Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine.

Urgent message: The anonymity of social media enables disgruntled patients, former employees, and/or community members to take out vengeance on an urgent care center through negative reviews and postings, typically out-of-proportion to the actual “offense.” Because of the importance of social media as an advertising and marketing channel, urgent care operators must be diligent in protecting their online reputation when these attacks occur.

Business owners know that word-of-mouth can be an invaluable ally for attracting new customers—or, it can be something that scares them away. Sadly, today’s world doesn’t operate as it did just a few years ago. Word-of-mouth now means word-of-keyboard. Online reviews and comments have the potential to radically affect whether a business thrives or not.

For urgent care centers, this is especially true. A few positive reviews can inspire confidence in the community and convince the public to visit your facility the next time a medical need arises. Positive reviews also shoot you to the “top” of search engine results, giving you an advantage over competitors. Conversely, a series of negative reviews can cause people to avoid your business before they even have a chance to experience your services for themselves.

In an age where anonymous internet trolls run rampant and activists turn to online methods of attacking individuals and companies they disagree with, it is more difficult than ever to battle defamatory comments.

 Damaging Fake Reviews

One of the biggest issues that urgent care owner/operators face regarding internet trolls is fake reviews. To be clear, it’s entirely possible that a clinic earns a negative review on its own merits—or lack of them. That is another story entirely.

However, a disturbing trend has arisen recently with social media at the epicenter. It involves non-customers posting fake 1-star reviews about a business online. Those utilizing the tactic include former employees with a grudge, competitors, and even people in the general public who merely want to cause trouble. Often, they take to social media sites like Facebook, Yelp, and Google to post their fake reviews.

Unfortunately, these platforms don’t verify whether or not a reviewer was actually a customer before allowing them to post. This means that someone with an online vendetta—even one who has never visited your clinic—can leave a damaging review online.

When fake reviews are posted, it is very difficult to get them removed. Unlike a comment, companies can’t usually delete reviews on their own. Rather, they have to wait for weeks for the social media platform to review a complaint. These policies are in place to preserve the integrity of review platforms by not allowing companies to delete negative posts. However, they are often more problematic than helpful.

For urgent care centers, time is of the essence. When a review containing proprietary company information, sensitive employment data, or HIPAA-protected patient information is posted online, waiting weeks for it to be removed isn’t an option. As a result, many urgent care companies choose to disable reviews on sites like Facebook. While it protects them from fake negative reviews and ones containing sensitive information, it also means that companies lose all of their positive reviews.

Ultimately, that can be just as damaging. If potential customers aren’t able to read reviews for an urgent care center, they may opt to go somewhere that does have reviews instead as it offers more certainty.

Harmful reviews can also come from actual patients who want “revenge” for their poor experience. Someone who perceives a provider coming across as rude or short could call for them to lose their license. A patient who waits longer than expected may demand that the entire facility be shut down. Rather than call the center to resolve a billing error, a patient decides the label the entire operation a “fraud” online. These “revenge” reviews are generally out-of-proportion to the actual negative experience. Still, urgent care operators must closely monitor them, as they can easily damage an otherwise solid reputation.

 Spiraling Employee-Based Disputes

While internet attacks on your urgent care center may be coincidental, they often stem from a problem that begins with an employee. Many of today’s movements operate on the mandate that all critics and individuals with differing opinions must be silenced. Hence, today’s “cancel culture” often spirals out of control on social media platforms.

Take, for example, a situation where an urgent care employee (or former employee) engages in an online “debate” with a stranger and makes a racially charged insult. The stranger could post a screenshot of the comments and information about the employee and their place of work in an online forum. Within hours, both the employee and urgent care clinic could be subjected to harassment by not only the original stranger, but also countless other anonymous users. This includes things like posting fake 1-star reviews as previously discussed, adding negative comments to the urgent care’s paid posts on social media, and contacting state agencies demanding the employee’s license to be revoked.

Believe it or not, this story is entirely true.

When employees make controversial statements online, they reflect not only on that individual but also their place of work. However, employers generally can’t control what their employees do when they aren’t at work. Still, some action needs to be taken to avoid being smeared online by angry groups because of something an employee says.

With that in mind, companies should strongly encourage their employees to be mindful of what they say on social media and use discretion when discussing controversial issues. Likewise, they should be encouraged to make their posts private, or only visible to family and friends. Employees should also be selective when accepting friend requests or engaging with various groups online.

Sticking to these actions protects both your business and your employees. Internet communities are anonymous and therefore free from accountability. Even without proof, they wield immense powers of libel and censorship. By keeping social media private and uncontroversial, employees will remain safer from angry online groups who disagree with their views and wish to cause harm.

 Tactics to Fight Online Trolls

The issues discussed so far have massive implications for any urgent care business. Without a positive reputation in the community, a clinic can’t thrive or attract new customers. That being said, urgent care owner/operators can take some steps to deal with online trolls.

One of the easiest methods of doing so is to delete negative comments. While this doesn’t work for reviews on some platforms, companies do have the ability to remove negative or angry comments from their posts (paid or organic). Now, the issue with doing so is that people may get angry and post more negative comments, encouraging others to do the same. If this occurs, companies should swiftly block or ban them from their page. This is especially true for non-patients, out-of-state posters, and those who don’t genuinely have a complaint against your business.

While it is possible to flag repeated posts as spam, harassment or hate speech in violation of the social media platform’s terms of service, doing so typically takes days, meaning the vitriol is sitting on your center’s post for all to see. Additionally, social media platforms are hesitant to censor posts that express an opinion, and they are not fact-finders to determine whether the opinion is valid or not.

Most people don’t recognize the fact that paid or sponsored social media content is an ad, not a First Amendment forum. Not only do companies reserve the right to remove negative comments, they should be encouraged to do so. Smearing a company on its paid social media channels is no different than going inside Walmart to post signs that read “Walmart sucks—shop at Target instead” and expecting Walmart to do nothing about it.

A second, and equally important step companies can take is to avoid engaging with trolls and inflammatory posters. Do not debate these people! Online cancel culture moves quickly. So long as a company doesn’t fan the flames, angry users will typically get bored and move on to their next “target” rather quickly. Unless they continue to cause trouble and post negative comments, not engaging is usually the best course of action. It’s unlikely trolls are open to any logical explanation, and their behavior shows they lack any kind of empathy for your business or employees.

 Stay Ahead of the Game

Although battling trolls as their negative comments pop up is mandatory, there are better ways of doing so. The better option is to stay ahead of the game.

Most social media platforms give companies the ability to block certain words or phrases from their page. A comprehensive moderation list helps automatically block most of the negative, angry comments that would be posted. Taking advantage of this functionality eliminates vulgarities, sexual innuendos, racial slurs, and everything in between from appearing on your pages and posts.

Florida-based marketing agency Be Brilliant! has compiled a free list of nearly 1,300 words that’s designed to block social media trolls. Whether you create your own list or use a precompiled one, this sort of pre-emptive strike can save you and your business a lot of headache down the road.

Ultimately, running a business means you’ll be exposed to the negative side of the internet at some point. Whether it’s an angry customer, someone who had a bad interaction with an employee, or just a plain troll, it is every owner’s responsibility to preserve their company’s reputation. By closely monitoring online chatter, removing negative comments and commenters, and pre-emptively blocking certain content, urgent care companies can shield themselves against the growing wave of defamatory Internet attacks being seen today.

How Would You Handle These Real-Life Examples of Social Media “Terrorism?”

·         A patient comes in for COVID-19 testing but due to a coding error the patient was charged $119 for a “new patient office visit” (99203), which hit her insurance deductible. Rather than contact the urgent care to have the claim reprocessed, the patient goes to social media with an allegation of fraud. Her public proclamation is that COVID-19 testing is “free” as advertised but she claims the urgent care further “deceives” patients by charging a $119 “new patient fee” to “do your paperwork.” There is no such charge in urgent care! When the patient’s review is deleted for misleading information and the patient is contacted to resolve the issue, the patient (upset about her deleted review) contacts at least four “friends” who within an hour all post additional reviews regarding the “new patient fee.”

·         A former employee engages in a social media debate with a total stranger who insults her appearance. The ex-employee then returns an insult of the other person’s appearance, using racially charged language. Her comment, headshot, and online profile then get posted to an “anti-racism” action board causing dozens of out-of-state people to message the urgent care, post 1-star reviews, and post negative comments on the center’s advertisements—demanding the employee be fired and that her employment record be appended to assure no positive reference in the future. Not only does the employee not work for the urgent care, meaning there’s nothing the urgent care can do, but total strangers go on to contact state licensing authorities to have the employee’s credentials revoked and even attack the “mentors” the ex-employee named in various threads. Death threats for the specific ex-employee were received. Insulting someone’s appearance is hardly an offense punishable by death! The former employee had been found “guilty” of a comment that easily could have been fabricated; anyone can make a meme. The episode, which continued until the urgent care fell sufficiently down the list of postings that users lost interest, could have been avoided if the employee had used discretion and common sense, including not engaging strangers in debate and keeping her job history “private.”

·         A patient comes to the urgent care center demanding nonemergent services but presents an out-of-state Medicaid card for a state where he hasn’t lived for over a year. Not only is the patient committing Medicaid fraud by maintaining Medicaid in a state where he does not reside, but there is no way the urgent care center can get paid by the out-of-state program. The patient is offered the cash price, and could have gone to the emergency room, but instead of paying becomes very angry. He posts hundreds of cut/paste comments to every prior posting on social media, which took hours for the urgent care to clean up. Once he was reported to the platform for “spamming” and banned from the social media page, he resorted to direct email threats to the urgent care, including that he would organize a protest and burn down every one of the urgent care locations. He also threatened to contact media, former patients, and former employees to “expose” the center’s “unethical practices.” While the urgent care did engage its legal counsel to conduct a background check and prepare a cease-and-desist order, rather than further escalate the individual’s vitriol, the urgent care sat on the materials with the hope he would eventually become bored and move on, which he did—after several days.

·         An employee of a competing urgent care center repeatedly posts comments on your center’s paid advertisements that the competing center offers COVID-19 and antibody testing for a lower price, with faster results. When the posts are deleted, they quickly reappear as other employees start to post the same comment. Simultaneously, multiple fake “reviews” appear containing “testimonials” of patients who allegedly balked at the urgent care and received “excellent service” from the competitor. It takes several iterations of deleting the comments and banning the users to get through all of the competing urgent care center’s employees who are posting.


How to Protect Your Urgent Care’s Reputation from Online Trolls and Social Media Terrorists

Alan A. Ayers, MBA, MAcc

President of Experity Networks and is Practice Management Editor of The Journal of Urgent Care Medicine
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