Online reviews have been integrated into daily living, with many people relying on the published words of others to select places to eat, buy coffee and get their car serviced or dry cleaning done. Inevitably dentistry has been dragged into the vortex of online reviews. Dr Annalene Weston, Dentolegal Consultant at Dental Protection, looks at the unexpected cost of this

Although it’s generally assumed that positive reviews drive business to us and, conversely, negative reviews push business away, l was unable to find a study to verify this as an absolute fact. As many will be aware, a recent case involving a negative Google review about a dental practitioner by a patient was successfully pursued, with the patient found guilty of four counts of defamation. In this case, evidence was provided to demonstrate that the defamatory comments were viewed by a wide audience and that they had an impact on the practitioner’s business.

So perhaps we can accept that based on the available evidence, it is more likely than not that online reviews have an impact on our business. The intent of this article is not to directly explore this, but rather to explore the impact that online reviews, specifically negative ones, have on us.

In short, if sticks and stones can break our bones, but names will never hurt us, then why does a negative online review hurt so very much?

Is it because the truth hurts?

Naturally, there may be occasions where an online review calls us out on a behaviour or action we are not proud of. Not one healthcare worker I have ever met has chosen to ignore the first mandate of medical ethics, “first do no harm”. Not one medical professional I know has made it their wilful intent to harm another. So rather than the sting of a negative review being caused by the outing of a practitioner for wilfully inappropriate behaviour, could it instead be that there are some incidents or accidents in practice that we are simply not proud of? Every healthcare practitioner will make mistakes, as we are, after all, only human. Living with these mistakes and their consequences can be hard.

Is it because our mistakes are laid bare for all to see?

In a world of open disclosure, our errors should be discussed freely without judgement. However, an open forum where our perceived shortcomings are set out, often solely from one person’s point of view for all to discuss, regardless of whether all the facts or presented ideas are actually correct, does not provide natural justice, nor constitute a fair hearing. Naturally, the unfairness of this makes us uncomfortable, but it is likely that the visceral response many have to negative online reviews is due to more than just that.

Is it because we don’t know how to fail?

With many healthcare practitioners exhibiting strong type-A personality tendencies, this possibility is a strong contender for why negative online reviews cause us so much stress. The majority of healthcare providers achieved highly at school, failing at nothing in life, and live their professional lives striving to be the very best they can be. Some even strive for the unattainable concept of perfection. For many healthcare providers, a failed treatment, dissatisfied patient or negative Google review actually signifies the first failure of their life. How then do you 'fail well' and use your failure as a valuable learning experience, if you have never learned how to? Embracing our humanity and forgiving ourselves (and each other) for less than perfect outcomes would see the profession move closer towards the no-blame culture of the airline industry we admire with such longing. Perhaps it would also serve as a balm to the negative emotions practitioners experience when they fail. Learning to fail, and learning from our failure, would assist in our development and growth as individuals, and as a profession at large.

Is it because our sense of self and values are challenged?

I truly believe this plays a major part in the pain we experience as practitioners when we are criticised, and this includes a negative Google review. Many philosophers posit that within each of us is contained not one but many, with a public face and a private face that may differ. Each of us truly knows who we are, and who we are not. We know which aspects of our jobs we perform well, and which we perform poorly. We also know our own values and are people of great integrity.

Consequently, being viewed as something we are not, or, to put it more simply, being accused of something you didn't do, hurts.

We are not liars and cheats. We do not swindle or steal, or mislead and deceive, and the fundamental issue with negative Google reviews is that someone we have provided care to, to the best of our abilities, says we did. In a very public way. It challenges our core values and sense of self.

This is compounded by our inability to meaningfully defend ourselves, as we are bound by the obligations of privacy and professionalism. Our integrity ties our hands and in a perverse catch-22 situation, prevents us from defending ourselves. Because to do so, and breach our obligations and requirements, would violate the core and professional values we seek to uphold.

So when faced with a negative Google review, see it for what it truly is. Take any learning from it you need to, and please do seek advice on how best to respond. Remember that your first response in this situation may come from a place of hurt, and is therefore probably not the one you want acting as a mirror to reflect who you really are.