The Other Side of the One-Star Review: Why Healthcare Providers Can't Tell Their Side of the Story

In today’s world, a one-star Google review can have a significant impact on a healthcare practice. Patients often use online reviews when deciding where to seek medical care, and understandably, they want to know about other patients’ experiences.

But there is something very important to understand when reading reviews of healthcare providers:

The healthcare provider may not be allowed to tell you what actually happened.

Healthcare Isn't Like Other Businesses

If you have a bad experience at a restaurant, you can write a one-star review, and the restaurant can respond publicly with its side of the story. They can explain what happened, correct inaccurate statements, and provide additional context.

Healthcare is different because of HIPAA—the Health Insurance Portability and Accountability Act.

A healthcare provider has an obligation to protect a patient's privacy. Even if a patient publicly identifies themselves as a patient and discusses their medical care in a Google review, the provider generally cannot respond by confirming that the person was a patient, discussing their medical history, explaining what occurred during an appointment, or correcting the patient's version of events with information from the medical record. The American Medical Association specifically advises physicians not to acknowledge that the reviewer is a patient or disclose patient-specific information in a public response.

This isn't merely theoretical. The U.S. Department of Health and Human Services has taken enforcement action against healthcare practices that disclosed protected health information while responding to online reviews. One dental practice, for example, paid $23,000 to resolve an HHS investigation involving disclosures made in responses to online reviews. Another healthcare provider paid $30,000 following an investigation involving a response to a negative online review.

So What Does a Provider Get to Say?

Very little about the individual situation.

A healthcare provider can generally make a generic statement about office policies or invite the reviewer to contact the practice privately, but cannot use the public forum to explain the specifics of the patient's care.

That creates an enormous imbalance.

The patient can tell the entire internet what happened from their perspective.

The provider may know that the story is incomplete, inaccurate, or completely inconsistent with the medical record—but cannot simply post the medical record in response.

In fact, even saying something as seemingly harmless as "We are sorry you had this experience during your visit with us" may potentially confirm that the person received care from the practice. HIPAA concerns can arise from acknowledging the patient-provider relationship itself.

What About One-Star Reviews?

There is another side of the story that prospective patients rarely get to see.

In our experience, some of the most negative reviews come from situations in which there was a significant disagreement between the patient and the medical practice about the care provided.

In some cases, patients have not followed recommended medical instructions or postoperative care. In other cases, patients have expectations that are inconsistent with what was medically recommended or discussed. And sometimes, patients have concerns about their care but decline the opportunity to return to the office and speak directly with the provider.

That last point is particularly important.

A healthcare provider cannot resolve a problem that they are never given an opportunity to address.

A one-star review may be posted before the physician has even been made aware that the patient is unhappy. The practice may have offered to see the patient, discuss the concern, review what happened, or determine whether something could have been done differently—but the patient may choose instead to go directly to Google.

The result is a permanent public record of one person's version of the situation, while the healthcare provider is essentially unable to provide the other side.

Before You Judge a Healthcare Provider by a Single Review

A one-star review should certainly not be ignored. Legitimate criticism can help healthcare practices identify problems and improve their processes. The AMA encourages physicians to objectively consider negative reviews and determine whether there are things the practice could do differently.

But patients should also remember that a healthcare provider's silence does not necessarily mean that the review is accurate.

It may mean the provider is respecting the patient's privacy.

It may mean the provider cannot legally disclose the information necessary to correct the record.

Or it may simply mean that the provider would much rather have a private conversation with the patient than argue about someone's medical care on Google.

Give Your Healthcare Provider the Opportunity to Make It Right

If you have a concern about your medical care, the best first step is usually to contact the practice directly.

Schedule an appointment with the provider.

Explain what concerns you.

Give the practice an opportunity to review what happened.

Sometimes there was a misunderstanding. Sometimes expectations were not clearly communicated. Sometimes the practice made a mistake and needs the opportunity to correct it.

And sometimes, after reviewing everything, the patient and provider may still disagree.

But at least both sides have had the opportunity to be heard.

The Bottom Line

Online reviews can be helpful, but healthcare reviews are fundamentally different from reviews of restaurants, hotels, or retail businesses.

The patient has the freedom to tell their story. The healthcare provider has the responsibility to protect the patient's privacy—even when that privacy protection prevents the provider from telling their own side of the story.

So the next time you see a one-star review for a healthcare provider with no public response, don't automatically assume that there is no explanation.

There may be a very good reason you aren't hearing the other side.

HIPAA may be the reason.