Soliciting Reviews From Patients: What’s Okay for Your Mental Health Practice?

We discuss the guidelines and ethical principles for mental health practices that want to build a favorable online profile through review sites.

Online reviews aren’t just for coffee shops and barbers anymore. Patients have the opportunity to write reviews (good and bad) for their doctors and other mental health care professionals. Such reviews offer practitioners some insight into their patient’s experiences and can provide useful feedback on how to improve their practices. 

But as almost every business owner learns, unhappy customers are more likely than satisfied customers to take the initiative and write about their perceptions. In an attempt to correct the imbalance and help build a positive online profile, many practitioners wonder if they can ask their patients to submit online reviews.

Practicing Psychologists and Mental Health Care Workers

The American Psychological Association (APA) Ethics Code does not allow psychologists to solicit testimonials from current therapy clients or others because of the high risk of undue influence. Similarly, the National Association of Social Workers Code of Ethics states that social workers should not solicit testimonials from current clients or other people who may be vulnerable to undue influence because of their particular circumstances. 

However, these limitations don’t prevent psychologists, LCSWs, and other mental health care workers from creating a positive online profile through their own writings and videos. Colleagues and other professionals in your field can also provide testimonials for your website, vouching for your expertise without requiring you to breach client confidentiality. 

Psychiatrists and other Medical Doctors 

Psychiatrists and other medical doctors are governed by the states’ practice acts and have different overseeing boards than psychologists and LCSWs. Under the Illinois Medical Practice Act, for example, psychiatrists may ask patients for reviews.

Nationally, guidance from the American Psychiatric Association Ethics Committee allows the solicitation of reviews from patients about their satisfaction and theorizes that asking for these reviews could contribute to improvements in psychiatrist performance and lead to better treatment experiences for patients. 

But while asking is acceptable, offering incentives is not. First, most review platforms explicitly prohibit incentivizing patient reviews.  To protect their integrity, review services must prevent companies from artificially boosting their customer ratings or, worse yet, paying for false reviews. On a related note, many review services prohibit “review gating,” or selectively requesting reviews from clients who have had a positive experience, while directing unhappy clients to discuss their experiences privately.

Patient incentives can run afoul of federal and state laws, as well. For example, psychiatrists who incentivize reviews from patients by offering discounts run the risk of violating the Anti-Kickback Statute (AKS), which makes it a crime to use offers or rewards of anything of value to lure federal healthcare program beneficiaries (i.e., Medicare, TRICARE, or Medicaid patients) to their practices.  Violating AKS could result in felony charges. 

Lastly, the FTC has recently issued guidance stating it’s unwise to incentivize positive reviews and risk noncompliance with the Consumer Review Fairness Act. Read more in our blog, “Why You Can’t Stop Negative Reviews.”

Responding to Online Reviews

Of course, psychiatrists should always be careful when responding to online reviews. When a patient suggests publicly that the doctor provided poor care, it can feel like an attack on the physician’s professional integrity. It’s natural to want to defend yourself or your practice vigorously.

However, regardless of what the patient has chosen to reveal online in a review, HIPAA requires that you protect their PHI, including mere acknowledgment of their status as your patient.  The best practice is to stick to general responses like, “We take your feedback seriously.” For more discussion, see our previous blog, “How to Respond to Negative Online Reviews by Patients.”

If you have questions about how to respond to negative reviews from patients, how to implement informed consent and disclosures agreements, or how to set up a company-wide social media and review policy, the experienced health care attorneys at Jackson LLP are here to help. 

This blog is made for educational purposes and is not intended to be specific legal advice to any particular person. It does not create an attorney-client relationship between our firm and the reader and should not be used as a substitute for competent legal advice from a licensed attorney in your jurisdiction.

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