Fertility Reviews

7 trigger points that infuriate fertility patients and lead to bad reviews for doctors

By Griffin Jones

What should fertility doctors say or not say, do or not do, to avoid angry reactions from patients on the internet?

observation, not advice

This is tricky. I can help practices increase their positive reviews, but I will not tell physicians how they should talk to their patients, because I am not a physician. I write prescriptions only to medicine I’ve swallowed myself. The reason I feel comfortable telling clinics to invest in Facebook ads, is because I have had success reaching new patients through Facebook ads. I’m comfortable telling fertility specialists how to respond to negative reviews online because I have improved doctors’ online reputations from the way I respond to reviewers.

I have never delivered a fertility diagnosis inside a consult room. I’ve never told a couple that their prospective IVF cycle has a 10% chance of success or called someone to tell them that their 3rd IUI was not successful. I have an idea of how I think I would communicate with patients, but I have little tolerance for arm chair quarterbacks. 

navigating the mine field with compassion

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What I can show you, however, are patterns that I’ve observed from upset patients: what I call “landmines” or “trigger points”. These are common themes that, when received a certain way, tend to send patients’ thumbs into a blaze of fury to light up their IVF center on the internet. By being aware of how patients recount certain interactions, you may better prepare for them.

“It’s not what we say, it’s what people hear.”—Frank Luntz, PhD

1). Body Mass Index
When a patient visits an IVF center, her initial testing may reveal that her body mass index (BMI) is too high for a fair probability of IVF success. Patients may first be referred elsewhere to help decrease their BMI. While I cannot tell you how to deliver this news, I can show you how it is sometimes received. Comments like, “he called me fat” or “they refused to even see me because I’m too fat,” are common on social media and review sites. I wouldn’t suppose that the physician used those words, but in a very difficult moment, this is what the patient may hear. 

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2). Age and Diminished Ovarian Reserve
“She told me I was too old to ever get pregnant”. The quality or quantity of a patient’s eggs may be low, and a physician may issue caution about the probability of successful treatment. What could be a very honest move, certainly in patients’ best interest that they not spend money and energy on unwise surgery, can send patients to their keyboards in anger when received the wrong way.

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3). Low probability diagnoses
Patients occasionally feel that their doctor is rooting against them, or shows no compassion for them when going over their diagnosis. Reviews commonly include boasting that the patient got pregnant, even though their doctor said they would not. This article articulates what patients sometimes write about their doctor after they have seen more than one specialist. 

4). Contact availability
“The two week wait” (#2ww) is one of the most notorious chapters of fertility treatment and it is only one of many anxious periods patients have to face. When one doesn't receive a call when she or he was told to expect one, more stress is added to the patient experience.  Failing to call with test results, not responding quickly enough to patient calls or e-mails, and not being available via the media which patients use to communicate are all landmines for patient reaction.

In fact, I would be very curious to know what percentage of negative fertility center reviews come during moments when the patient is waiting for correspondence from the provider. When worries about treatment monopolize a person's mental bandwidth, the wait for answers turns seconds into hours. It is a feeling of helplessness and desperation in which lashing out against the provider online may be an attempt to regain a sense of control.

5). Face time with doctor
Smaller fertility practices frequently claim that individualized care is their edge over larger practice groups. It is an advantage, if in fact, the patient gets to spend more time with the provider. Rarely seeing one’s physician is a very common pain point that leads patients to say things like “baby factory”, “only in it for the money”, and “looked at me as a dollar sign”.

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6). Punctuality and preparation
Doctors are very busy people. So are patients. With high demand from patients, and a nearly infinite number of scenarios that can arise at any moment, the need for providers to maximize their time can make timeliness impractical. Still, patients feel slighted when they are not seen on time because their time is valuable too. The same goes for when they feel the doctor has not read their chart, not taken the time to thoroughly answer their questions, or rushes through their appointment. 

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7). Absolutely anything to do with billing
If these scenarios are landmines for fertility center reviews, the billing department is a minefield in and of itself. Billing issues might account for 1/3 to ½ of your negative reviews. In short, the billing department is arguably the greatest liability to a fertility practice’s online reputation. Patients often feel ambushed by the costs that they incur during the course of treatment. Insurance coverage (or lack thereof), reimbursements, deductible requirements, and variability in medication costs are pain-points unique to healthcare. Patients may lash out against their practice in a public forum because they do not experience these annoyances in most other consumer categories.

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To make matters worse, prospective patients receive very little education about IVF costs prior to treatment. In fact, some practices refuse to detail any cost information on their websites because they are afraid that it will dissuade people in need from seeking a consultation or that it will give a competitive advantage to other IVF centers. Many fertility clinics would rather bury their heads in the sand and hope for the best, than properly use digital media to educate patients about the headaches of insurance and billing.

Setting the stage

As a fertility specialist, you are walking into a minefield of patient anxiety and frustration. I don’t think it would be possible to tip-toe around every possible pressure point. Instead, what may be more prudent, is to disarm the tension as much as possible from the very beginning. Of course, I can’t tell you what to say to patients. From what I observe from their accounts, however, is that many patients do not hear their concerns addressed in this way:

“What you are going through is extremely difficult at times, and that is perfectly normal. You’re not alone because we’re here to help you with everything we can and connect you with resources for those things we can't control. We wish we could wave a magic wand and make everything better right now, but there will likely be parts of this process that are very frustrating.

"Billing, medication costs, and insurance can be a big headache. You may see a charge for a service and think what the heck is this? Just ask, we're here to help you through it.

"There may be times when we don’t call you back as quickly as we want to because our nurses are helping other patients in the same way we want to help you.

"We always try to be on time for our appointments, but every now and again, a patient needs a little extra time with her doctor, and we want to extend that same level of care to you.

"We often have to be the bearers of very delicate news. We balance optimism and our eagerness to help you have a healthy, beautiful baby with our duty to inform you of the implications and realistic outcomes of your different options.

"You don't have it easy and neither do we, but the plus side is that we’re working together. We hope you’ll tell us if we are falling short at all during this process because we need your help to do our best for you".

Satisfaction equals experience minus expectation

By setting expectations abundantly clear ahead of time, you may be able to prevent negative reactions when, not if, issues arise. Some patients develop their own expectations, regardless of what you do to help set them. It’s okay if some people are not satisfied with your practice and staff as long as the dissatisfied number is the lowest it can be. There are certain pressure points that must be approached with empathy during the already tense fertility journey. By setting the stage and disarming the mine field, you can reduce the number of complaints about your practice and doctors, and increase patient satisfaction.

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If it's too late and you need examples on how to respond to negative reviews, read chapter 4 of the Ultimate Guide to Fertility Marketing

A Stern Warning for Fertility Clinics Who Complain About Patient Review Sites

By Griffin Jones

"Change is not painful. resistance to change is painful."

Consider this a gentle "love tap" from a friend. 

A direct warning from me is far milder than what the market has in store. If I don't speak up about this single issue now, then I am neglectful in my duty to help protect the field of reproductive health from cultural and technological shock, because the internet-led market has proven to be unforgiving.

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When I entered the fertility world, I accepted the responsibility of preparing those inside the field from the disruption coming from outside. I built a company to help bridge the gap between the status quo of reproductive health and what's happening in the rest of the tech revolution. So that we're not dealing with contemporary business buzzwords, allow me to give this definition to what entrepreneurs and venture capitalists call "disruption":

  • Major enterprises losing double-digit market share or going out of business within 36 months due to brand new players who come from outside of their field. 

ONline reputation is hardly the tip of the iceberg

This article does not come in reference to any one particular conversation I've had (perhaps even with you) in the last few months...because I've had several. Some have been with clients, some with vendors, some with strategic partners; it's a recurring theme.

When I first started creating content for fertility practices, the topic of "online reputation" is what really piqued the interest of fertility doctors. Many of us are concerned with what people say about us online. We often find the comments to be unfair, untrue, or at the very least, unkind. As we explore, however, you may agree that the root of the issue has less to do with the comments of others and more to do with a strategically flawed grasp for control.

Technological and cultural change are sweeping through nearly every facet of society. We are dissecting online reputation in this instance, simply because it happens to be a very common pain-point. In this deep-dive, we closely examine

  • The cause behind the information shift of the last twenty years
  • Why patients have embraced it
  • The four principal reasons that practices have NOT embraced it
  • Why patients rely on social proof to make decisions
  • The real threat to a fertility center's online reputation
  • What to do once we've stopped resisting 

Many doctors tell me that negative reviews upset them to the point where they can't sleep. You've done everything you could, and if you could wave a magic wand, you would wish for nothing less than for your upset patient to have a healthy baby and a happy family. Before we separate your perspective from the patient's right to have and share a completely different perspective, let's first examine the informational shift that has happened over the last two decades.

the human need to move away from information ASYMMETRY

For any patient to think that she or he is more qualified to review her or his case after a few hours (or even hundreds) of internet research, must be insulting. If you're a fertility doctor, you've gone through four years of undergraduate studies, four years of medical school, four years of residency, and three years of REI fellowship. That's fifteen years of higher education, followed by some of the most demanding board exams in medicine. If you've grown accustomed to this legacy of information control, it's because you've worked extremely hard to do so. 

Information asymmetry, wherein the seller (provider) almost always has an information advantage over the buyer (patient) is wonderful...when you're the seller. Recall other pre-internet situations in which you have been the buyer. Call back to a time when you had to buy a car when only the car dealer knew the manufacturer's suggested retail price (MSRP) or its pre-owned history. Think of buying a house when only the realtor knew the last sale price, its home improvements, and recent sales in the neighborhood.  How did that feel? The best real estate agent in your market has a lot more experience buying and selling homes than you do. She may also be a very authentic and trustworthy professional. Does that mean she should expect you not to use Zillow and Trulia? You don't need me to explain the deep-seated human need to shift from information asymmetry to information parity. As consumers, we do it every day.

For over a century, virtually the only way for someone to obtain in-depth knowledge about any given medical condition was to attend medical school. Like our example of home-buying, patients had a scarcity of information, few provider choices, and no means to talk back. Contrast that with our very different world today.

The drive toward information parity

change coming for ivf centers

When I was a kid in the early 1990s, I wanted a million dollars so I could buy my own video game arcade. Now I have one on my phone (that I have never used). Every one of our patients walks around with a super computer in his or her pocket at all times. Within sixty seconds of being diagnosed with infertility, one can

  • Read various definitions of infertility
  • Study the most common causes
  • Research potential treatments
  • Compare providers
  • Watch video explanations from medical doctors from around the world
  • Find humor and relief from satirical and artistic content
  • Connect with thousands of other patients via social media

Information asymmetry is over. Forever.

patients often need to rely on each other 

Some of us are frustrated that just because our patients have access to virtually limitless information, that does not qualify them to make any diagnoses or prognoses. Correct; they are not medical doctors. They don't have to be. They are human beings with opinions and emotions and they have a right to share their experiences with each other. They frequently have to turn to one another for social proof to help them assess this information.

Also known as informational social influence, social proof is the psychological phenomenon where people rely on the actions and opinions of others to determine the appropriate behavior for a given situation. Talk about ambiguous social situations! What is the appropriate mode of behavior when someone learns that they've been diagnosed with infertility? When they've paid $18,000 of their life savings for two failed IVF cycles?

Social proof may be even more necessary for those dealing with infertility because of the tremendous social pressure to have children. When so few people in one's social network can relate to what they're going through, our patients frequently have to turn to the internet to find those who can empathize with their emotions and relate to their experience. 

information parity meets social proof meets technology

Imagine having to spend thousands of dollars of your own money on fertility treatment, and having no way of knowing which doctor or clinic could be the best fit for you. Along comes a fantastic user experience (UX), with sleek design and fields of search deeply relevant to those struggling with infertility. 

I don't own any equity in or have any commercial partnership with Fertility IQ at this time. Yet when I set myself free from my own desire to have perfect control over my paying clients' online ratings, and put myself in the position of the patient, it's easy to understand why they are using the platform in the hundreds of thousands. Instead of comparing apples to oranges on Google reviews, RateMDs, ZocDoc, Vitals, HealthGrades, or even Yelp, people with infertility read verified experiences from patients by their

  • Age
  • Diagnosis
  • Type of treatment(s)
  • Number of treatments
  • Success or failure of each treatment
  • Income level
  • Number of doctors seen

Complaining about Fertility IQ or any other review site is not as trivial as disliking a website. It's partaking in the exhausting struggle against what patients desperately seek. It is the hubris attempt to fight the human drive to move away from information asymmetry toward information parity. The market, whether through Facebook, Instagram, FIQ, Google, or any other platform will find a way to give it to them. It does not give a damn if we are inconvenienced.

the four main reasons for resisting patient reviews

Tech disruption in infertility field

I won't tell you to let go of control because we can't let go of something we don't have. If Muammar Gaddafi, the despot who antagonized western powers for decades, couldn't suppress social media, how could we? Why would we want to?

Well, after hundreds of conversations with fertility doctors, nurses, and practice managers, I've identified four principal reasons that we yearn to have control over what people say about us online, leading us down the path of most resistance.

  1. What we do is so hard and complicated. People don't have a right to criticize what they don't understand
    Consider the phenomenon of flight. What a magical experience. Distances that would have taken us weeks to travel a century ago, now take us a few hours. Instead of physical exertion, we're served snacks and alcohol while we enjoy unlimited entertainment on our personal supercomputers. The logistics, expertise, and technology required to provide this luxury to us are overwhelming.

    Left to my own devices, I would be lucky to mount a camel for a few miles. I still hate United Airlines, and so do you, and so do millions of our peers. Could we do a better job piloting, procuring maintenance for tens of thousands of aircraft, and maintaining schedules for tens of millions of travelers? Absolutely not. Should we have any right to complain when we're inconvenienced by what is still a tremendous luxury compared to the alternatives? Should is irrelevant; we do have the right, and we frequently exercise it. We are citizens of countries where free speech is (meant to be) protected by our constitutions. 

  2.  These reviews are fake
    Of the four reasons for resistance, this is the most legitimate, if the review is in fact illegitimate. False reviews are a real problem. Up to 15% of online reviews may be fake. If you are certain that a review is not from a patient at all, but from a competitor or an internet troll, flag it for review. I recommend flagging the review from more than one user account. At Fertility Bridge, we see fake reviews rear their ugly heads, and aren't always able to get them taken down. It's unfair and it pisses me off too. Because at least 85% of our reviews are authentic, let's focus on what we can control.

  3. Only unhappy people leave reviews
    A widely held assumption among fertility doctors is that IVF center reviews are overwhelmingly negative. This simply isn't true. In an analysis of 504 fertility clinic reviews, conducted by Fertility Bridge in 2015, 63% of reviews were positive and 37% were negative. Yes, there are reasons that people are motivated to leave negative and positive reviews about their practices. Someone may not have been able to become pregnant and want to take it out on you. Others may sing your praises because they were pregnant. Still, some centers are able to minimize their negative comments and maximize their positive ratings; that is our goal.

  4. Negative reviews use libel and slander
    If you'd like a good laugh with your morning coffee, read RateMDs' FAQs for doctors. In 12 paragraphs, they tell you how you can go pound sand if you think you're going to sue them. Vitals and HealthGrades do too, but RateMDs is the most humorous.
    Sometimes reviews violate the platform's terms of agreement by using hateful or vulgar language, and the site will remove them. Most of the time they do not.

the greatest threat to the accuracy of your reputation

Once we've moved beyond our four cardinal motives for resisting public feedback, we can focus on the real liability to the accuracy of our online reputations.

Last summer, in a summary of fertility doctors' responses to their online reviews, I corrected the old adage, "the customer is always right," to "the patients (plural, meaning the market) are always right". I'll use my own company as an example. Fertility Bridge served eight IVF clinics in 2016. If two of them were dissatisfied, one held a neutral opinion, and five were delighted with the service they received, I might be able to identify a few patterns. But what I would really want to do, is increase the volume of evaluation. Eight sources of feedback? Better than three, I guess. Thirty would be a heck of a lot better. 

The same is true for an IVF center's online reputation. When a fertility doctor has two scathingly negative reviews, one luke-warm review, and one glowing review, the public doesn't have enough information to accurately judge this physician. Very often, fertility doctors have unfavorable online profiles because they simply don't have a high enough volume of reviews on that particular platform. Forget these four motives for distrusting online review platforms; lack of volume is our worst enemy. The higher a clinic's volume, the more likely their reviews are to be positive. Period.

what to do now

Okay, Griffin. We've stopped resisting. We have a high volume of reviews but our ratings are still low. We still hate this. Make it go away.

disrupting the fertility field

If we've truly made it thus far, then we have the best road map for operational/personnel adjustments that we could ever ask for.  We have data to identify the most common problem areas in our practices and fix them. That's right, the same platforms that take control away from us give it right back...if we choose to act on it.

In my opinion, no review site makes it easier to evaluate customer service patterns than Fertility IQ. Clinics are rated by 

  • Operations
  • Scheduling
  • Billing department
  • Nursing Team

Physicians are rated by

  • Whether they treated their patient like a person or a number
  • Communication
  • How often they saw their patients at appointments
  • Response time

When we can measure how patients adore our nursing staff, and their disappointment in when their calls are returned, it's a lot easier to smoke out capacity-related issues that hinder the excellence of our practice experience. Of course we don't have to wait until patients leave our practice to listen to their stories. We can use tools like Press Ganey or Rep Check Up to solicit patient feedback, in-house. Public ratings are the final word, however, and in the eyes of the public, perception is reality.

a new review site is barely a baby serving of disruption

We've hardly seen the tip of the iceberg, my friends. If we cannot adapt to the reality of how patients use the internet to share their experiences, we are not long for what is to come. Regulation has sheltered healthcare from many of the market effects that have impacted other areas, but it won't hold forever. The executives of Zoc Doc, Vitals, and Health Grades are not worried about awkward run-ins at ASRM with physicians who subscribe to their premium offerings. They are interested in being the marketplace where patients find their providers.

FertilityIQ was started in the birthplace of many other innovative tech companies, the San Francisco Bay Area. It was started in the way most disruptive tech companies are, from outside. FertilityIQ doesn't receive funding from IVF clinics. They didn't need our permission to build their company and patients don't need our permission to share their experiences on their platform. This is what disruption looks like. Thousands of entrepreneurs are chomping at the bit to change healthcare in their own way. If we stay in the habit of yearning for control that we don't have, we will wistfully long for the days of unfavorable online profiles being our biggest pain in the neck.

Blockbuster Video chose to be nostalgic about the adventure of going to the video store. Netflix didn't. Marriott could have invented the world's most used lodging app; AirBnb was happy to do it instead. The largest taxi companies balked at the idea of hundreds of millions of passengers choosing to ride in a strangers' car; Uber bet the pot on it and became a multi-billion dollar company.

We are presented with an incredible moment in time to use new market opportunities to build the most successful versions of our practices. I started a company inside of our field, rather than outside, because it is far more agreeable to strategically adapt to technological and cultural change than to be rocked by the market. This is just advice, you certainly don't have to take it. Before you decide anything though, you might ask yourself if what you do now will make you right or wrong in the context of history.

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To learn more about how to improve your fertility practice's online reputation, and to adapt to new patient behavior, download your free copy of the Ultimate Guide to Fertility Marketing

Why did these 9 patients just leave word-of-mouth referrals for their fertility doctors on Instagram?

By Griffin Jones

**Fertility Bridge does not endorse any of the programs or doctors mentioned. They come from responses from our Instagram community**

"The only thing that matters is the lab"

That's what a board-certified reproductive endocrinologist (RE) told me over lunch at the 2016 American Society for Reproductive Medicine (ASRM) annual scientific congress. "The patient experience doesn't matter. The only thing that matters is if they get a baby or not." My efforts to show him all of the evidence to the contrary were fruitless. That was the end of the conversation. Why try to convince the inconvincible?

In some perverse way, it excites me when people are so neglectful of what our patient population demands. Meritocracy might be a lofty ideal, but I love working with fertility clinics who take IVF cycles from people who think like that. A slop-eating grin came over my face as I stared at his plate and thought of the perfect metaphor:

I'm going to eat your lunch.  

 Who are they and what did people say?

Who are they and what did people say?

Satisfied don't mean delighted

A 2014 study by Software Advice states that 61% of patients evaluate their new doctor before their first appointment. Over 40% of new patients of Fertility Bridge clients confirm having read online reviews before scheduling their first visit. Nearly 30% say they were referred by a friend.

Bain's Net Promoter System suggests that patients can be divided into three categories across a satisfaction scale from 0 to 10. The single question is, "how likely are you to recommend our practice to a friend or family member?" Those who answer between 0 and 6 are called detractors. They actively discourage others from coming to your practice. Those who respond with a 7 or 8, are labeled passive, because their referral rates are less than 50% of those who respond with a 9 or 10. Finally, those who respond with 9 or 10 are promoters, people who sing the practice's praises to anyone who will listen. You can read more about using your practice culture to turn patients into promoters in Chapter 2 of the free e-book, The Ultimate Guide to Fertility Marketing.

I know many of these promoters very well. They brought me into the field of reproductive health in the first place. After all, people don't get so fired up after they buy a power washer from the Home Depot. So, among thousands of people in the trying-to-conceive (#ttc) community on Instagram, who are actively undergoing or pursuing fertility treatment I asked them the question. Would you recommend your fertility clinic, and why?

1). By Name in New England

Absolutely and I actually have. The first place we went to was terrible and I've shared that with people who have asked for recommendations. I wish I had done some thorough research beforehand but I wasn't aware how common infertility is and how many clinics were out there. The second place was beyond anything I could have hoped for! We saw Dr. Gargiulo at the Center For Reproductive Care (CRC) in Stratham, NH. We are less than an hour away from Boston which is home to some of the top hospitals in the country so we fortunately have a large number of places to choose from. The entire staff at CRC was absolutely fantastic.

I was greeted by name every single time I walked into the office and the nurses were amazing when it came to making the entire process less stressful and knowing when to crack a joke to lighten the mood. The thing that really set CRC apart was the welcome packet. In addition to the typical insurance forms they included an illustrated book that talked about how to talk to all of the different people in your life from co workers to your spouse. Also, they make sure to include that due to the sensitivity of this journey, no one under the age of 18 is allowed into the office for any reason. Reading that one policy was the moment I knew we had finally found the place that truly focuses on their patients and not their numbers.

2). Memorable in Montana

I totally would! I should mention, my RE and her partner are the only ones in the state. Even if she wasn't, I would still recommend her. Her name is Dr. Stacy Shomento with Billings Clinic. Dr. Shomento is in Bozeman, and that is the staff I know and love! She has a pile of patients, but always gives you lots of time and takes a personal interest in you. She also has a stellar, amazing, outgoing staff. Infertility is very personal and invasive. Having a comfortable relationship with the medical staff is a must for me.

She took the time to make personal connections and remembered us, not just our chart. Really, because RE's are so busy, you end up dealing a lot with your nurse, so they really need to be awesome.

3). Compassion in California

I totally would!!!! Coastal Fertility in Irvine, CA is the best! So compassionate. Dr. Werlin rocks!!! He's amazing!!!

4). Knowledge in New Jersey

I would. More specifically, I would recommend my doctor, even though all the doctors are great. Dr. Marcus Jurema from Reproductive Medicine Associates of New Jersey (RMANJ) is what every reproductive endocrinologist should be. I'm thankful I have him in my corner. My doctor is part of RMANJ and was originally with IVFNJ before the merge. I've had several issues with several staff members with both practices.

There's very little communication within the company within different departments (billing, nurses, etc). I'm sure that's because the company is just so big. With that being said, RMA has the best labs in the state, maybe the East Coast. Because of that, I can't leave. Plus, my doctor is amazing.

He teaches as he goes. He knows I need technical info, good or bad. I can't have anything sugar coated. I'm a medical assistant so I research everything. He knows that and will give it to me straight, while also holding my hand through the bad stuff. He's been with me from day one, with every cycle and every loss.

5). Benign in Boston

We switched doctors for our last round of IVF, but we stayed at the same clinic, IVF New England. The nurses are magnificent and since that's who you're interacting with the most, it's invaluable. I never felt like a number there, even though they're a bigger clinic. I always knew I was in good hands, even after 4 failures with my first doctor. It took me a long time to decide to switch. It broke my heart to try someone new, because I trusted him implicitly.

My new RE, Dr. Pauli is amazing. I don't regret not going to him sooner but I'm so glad I did. We were successful on our first round with him and I'm currently 11 weeks pregnant. I love that both doctors called with results of the bigger tests (pgd, era etc) and called to check in on us. Dr. P. called me once with results while he was on vacation.

I have nothing but good things to say about IVFNE. They're not perfect, and some of their methods aren't for everyone. But they are perfect for us. Even if we never got pregnant, I wouldn't feel any differently.

6). Education in the OC

Yep!!!! HRC Fertility in Newport Beach!! I think the best thing about HRC is the coordinator is amazing financing and they can do preimplantation genetic screening (PGS) with a fresh transfer. My doctor was very, very busy all the time, but he did give me pregnant the first time. He never did an ultrasound which I thought was odd but I love the girl who did my ultrasounds.

My doctor was always kind, and answered all my questions but the relationship was definitely not personal. I don't care about that; I want results, and he provides results.

My tech was wonderful because she would walk me through exactly what she was doing. During stims, she would explain what she was counting, what she was looking for, and what she saw. Same after I became pregnant. They followed me for 11 weeks.

7). Making changes in Maryland

Our first one, absolutely not. We were a paycheck at [a very large fertility practice group] and never felt like patients. Our RE told me that our son "must have been a lucky egg and I wanted to go cry in the car, go ahead". It was the worst year of my life. My new doctor, Dr. Mary Ann Sorra with Natural Fertility, actually held my hand when I was put under for a laparoscopy. It feels so nice to finally be cared about.

8). Looked After in Louisiana

Definitely. Arklatex Fertility and Reproductive Health with Dr. Vandermolen. I just felt like they're all so patient. Any time I had questions, I could call the nurse and she would call me right back. They knew me by name. The success rate for the doctor is pretty high, which is always a plus. When I first went to him, he told me what was going on. I felt like I had options instead of having him tell me what I was going to do.

9). Genial in Jersey

Absolutely! RMANJ, because of their lab. I was told I was going to be treated as a number, but on the contrary, I got to talk with my RE personally. He even called me right before my egg retrieval to know how I was doing. The nurse was always on top of things and answered me right away.

The transfer was very detailed oriented. They addressed yeast infections and progesterone levels while my previous clinic always dismissed my concerns.

"A great lab is necessary, but not sufficient"--Jake Anderson-Bialis

While I chose not to include the names of these volunteer promoters, they are perfectly willing to share their experiences with thousands of other people in the infertility community on Instagram. We often believe that people only recommend their IVF center online if they become pregnant or have a baby. We're told that they'll leave negative comments if they have a failed cycle, but research from Fertility Bridge and Fertility IQ show that that's not exactly true.

 True for almost every fertility clinic review we read.

True for almost every fertility clinic review we read.

"No question, if a patient has a good result, they're more likely to recommend their fertility doctor/clinic," says Fertility IQ co-founder, Jake Anderson. "With that said, when we look at patients who had failed cycles, it's very clear who is likely to recommend the doctor, and who definitely won't."

It seems that the contrapositive is also valid; when we look at patients who've had successful cycles, it's clear who will be the source of future patients in the form of word-of-mouth referrals. Many people have success at their fertility centers and are "satisfied", but we see in these recommendations that it's compassion and personal connection that turn former IVF patients into zealous promoters of their practices. So the next time a competing fertility doctor tries to convince you that the patient experience is meaningless, and clinical outcomes are all that matter, don't feel disappointed when you can't change his mind. Eat his f'ing lunch.

_________________

For strategy on improving the patient experience, read chapter 2 of my free e-book, The Ultimate Guide to Fertility Marketing, by clicking the button below.

 

 

 

The 7 Worst Responses to Fertility Doctor Reviews on the Internet

By Griffin Jones

"The customer is always right"

Who knew this hyperbole, coined by Harry Selfridge in 1909, declaring his department store's commitment to customer service, would go on to become a thorn in the side of employees everywhere? It's a terrific internal mantra to aspire toward, but it can be very harmful when interpreted as a universal rule. Customers, or in our case, patients, may sometimes project their frustrations on to you or your staff and no one has the right to be abusive to your team members. Maintaining the notion that a single patient's point of view is infallible can put unfair stress on our employees. Gordon Bethune, former CEO of Continental Airlines, says that when companies don't support their employees when a customer is out of line, resentment results and service deteriorates. If we don't care for and support our staff members, how can they in turn care for and support our patients? 

 I can't say I agree with the first part of this sentiment, but certainly the latter

I can't say I agree with the first part of this sentiment, but certainly the latter

In the case of public reviews of our practices, feedback isn't necessarily valuable when it comes from a focus group of one, but rather when we observe recurring themes from multiple people. The patient (singular) might not always be right, but the patients (plural, collective) are ALWAYS right. We should err in favor of the patient's perspective because it defines for us a higher standard of performance. But how do we respond to a negative comment when it's just plain unfair or untrue?  If you know in your heart of hearts that a particular reviewer is in the wrong, and you've truly done everything you can to make things right, you don't have to respond at all. If you're uncertain, or you want to publicly affirm your practice's genuine concern for every single patient, I have a better axiom for you:

"the patient might as well be right"

Remember, we're dealing with the court of public opinion. Miranda rights apply; anything you say can and will be used against you. For that reason, I'm concerned with the way many practices (cough, physicians) react to defend their case. Prospective patients reading our reviews have no way of knowing what really happened within the walls of your office. They can only judge us by how we respond in kind. Instead of winning the benefit of the doubt, we may say something to fall out of favor.  What's worse, physicians frequently disclose protected health information (PHI) when they attempt to argue their side of the story. To show you just how much our words can produce a completely undesired effect, I pulled seven real-life examples of how fertility specialists and practice administrators have answered negative public criticism. Warning: they go from bad to worse.

7 worst responses to fertility doctor reviews on the internet

7). Less is more

This response starts and ends just fine, but the physician gives into the temptation to make a correction. Responses to negative reviews are not the venue to discuss treatment protocol, or success rates, for that matter. The first two and last two sentences would have been fine for this response. Keep it short and take the conversation offline.

6). some battles aren't worth fighting

I didn't include the review here because it was very long. It was indeed an attack on the doctor himself. For that reason, it's better not to respond. We should respond to all negative reviews where we can at least offer a resolution, and none of those to which we cannot. When the commentary is a direct attack, nothing can be gained from turning the monologue into a dialogue, especially when it is the only response on the page.

5). Let your positive reviews speak for you...not the other way around

We don't get to determine if a reviewer's post is "excessively negative", our readers do. People browsing the page will notice when most people have a very high opinion of us. Pointing it out to them makes us look defensive. Besides, referring to this patients' initial consult and following correspondence discloses PHI.

4). Let it go, just let it go

As you can see at the top of this review, this doctor has a stellar online reputation. This is one of his only negative reviews. He doesn't need to defend his honor, his most delighted patients have already done that for them. Still, the response goes on to drag out the argument and include PHI. Very dangerous. 

3). No one can tell patients how to feel

"Just relax" or "stop worrying and it will happen" are two phrases that our patients unequivocally detest. Though likely not intended this way, insisting that a patient's bad news was delivered appropriately, when he or she feels the opposite, follows a similar vein. The practice's rapport is undermined and once again, more PHI.

2). No, seriously. let it go

Another REI, whose patients overwhelmingly love him otherwise. Responding to this single negative review in this way leaves a poor impression that is probably not representative of who he is as a physician. I don't see any of the 18 identifiers of PHI in this exchange, but it strikes me as an unnecessary risk.

1). I know it hurts, it's just not the place

I didn't include this review because the response is plenty long as it is. Besides, the doctor painstakingly recaps everything. I won't mince words, this is the worst response to a fertility center review that I have ever seen. I don't necessarily fault the physician for feeling this way. These comments seem to have really hurt him. He may have really cared about this patient and put forth his best effort to provide her with exceptional care. It sounds like he wanted to be completely transparent about the potential outcome. The patient didn't receive it that way, and that must be terribly disappointing. It's simply not the appropriate place to express one's disappointment. This response is one of the only accounts that prospective patients have to judge this physician's personality. Without knowing anything else about this doctor, fertility patients are left with a very poor impression.

hold your fire

You have three options when someone leaves negative criticism about you or your practice. You can

  1. Not reply at all
  2. Have a trained, neutral representative answer on your behalf
  3. Wait until your head is clear enough to leave a brief, solution-oriented response

I don't share these seven examples with you in jest. The way in which our words can betray us is a very serious concern. It's a threat to your brand and often, a legal liability. What may feel vindicating for a moment could be disastrous to your public image for a much longer time. Your time and energy are better spent on constantly adapting to collective patient feedback and delivering the best possible experience to the people you serve. You have my permission to give yourself permission to not be perfect. While it's necessary to devoutly heed collective patient opinion, there are times when you just aren't able to please certain individuals. Our goal in responding to negative reviews is not to defend our case in a particular incident but rather to show that we deeply care about how our patients perceive their interaction with us.

You can read my six critical rules for responding to negative reviews right here. If you want to reply to a negative remark that someone made about you online, and you don't want to make matters worse, just send me an e-mail or give me a call. We'll write a much better response that could make the patient feel better, will hopefully make you feel better, and will certainly make prospective patients feel better about you. 

 

5 Hidden Patterns Uncovered Across the Top 25 Fertility Doctors in Patient Reviews

By Griffin Jones

What a world it is where patients can form an opinion about their fertility doctor before they even schedule an appointment. A 2013 study shows that 90% of respondents reported that online reviews influenced their purchase decisions. Through public feedback from their peers, people dealing with infertility have a plethora of information to make their decision from online review sites that exist for the benefit of the patient. Here's where it gets interesting.  Fertility centers can also benefit from online reviews--good, bad, or neutral--by using them to deeply understand and adapt to patient habits. By carefully examining the online reputations of the most highly rated fertility specialists in the country, we have further decoded the messages that patients are sending loud and clear.

We know from initial research that the success of an individual's treatments using Assisted Reproductive Technology (ART) greatly influences how they write their review of their fertility clinic. Positive fertility clinic reviews are three and a half times more likely to mention a baby or pregnancy than to mention lack of success or make no mention at all. Equally, negative reviews are three times more likely to reference leaving the practice before success than to mention a baby or to make no mention at all. We also know that positive fertility center reviews outnumber negative reviews by more than 2 to 1. Getting some ideas from Joseph Davis, DO of RMA of New York, we wanted to dig beyond these observations to try to answer more questions: 

  1. Do the same patterns apply to fertility doctors with almost no negative reviews?
  2. Does an REI's rating correspond to his or her practice's success rates?
  3. Do the clinics with the highest success rates have high online ratings?
  4. What is the correlation between an REI's gender and his or her online reputation?
  5. Are younger docs rated more highly than their veteran colleagues? 

Limits to the data

First,  several review sites are popular for rating fertility doctors, and they are not uniform. Some sites, like Healthgrades, offer only star ratings without qualitative responses. Other sites likes Fertility Authority, Vitals, Google, and Zocdoc have the option to leave star ratings with or without comments. Yelp and RateMDs include qualitative responses with their reviews. Yelp tends to be more deeply populated by place (practice) reviews as opposed to reviews for individual doctors. In the latest phase of this research project analyzing fertility doctor reviews, I chose to use RateMDs because it is the easiest platform to search by sub-specialty.

There are 2,264 reproductive endocrinologists listed on RateMDs, mostly from the United States and Canada. We can search them by both highest-rated overall and per metropolitan area. Still, RateMDs isn't a perfect source. There are many duplicate profiles and only 1,205 (53%) of the physician profiles have any reviews at all. Furthermore, the rate of adoption for every review site varies widely by market. On RateMDs for example, there are 929 reviews of reproductive endocrinologists in Toronto, but in a very similarly-sized market, Houston, there are only 380. Lastly, you may be listed as an OBGYN, and not as an REI (or both in the case of duplicate listings). With that said, when we check someone's RateMDs rating (if they have ten or more reviews) against reviews on other platforms, we find they are consistent. 

I'm really excited by a newer review site that Dr. Dan Nayot brought to my attention, called Fertility IQ. You may have thought it was my site if I sent you the link to your listing. It isn't. Though I sometimes wish it was, because much of the data that I aggregate manually, they will soon be able to export with the click of a button. Most doctors don't yet have enough reviews for meaningful comparison, but I see this site becoming very popular over the next six to twenty-four months. The user experience (UX) for patients is outstanding and the site validates patient authenticity. Both the qualitative and quantitative questions are more in-depth than any other channel. Above all, there is a market need for a uniform, clean, and extensive platform to compare fertility doctors and clinics, and I hope this is it. In the meantime, I manually scour reviews for data like a cyber caveman.

 Fertility IQ's home page

Fertility IQ's home page

Of course, there are limits to ranking clinics by IVF success rates as well. Partly because the Society for Assisted Reproductive Technology (SART) appeals that success rates not be used to compare clinics. Consequently, they don't rank them in a spreadsheet that we can easily pull. So we use the site, fertilitysucceessrates.com. While Fertility Success Rates makes it easy to check the top 25 clinics in the United States, some clinics are missing from the site's overall listings, even though their data can be found in the annual CDC report. Despite the limits in our data, we continue to notice some interesting patterns. 

1). Do the same patterns apply to doctors with almost no negative reviews?

Yes...and no. I analyzed the first ten reviews of each of the top 25 rated reproductive endocrinologists. Of the 250 reviews

  • 164 explicitly referenced a baby or pregnancy
  • 70 contained neither a reference to a baby or pregnancy nor mention of lack of success
  • 1 mentioned a lack of IVF success
  • 10 described that they were still in treatment
  • 3 referenced treatment other than ART
  • 2 were negative reviews
Top 25 fertility doctor reviews mention pregnancy

So these doctors were actually even more likely to have their reviewers mention a baby or pregnancy than their colleagues at large, 66% compared with 60%. What's interesting is that their reviewers were also almost twice as likely to make no mention at all, 28% to 16%. The difference came from those who described still undergoing treatment; 14% for all positive fertility clinic reviews and only 4% for these top 25. Only 1% of these reviews were negative or explicitly referenced a lack of success in treatment. What could be the reason? We know these doctors don't enjoy IVF success rates of 99%. Let's come back to this after we investigate how clinical success rates impact online reputation.

2). Does an REI's rating correspond to his or her practice's success rates?

No. Watch as we take the top 25 ranked reproductive endocrinologists on RateMDs. Then we check them against the top 25 clinics from the 2013 SART reports. Do you have any guesses of how many doctors appeared in both spreadsheets?

Randle Corfman, MD of the Midwest Center for Reproductive Health was the only one. In other words, while success of ART treatment largely predicts how someone will leave a review, success rates do not directly correlate to a physician's online reputation. 

 These are the highest rated reproductive endocrinologists on ratemds.com 

These are the highest rated reproductive endocrinologists on ratemds.com 

3). Do practices with higher success rates have higher online ratings?

Not by much. It should be stated that practice ratings can be even more difficult to garner than individual physician ratings. For those in the top 25 in success rates, I used the review site that offered the most ratings per clinic. If there were less than ten responses for a clinic on any one review site, I left their rating blank. In a rating scale of one to five, the ratings of 19 of the top 25 clinics in success rates ranged from 2 to 4.5. The mean rating was 3.7 and the median was 3.5. The median for fertility centers at large lies between 3 and 3.5. 

 Top 25 U.S. fertility clinics by 2013 success rates

Top 25 U.S. fertility clinics by 2013 success rates

4). What is the correlation between the gender of the REI and his or her online rating?

The correlation (or lack thereof) of a physician's gender to fertility doctor reviews will be interesting to further explore.

  • Do patients have higher standards of judgement for one gender?
  • Does each gender tend to employ different communication styles that are more or less effective?
  • Do patient biases cause a message to be received differently from one gender than another?

This is what the current data show us:

  • Of the top 50 rated REIs on RateMDs, 22% are women and 78% are men.
  • Of the bottom 50 (of those with a minimum of ten reviews), exactly 50% are men and 50% are women. 
Top 50 rated fertility doctors in US
 *Of those with ten reviews or more

*Of those with ten reviews or more

To try to offer some context, Valerie Baker, MD, President of the Society for Reproductive Endocrinology and Infertility (SREI), references a recent REI workforce study published by Fertility and Sterility. 38% of the respondents were female and 61% were male. 

5). What is the correlation between ratings and years in practice?

I often hear people say that new physicians coming out of residency and fellowship are more savvy of their online reputations than are veterans in the field. I don't know that we have a sufficient way of being able to validate or disprove this inference at this time. We would have to know the year that every REI completed her or his fellowship and their ages; data that isn't easy to find. I can only offer some marketing insight.

I see at least three doctors in the top 25 who I know are under age 40. Two of them are the top rated fertility doctors in metro areas of larger than six million people. Newer doctors can leverage a high online rating to negotiate a partnership plan with a recruiting practice because they can build their online reputation and social media loyalty to become the highest rated fertility doctor in their area before they even complete their fellowship. Conversely, recruiting clinics can look at a physician's online rating and social media presence to make more educated personnel decisions. 

Decoding the bigger picture

What lessons are we left with? No clinic and no physician can boast IVF success rates of 99% or anywhere close to it. Yet we count at least a few dozen doctors whose negative reviews are less than 1% of their online reputation. When we look even closer, we see that while success of individual ART treatments influences patient reviews, clinics' success rates don't necessarily predict their online ratings.

This shows us that we are not destined to have a third of our patients report dissatisfaction. As success rates majorly improve across the field, we see that patients still expect more from their care experience than just clinical treatment. Patients who haven't found success through ART may not leave rave reviews or promote their practice on social media and we can appreciate that. Still, if we can deliver to them a better experience than they ever would have had without us, they may not feel as though their only recourse is to express their disappointment online. Analyzing how fertility clinic ratings relate to ART success rates helps us understand exactly to what patients hold their fertility centers accountable.

 

Legal Considerations When Responding to Online Patient Reviews: An Interview with Eric Goldman

 Eric Goldman

Eric Goldman

This is the third interview in a series which explores digital media and the law, including questions about HIPAA and online engagement.  Eric Goldman is a professor at Santa Clara University School of Law. While Mr. Goldman's answers don't provide us with legal advice, they do give us some insight into how fertility practices might consider the law when responding to patient reviews online.

Jones: Should physicians respond to reviews written about them online? Why or why not?

Goldman: In most circumstances, physicians either should not respond to online reviews or respond generically by thanking the reviewer and indicating that the physician appreciates and carefully considers online feedback. It rarely makes sense to get into substantive discussions with reviewers online. Not only could such discussions implicate HIPAA, but physicians often look thin-skinned and petty when they attempt to debate fact matters online. Furthermore, increasing the number of comments to a review may actually cause search engines to rank the content higher (a counterproductive result if the review is negative). If the physician chooses to engage a negative review about the facts (which is rarely if ever advisable), the response should discuss the office’s general practices and not discuss how those practices were applied in the reviewer’s specific situation.

J: What information should physicians never include in their responses to reviews?

G: Given the boundaries of HIPAA, there are few circumstances where a physician can discuss any individual facts about the reviewer. Indeed, it is potentially problematic to even acknowledge that the reviewer is a patient.

J: Are there different implications for responding to patients when their identities are public (ex. Facebook) vs. when they are anonymous (ex. RateMDs)?

G: I couldn’t think of any.

J: Are responses to reviews considered protected health information (PHI) if the patient posted the information?

G: It’s a risky practice for physicians to confirm information that a patient or family member voluntarily publicly disclosed.

J: What should physicians and practices always be wary of regarding online reviews and their public reputation?

G:

  1. Prospective patients are increasingly looking at other patients’ reviews when selecting physicians. I know many physicians wish this weren’t true, but there’s no point pining for an alternative universe.
  2. Prospective patients are savvy enough to discount outlier reviews. If one negative review is surrounded by multiple positive reviews, it will have minimal effect on the physician’s reputation.
  3. Patients’ reviews of their physicians are overwhelmingly positive, i.e., in some cases 90%+ of patients’ reviews are positive.
  4. If a physician deals with dozens or hundreds of patients, inevitably there will be a few unhappy patients who will vent online.For these reasons, physicians should be actively encouraging their patients to review them online. This will better inform future prospective patients, and it usually will help create a base of positive reviews that will insulate the physician from the occasional negative reviews that inevitably will come.

G: A final thought: getting negative feedback never feels good, but it can provide a candid insight into the patient’s experiences. If the physician can overcome the emotional sting of a negative review, there may be valuable customer feedback that can help physicians do a better job meeting their patients’ needs.

If you would like to read a short essay by Mr. Goldman which explores how doctors and other healthcare professionals have responded to patient reviews of their services and addresses how they should deal with patient reviews in the future, you can find it here.

5 Rules for Writing a Negative Review That Will Make Your Fertility Clinic Listen

By Griffin Jones

"If you're not a size 5, this doctor does not want to help you."

"After trying to contact the Dr. several times, I realized that no-one at this facility gave a crap, or even pretended to care".

"_____ is the worst doctor one can go to...I wanted to smack him right in his office."

Yikes. These are what negative fertility clinic reviews look like sometimes. These aren't hypothetical examples. They are real reviews of fertility doctors in three different U.S. cities. The reviewers may have needed to vent their frustration. Research from Harvard University shows that the stress and anxiety caused by infertility are equal to that caused by cancer. If you are writing a review about your fertility clinic, you may want to use the opportunity to release some of the tremendous frustration and anxiety. Your doctor or practice may be the person to release that on to. Heck, he or she might even deserve it. If your goal is simply to vent your pain and project that on to someone who may be partly responsible, I understand. I do it too often, for far less serious affairs. I make Delta Airlines feel my wrath on Twitter every time I fly with them. It doesn't solve the issue, but I feel a little better. For couples spending thousands of dollars on an emotionally draining fertility journey, the yearning for vindication must be very strong when they are failed.

If your goal is to be heard and listened to, however, may I suggest another approach? As someone that helps fertility centers respond to negative and positive reviews, I would much rather you feel the lasting vindication of a corrected problem than temporary relief. I want your problem to be corrected (most of the time it can be, one way or another) and I want the practice to get better. The way you write your review often determines what is done with the information it contains.

Google recommends that your criticism be constructive, because "business owners often use feedback to improve their offerings". In fertility terms: we don't want your legitimate disappointment to be interpreted as an inevitable byproduct of infertility's emotional burden . That perception won't benefit the practice or the prospective patient reading the review. If the comments are vindictive, as opposed to constructive, the practice may perceive your bad experience as inevitable. We want them to view it as evitable (that's not a word). We want reproductive endocrinologists (RE) to use reviews as measurable action items for improvement. If negative reviews are inevitable, then there's nothing to improve upon to avoid them.

If you were wronged in your experience, it should be rectified. Don't you at least want other people to heed your advice so they don't incur the same mistreatment? The prospective patient needs to be able to hear your concerns apart from your frustrations. Venting may be better suited for Instagram posts, private Facebook groups, support groups,  and forums. Review sites are  places to be heard because they carry weight with the practice and they influence the person making the decision to schedule a consultation. I advise fertility clinics  on how to respond to negative reviews, so that the practice listens to their patient. Here's how you can write reviews that practices and other patients will listen to:

1). Share a brief background about your journey: You have two audiences. The second is the fertility center. The first is the person who's deciding which practice she should go to. The more you have in common with your audience, the more they will pay attention to you. Whether you're fighting PCOS or coping with secondary infertility, it will help someone to know that.  Write two or three sentences about the problems you've been facing, for how long, and how it's made you feel. Forget the details that don't help you connect with your reader. 

2). Refrain from name calling and cursing. I tell fertility clinics not to respond to "vindictive reviews" which include the presence of vulgarity, name calling, and/or lack of reference to a particular problem. If someone calls the doctor "a complete idiot", the dialogue is already too hostile for us to participate. The entry to the conversation is closed before it's ever opened. The same goes for four letter words and other offensive language. To remain professional, the clinic/doctor has to keep away from these combative zones.

3). Give the benefit of the doubt when referring to people by name. Some review guidelines, like this one from Lifehacker, recommend leaving out proper names entirely. I disagree. Your review is a log of the most important events of your experience. If you really feel that someone from the billing office was exceptionally rude, or that your physician didn't listen to you, those details belong in your log. Just give the person the benefit of the doubt before you light them up. Show the reader that the issue is not a personal conflict between you and the team member. Offer the benefit of the doubt, then describe the problem. Example: "I know Dr. Blank has to see a lot of patients, but I really felt let down by how little time I had with him." By focusing on your feeling rather than the team member's short coming, the practice can do the same.

 Because this reviewer gave the physician the benefit of the doubt, we weigh the rest of the review with more deliberation.

Because this reviewer gave the physician the benefit of the doubt, we weigh the rest of the review with more deliberation.

4). Mention redeeming qualities if applicable: The doctor was late, the billing staff was rude, but if there was a nurse that made an extra effort to make you feel comfortable, that is worth mentioning. If it was an all around awful experience, don't force a compliment; it's important for people to know. Still, including a positive mention allows the reader to see your standard for what is acceptable and what isn't. Your experience informs your judgement, rather than blinds it.

5). Tell us what you had hoped for. Stating your expectations allows the practice to see exactly where they didn't meet your standards. It gives them actionable opportunities to improve and to correct the issue you're having. For example, "I hoped I would have a half hour with Dr. Blank, but instead I only saw him for two minutes." The practice can assess that they either need to allot more time for patient visits, or notify people that visits are very short. "I thought that insurance would cover these medications, but I had to pay out of pocket," shows the practice that they have to invest more time in helping people with insurance claims.

How to respond to negative fertility clinic reviews

You have a right to vent and a right to be listened to.  Exercise both, just exercise them separately. If you want to be heard, you will be better served by leaving a concise, focused review, even if it's a one-star rating. You have two audiences: the practice themselves, and the prospective patient using these reviews to make their decision. There is a chance that the practice will consider your concerns, and make an effort to correct the situation. If they do, thanking them or upgrading your review will encourage them to take patient feedback very seriously. If they do not, then they deserve the negative impact that it has on their reputation. Twenty years ago, you would have had very little power to express your thoughts and feelings. Today you have the power to affect infertility treatment for the better. Use it wisely.

7 Musts for Using Online Reviews to Avoid Choosing the Wrong Fertility Clinic

By Griffin Jones

Too often, I read an online review of a fertility clinic, in which the person says they wish they would have read other reviews before choosing that practice. In doing your online research, I strongly encourage you to take advantage of the reported experiences of other people, to help inform your decision. More than just a few times, I have read reviews where the person regrets choosing the fertility clinic despite reading negative reviews, sometimes because they followed the advice of a friend.

 A review from RateMDs

A review from RateMDs

Whenever I make a serious decision in life, I first want to speak to as many like-minded people as I can. I look for people who I feel share my profile and I deeply explore their experiences. For you, as a person coping with infertility, this will include consulting the #infertility and #ttc communities on social media, going to peer support group meetings, and thoroughly reading online reviews.

Part of what I do for a living is help fertility centers and doctors improve their online reputation. There's no real shortcut here. You can't delete reviews that other people write about you on the internet. In a 2016 world, practices need to make sure you have the best experience possible. If you're satisfied with the effort and attention that you received from your care team, you won't leave a negative review. If you're delighted, you will want to tell the world. That's better advertising than they could ever purchase. Fertility practices greatly benefit when they have a stellar online reputation, but that benefit belongs first and foremost to you. Online reviews exist for the people reading them, not the people they are about. 

I've written guidelines for fertility centers on how to respond to both negative and positive reviews. Now I want to share that experience with you so you can use fertility doctor reviews to avoid regrets and find the best fit for you. Here are seven things to keep in mind when finding a fertility center:

1). Check multiple review sites. Different review sites are more widely used in different cities. Check these nine sites to see which have the most reviews in your area. Simply enter your city, state, or province into their search field, and select the corresponding specialty.

  1. RateMDs: Reproductive Endocrinologist
  2. ZocDoc: Infertility Specialist
  3. Vitals: Reproductive Endocrinologist
  4. Healthgrades: Reproductive Endocrinology and Infertility
  5. UCompareHealthCare:  Reproductive Endocrinology
  6. Fertility Authority: Fertility Doctor or Fertility Clinic
  7. Yelp: Fertility
  8. Google Reviews: Appears in the Google+ frame of a search for the clinic/doctor's name
  9. Facebook: Usually linked to the practice's website

2). Read beyond the star rating. In my opinion, Vitals, Healthgrades, Fertility Authority, and UCompareHealthCare, are the least helpful of the above options when searching for a fertility clinic. I suppose if there are enough responses, then it helps to see if someone has a two star or a five star rating. Still, I think these sites are better designed for a chriopractor or a dentist; a specialty where a rating on timeliness and billing would suffice.

You know all too well that infertility is much more emotionally involved than that. I recommend diligently reading the comments. ZocDocs, Google Reviews, Yelp, RateMDs, and Facebook are sites where the star rating is accompanied by a comment (you know, an actual review). Read as many as you can. If there are enough, you will be able to get a better idea of the practice or doctor. 

3). Read as many reviews as you can find. Two or three samples won't show you a complete picture of the personality of a physician or the culture of a practice. Thirty will. Look for recurring themes. If eight out of nineteen reviewers call the doctor "arrogant", or fourteen people say she "is the most compassionate person ever", that is probably more reliable feedback.

4). Be aware of the bias that exists because that bias matters. Positive reviews are far more likely to come from people who became pregnant and negative reviews are far more likely to come from those who did not. In a study I conducted in 2015, I found that positive reviews are three times more likely to mention a baby or a pregnancy than to mention unsuccessful treatment or to make no mention at all. Equally, negative reviews are three times more likely to mention a lack of success than to reference a baby/pregnancy or to make no mention at all.

Study on negative fertility center reviews

This is massively important because, as a prospective patient, you should know that no one can guarantee a 100% probability of success. There are several doctors and practices with very few negative reviews. This isn't because their IVF success rates are at 85%--that doesn't exist. It's because of their bedside manor, helpfulness, compassion, reliability, and communication. All of these things matter to your choice, because the clinical result of a pregnancy is not the only factor in your experience.  A physician or clinic with many authentic positive reviews and few negative ones is more likely to properly set and manage your expectations.

study on positive fertility clinic reviews

5). Utilize Facebook: With regard to the above, know that Facebook reviews for fertility centers are far more likely to be positive than negative. My untested hypothesis is that this is because we generally use our real names and identities on Facebook, as opposed to a username (Yelp) or remaining unidentified (Ratemds). Recalling a negative experience may be too emotionally burdensome for someone to associate with themselves so personally and yet so publicly. In my personal opinion, a fertility center with less than a four and a half star rating on Facebook is not a good sign. For other sites, a good practice and team could still feasibly have a three and a half star rating. Again the number of reviews matters (at least ten).

6). Message the reviewers. Sometimes people will leave their contact information in their review, because they would love to answer your questions and share their experience. In the case of Google+, Yelp, and Facebook, you have the opportunity to click on that person's name and send them a message. Take advantage of that! If it were 1996 instead of 2016, you would have to wait outside of the fertility practice like a creep to ask people what it was like. Today, those that want to share their experience are doing so publicly. There's no magic number of conversations that you should have, so let's call it five.

  • Tell them what your greatest concerns are.
  • Ask them what their greatest concerns were.
  • Were their concerns relieved or confirmed?
  • What did they learn from their experience that they wish they had known before? 
 Remember to search for other cities and suburbs around you.

Remember to search for other cities and suburbs around you.

7). Leave your own review after your experience. At least one, on the site that you found most helpful. If you go to the deli to buy a $5 sandwich, and you're not satisfied, you don't have to tell the world. Anyone can live with the consequence of a mediocre lunch. With your journey, aren't you almost compelled to offer your experience so that someone can make a more informed decision? With the emotional cargo, financial burden, and uncertainty that characterizes the infertility journey, aren't you obliged to warn or make recommendations to others? There are countless couples and individuals that share the same concerns as you and your partner; your opinion could really help them. Use a site where you leave your real name or one where you remain completely anonymous, depending on your personal preference. It's not my place to say, but I think that the prospective patient population would be much better served if every person that underwent fertility treatment left an online review afterward: good, bad, or neutral.  

Take advantage of the wisdom of others

Online reviews don't exist to benefit hotels, restaurants, vacation destinations, products, or medical practices. They exist to benefit guests, patrons, consumers, and patients. Fertility clinic reviews are channels for you to share your experience and the purpose of these channels is to benefit other people facing choices similar to ones you have faced. If you are considering a fertility doctor or practice for the first time, please, don't just look at their website. Take advantage of the wisdom of others who will be able to greatly inform your decision. If you are a veteran of fertility treatment, please give others something to consider by writing an online review.

Did you read reviews before you chose your fertility practice or are you using them now? What have you discovered?

New Research: IVF success impacts fertility clinic reviews. But how much?

By Griffin Jones

I wish I could say that this new research provides us with all of the answers we've sought, but I think we're left with new questions. That's fine by me, I find it encouraging. We've talked about reproductive endocrinologist (RE) and fertility center reviews, and the psychology behind them. This new data helps us understand how success of treatment impacts the rating of a fertility clinic or fertility doctor review.

 Success of ART cycles largely predicts whether an infertility patient will leave a positive or negative infertility clinic review.

Success of ART cycles largely predicts whether an infertility patient will leave a positive or negative infertility clinic review.

The best possible patient ratings are necessary for the growth of the practice. Studies show that among those who sought online physician ratings in 2013, 35 percent reported selecting a physician based on good ratings and 37 percent had avoided a physician with bad ratings. Further studies reveal that the use of online reviews to select medical practices is rapidly increasing. In addition to the business benefit to the practice, many REs have told me how much they are troubled by negative accounts from patients.

Many of you observed that reviews are very often extremely positive or scathingly negative, with not too many in between. Some contend that reviews aren't based solely on success of treatment, but on many factors including bedside manor, helpfulness of staff, and accessibility. It turns out, both views are correct. From my analysis on both positive and negative reviews, it's clear that people are rating their interaction with the physician or staff. But when I saw so many REs with a three star average from polarized one and five star reviews, I wanted to examine the numbers.

In this phase of the project, I used Yelp as my source. This time, I chose to look at the reviews of practices, instead of individual physicians. Though it should be stated that the two are interchangeable. 

The analysis included:

  • 504 reviews
  • 67 practices
  • 40 metropolitan areas in the U.S. and Canada
 60% of all positive IVF clinic reviews include the mention of a baby or pregnancy. 

60% of all positive IVF clinic reviews include the mention of a baby or pregnancy. 

I did not count neutral (three-star) reviews. Of the 504 reviews, 63% were positive and only 37% were negative. This seems to dispel the notion that people are more inclined to leave reviews when they have had a negative experience. Of 319 positive reviews, 286 were five-star ratings and 33 were four-star ratings. Of 185 negative reviews, 142 were one-star ratings and 43 were two-star ratings. This supports the idea that fertility reviews are more likely to be polarized. 

One observation that surprised me was the number of positive reviews that came from people who were said they were still in treatment. 14% of all positive reviews came from this group compared to only 7% of negative reviews. Those categorized under "other treatment" are those who were egg donors, undergoing surgery for reasons other than infertility, people who were having their eggs frozen, etc. When not considering those reviews from people still in treatment or other treatments, positive reviews were 350% more likely to mention a baby or pregnancy than to reference unsuccessful treatment or nothing at all. Negative reviews were 300% more likely to mention leaving the clinic without success than to make no mention at all or to reference a baby or pregnancy. 

With the recent analyses of positive and negative reviews, and with this phase of the project, we have some data to make further hypotheses. You're free to draw your own conclusions, but I'm left with the following lesson.

Fertility clinic reviews are stories. However, the stories are not about the RE or the fertility center. Rather, the physician and the practice are characters in the story. Looking at the patterns, only 2 % of positive reviews say that their treatment was unsuccessful and only 2 % of negative reviews mention a baby or pregnancy. If a patient is able to conceive using assisted reproductive technology (ART), the RE will most likely be cast as the hero of the story. It is far less likely that the patient will leave a positive review if their treatment was unsuccessful. The role of the hero won't be offered to you. Maybe that's okay.  Because most of the time, it appears that we can prevent you from being cast as the villain.

The most common word used to describe REs in negative reviews is "rude". As one very highly rated Illinois RE told me, "I can't imagine my colleagues would ever be deliberately rude. Yet, given the emotional state of the patient, they're perceived this way." Meanwhile, the most common adjective used to describe REs in positive reviews is "knowledgeable". No one can become board-certified in reproductive endocrinology and infertility without being knowledgeable. Still, it's only when the account is positive is this quality attributed to the physician. They appear to be character traits, decided by the author of the story.

 63% of all negative fertility clinic reviews explicitly mention leaving the clinic without a baby or pregnancy.

63% of all negative fertility clinic reviews explicitly mention leaving the clinic without a baby or pregnancy.

Thankfully, the research does not seem to conclude that physicians and practices are doomed to receive negative reviews at a rate relative to unsuccessful ART cycles. There are dozens of REs and some fertility centers in the United States and Canada with very few to no negative reviews. At first look, their reviews follow the patterns above. To me, this suggests that for various reasons, the patients do not feel compelled to publicly project their frustration and emotional pain on to the practice after an unsuccessful treatment. I'm interested in investigating those reasons.

I believe that being able to identify those reasons and convert them into actionable habits will greatly improve the experience of the patient, and consequently spare the fertility center and the physician from public chastising. It would be injudicious to suggest that we can eliminate negative reviews entirely, but it seems we can certainly minimize them, and thereby reduce your number of sleepless nights.

We will continue our investigation of public patient feedback to identify the habits that lead to more positive patient reviews of REs and fertility clinics, ensuring sustained growth for the practice, and a better experience for the patient.

Use patient reviews to improve the patient experience and acquire "word of mouth referrals". Read chapter 2 of my absolutely free e-book, Digital Marketing for Fertility Centers: How to Use Digital Media to Attract New IVF Patients in 2016.

 

The 25 Best Words to Describe REs in Fertility Clinic Reviews

By Griffin Jones

Now, on to the good news.

In an earlier post, I had written about the 28 harshest words that people use to describe reproductive endocrinologists. Paying attention to the words that people use to desrcribe their REs and their fertility clinics begins to offer insight on how we can improve their experience. This time, I made a word cloud of the most common positive adjectives that people use in RE reviews.

 A word-cloud of the 25 most common positive words to describe reproductive endocrinologists in online reviews

A word-cloud of the 25 most common positive words to describe reproductive endocrinologists in online reviews

Once again, using ratemds.com, I analyzed the descriptive words used in four, four and a half, and five star reviews. 

The vast majority of reviews centered on the doctor's demeanor, personality, and communication. Interestingly, however, the most commonly-used adjective does not tell us anything about a physician's bedside manor. The word knowledgeable appeared in 175 reviews. As in the previous phase, I only counted an adjective once per review. If a review didn't use any adjectives to describe the physician or staff, I skipped over it.

If you would like to look at the raw data, e-mail me at griffin@fertilitybridge.com and I will be happy to send it you. Otherwise it included:

  • 592 total reviews 
  • 144 REs
  • 167 different adjectives
  • 54 greater metro areas or states/provinces 

Two crucial qualitative observations carried over from the other phases of the project.

  1. Physician=staff=physician. Although the reviews are for the physician and not the practice as a whole, the staff are reviewed in the majority of reviews. Often, the feelings regarding the staff are the same as they are for the physician. Sometimes however, opinions toward staff either bring down or raise the rating of the doctor.
  2. It's not about success of treatment. Oh wait, it is. Clearly, patients are reviewing the physician based on their bedside manner. But positive reviews disproportionately mention a baby or pregnancy, while negative reviews disproportionately mention leaving the practice without success. The next phase of my project will be to analyze how many reviews contain mention of a baby, and how they correspond to the star rating of the review.

What observations do you have? I've been getting more feedback than ever and sometimes your ideas become a new phase of the project!

If you're not on my e-mail list, and you would like a little bit more explanation of the study, you can watch my video post below.