Reversing the Antibiotic Resistance “Yelp Effect” Through the Use of Emotionally Framed Responses to Negative Reviews of Providers: Questionnaire Study

BACKGROUND: The overuse of antibiotics has rapidly made antimicrobial resistance a global public health challenge. There is an emerging trend where providers who perceive that their patients expect antibiotics are more likely to prescribe antibiotics unprompted or upon request. Particularly, health care providers have expressed concern that dissatisfied patients will provide disparaging online reviews, therefore threatening the reputation of the practice. To better deal with the negative reviews and inform patients, some health care staff directly respond to patients’ online feedback. Engaging with patients’ online reviews gives providers an opportunity to prevent reputational damage and improve patients’ understanding of the antibiotic resistance problem. OBJECTIVE: We aim to test the effectiveness of different response strategies to the negative patient online reviews on the readers’ perceptions of the health care provider and their perceptions related to antibiotics resistance. METHODS: Two experiments were conducted to examine the impact of message tactics (apologizing, inducing fear or guilt) that can be employed by health care providers when responding to patients’ negative online feedback related to not receiving an antibiotic. RESULTS: Overall, our results demonstrated positive impacts of responding to patients’ online reviews. In study 1, we found apologetic messaging and use of emotional appeals in the response were effective in making readers feel more favorable toward the message. Readers also expressed a greater credibility perception toward the provider and willingness to visit the clinic when emotional appeals were used. Findings from study 2 largely supported the effectiveness of a fear-based response in improving the readers’ credibility perceptions and willingness to visit the clinic. The fear-inducing information was particularly effective among parent readers. CONCLUSIONS: This paper demonstrated that a strategic response to online patient complaints could prevent reputational damage and minimize the potential negative impacts of the review. The results also glean insight into the step toward developing a novel intervention—crafting a persuasive response to patients’ negative feedback that can help improve the understanding of antibiotic resistance problems.