Complaints require practitioners to dig deep and conduct themselves with professionalism, patience and grace. In this article we reflect and learn from a case where, while difficult, the complaint process has been navigated smoothly... right up until it wasn’t. 

Miss G was a recent graduate hygienist working full time in an inner-city private practice. The practice had a long standing and loyal patient base, often having new patients referred to the practice via word of mouth from their existing patients. Recognising the power of word of mouth, the practice regularly monitored their online reviews so they could respond and follow up as appropriate.

One Tuesday, Miss G went to the waiting room to bring in her last patient before lunch, Miss Z, who was a new patient to the practice. Miss G was unfortunately running slightly behind, having been held up with an examination that took longer than expected in her treatment room, and from the outset Miss G could feel the tension radiating from her patient Miss Z. Miss G apologised for the delay and escorted Miss Z into the surgery.

Miss G began by reviewing and discussing Miss Z’s medical history, however Miss Z appeared uninterested in engaging in this conversation, indicating “I have already filled out that huge form, can we just get on with things”.

Miss G proceeded with beginning the clinical assessment and querying with Miss Z the relevant information about any concerns she may have, oral hygiene habits and then recommendations based on her assessment and diagnosis. Miss G recommended a general clean and Miss Z agreed as “that was what she was there for”. The conversation continued to be stilted and uncomfortable throughout the appointment and additionally, Miss Z was highly sensitive throughout the clean. Miss G then discussed her oral hygiene recommendations for ongoing home care at the completion of the appointment, and escorted Miss Z to the front office to hand her to the reception. Miss G was relieved when the appointment was over, happy that her lunch break was directly after, to give her time to regroup for the afternoon.

The following week, Miss G was in the back offices when her practice manager came to have a chat about a Google review that had been left, that unfortunately mentioned Miss G specifically. On reading the review, it became apparent that Miss G had not been the only one feeling the awkwardness between her and Miss Z. Unfortunately, Miss Z had elected to move forward with what Miss G felt was a particularly scathing and unfounded negative review, suggesting not only that Miss G unable to time manage, that she was arrogant and rough, and it was the most unpleasant clean Miss Z had ever experienced. Understandably, Miss G was incredibly upset. 

In keeping with their complaints policy, the practice reached out the Miss Z, to discuss the concerns raised directly and try to come to a resolution.

Throughout this process, the communication with Miss Z, while cordial, remained strained. Things moved towards a resolution with the practice offering a refund for the clean provided that day, as a gesture of goodwill. Miss Z accepted this offer, and the paperwork was sent through, to finalise the refund agreement.

Regretfully, the paperwork provided to Miss Z was based on a previous legal document that had been utilised in another matter, which was a large and quite confronting document. Additionally, there had been additions made, that stipulated that the refund would only be issued after confirmation that the negative review was removed.

This was the final straw for Miss Z, who had remained suspicious throughout the entire process. After receipt of the ‘legal document’, Miss Z promptly replied, advising that her review was a genuine representation of how she felt she had been treated at the practice and would not be removing it.

Ultimately, Miss Z declined the offered refund, and additionally, chose to return online and further add to her review, outlining what she felt was unethical behaviour, attempting to “gag” patients from making honest reviews, and bribing them to remove unfavourable reviews to alter their star rating. Miss Z additionally took her concerns to the Dental Board directly, raising concerns regarding both the treatment she received, as well as additional concerns on what she felt was a blatant inducement to encourage review manipulation.

A very disappointing result for all involved, especially for Miss G, whose name was connected to the review in question. Understandably, Miss G elected to reach out to Dental Protection, for assistance in preparation for the anticipated notification from the Board.

Learning points 

• The Dental Board of Australia Code of Conduct stipulates that patients have the right to raise concerns about their care, and similarly the expectation that practitioners work with patients to resolve the issue, locally where possible.1 

• Additionally, the Code of Conduct outlines the professional values expected of registered health professionals. Further to the being ethical and trustworthy, the Board expects practitioners to exhibit qualities such as integrity, truthfulness, dependability and compassion.2 

• While a practitioner can ask for a review to be removed, they need to be mindful on if this has any implications, especially when considering Ahpra’s Guidelines for Advertising a regulated health service. This Guidance outlines that under the National Law, Section 133(1)(c), the risk of harm by using testimonials in advertising is greatest where it is:

“false, misleading or deceptive or likely misleading or deceptive, including testimonials that are: 

 -selectively published or edited, or 

-fake.” 3 

While the practice was not directly utilising the reviews and testimonials in their advertising, Miss Z certainly felt that making the offered refund conditional on removal of her review was an intended manipulation. 

• Lastly, practices and practitioners need to be mindful if these requests are contraindicated by other regulating bodies or service providers. In particular, these situations are explicitly referenced by Google in their policies on Rating Manipulation, stating: 

“We do not allow merchants to: 

-Offer incentives – such as payment, discounts, free goods and/or services - in exchange for posting any review or revision or removal of a negative review. 

-Discourage or prohibit negative reviews, or selectively solicit positive reviews from customers.”4 

• Additionally, the Australian Competition and Consumer Commission has a clear position on online product and service reviews. The ACCC is live to the potential that manipulation of reviews can contribute to business’s misleading consumers if they:

• suppress or edit negative reviews 

• remove genuine reviews that are negative.5 

References 

1 The Code of Conduct. 4.6 Complaints – found here Australian Health Practitioner Regulation Agency - Shared Code of conduct 

2 The Code of Conduct, page 6, Professional values and qualities – found here Australian Health Practitioner Regulation Agency - Shared Code of conduct 

3 Ahpra’s Guidelines for Advertising a regulated health service. 4.3 Testominials, pg 14 – found here Dental Board of Australia - Guidelines for advertising a regulated health service 

4 Google Prohibited & Restricted content – Fake and Misleading Content and Behaviour – found here Prohibited & restricted content - Maps User Generated Content Policy Help 

5 ACCC Online Product and Service Reviews – found here Online product and service reviews | ACCC