Feedback - (Friend Or Foe?).By DentistGoneBadd

I have two dogs. Between them, they have seven legs. Despite that, the owner of three of the legs is always game for a long daily walk and most mornings recently, we have trudged off for an arduous wade through the glorious mud of rural central England.

Lovely though it is, I do get a little bored as I try and extricate my wellies from the goo every few yards, so I often play audiobooks through my iPhone as I trudge relentlessly on, trying to desperately keep up with a disabled, but very game Staffy/Bullmastiff cross and her sidekick black Labrador.

My choice of listening is almost invariably something from Radio 4. Recently it’s been past episodes of I’m Sorry I Haven’t A Clue, or The Unbelievable Truth. Last week, I downloaded Alexei Sayle’s Imaginary Sandwich Bar. Alexei is one of my favourite comedians of all time and this Radio 4 programme was a welcome return to the airwaves after he spent quite a few years writing short stories, novels and autobiographies.

In one of the episodes, Alexei was regaling his audience with an anecdote about how he was invited to a literary event a few years ago, attended by professional literary critics and ‘literary bloggers.’ Of the latter, most of them failed to turn up to the event, but Alexei spoke to one of the bloggers that did attend and asked how she got into literary blogging. The response was: “I’ve got a bad back!”

The comedian was lamenting the fact that nowadays, EVERYONE is a critic and can get their views distributed to a very large audience on the internet with no great effort. There was a time when professional literary, theatre, film and art critics were the only ones able to destroy a piece of work with a few well-chosen epithets, but now, it’s open season on anyone who creates art in any form, from anonymous vindictive grouches with mobile smartphones.

I had Alexei’s views on amateur critics in mind when I came across a story the other day on an Australian dentist who has taken Google to court to force the company to reveal the identity of an anonymous person who posted a negative review of him on the internet.

The Melbourne-based dentist, Dr Matthew Kabbabe, who specialises in tooth-whitening, sought the order so he could sue the patient behind the review, for defamation. Dr Kabbabe claimed user ‘CBsm 23’ had damaged his business by telling others to "STAY AWAY" from a procedure criticised as being "extremely awkward and uncomfortable.”

Google had previously refused a request to remove the review or give information on the reviewer’s identity. The company has previously been reluctant to remove bad reviews from its site although it has done so in the past as a result of court orders. Google will be forced by the court ruling to hand over personal details of the reviewer including name, phone numbers and IP address.

So, the dentist bites back! About time too.

It’s never been easier for UK patients to destroy a dentist’s reputation. The NHS website (formerly NHS Choices) allows for patients to leave their comments on dental services they receive, often anonymously and often written wiv no regard to grammar or propper spellin’ like. Then you have Twitter, Facebook and Instagram where I have seen a number of negative comments about dentists placed – sometimes by other dentists.

Genuine review from NHS website

I know dentists who are distraught when they have unjustifiably negative reviews placed on the web and there is little that can be done about it, other than present a well-thought out answer underneath. Unfortunately, considerate responses from practitioners often come across as being a little feeble in the face of the often vituperative comments made by the patient, and the damage remains done.

This critical assault on individual members of the dental profession doesn’t only come directly from the public, it also comes from the press, courtesy of GDC hearings and the lovely dental litigation firms. For most litigation brought against dentists outside the GDC, settlements are carried out privately and out of court. There is no reason for the details of these actions to reach the public domain, and most of the time, they don’t.

One very well-known firm of dental litigation solicitors however, actively seeks to publicise cases it wins in dental ‘negligence’ cases. The rationale behind this is to presumably drum up more work from the public (as if their radio adverts don’t do that already) by splashing the details of the case all over the papers. It’s highly likely that this particular bunch uses a PR firm to distribute its ‘wins’ to the media, unless the lead solicitor rings up some hack on a national and boasts “Guess what we just did to a dentist?”

The results of such widespread publicity can be devastating to a practitioner. I know a dentist to whom this happened a few years ago as a direct result of this firm’s appetite for publicity. The dentist was an exceptionally caring and competent practitioner and the publicity was crushing, to the point that she sought early retirement from the profession she loved.

There is literally, nothing you can do in this situation. She couldn’t make any comment in her own defence because of patient confidentiality, and so a good reputation grown over 25 years is just thrown to the dogs as a result of a greed-driven law firm.

A while ago I wrote about the time I had a five year-long encounter with the GDC as a result of the crook who bought my practice goading patients to complain about me. The three cases didn’t get past the preliminary committee stage, but at the back of my mind, I was constantly worried about a hearing and the consequent publicity that would follow it. That worry of damage to my reputation was all-consuming and soul-destroying and was more intense than the fear of facing sanctions from the GDC.

But when a disgruntled patient puts up a negative review on the internet, is there anything you can effectively do? Well the crook who bought my practice did three things. Firstly she produced a huge number of fake reviews to swamp the NHS Choices website and dilute the effect of the genuinely negative reviews that she DID deserve. And I know they were fake because while I was dealing with her before the sale, I realised she couldn’t spell certain words and the same spelling mistakes were dotted among all the fake reviews. The second thing she did was remove Google links to negative reviews via the European Union’s ‘right to be forgotten’ law (a course not open to the Australian dentist because it only applies in the EU). Finally, she avoided negative reviews on the NHS website by leaving the NHS altogether. Radical!

In the past, recommendations and ‘reviews’ were carried out only by word of mouth. In small communities, practitioners soon earned good or bad reputations via chit-chat at the supermarket or down the pub. “I wouldn’t go to him, he’s a butcher” is the classic. I worked in a town many years ago where a single-handed practitioner who practised down the road, had a mixed reputation. “Old Bev is a good sort. She’ll help you out with toothache, but she’s bloody awful.” We always saw her dry sockets on a Monday from when she did extractions on the previous Saturday.

I feared I might gain the ‘butcher’ mantle one day when I walked into the local minimart. I’d recently taken over my own practice and a few days earlier I had been treating one of the counter staff. To be precise, I was taking an infected lower six out. Despite a number of ID blocks, I couldn’t get her numb enough to completely kill the pain of the extraction, but she insisted I carried on regardless, which I was reluctant to do. As I walked into the supermarket after work, she was on the counter and had a queue of customers. I overheard her saying “This bloke p****s me off. He’s a right sadist.” Fortunately, I learned later when I complained to my staff what had happened, she was an incredibly unpopular resident of the town and nobody listened to a blind word she said anyway, but it could have gone the other way. For a single-handed practitioner, that wouldn’t have been good news.

But I did have a narrow escape from negative and widespread publicity very early on in my career. I had been treating a bank manager who snapped off a non-vital upper lateral and needed root-filling before providing a post-crown. It was a bit of a tricky root-canal and it took me about three visits. The patient refused a temporary crown, but it was obviously made clear that the ultimate aim was to place a crown. Having just graduated I stuck rigidly to the rules and in those days we were taught to leave it at least three months before crowning after a root-filling. This was in the old fee-per-item NHS days and at the end of the root-treatment, we closed the treatment plan and the receptionist was instructed to make a crown appointment in three months.

The next day I was in the surgery and was listening to BRMB, the local Birmingham commercial radio station. They had a programme on dentists and dentistry and they had a chap on who was whining on about how ridiculous it was that he had to have umpteen appointments to fix “What after all, is just a STUMP!” Fortunately, the radio presenter cut him off just as he was about to name the practice, which was of course, the one I worked in and I was the dentist. I ran into reception to find out what had happened the previous day. The patient had paid up, but hadn’t been given a follow-up appointment because the receptionist hadn’t seen my note requesting one. We rang him up, but he declined another appointment, announcing he was going to go private!

When I think about it, a review on an obscure website doesn’t seem quite so bad.