US medical malpractice litigation gives us a surprising insight into what drives our guests to take their gripes online
Love it, loathe it or simply live with it; you know as well as I do that TripAdvisor is here to stay. I would imagine many of you even have a strategy to use the platform to your advantage. What you really want to know though, is how to avoid those damning and damaging reviews which inflict such heartache, anxiety and even anger. The business impact can be considerable; a ‘TrustYou’ study reveals that if the share of 5-bubble reviews increases by 10%, the number of bookings increases by 10.2% in Europe and 7.8% in Asia-Pacific. A Cornell study found that a one-point increase in reputation (based on a five-point scale) can result in a hotel’s ability to raise room rates up to 11.2%.
The power is now firmly in the hands of the consumer/guest, and with more than 300 million using TripAdvisor every month, unregulated and often unwarranted reviews can damage a brand. The internet is awash with hoteliers directing anger, protestation, blame, and even law suits towards TripAdvisor, who show consideration of the problem via their ‘moderation and fraud detection’ unit. But stone throwing is not what I’m here to do, as prevention will eradicate the need to blame. I’m here to promote the former.
But can we really prevent negative online reviews?
If at this stage I start talking about filing law-suits for malpractice against physicians, you’d be forgiven for thinking you’ve accidentally clicked on a pop up for a phoney online lawyer (“Sue a doctor, 100% no win, no fee!!!” etc. etc.). Stay with me, because the answer to the bold question above lies in striking studies from the seemingly unrelated health care profession.
Two great authors of our time; Malcolm Gladwell and Daniel Goleman have both drawn on the same research in their influential books ‘Blink’ and ‘Working with Emotional Intelligence’. To drastically distill the expansive work of the world’s foremost researcher on patient-physician communication, Dr. Wendy Levinson - doctors who communicate more effectively, get sued dramatically less than their less emotionally intelligent counterparts (and often have never been sued at all).
“Believe it or not, the risk of being sued for malpractice has very little to do with how many mistakes a doctor makes. Analyses of malpractice lawsuits show that there are highly skilled doctors who get sued a lot and doctors who make lots of mistakes and never get sued. At the same time, the overwhelming number of people who suffer an injury due to the negligence of a doctor never file a malpractice suit at all. In other words, patients don't file lawsuits because they've been harmed by shoddy medical care. Patients file lawsuits because they've been harmed by shoddy medical care and something else happens to them.”
from Malcolm Gladwell’s ‘Blink’.
Let’s transfer this observation to hospitality. What makes hotel guests complain? Guests’ gripes are generally not with stuff - they are with employees not caring about stuff. Slow Wi-Fi, missing side orders and unavailable early check ins don’t compel people to the poisoned pen (okay, keyboard). Guests go online to complain because they feel as though nobody cares about the slow Wi-Fi, missing side order and unavailable early check in, and nobody adequately cares about the impact that this might have on them. We’ve all been on the receiving end of things that have gone wrong in hotels or restaurants, but think - was it the thing itself that got your blood boiling, or the way it was handled?
Unfortunately over the years, I’ve had dozens of instances of being made to feel that my feedback was not important. There’s no simpler example than an experience in a hotel in the UAE last year. A porter escorted me to my room on arrival and on opening the door, the stench of stale cigarette smoke was immediately apparent. The porter concurred but when calling down to reception, explained to his colleague; “I’m in room 24 and the guest says it smells.” I hope I don’t need to elaborate on what’s wrong with his chosen communication (beyond referring to me as ‘the guest’ when my name was known to him). It was the start of a highly frustrating experience and, had I not been there on a professional basis, I can assure you I would have been more than tempted to vent online.
So let’s return to the research and see what made the difference between those physicians who were sued, and those that weren’t.
Levinson recorded hundreds of conversations between a group of physicians and their patients. Roughly half of the doctors had never been sued. The other half had been sued at least twice, and Levinson found that just on the basis of those conversations, she could find clear differences between the two groups.
What were the differentiators?
Listening - In the sued group, only 23% of time was the patient given the opportunity to complete their opening statement; resulting in a significant loss of connection and feeling of understanding between patient and physician, as well as the inevitable receiving of incomplete information. Those few that allowed the patient to finish their statement gained a far greater level of trust.
Time - The surgeons who had never been sued spent on average three minutes longer with each patient than those who had been sued did.
Tone of voice - When reviewing tape recordings of the interactions, psychologist Nalini Ambady filtered them to remove high-frequency sounds and leave a kind of garble where only pitch, intonation and rhythm remained. Using qualities such as warmth, hostility, dominance and anxiousness, she was able to predict which surgeons got sued and which didn’t. Ambady was stunned by the results.
“All they were using for their prediction was their analysis of the surgeon's tone of voice. In fact, it was even more basic than that: if the surgeon's voice was judged to sound dominant, the surgeon tended to be in the sued group. If the voice sounded less dominant and more concerned, the surgeon tended to be in the non-sued group.”
Rapport - The level of training and credentials of the physician bore no correlation to the amount of litigation faced. Many patients simply refused to pursue legal action against practitioners that they liked:
"People just don't sue doctors they like," is how Alice Burkin, a leading medical malpractice lawyer, puts it.
Missing Clues - Physicians in the sued camp frequently missed information from patients, who offered verbal cues as to their emotional state or social concerns. These clues represented clear chances to demonstrate empathy and understanding and thus deepen the emotional alliane between the two parties. These clues were referred back to in only 38% of instances.
So how can your teams benefit from this research in their handling of guest feedback?
LISTEN - When a guest wants to complain, always allow them to finish what they are saying. Not only will you receive complete information, your guest will immediately feel that someone is listening - and if they don’t feel heard, where do you think they might resort to find a wider and more receptive audience?
Give them your TIME - I get it, you’re busy, but would you be willing to go back in time and find just three minutes of your time when faced with a ‘terrible’ rating on TripAdvisor? Take notes, ask questions and if necessary, investigate the issue and gather information from colleagues/glitch reports.
Consider your TONE - Once you’ve listened to your guest, think about your tone, and whether it reflects the gravity of the situation. It really helps to actively think about being warm, humble and empathetic, as this will come across in your tone.
Build RAPPORT - This doesn’t mean to strive to become the guest’s best friend, but rather to create an emotional connection. Handling feedback in an understanding and positive manner will make them recall the incident in a different light. Think about your body language and techniques such as mirroring, back-channeling (that’s another article in itself) and reflective listening (“I want to make sure that I’ve understood you correctly Mr. Jones…”).
TUNE IN - Look for additional clues and show that you’ve understood them. If a guest tells you that they were late for the theatre as a result of their broken hairdryer - don’t ask why they didn’t call down for another one; let them know how frustrating that must have been and how you hope that it didn’t spoil the show.
ACCEPT negative feedback - looking to justify issues or change a guest’s opinion of one will only exacerbate the situation and frustrate the guest. ‘Difficult’ guests so often become so as a result of aversive employee behaviours.
Be GRATEFUL - when a guest brings an issue to you, be grateful to them and thank your lucky stars that you have the chance to put things right, before they log in to TripAdvisor.
Empower your teams with these steps and look forward to tracking your all new and improved TripAdvisor ratings.