Basic Policy on Google Reviews

Introduction: A new perspective on choosing a clinic

When looking for a clinic, it has become common for many people to start by searching on a smartphone or computer.
These online reviews now play an important role as the “digital front door” of a clinic.

Local reputation and introductions from acquaintances are still very important,
but in recent years, information on the internet has also become a major criterion for choosing a clinic.

Among reviews that anyone can post easily and anonymously, some contain content that differs from the facts, misunderstandings, or even malice.
Such posts are creating new challenges for both patients and medical institutions.

Google reviews have become an extremely important element of running a clinic today,
and here we explain our basic thinking and policy.

Our basic policy on how we handle reviews

We take every review we receive seriously, as valuable feedback that helps the clinic grow.

On top of that, there are two principles in our response that we will never compromise.
One is that, in every case, westrictly protect patients’ privacy and confidentiality.
The other isnot to aim to win arguments online, but to use the feedback we receive to improve our daily care and operations.

It may be true that the current review system sometimes feels unfair.
However, rather than seeing this negatively, we believe it is most productive to focus on the parts we can control ourselves.

Why negative reviews arise

1. Problems with patient experience

It is known that most negative reviews are not about the physician’s diagnosis or surgical skill, that is, medical technique itself. Rather, most of the problems raised are concentrated in areas related to “patient experience.”
Specifically, the great majority are operational and communication issues, such as “the wait was long even though I had an appointment,” “I was bothered by the staff’s wording,” and “the doctor seemed busy and did not listen enough.”

Patients visit a clinic feeling anxious about illness or injury and in an emotionally sensitive state.
In such a state, even a minor inconvenience or a response lacking empathy tends to stay in memory as dissatisfaction with the clinic as a whole, even if the quality of care is high.

2. The gap between medical reality and patients’ expectations

Another major cause is the gap between the “natural course” of a disease and the patient’s expectation that it “should get better right away.”

For example, there is no specific cure for viral conjunctivitis (pink eye), and treatment centers on symptomatic care to reduce inflammation.
Symptoms generally peak about a week after onset, and complete recovery usually takes two to three weeks.
In other words, after visiting a clinic,a temporary worsening of symptoms is medically expected and does not necessarily mean the initial treatment failed.
However, if this medical reality is not communicated well enough, an expected worsening of symptoms may be written in a review as dissatisfaction or distrust toward the doctor.

The clinic’s dilemma: the “invisible wall” of the law

On the other hand, the law strictly limits the detailed rebuttals or explanations a clinic can give in response to reviews. Patients are free to post anonymously, but medical institutions are bound by strict confidentiality obligations set by the Act on the Protection of Personal Information and the Penal Code.

Even if the content of a review differs from the facts, a specific reply such as “no such patient came in that day” could indirectly acknowledge that “that person is a patient.”
Even when a patient discloses their own condition in a review, the provider’s duty of confidentiality is not lifted.

Because of this “information asymmetry,” clinics are easily criticized one-sidedly, becoming, so to speak, a “digital punching bag.” In recent years the problem has become so serious that many physicians in Japan have filed a class action against Google.

Our specific response process

With this background, we have set the following process for Google reviews.

Checking and classifying all reviews

First, we read every review and analyze its content objectively. We then carefully judge whether the point raised is legitimate feedback that suggests an operational improvement, or a malicious post that is not based on facts or violates Google’s policies.

Replying while observing confidentiality

The purpose of a reply is not to “win” an argument with the poster.
It is to show a professional and sincere attitude to all the future patients who will read the exchange.

In a specific reply, we first thank the person for their feedback, avoid mentioning any particular individual or situation, and express our willingness to improve in general terms. We never confirm or deny whether the poster was actually a patient of our clinic.
If you need a detailed consultation, please speak with us in a private setting, such as after a visit to the clinic or by phone.

Handling malicious reviews

There are also deliberately false posts and posts by unscrupulous vendors who demand money.
For posts that violate Google’s policies or amount to defamation, we do not argue in public; we report them through Google’s official procedures and request removal.
If we judge that legal action is necessary, we work with a lawyer to proceed with procedures such as a “request for disclosure of sender information.”

The best reputation management is providing an excellent medical experience

Responding to negative reviews is also important, but that is only the defensive side.
At the center of our reputation management (Online Reputation Management, ORM) is providing an excellent patient experience every day and preventing negative reviews from being written in the first place.

Managing expectations

During the examination, we carefully explain the timeline of recovery from the condition and tell you in advance about symptom changes that may occur, so as to reduce your anxiety and prevent misunderstandings.

Clear explanations

We place “explaining carefully until the patient understands” at the center of our care.

Using the monitor in the exam room, an iPad, and so on, we try to explain visually, letting you look at your own test images.

Many explanations using images are also posted on our website.
After the explanation, we hand you a link to the relevant page as needed.
This lets you deepen your understanding even after you return home.

We would like to hear your opinions

Patients who feel dissatisfied tend to be more motivated to post reviews than patients who are satisfied.

To correct this bias and make visible the voices of the great majority of patients, the so-called “silent majority,” we have decided to ask everyone to share their experience.

We offer two ways to give feedback.

1. Send your feedback directly to our clinic

If you would like to send us feedback directly to help us improve, please use the “Satisfaction Survey” below.
The feedback we receive is shared within the clinic and will surely be used for future improvement.

2. Share your experience in a Google review

You can post using the QR code displayed in the clinic or the link below.
Your voices help other patients and are a great encouragement to us.

Link to Google reviews
https://g.page/r/CcfgyMH02_UaEAE/review

We want to stress that we never offer discounts or goods in return for posting a review. Such conduct is called “stealth marketing” and is illegal under the Act against Unjustifiable Premiums and Misleading Representations.

Looking ahead

The environment surrounding online reviews may be at a major turning point. For now, however, each clinic must bear the responsibility of protecting and building its own reputation.

Online reputation can no longer be ignored; it is one of a clinic’s important operating assets.
We have decided to face this new reality sincerely and strategically, without looking away from it.

We believe that Online Reputation Management (ORM) is another important responsibility that reflects the quality of our care and our sincerity toward patients.

References and websites consulted

1. References on Google’s policies

Policy on user-contributed content on Maps
This clearly sets out which kinds of posts Google treats as policy violations, such as “malicious,” “spam,” “false,” or “impersonation.” It is the objective standard we use when reporting inappropriate posts to Google.
https://support.google.com/contributionpolicy/answer/7400114

Tips for replying to reviews
Official tips from Google for businesses on how to reply to reviews. Our reply policy is also based on the constructive, privacy-conscious communication described there.
https://support.google.com/business/answer/3474050

2. Laws and guidelines on confidentiality

Act on the Protection of Personal Information (e-Gov Laws and Regulations Search)
The basic law governing the handling of personal information, which all businesses, including medical institutions, must follow.
https://elaws.e-gov.go.jp/document?lawid=415AC0000000057

Penal Code, Article 134 (Disclosure of Secrets) (e-Gov Laws and Regulations Search)
It sets out the penalty for physicians, pharmacists, and others who disclose, without justifiable grounds, a person’s secrets learned in the course of their work. It is one of the legal bases of our strict duty of confidentiality.
https://elaws.e-gov.go.jp/document?lawid=140AC0000000045_20220617_504AC0000000068&num=134

Guidance for the Appropriate Handling of Personal Information by Medical and Nursing Care Providers
Guidelines specific to the medical setting, jointly prepared by the Personal Information Protection Commission and the Ministry of Health, Labour and Welfare. They explain concretely, among other things, that even when a patient has disclosed their own information, the provider’s duty of confidentiality is not lifted.
https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000027272.html

3. Laws and guidelines on advertising and marketing

On advertising regulations under the Medical Care Act (Ministry of Health, Labour and Welfare)
It sets out what medical institutions must not do when publishing information on websites and the like that is regarded as advertising (for example, false or exaggerated claims, or posting patient testimonials).
https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/kenkou_iryou/iryou/kokokukisei/index.html

From October 1, 2023, stealth marketing violates the Act against Unjustifiable Premiums and Misleading Representations. (Consumer Affairs Agency)
Official information showing that providing money or services in return for review posts and then promoting them without disclosure (stealth marketing) is prohibited by that Act.https://www.caa.go.jp/policies/policy/representation/fair_labeling/stealth_marketing

4. Information on legal action against malicious posts

Information on the Provider Liability Limitation Act (Ministry of Internal Affairs and Communications)
A law that sets out, among other things, the procedures by which a victim of defamation or another rights violation on the internet can ask a provider (platform operator) to disclose the poster’s information.https://www.soumu.go.jp/main_sosiki/joho_tsusin/d_syohi/ihoyugai_04.html

5. Overseas guidance on medical ethics and communication

AMA Code of Medical Ethics Opinion 2.3.2 – Professionalism in the Use of Social Media (American Medical Association)
The American Medical Association (AMA) ethical guidance on physicians’ use of social media. It sets professional standards of conduct, such as maintaining boundaries with patients online and protecting patient confidentiality in every case.
https://www.ama-assn.org/about/ethics/social-media-guidance-physicians-taps-timeless-principles

Responding to unwarranted criticism of you or your staff online (General Medical Council, UK)
Ethical guidance for physicians from the UK General Medical Council (GMC). It stresses the importance of responding calmly and professionally to unwarranted online criticism and of never breaching patient confidentiality.
https://www.gmc-uk.org/professional-standards/the-professional-standards/confidentiality—responding-to-criticism-in-the-media/responding-to-criticism-in-the-media

6. U.S. federal law on protecting patient privacy

HIPAA and Social Media (U.S. Department of Health & Human Services)
The official view of the U.S. Department of Health & Human Services on the Health Insurance Portability and Accountability Act (HIPAA) and social media. It explains the strict rule that even when a patient posts their own information online, the provider’s duty of confidentiality is not lifted and no patient information may be disclosed.
https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html

7. Academic research on online reviews and quality of care

Online Physician Reviews: The Good, the Bad, and the Ugly (Journal of Medical Practice Management)
A paper in a medical journal on online physician reviews. It analyzes the tendency of many reviews to evaluate “service” aspects such as communication, waiting time, and staff attitude rather than the physician’s clinical skill.

Ellimoottil C, Leichtle SW, Wright CJ, Fakhro A, Arrington AK, Chirichella TJ, Ward WH. Online physician reviews: the good, the bad and the ugly. Bull Am Coll Surg. 2013 Sep;98(9):34-9. PMID: 24455818.
https://pubmed.ncbi.nlm.nih.gov/24455818/

8. U.S. regulations on advertising and marketing

Online Reviews and Endorsements (Federal Trade Commission)
Guidelines from the U.S. Federal Trade Commission (FTC) for businesses on online reviews and endorsements. They clearly set out the illegality of reviews given in exchange for compensation (stealth marketing) and of posting fake reviews.
https://www.ftc.gov/business-guidance/advertising-marketing/endorsements-influencers-reviews