For most doctors, Yelp is one of the four-letter words they never want to hear again. Yelp, and other review sites like it, have effectively changed the landscape of reputation management, and not in a good way.

Here’s what you need to know.

Basically, human nature has shown us that people love bad news. This is, after all, the premise behind reality TV shows. We love watching train wrecks and can’t turn away. Whether we admit it or not, many of us actually enjoy nasty rumors, innuendo and gossip. This theory is known by psychologists as ‘negativity bias’, and it is an integral part of humans’ innate survival mechanism that causes us to avoid fear. We are basically hardwired to ignore all the good things and focus on the bad stuff.

This is one of the basic pillars behind the Yelp brand; they smartly calculated that humans like to like to read negative stuff about other humans. And there you have it.

So, no matter how great you are at what you do – as a plastic surgeon, dermatologist, aesthetic nurse, medical aesthetician or other specialist – it is impossible to get 100% positive reviews period. In fact, I would argue, it is an unreasonable goal on so many levels. Everyone has a bad day every now and then; we are human after all.

Another reason the decks are stacked against physicians and other professionals is that fake reviews from anonymous consumers are a major problem and growing. Just as Facebook, Twitter and Google are under siege by Congress for allowing fake news outlets, bots, and bogus accounts to invade their platforms, so should review sites that hold all the cards. The burden is on you to prove that a review is fake or defamatory to get it taken down, and as any doctor who has tried this will tell you, it is not easy or cheap, and it is rarely successful.

Therefore, you need to have a strategy to deal with negative reviews as they arise because they are destined to. Regrettably, Yelp is among the worst offenders of review sites that are patently disinterested in helping businesses, especially, doctors navigate negative reviews. Yet, online reviews have emerged as critical to the success of any medical practice.

According to, consumers read an average of 7 reviews before trusting a business, and 85% of people trust online reviews as much as a personal recommendation.

Having a strategy to respond (or not to respond) to online reviews is vital to any practice today. Consider best practices for how to approach a negative review.

Here are 5 options:

  1. Ignore it and just bite your tongue.
  2. Respond in the first person as the doctor.
  3. Post a response from the practice in the voice of the manager.
  4. Read the site’s terms of service to see if the post is in violation.
  5. Hire an attorney and go for the jugular.

Of the above, my gut instinct is to stick with #1 and move on. But if you must respond, tread carefully. Your response will be multiplied to the whole Yelp universe with one click. You are essentially speaking to everyone who reads the review, including potential future patients, colleagues and competitors.

The best thing to do when you receive a bad review is to do nothing. Take 24-48 hours and blow off some steam. DO NOT respond from an emotional place, and please refrain from taking a less than 5-star review too personally. In general, it’s a bad idea to ever display your anger in a public forum. There is no upside to that, and you can’t take it back once you post. At the end of the day, you must protect your practice and reputation 24/7.

Replying is your opportunity to make things right but this must be done gingerly. If a patient brought a complaint to you or your staff directly, you would probably try to make it right even if you disagreed. But when it comes to online reviews, it’s much harder to turn it around. Although replying may demonstrate to other readers that you take feedback seriously, it’s a slippery slope for healthcare practitioners. For starters, there is the HIPAA thing to consider. By acknowledging in a public forum, a doctor-patient relationship, you may be in violation of that binding regulation.

Another strategy lies in search engine optimization. When potential patients want to read reviews about practitioners, they don’t only go to Yelp. They may go to Google, Facebook or RealSelf first, and then countless others that are popping up all too frequently. If Yelp constantly ranks high on a search perhaps you have not been proactive about pushing it off the first page. This strategy can help to downgrade the important Yelp holds over your practice by promoting positive reviews on a selection of other sites.

The bottom line is that you must constantly strive to generate positive reviews to push the negative ones down and off the first page. Yelp isn’t going away anytime soon. Reviews are not going away either. In fact, they will take on more weight moving forward as consumers are demanding even greater transparency. The struggle is real.

Looking for more online marketing tips? Check out Wendy Lewis’ best-selling book, Aesthetic Clinic Marketing in the Digital Age (CRC Press 2018).