Why Treating Online Patient Reviews as Reputation Undermines Trust and Performance
This is Part 2 in our series on the strategic value of unsolicited patient feedback. Read Part 1: The Strategic Value of Patient Feedback You’re Already Sitting On.
Many health systems fall into one of two camps when hospital reviews turn negative: they suppress them, or they neutralize them.
For a brief time, these interventions appear to work. Outwardly, performance stabilizes, ratings recover, and first impressions improve. But before long, negative reviews resurface and the cycle repeats, consuming more resources to defend optics than to fix the underlying issues.
This article examines two common reputation-first responses that undermine trust and performance, and what changes when patient feedback informs operational strategy instead.
Suppress
When online ratings decline, many organizations increase the volume and visibility of positive reviews to offset negative ones.
This takes two main forms: systems solicit positive reviews from satisfied patients or rely on syndication strategies and external vendors to push favorable content higher in search results and redistribute it across platforms.
Star rating and first impressions improve initially, but the underlying drivers of dissatisfaction remain unchanged. It creates a vicious and costly cycle that repeats:
- Resources are spent on increasing the volume and visibility of positive reviews
- Ratings and first impressions improve
- Underlying issues and dissatisfaction persist
- New negative reviews appear and ratings decline
Reputation management, when disconnected from operational change, becomes a short-term stabilizer with long-term cost. Investment shifts toward maintaining the appearance of improvement rather than actually delivering it.
If recurring issues aren’t dealt with, it does not take long for a glossy five-star façade to lose credibility. Patients are discerning and spot these patterns quickly. If lived experience fails to match what they read online, suspicion grows and trust erodes.
Trust, once destabilized, impacts utilization, retention, and adherence and is expensive to rebuild. It does not demand perfection or flawless care; it demands transparency, responsiveness, and evidence that when something goes wrong, something will change.
Organizations focused on vanity metrics and optics will pay the price.
Neutralize
If the first instinct is to suppress negative feedback, the other is to neutralize it with carefully worded, heavily sanitized replies.
Someone takes the time to write a detailed account of a missed diagnosis, a long wait, or feeling dismissed, and the response is templated: “We’re sorry to hear about your experience. If you’d like to discuss this further, please contact our patient relations team.”
This creates a mismatch. The patient offered detail and vulnerability. The response was generic and procedural.
The irony is that replies like these are typically designed to reduce reputational and legal risk. They are approved, aligned, and carefully constructed to say the right things without saying too much. Yet even polite, well-meaning language can read as disingenuous or indifferent.
Patients scroll. They notice when the same response appears beneath every review. To the organization, it looks like closing the loop. To the patient, it looks like going through the motions without demonstrating any meaningful change.
There is another consequence.
Responses that redirect patients to call a number, fill out a form, or restate their complaint through another channel shift the burden back onto them. It effectively says: start again.
From the patient’s perspective, they have already done the work. They are often navigating stress, illness, and emotional fatigue. Asking them to move through additional steps reinforces the belief that raising concerns is exhausting and unlikely to lead to change.
Service research describes this pattern as “complaint inertia”. When dissatisfied customers are asked to formally escalate a complaint, most won’t. They quietly disengage or leave instead. Healthcare is no exception. Formal complaints only represent a narrow slice of dissatisfaction. The rest shows up later in missed follow-ups, lower adherence, and patient leakage.
What Changes When Online Patient Feedback Is Treated as Operational Intelligence
Instead of asking, “How do we protect the rating?” leaders begin asking, “What is this telling us about how the system is performing?”
Negative reviews stop being reputational threats to contain. They become leading indicators of recurring friction in access, communication, coordination, retention, revenue, and more. Patterns start to matter more than individual comments, and the conversation moves from optics to operations.
Case Study: ECU Health Orthopedics
When ECU Health Orthopedics began systematically listening to what patients were saying online, they discovered a problem that didn’t show up in their surveys. While patients consistently rated their clinical care highly, online feedback revealed that the physical environment was negatively impacting their experience.
Instead of bolting on a generic response or burying the signal beneath more positive reviews, ECU Health Orthopedics addressed it directly.
They redesigned key areas of the clinic to make the environment more welcoming, accessible, and patient-centered. The result was measurable. Following the redesign, ECU Health Orthopedics reported a 10% increase in new bookings.
The Lesson
Online patient feedback, particularly negative feedback, is one of the most underused yet operationally significant assets in modern healthcare.
Patients do not offer criticism to be unkind. Most want better care for themselves and for those who come after them. Their feedback is an invitation to improve.
When organizations respond with transparency, specificity, and visible action, the distance between online ratings and lived experience begins to narrow. Confidence grows and credibility strengthens.
Experience management requires healthcare leaders to confront uncomfortable truths head on, own them, and translate them into specific, meaningful actions across the organization.
Used this way, online patient feedback becomes so much more than a reputational signal. It becomes the most valuable, strategic asset in your toolkit for shaping performance, strengthening trust, and guiding smarter business decisions.
To learn more, email hello@pephealth.ai or request a demo.
