Nobody likes bad reviews. Especially health care delivery or service organizations. Because bad press means customers (patients, referring physicians, etc.) will think we are unsafe or unfriendly. And it will surely lead to lawsuits, regulatory intervention, loss of competitive positioning, etc. Especially if it's online.
Well maybe there's another side to this story - at least if you believe the lessons of The Upside Of Bad Online Customer Reviews which appeared on Forbes.com August 4, 2009. This short piece by Mirela Iverac, a frequent Forbes contributor, is a provocative read for those health care leaders who might be willing to consider the other side of conventional wisdom on this point.
Lemons into Lemonade
Iverac recounts the counterintuitive experience of online retailer eBags which publishes uncensored online reviews of the products it carries:
"eBags is among the only 50% of online retailers that offer online ratings and reviews, according to the latest figures from Forrester research. Meanwhile, 80% of Web buyers troll reviews when shopping online."
I'm one of the 80%. Are you? Do you think it's any different for health care consumers? Given the proliferation of online health information sites and the enhanced attention health care organizations are giving their own sites, I doubt it.
In 2004, eBags first leveraged negative online consumer feedback about one of its products into a major retail success. Since then, it has apparently repeated the trick many times; using consumer structured feedback to learn about product deficiencies and then correcting them.
Improvement v. Ratings
Carefully structured surveys used by health care provider organizations may get to some of that information - but let's be honest. Both survey organizations and the health care provider organizations that engage them benefit from positive results. Have we ever surveyed health care consumers to determine how much stock they put in Press-Ganey, for instance?
So what this is really about is obtaining the critical customer feedback necessary to make changes that will actually make things better (and safer) in the eye of the customer. The willingness of consumers to state their opinions (and disagree with each other) online can be invaluable and it's underused - actually avoided - by hospitals and providers. When is the last time you browse a hospital web site that had online consumer comments on the patient experience in the ED? A terrifying thought for hospital CEOs. But as Iverac sees it:
"The lingering fear: Negative reviews will send customers running the other way...It's misplaced. Barely 25% of online shoppers report that they are unlikely to purchase a product after reading negative reviews, and most take those reviews with a bowling ball of salt. Truth is, negative reviews probably won't hurt your business--and they ultimately may help boost customer conversion rates."
She goes on to provide additional examples of other retail and service companies that have turned receptiveness to public feedback into an asset. The eBag experience seems to prove this out:
"Nearly 1.8 million reviews are now on eBags' Web site. According to BizRate, online reviews are one of the top reasons customers choose eBags over "50 sites they could find on Google selling the exact same product, often at the exact same price," says [eBag Founder]Cobb."
Managing Expectations
Of course health care is different. Or so we say. But consumer choice behavior is probably not as different as we'd like to believe and the world is changing more in the direction of showing reality everywhere. There's probably a "first mover" advantage to be had here - not to mention incalculable operational and safety improvement opportunities to harvest.
As Iverac points out through additional examples, there's another side to all of this too. "Making it right" for complaining consumers can yield very positive - and equally public - image enhancing "word of mouth" support.
Finally, comes advantage in the ever important management of customer expectations as they read a mix of positive and realistic experiences:
"A final, powerful psychological aspect to bad reviews: According to studies by Bazaarvoice, provider of customer-review software, exposing a product's weaknesses sets realistic expectations, thus reducing the number of product returns."
I'm not advocating jumping into this with both feet but after reading this piece it seems to me that as health care leaders we've been a bit too squeamish about publishing some of our blemishes. After all, if it's good enough for eBags...
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