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Social media is an amazing tool which, in its finest form, can be utilised to heighten your profile, increase brand awareness, promote your services, and fruitfully interact with colleagues, patients and the public. It is important, however, to remember that social media is a double-edged sword and it is just as easy for it to be used maliciously, resulting in dire consequences.

With positives such as being a low-cost means of advertising (free, really – anyone can set up a Twitter or Facebook account), giving your skills increased exposure, improving patient communication and enjoying the convenience of immediate feedback, it may be hard to see the negatives of participating in social networks. Unfortunately, there are a few, and they can have a huge impact if not acknowledged and dealt with efficiently. These include the potential for compromising patient privacy, receiving unwanted solicitations from advertisers, the cost of time spent away from patient care and the dread of negative feedback in full view of the general public. So, although it is an incredibly powerful mechanism that can be used for good, it’s also one that needs careful handling.

In March 2013, the General Medical Council (GMC) made some common sense recommendations regarding the use of social media. These include advice such as; keep separate accounts for personal and professional use, maintain patient confidentiality at all costs, don’t inappropriately criticise colleagues (obviously) and monitor your own internet presence. The web terrifies many clinicians and it is not hard to see why, when a career forged over decades could be snuffed out at the unwise click of a button. Remember also that when using social media, defamation rules apply.

However, as I said earlier, it IS a powerful and (crucially) free or at least cost-effective tool that, used correctly, can undoubtedly be an asset to your practice. Even if you think you don’t have an online presence, you probably do already. Just because you haven’t set up a Twitter, LinkedIn, Pinterest, YouTube channel or Facebook page, it doesn’t mean you are not being talked about online. The perennial marketing adage is ‘if you do not seek to position yourself, the public and your competitors will gladly do it for you’. So, it’s time to take a stand.

Contrary to popular belief, you don’t need a huge amount of time to run a social media account. There are free tools, such as Hootsuite and Tweetdeck, that will help you manage your social media presence and post to various networks for you, simultaneously and at scheduled times, if you so require. This means that you can schedule your day’s posts before you even start work, comforted in the knowledge that an app is doing the timing work for you.

These networks are all available as free apps to download on your smartphone, so it seems silly, if not outright foolhardy, not to take advantage of them. They are easy to use, meaning you can have a quick skim between patients or when waiting for an operating room. If you’re not the type to be posting #selfies on Instagram or exchanging witty online banter with the likes of Stephen Fry, make sure someone involved in your practice management, marketing or PR is maintaining some kind of online presence for you.

If you’re ready to dip your toes, establish first what you want out of the initiative. More patients? Fresher image? Thought-provoking interaction? Decide, then do it with gusto and don’t be anonymous – change that Twitter egg icon to a logo of your business or a photo of yourself; this is your online image, a reflection of your brand, therefore an extension of your practice. Engage with people on topical subjects and reply if they ask a question – if you don’t interact, potential patients could think your practice or clinic may be equally as unresponsive. Make sure your team is careful with promotional strategies; nobody likes spam and constantly posting promotions or special offers will be seen as exactly that.

Sites such as Twitter and Facebook need nurturing; empty pages and feeds are magnets for spammers who will use them to advertise their own competitions or even post inappropriate material. Even if it is ­just five minutes a day, take that time to refresh your content, reply to any messages and basically be seen as ‘present’. You can have someone – a friendly intern, your PR or practice manager – run the feed, and fear not: they don’t have to ‘pretend’ to be you; simply represent the practice. Your business will thank you for it.

Ok, so the inevitable negatives. I won’t lie – social media can be, on occasion, a nasty school playground with bullies aplenty. This is a good example of why pages and feeds need to be carefully managed; a quick and courteous response to a negative post along with an offer of help via phone or email will make you look good and detractors appear rude and uncompromising. But ‘internet trolls’ are a completely different ball game and you should learn the difference: trolls set out to be inflammatory, rude or insulting to deliberately cause a reaction. Don’t allow them this opportunity; deal with them calmly, or ignore them entirely. They’ve probably never even set foot in your office so it’s not worth getting into an argument; this will make you appear unprofessional.

Negativity spreads quickly however, so dealing with an actual disgruntled or unfavourable review or criticism (not from a troll!) immediately is the most efficient course of action. With the increase in Yellow Pages and TripAdvisor-type directories and review sites, today’s clinicians face a more open market, which can also leave them vulnerable. Many an evening or a weekend (publicists have no life, by the way) I have found myself having to leap onto a client’s Twitter or Facebook page, immediately tackling any complaints that have appeared.

If you do find yourself in the position of having received negative feedback, whether merited or not, there are some specific steps you should take. Firstly, make sure to deal with them immediately; it is far more productive to acknowledge and listen to people than ignore them – most people take to the internet to air grievances when they don’t feel they are being looked after or cared for.

The anonymity of the web doesn’t just shield genuine patients wishing to share an authentic, bad experience but it also unfortunately protects impersonators (such as ex-employees or competitors) or extorters who may be out to purposely damage your practice and your reputation. First and most importantly, don’t lose your cool! Whilst ignoring the comments may not be the correct avenue for you, getting involved in an undignified scrap is equally, if not more, inadvisable.

If faced with an online review which you know to be inherently false or defamatory, you may wish to explore first whether the comments can be easily removed. This involves looking carefully at the website’s terms and conditions. Each site will have specifics as to who can leave a review, and what they might be able to say (for example, certain forums don’t actually allow the clinician to be named). If you can prove that the content violates the forum or review site’s terms and conditions you can have the offending material simply deleted by the site’s own webmasters.

However, in most cases a negative Facebook comment or online review may need to be challenged. Often, the person is purposely seeking to activate the clinician’s ego – so don’t rise to the bait. Remain calm and polite, if anything, be effusive. Suggest a chat on the phone, a face-to-face visit to the practice, anything to get the dialogue offline! Offer sympathies if they’re having a difficult time and show your readiness to do whatever it takes to solve the problem. Be diplomatic, even if you’re feeling riled. Perhaps the patient has genuinely had a terrible experience – use this as a learning opportunity. Maybe your team wasn’t responsive enough, or the person didn’t feel cared for? Demonstrate your willingness to investigate and do the opposite of hiding: over-communicate. Thank them and say you are committed to tackling any issues together. But above all, lead the conversation off the web!

Crucially, know that saying ‘sorry’ does work. A lot of patient complaints have more to do with their perception of an experience rather than the experience itself: if they feel like you don’t listen, they may take to the internet to find people who will.

At least some negative reviews can be avoided from the very beginning of a patient’s time with you, at the consultation stage. Make sure that you manage expectations from the offset; the majority of complaints are down to unreasonable expectations (which you should have spotted from the start) and lack of clarity on financial terms. Ensure that they are fully aware of your revisions policy and aftercare, and if possible have this paperwork signed. You can prevent many confrontations down the line through careful patient selection. Turn prospects away if you must, and be humble about the reasons why – perhaps someone else’s skills might be better suited to their particular complaint?

I do of course recommend seeking legal advice, if necessary. But this should be your last resort – from a public perspective you will never (trust me on this) appear sympathetic against a ‘defenceless’ patient, even if they’re clearly unhinged. If you feel there’s nothing else you can do to address the situation, then feel free to explore this avenue but know that it will get expensive: make sure that there is genuine damage other than your own bruised ego.

The above all might seem like an enormous amount of hassle – but you can actually prevent a lot of this stress if negative comments are simply drowned in positive ones. It’s common sense! You probably look for a healthy, realistic ratio yourself when scanning reviews for a good hotel or restaurant. Not all comments will be ‘five stars’ but the occasional two or three can lend the rest of the comments legitimacy. If all the feedback is enthusiastically (and improbably) gushing, wouldn’t you question if it’s the employees themselves writing it?

‘The solution to pollution is dilution’, is a saying I heard recently and it is entirely appropriate. From today onwards, encourage your happy patients to go online and leave reviews. Actively join the top directories that come up on the first page of Google and populate your listings with photos and information about your practice. Appear open, connected, on the pulse. This does require you and your team to be truly proactive: set up those pages and ask people to share their experiences – incentivise them, even. Maybe have an iPad in your office where they can do it before they leave? This might seem utterly counter-intuitive to you, but down the line if you are faced with the one detractor (as most are, eventually), his or her comments will just be one of 100+ positive ones. While I’m on the subject – give the public a little bit of credit! Most people can differentiate between a genuine complaint and an imbalanced, unreasonable one.

Every patient who leaves your office satisfied is an opportunity to enhance your practice’s image online. So, take ownership of your reputation. Work with your PR and search engine optimisation (SEO) companies. Regularly audit your online presence and prepare to experience a whole new world wide web.

 

Declaration of competing interests: None declared.

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Tingy Simoes

Author of the first-ever PR manual aimed at plastic surgeons and professionals in cosmetic medicine How to Cut it in the Media.

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