spam) account. https://www.thedailybeast.com/far-right-twitter-keeps-falling-for-the-same-liberal-troll Typically, we check to see how many followers the poster has and if our response will make it worse than just ignoring them, which is generally the case for Twitter. I hope this helped, if you have additional questions, please let me know.

Jump to this post

Thanks for the resource suggestion @stacytheobald! I will have a look at it after I post here.

In terms of my professional obligations as a Psychologist here in Ontario, Canada, I am responsible for my twitter feed. I think my terminology was a bit sloppy in the first post… so I'll try again here 😉

If I block a user on twitter (I used the word 'delete' before), then the offensive tweet is removed from my feed. So are all of the other tweets from that particular user. So, this satisfies one component of my obligation.

The second level of obligation is to address the impact of the tweet on the community. I've reported offensive tweets to Twitter – their system offers me an opportunity to block the user (which I will) and then their own internal process of review is triggered. I can't control the outcome of that. But in terms of my own feed, the offensive tweet is removed and any Retweets by followers in my community (of the offensive tweet) will also be blocked from appearing in my feed.

Sometimes I have found a tweet in poor taste, but not flagrantly violating the ethical guidelines for Psychologists. I have used the side drop down menu on twitter to indicate "I don't like this tweet" and it seems to go away in my live feed. While that satisfies me (because I don't want to see it), I'm not quite sure about it's overall impact on the community. This last part is where some of lingering concerns are….. managing tweets that enter a more 'grey' area (ie., where blocking a user feels too strong and lack of response feels too weak).

Discussing the issue has been helping me organize how I describe my behavior… so again, much appreciated!

REPLY
@matthewrehrl

When considering such things as Reputation Management Teams and Hugging your Haters, I think everyone should consider at least the possibility of how these efforts could worsen care and increase patient mortality. (As a starting point read the HBR article on The Feedback Fallacy): https://hbr.org/2019/03/the-feedback-fallacy

One simple example. Say a physician is seeing 40 patients a day, 4 days a week, gets a negative comment from a patient, which was bounced up to the Reputation Management team or some other Hugging Your Haters approach. Fair or not ( but especially if not), elevating this complaint to the level of the CEO may upset that physician for the next several weeks, subtly affecting the care of hundreds of patients. If it was an unfair complaint and was not handled perfectly, it may result in a highly experienced physician leaving the clinic, which can have a dramatic impact on an entire patient panel.

I am very wary of systemic approaches which can impact care, and, as a general rule, I start off with the assumption that administrative changes or software changes will negatively affect the very delicate interaction between physician and patient in the room until proven otherwise. One simple check – consider an email to every provider in your clinic describing the protocol for how you handle social media complaints and ask one question: Do they think this will this improve or worsen patient outcome?

Jump to this post

@matthewrehrl I continue to be extremely grateful for your posts reminding us about the impact our work may have on physicians and patient care. How would you feel about a recommendation that every in-hospital social media team have a physician member who meets with them on a regular schedule (monthly?) to collaborate and give insight as to how the team's social media strategies are helping or hurting physician morale and patient care?

REPLY
Please login or register to post a reply.

© Mayo Clinic Social Media Network. All Rights Reserved.