The NHS and feedback - there is a better way

One of our staffers had occasion to pay a visit to a hospital this week. And guess what they saw? This...

Here's the form...

And this was next to the lifts...

How is this feedback collated? (Goodness knows). Is it visible to other patients? (not that we can see). Does it recieve a response? (No). Is it shown on their website? (No). Seriously? In 2021?

Let's look at another medical operation, a relatively recent client of ours:

This form can incorporate specific questions if required (and these can be varied over time)

All collated, scores recorded, incorporating a response mechanism, paperless, visible to all potential patients.

That last point is crucial: what does anyone considering medical treatment need more than almost anything else? Yes: reassurance. 

And as many as possible on Google as well:

Need we say more?

ABC of Reviews: 3. What if your business does nothing?

Behind this question invariably lurks that dreaded emotion: fear. A perfectly rational fear born out of the experience of reading reviews of other businesses, that by engaging with reviews your disgruntled customers (and we all have them!) will impact and even dominate your business's reputation. It is this fear that must be addressed before any steps are taken along the road to effective review management.

So here are some answers:

Note: we have used the medical profession to illustrate this article for two main reasons: firstly, consumers place a very high value upon reviews of medical services and secondly because some business people think 'my relationship with my customers/clients/patients/guests is so personal they won't want to write a review' and you don't get a relationship any more personal than that between a medical practitioner and their patient.

1.  Exactly that - nothing - may be the result. It will, initially at least, result in your business looking like this in search...

 But do be aware that Google will helpfully display these five suggestions immediately underneath where the business's reviews, if it had any, would normally be (you might be surprised to learn just how many searchers believe these have been hand-picked by Google on a subjective basis):

2. Some of your really happy customers - rarely many (just think for a minute, how many Google reviews have you personally written unprompted?) - will go ahead and write reviews anyway, so you will look like this...

3. Your worst fears will be realised anyway. Remember that anyone can write a Google review at any time, they don't need your permission...

4. Your business will begin to lag even further behind your competitors in local search...

...and note that searchers are able to select a minimum score to narrow their choice down to highly-rated businesses, in this case, those scoring 4.5 or higher (see 'rating' right under the Google logo). We soon expect them to refine this further to include both rating and a minimum number of reviews).


5. Most important of all, your business will miss out on looking like this...

This recent client of ours specialises in treating women for issues arising from the unpleasant side-effects of the menopause. It is hard to think of a more personal issue upon which to write a review yet these women have realised what a huge benefit they provide for their fellow sufferers by doing so. If you take the time to read the reviews themselves - google the Harper Clinic, we promise what you see there will prove to be a real eye-opener - you will see just how powerful even a small number of well-written and relevant reviews can be.

So: doing nothing is almost certain to expose your business to negative reviews as well as depriving your business of a really powerful marketing opportunity. All businesses should engage, the only question - which will be comprehensively answered in this series of articles - is 'how?'.


Some statistics:

The following chart is taken from an in-depth study made by three professors at Columbia University in 2019:

What it shows, for Yelp - an open reviews platform very much like Google - is that, while most customers (67%) write positive reviews a significant number (19%) will write less complimentary - and potentially harmful - reviews. Without a resilient review management strategy in place, a business risks 'conforming to the norm' with a review profile such as this. 

Reviews and the medical profession - did our predictions come true?

We first wrote about reviews and the medical profession way back in 2014. So were we right? First lets look at what we predicted:

1. That reviews of medical services, be they general practice or specialist, would become popular with patients
2. That Google would become the vehicle of choice, both for those posting the reviews and those reading them
3. That practitioners that did not find a way of actively engaging with reviews would ultimately suffer, for two reasons: first, medicine is, by its very nature, a complex subject to review accurately and second, the motivation for a dissatisfied patient to write a review is so much greater

And all these led us to the same conclusion: that the medical (and associated health and caring professions) would do well to adopt a proactive attitude to reviews.

What has happened?

1.  Reviews becoming popular

Tick one. Reviews of medical services, of whatever kind, have multiplied over five-fold since 2014. GP practices that had one or two reviews then commonly have ten, twenty or even thirty now, often many more...

Four years ago this GP surgery had no reviews. Now, as you can see, they have over thirty

2.  It's Google all the way now

Tick two. The alternatives have faded away - simply because Google reviews dominate in search. 

Looking for a GP? 

...whether the potential patient conducts a simple search (top) or a map search (bottom) they are shown local surgeries with their Google scores prominently displayed.

Looking for a specialist?

An example of one that has begun to harness the power of Google reviews...

3. Those that have not engaged will have suffered

Tick three - in a very high proportion of cases. If your practice does not engage one of two things will happen (often both, one following the other)...

• you will have no reviews:

...fine, but not especially helpful for potential patients looking for reassurance before choosing a GP. Much more important, it leaves the field wide open for dissatisfied patients to very quickly dominate the impression created in search. It is so easy to go from looking like the practice above, to this...

...a surgery that had no reviews until a year ago!

So what do you need to do?

In a word: engage.

We are fully alive to the fact that we are asking you to put your reputation on the line by proactively inviting reviews, but we are advising you to do exactly that.

Managing that risk

We all recognise that those who feel they have been insufficiently well treated - whether that be by the hotel or restaurant of their choice or their medical practitioner - will be much more motivated to write a review than those who are happy. So we - and you - need a mechanism to balance that equation. That mechanism is moderation.

Moderation

Moderation is the process whereby a review passes through a 'safety net' (operated by HelpHound in conjunction with both the practitioner and the patient/reviewer) before the review is published - that safety net operates in the best interests of both the reviewer and the practitioner to ensure that the review is factually correct and contains nothing that might mislead the person relying on that review to make an informed choice. For those that would like to mine don into the fine detail of moderation there is a separate article here.

Results

No matter what our clients' professions, our ultimate aim will always be to have them scoring in excess of 4.5 on both their own websites and on Google. A 'perfect 5' is attainable in some cases, but it would be unreasonable of us to lead anyone to expect that at outset.

It may well be that some processes within the individual practice need tweaking to improve the business's CRM (a one star review complaining that the phone 'is never answered' has exactly the same impact on a practitioner's Google score as a one star review of a complex medical procedure) but HelpHound will always advise on that before going ahead and implementing any review management processes.

The next steps

Implementation is always planned very thoroughly indeed. No stage is implemented - asking patients to write a Google review, for instance - until the previous stage (asking for a review to the practitioner's own website, in this case) has been thoroughly tested and proven.

At HelpHound we support all our clients every step of the way, from first review to their ultimate goal (as described above). We act in exactly the same way as all your other professional advisers - just focussing on reviews as opposed to legal or financial issues.

Last, but not least, we have no contracts with our clients (apart from our terms of engagement) so we are fully aware that we have to deliver month-in-month-out.

Doctors - what happens if you ignore Google reviews?

This happens...

...maybe not straight away, but over time.


Why?

It is simple really, and its all down to a combination of human motivation and how we interact with the web. People are just more motivated to write negative reviews, often in the heat of the moment, and often putting the blame on the wrong agency.


The two reactions to this behaviour.... 

1.  Logical: these are just 17 opinions out of many thousands, of course some people are going to be unhappy/disappointed but this should not colour a prospective - or existing  - patient's view of the surgery (remember that most existing patients will see your reviews simply by the accident of them being in their eye-line when they look up your phone number/address/website).

 

   

 Reviews like this do get read - and do influence people - witness the eight 'thumbs up'. The fact that the review has not received a response from the surgery serves to further endorse the patients' opinion

2.  Emotional: "How can I possibly entrust my health and welfare to a surgery that scores so low (and/or has so many negative reviews)?"


The reality

Everyone reads reviews nowadays, and their reaction is likely to be a combination of both. 

No-one has to actively search for Google reviews, they are displayed in every search. In addition, many more reviews are being written - fourteen of the seventeen reviews of the surgery above have been written in the last twelve months. That pattern is not going to reverse itself any time soon.


The solution

Surgeries must engage - with Google. That does not mean abandoning any current patient feedback mechanisms, far from it, but it does mean incorporating modern professional review management into their interaction with patients.

Otherwise: dissatisfied patients will continue to post to Google, just in increasing numbers (as more and more people find they are able to write a Google review).

Preventing inaccurate or misleading reviews 

By sending an email or text to the patient asking them for a review to be independently verified and moderated by HelpHound potentially misleading or inaccurate reviews will be sent to the surgery so they can engage with the patient pre-publication, reviews will then be displayed on the surgery's own website and the reviewer then invited to copy their review to Google.

HelpHound

We are here to provide you with professional advice, and to design a review management strategy that dovetails with the way you operate your particular surgery, not shoehorn you into some 'off the peg' reviews solution.




Please feel free to comment on this article - link below - and subscribe - centre right - so you can be sure to receive every article as it is published. If you would like more information just email fiona.christie@helphound.com

Reviews in 2015 - a mid-term review

So much has happened in the world of reviews recently that we felt it only right not to wait until the end of the year before bringing you one of our regular reports.

Google, so dominant in search - 68% worldwide - is introducing changes at such a rate that the contrast between search on 1 January this year and now is as marked as any full year previously.

So - how does this affect our world, the world of professional review management?

The Big One...

Is the demise of review websites. They're not quite dead yet, but they are dying. Don't look at their metrics, look at their share prices: Yelp down from $85 to $25, TripAdvisor down from $95 to $70, Angie's List down from $9 to $5. And the only reason TripAdvisor and Angie's List have not quite taken the hit that Yelp has is their fractionally smaller reliance on Google (for now).

Why?

This is so simple: because Google has ramped up its own review offering. Search for any kind of business and who do you see? Trustpilot reviews? No - Google reviews. Yelp reviews? No - Google reviews.

You own a business and you'd like your Yelp reviews to show in your Google ads? They did last year (with a nice star rating). This year? Google reviews.

Reviews may be small beer for Google, but with the number of Google users and their positioning in search it will be Googlers, not Yelpers, who dictate inward business flows for you from now on. 

The impact for your business

If you have committed resources (effort and/or funds) to getting reviews to any specialist review site you should be examining strategies for redirecting that energy. For the forseeable future the there are only two places you are going to need reviews:

• On your own website
• On Google

Just imagine that you accumulate a hundred great reviews on Google and your competitor has only five, ten or fifteen, how great will you feel? And what if that position were reversed?

While we're on that topic (reviews on your own website)...

Retailers were quick to recognise the value of reviews on their own sites; they understood, early on, that consumers would buy with more confidence if they were given credible (independently verified) reviews.

Retailers like John Lewis have been quick to recognise the power of reviews, service providers and the professions less so. This is, in part, due to the understandable 'fear factor': the realisation the power one single negative review may have to deflect business. For more about how HelpHound reduces this 'fear factor' read on here.

 
But service providers and the professions have been much slower to climb aboard: the old fashioned 'testimonial' still pervades. It is important for businesses to understand that independently verified reviews, hosted on the business's own website, are just as important in driving new business for estate agents, solicitors and financial advisers as they are for electricals and white goods retailers.

With the current dearth of businesses like these hosting independently verified reviews, the opportunity for those in these sectors to steal a march on their competitors is still massive.

Action needed

Lose the fear: and stop treating reviews as an add-on and integrate them into your core marketing plan. Get a professional review manager like HelpHound to work alongside you (you will need them for the crucial independence, if for nothing else).

Make sure that they can cover both bases for you: reviews on your own website and reviews to Google.

Then sit back and watch the results roll in - guaranteed!

Ongoing review management - it is SO important

In your first weeks of operating Dialogue your business has gone from no reviews on its own website and no (or very few) reviews on Google to 'lots' on your own site and 'some' on Google. What happens now?

To get the right answer to that question it is important to understand how consumers use reviews. There has now been plenty of academic research in that field and all of it points to the following:

1. The pure number of reviews can either boost or dilute the impression you create online. Put simply: a business with 100 great reviews looks bigger and more successful than a business with 50 (and much more so than one with none). The message here is loud and clear: never take your foot off the throttle.
2. Recent reviews matter: If consumers see that the last review was written months ago that runs the risk pf creating the impression that it was written by the business's most recent customer. Then some will draw the conclusion that you are not a great force in your marketplace.
3. The content of reviews is important: it is used by Google to create the three 'rich snippets' shown in the Knowledge Panel (the box that pops up to the right in search containing all your business details - see illustrations below), so encouraging customers to make content detailed and relevant is a good idea. Simply explain how important this is to your business and your customers will respond with great content.

More detail:

Pure numbers

Remember that four reviews a month will add up to fifty by this time next year (and how many of your competitors have anything like that number)? Perseverance is the key here.

Recent reviews

If you build the fact that you will be inviting reviews into all your dealings with your customers they will be upset if you don't invite them, rather than the other way around! That's the way to keep your reviews fresh, as well as the numbers steadily growing.

Rich snippets*

Rich snippets are one of the most important aspects of the Google Knowledge Panel - there for all to see, every time you feature in search results. Negative rich snippets can do untold harm. Here's what one client's looked like when they joined at the end of last year:

And here's what they look like now (less than three months later):

And for anyone wondering about this business: they are a large well-established lettings agency with a very positive and proactive attitude to tenant relations. But with thousands of tenants it was all too easy for the disgruntled minority to dominate what was being said online, so the impression being given was heavily skewed towards that tiny (but vocal) minority's opinions. Dialogue has redressed the balance for them (and will continue to do so).

And one last thing...

There's much more to our role, but clients refer time-and-again to the 'discipline' element, by which they mean that Dialogue ensures that they are always up-to-date as far as reviews are concerned; that they are consistent in requesting (and therefore getting) great reviews, month in, month out.

*Rich snippets: Google software analyses the content of all your reviews, looking for the three predominating themes, it then chooses a phrase from a review that relates to those themes and displays all three as illustrated above.

Dialogue for the Professions - getting off to a great start

The professions (in this context: medicine, the law, financial management, estate agency and the like) come to Dialogue with one (small and eminently surmountable) disadvantage and one massive advantage, compared with, say, those in hospitality.

Whereas hotels and restaurants have numbers in their favour when looking for customers to write reviews (a hundred bed hotel is likely to host upwards of 15,000 guests a year) the professions have an asset that more than makes up for their lack: the customer (client) bond is profoundly greater, and this can be employed to great effect.

Your objective

Your aim will be to get as many great reviews to your website as you can, and get as many of those posted on to whichever external website matters the most (for the purposes of this article let's call that Google). 

To do this effectively you must make the most of this bond. You must optimise the ratio of clients who respond to your invitation to a) write their review to your website and b) go on to copy that review to Google.

Optimising response

In an ideal world every client would respond (to both the invitation to your site and to Google). But we all operate in the real business world, where time is at a premium and emails, despite best intentions, go unanswered.

So our advice to our new clients (born of over eight years' experience) is as follows:

1. Build the fact that you will be asking every client to write a review into every aspect of client contact. Mention it when you first meet ('We invite all our clients to write a review...') and clients will be actively expecting your email when the transaction is completed.
2. Make sure all client-facing staff reinforce the message. For instance, clients will often thank staff over the phone or by email, if staff are trained to say 'Oh, please do remember that when you are asked to write your review' the message hits home.
3. Don't just email (the invitation to write the review) and hope. Most important of all, follow up with a brief phone call.

The crucial phone call 

It takes less than a minute, and it should go something like this...

“Just calling to say that the review you’ve been asked to write is really important to us. Once you have posted your review you will be asked to copy it to Google, this helps us create local awareness, so I’d be really grateful."  

Everyone has their own words to communicate the same message: 'please don't ignore the emails'.

What we do know...

Is that if you do this, you will get reviews, great reviews to your website and great reviews to Google. 

And before you know it, the phone call will become second nature, part and parcel of your customer service regime. 

Click to enlarge or email karen.hutchings@helphound.com for your very own copy

Yelp - right up there for reviews of Doctors - and Stepford Wives

Two medical related reasons for Yelp to be in the news today. First: they are now sharing the lead in online reviews of the medical profession with a specialist site (Healthgrades):

Read full article here

Second: A Kansas City orthodontist has again raised the question of a patient's right to free speech online: by threatening to sue the poster of a three star review on Yelp. 

See the full story here

This case also brings into question (again!) the Yelp 'review filter' - there have been 95 reviews of this orthodontics practice and 90 - yes, ninety - have been filtered. We had a long hard look at both filtered and unfiltered reviews to see if we could divine any logic. Let's have a look...

First the five unfiltered reviews:

1. Five star - the reviewer has written 19 more reviews and has 13 Yelp 'friends'
2. Three star - the contentious review. The reviewer has written 70 more reviews and has 27 'friends'
3. One star - a troll who has written no more reviews and has no 'friends'
4. One star - another trolling review. Has written fourteen more reviews and has three 'friends'
5. Five star - 73 more reviews and 43 'friends'

Now the filtered ones:

Most, both positive and negative, are singletons (that is: they are the only review posted by that reviewer).

Now, we would understand the logic behind Yelp's filter if the two blindingly obvious trolling reviews had been filtered. But they have not. Here they are so you can judge the value they give to the Yelp community (and anyone searching for an orthodontist):

We fail to see why anyone would vote either of these 'Useful' but 13 Yelpers have to date

The message for UK medical professionals

All of this kind of comment is unhelpful to medical professionals. Sites like Yelp ought to do more to ensure the reviews they publish are written by people with first hand experience of the business being reviewed. But they are seemingly reluctant to push too far down this road for purely financial reasons. Instead they appear to be focusing on lobbying state legislatures to toughen up freedom of speech legislation to allow any 'genuinely held opinions' to be submitted and published. They seem to be blissfully unaware that the same people who write their reviews are the kind of people - the 'Stepford Wives' of Shellie W's review - who will lose their jobs when, in turn, their own employers fall victim to unfairly damaging reviews.

In the meantime businesses (and medical professionals should see themselves under this heading for the purpose of reviews - they are treated no differently) owe it to themselves and their patients to find a better way of engaging with reviews.

Dialogue™ for the medical profession

More than ever before the medical and caring professions have to address the concept of reviews

First let's examine the current state of the reviews and the medical profession...

Specialist sites

If a business or service exists you can be sure that there will be review sites specifically targeting it, it's the nature of the web. Here are some examples:

From NHS Choices

From IWantGreatCare

General sites

A 'general' review site is one where anyone can comment on any type of business or service, from accountants to zoos. here's an example of a review on Yelp, the big daddy of them all...

Yelpers don't pull their punches!

Benefits

Everyone wants reviews: patients commonly search the web for them; they want to know what the existing patients of a given practice or practitioner think. In today's competitive environment practitioners welcome honest feedback as a way of attracting new patients, and, just as importantly, a way of gaining valuable insight.

Drawbacks

Not all reviews are written with the best of intentions: some are written maliciously (some have even been known to be posted by competitors)! Much more commonly, misguided (and potentially damaging) opinions are posted about complex medical issues without the practitioner being able to engage with the patient beforehand.

Is this really representative of the practice?

Right-of-reply

With reviews of hotels or restaurants the simple 'right-of-reply' which is incorporated into most review sites may be all that is needed to correct misconceptions. This is not enough for medical issues: they are far too important, for the patient in question and for the potential patient reading the review. There has to be a better way...

There is. All reviews at HelpHound are moderated (read by trained professional moderators) in a process we call Resolution ™, and any reviews that contain issues which should be addressed by the practitioner are first forwarded to that practitioner for response. 

People actively engage with this process and both parties find it rewarding, to the extent that over 99% of reviews that are written and subject to Resolution result in no final review being published. 

Administration

It's every medical practitioner's nightmare - more paperwork, more complex technology. How to keep track of the 47 sites where a patient might comment? The answer is simple: you don't have to. 

Invite all your patients to write a simple review, direct to your practice, once a year and/or whenever they feel the need...

What your patients' reviews will look like on your website - a mock-up with thanks to Abingdon Medical Practice

HelpHound will moderate them and we will publish them on your own website; we will also invite your patients to post their reviews to Google so you don't look like these GPs when future patients search:

Your prospective patients are looking for reviews - here (on Google) and on your own website, but only one patient has posted one review on one of these practices. What a lost opportunity to benefit for everyone concerned, practice and patients alike

To summarise

Dialogue brings you and your patients all the benefits of reviews and none of the drawbacks: it can only be good for you both.

• Great feedback, easily analysed 
• Positive comments to show to prospective patients
• Negative issues managed in private, benefiting both parties equally
 

Please contact Karen Hutchings (karen.hutchings@helphound) for more details.