I won’t bore you with stats about how negative reviews impact your business or hurt your search engine optimization (SEO), or about how 88% of consumers have used online reviews to determine the quality of a local business – I’ve already done that here and here.

And I gather you already understand the impact a doctor’s reputation can have on the success of his or her practice, for better or worse (at least I hope you do).

I’m writing this article today because I keep hearing doctors and other marketers complain about how hard it is to acquire patient reviews, and I’m getting tired of the conversation.

I’m tired of the shortsighted approach everyone takes to acquiring reviews.

The conversation needs to change.

I’m exhausted, and it’s not working for your practice.

Let me know if any of this sounds familiar?

  • “I keep telling them to ask for reviews, but they never get any.”
  • “I don’t understand why I’m getting this negative feedback. We’re doing everything we can to get more positive reviews.”
  • “What can we do to get our happy customers to leave more reviews?”
  • “Should I start asking patients to leave reviews on other platforms?”
  • “If I get more reviews, will it help my SEO?”

The reason you’re not improving your online reputation is simple: You’re asking the wrong questions, and your approach is terribly flawed.

Instead of implementing a process by which you can continuously measure and improve patient satisfaction, you’re busy trying to optimize for review count to help improve your SEO. Or worse, you’re hell bent on amassing more Google Plus reviews than your competitors for no other reason than to have more “stars.”

Rather than surveying your patients on a regular basis to measure your ability to deliver a quality overall patient experience, every 2-3 months you decide you need more reviews on Google Plus, so you send an email out to your patients hoping they’ll leave reviews. But what does that teach you about your ability to satisfy patients? Nothing. And what actionable insight can you extract from reading your happiest patients’ reviews that will help you improve patient experience? None.

Small businesses like your medical practice are missing a process altogether. More frighteningly, online review sites and digital marketing tactics have baited you into thinking review count is more important than improving your patients’ experience. Yikes!

I’ve created resources to help, like the Dos and Don’ts of Acquiring Patient Reviews, the Incredible Review Creed, and the Patient Satisfaction Survey, and I believe they have. But the final piece of the puzzle to implementing a system for measuring patient satisfaction is to learn how to audit your existing online reputation. It’s one thing to amass reviews; it’s another thing to audit those reviews and extract meaningful insight that will help you make improvements to your patients’ experience.

In this article, I’m going to show you the four step process to conducting your own patient review audit. And I’ll even share a real example of a patient review audit, along with seven tips for performing your next review audit. And when you’re finished reading this article, you’ll be well equipped to start implementing a process for improving patient satisfaction so you can stop obsessing over your number of reviews. The day you focus your attention on improving your patient’s experience is the day you win the online reputation game.

Let’s get started.

The Four Step Patient Review Audit

The patient review audit includes four simple steps:

Step 1

First, decide which review websites you will use in your audit. I’ve discovered that the best medical niche review sites to extract reviews for a review audit include: RealSelf.com, Vitals.com, RealPatientRatings.com (if you use this software), and RateMDs.com. And of course, include Yelp.com and Google Plus.

Step 2

Separate negative reviews that appeared three or more times in the last three years into their own column. Once you have your recurring negative reviews in one column, organize them into like groups. For example, highlight all reviews that complain about a long wait time in the color red, highlight all reviews that complain about staff in the color blue, highlight all reviews that complain about a breast augmentation in the color yellow, so on and so forth.

Step 3

If the same negative experience occurred only two times in the last three years, file those reviews into their own list, just in case more show up down the road. However, if an odd, unique, or dangerous experience happened *twice*, throw it into the master list of recurring issues. For example, if two different patients both mention that they contracted an infection from unsterilized needles, add those negative experiences to your master list due to the severity/seriousness of those particular experiences, even though it’s only two incidences. You can live with multiple offenses of certain poor experiences (e.g. long wait times), and patients will still come back. But for serious, perhaps life-threatening, patient experiences (e.g. infections from unsterilized needles), just one offense can ruin your practice forever.

Step 4

Summarize your findings and create a plan to resolve future negative experiences. Include practical solutions for each recurring issue.

Example of a Real Patient Review Audit

To help you visualize what the patient review audit should look like, I decided to do one myself and share it.

I found a plastic surgeon in my locale (to remain unnamed), who, for the most part, has a positive online reputation. However, there were a few of the same negative patient experiences that kept popping up across multiple review sites. You will likely find that, when conducting your patient review audit, after a few minutes of compiling your list of negative reviews, most of them all stem from two or three of the same issues.

Click to expand


Patient Satisfaction Summary

Overall, patient satisfaction is high, with a 5 star average on RealSelf.com, a 4.5 star average on Vitals.com, a 4.5 star average on RealPatientRatings, and a 4 star average on Yelp.com. However, there are three issues patients keep mentioning that seem to take up the lion’s share of negative sentiment: the wait time is far too long, the perceived value of results don’t justify the high cost, and breast implant patients repeatedly feel that their implants were too large and were unhappy with cost of revision.

Of your treatments, breast augmentation, lip injections, and liposuction experienced the most negative sentiment across the board. Of all your 20 negative reviews, you responded to zero of them. Also, there were two unique situations that two different patients were unhappy about, and one situation with injections that particularly stuck out:

1. The staff is too pushy:

“Lastly, I wouldn`t necessarily recommend buying or being sold by the nurse. She was very pushy to get me to buy things and the last time I mentioned to her I didn’t really feel the need to spend anymore money this after surgery, products etc.”

“Office staff was ok. Seemed to pressure patients into paying the non-refundable deposit.”

2. Capsular contraction:

“… At my post-op appointment, [doctor] denied I had an encapsulated breast, even though the breast was very high, palpably hard, did not move much in its pocket, and was becoming painful… I consulted with another plastic surgeon, who diagnosed Grade III/IV CC, which required surgery. I am disappointed that [doctor] did not recognize and diagnose the encapsulation.”

“After 13 months I developed capsular contracture and was diagnosed with grade IV by a reputable surgeon in Newport Beach, and [doctor] also diagnosed me with capsular contracture.”

Note: Grade III and IV capsular contracture

3. Fillers injected wrong:

“The bottom half of my face (around the mouth) with major bruising when I believe he hit a nerve above my top lip which bruised for 4 weeks- and paralyzed my smile for 3 months by improper injection area on a separate occurrence.”

***This one sticks out primarily because you did not respond to it, and because the word “paralyzed” is crippling. Since this patient is likely not a plastic surgeon or trained injector, they cannot make claims that you injected the filler improperly.

Practical Solutions

First and foremost, implement a plan to monitor your feedback online and to respond to negative reviews. You can use a service like Yext.com or assign a staff member to monitor the major review sites on a regular basis. By not responding to over 20 negative reviews, not only does it look like you don’t care about patient satisfaction, but it also leaves a lot of misinformation on the table that only you can clarify for future patients.

1. Reduce the amount of patient wait time

Most patients note that you spend a great deal of “one-on-one” time with them in their consultation, which is awesome, but likely the reason the wait is so long. Since the wait is negatively impacting your patient experience, you need to resolve the issue immediately. A few practical solutions:

a. Reduce the number of consultations you see in a day.

b. Extend your business hours, or work on Saturdays (ugh).

c. To show your patients that you respect their patience, utilize your low-cost non-invasive aesthetic treatments (fillers, facials, skin peels, etc.) as free waiting room treatments. Talk about turning a negative into a positive!

d. Improve the process: tighten up your policies on late fees and no shows, gather patient information before they arrive, delegate patient intake to less skilled staff.

e. Embrace solutions like zwivel.com pre-consultation software (free) that will help weed out tire kickers before they even schedule a consultation.

2. Implants too large + revision costs

If you read between the lines of these reviews, patients were unhappy that, despite asking for smaller cup sizes, you still swayed them to go larger. The revision cost was unjustified simply because they asked for smaller implants and didn’t get them. Solution:

a. Listen: this issue spotlights an inconsistency in attention to detail as well as a habit for being too subjective. For example, one of the patient’s sites that you determined her cup size not by asking her, but by saying, “whatever looks beautiful on you.” She also follows up by stating she trusted you, so she let you decide. Two others mention that they were adamant about not wanting to go too big, but felt that you convinced them otherwise.

b. Perhaps an investment in patient education software, like TouchMD, will help you show patients during their consultation how the different cup sizes will look on their body, therefore hedging against any speculation.

3. Overpriced

Rule number one of marketing is that no one (and I do mean no one) buys on price (unless you are selling a commodity, like Botox). The root of the overpriced discussion stems from patients not understanding the added value that accompanies higher prices. Even satisfied patients complained about the cost of services in a few reviews. Solutions:

a. Make a concerted effort to educate patients on why your prices are higher, and because you’re a “reputable surgeon” isn’t a good enough answer. Instead, give them the added benefits that come along with price, and have those benefits prepared during your consultation to present to the patient. The better you can prove the added value, the fewer complaints you’ll receive about price.

b. Ultimately, if you’re one of the more expensive in your market, you need to deliver the best results. Otherwise, your patients will always win the price argument. In your case, your negative reviews stemmed almost exclusively from breast augmentation, fillers, and liposuction. Take a close look at all three treatment/procedures and improve your execution.

In Sum

Given that you don’t respond or monitor negative feedback, it’s clear that you have not made patient satisfaction a core part of your business model. The fact that the same recurring negative sentiments have populated your review profiles since you started further supports this assumption.

Make patient satisfaction a core part of every patient’s experience. Not to get more reviews, but to improve your quality of service. Stop thinking about “review count,” and start thinking about measuring patient satisfaction with a patient experience survey. Optimize for quality, not reviews. And since you have several negative reviews costing you money, implement a plan for acquiring more positive reviews.


7 Patient Review Audit Tips

In order to perform a successful patient review audit (one that reveals actionable insight that you can share with your staff and implement a plan for improvement), it’s important to remember several key factors that will contribute to your success or failure:

1. Learn the nuances of each review platform

All review sites differ in some way. Yelp tends to feature more negative reviews because unhappy patients would rather go to a familiar website to leave a negative review than to one of the medical niche websites you suggested on your review card. RealPatientRatings authenticate their reviews by sourcing reviewers directly from your patient database, so all of their reviews are bona fide. Review sites that allow you to use a kiosk (iPad usually) to amass reviews are typically heavy with positive reviews. This is because most patients aren’t 100% truthful when they can’t hide behind the anonymity of the Internet. Keep all of this in mind when auditing your reviews to better inform your results.

2. Don’t just measure negative sentiment, measure positive, too

The primary goal of a patient review audit is to identify recurring issues patients site. However, take an inventory of the positive reviews in proportion to the negative reviews. If you found 20 negative reviews, but you have 300 positive reviews, while you can still improve, don’t beat yourself up.

3. Track which procedures receive the most negative feedback

In most cases, you’ll discover that patients usually complain about the same 2-3 treatments or procedures. Track the procedures that get the most negative reviews, and track the procedures that get the most positive reviews. Tracking both will help you identify which procedures you need to improve, and which procedures you’ve mastered.

4. Track review dates and review from the same person across multiple platforms

Again, measure reviews as far back as three years, no longer. Hopefully, you improved any recurring bad habits since three years ago, but monitoring dates will help you monitor your improvement. For example, if you run a patient review audit and improve your poor patient experiences, at the end of the year, you can audit your reviews again to learn if you were successful. Also, if you discover that one patient left a negative review about her breast implants and left that same review on ten different websites, make sure you only count this as one review.

5. Conduct your review audits quarterly or biannually

You can’t just run a patient review audit once and think you’re going to fix all of your problems. However, you don’t need to run one every month, either. Instead, run a patient review audit every quarter or biannually.

6. Use your judgement

Once you start reading hundreds of patient reviews, you’ll develop a sense for which ones are totally bogus and which ones are genuine. Use your instincts!

7. If you only have a few reviews…

The fewer reviews you acquire, the more important it is that each one is positive. A Yelp account with 50 total reviews, 15 of them negative, looks far better than a Yelp account with five total reviews, four of them which are negative. If you don’t have enough quality reviews, implement a strategy for improving your patients’ overall experience. 


A patient review audit will help you identify weaknesses in your patients’ experience. It will also help you discover issues you never knew existed, like the fact that your front desk employee hammers every patient with high-pressure sales. And though this audit will help you measure patient satisfaction tremendously, it’s just one block in the reputation management pyramid of success.

First and foremost, you should always reply to negative online patient feedback. If you don’t, your future patients will assume negative feedback is accurate, even though most negative reviews are emotional and filled with misinformation- misinformation that only you can clarify. And if you truly want to hedge against negative online reviews, resolve your patients’ issues before they leave your practice. In the example I provided above, the most alarming issue was that the doctor had multiple follow-up consultations with unhappy patients, yet he still let them leave knowing that they were unhappy. What did he think they were going to do?

Last, the only real way to improve your patients’ experience with your practice is to make patient satisfaction a core part of your business model. That means measuring patient satisfaction on a consistent basis. Download the ***updated*** patient satisfaction survey below, print it out, and hand it to your patients at the point of sale. It measures the quality of everything from your staff to the facilities and accommodations.

And remember: “Your reputation is like a bad tattoo… it’s permanent!” Think of a patient review audit as the “laser tattoo removal” of online reputations. The only way to get rid of unwanted reviews is to fix the real problem: poor patient experience.


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