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Ordinarily this wouldn't warrant a post on the blog, but given the impact it can have it's good to clarify how things work. It may surprise you to know that we're a physiotherapy clinic. I know, shock-horror. A physiotherapy clinic is a business whose primary trade is in services of a health or health-supporting nature, to members of the public who engage with us on a voluntary basis in exchange for money. This may all seem pretty simple so far, and it is. As a business, we maintain public-facing elements like our social media, our communications, community sponsorships, and our business profiles. Some of these business profiles offer the opportunity to give feedback, like the star rating systems on HealthEngine, the Google Reviews System, and the recommendations on Facebook.

Prior to this year, Atlas Physio was pretty aggressive in collecting this feedback and displaying it for customers. However, we've decided to change that moving forward.

This is due to some of the legal obligations we are subject to as a business that employs registered health practitioners, and which operates subject to the laws around health and advertising. When we mix marketing and medicine, the result is largely marketing with a medical twist. To address this, the Australian Health Practitioner Regulatory Agency provides codes of best practice whose purpose is to bring advertisements in line with what is acceptable under national law. This is where the whole show gets a bit tricky.

So what's the big change?

We're changing how we take on feedback, and what feedback we accept.

Our feedback system is already disabled on Health Engine following the resolution of ACCC v HealthEngine Pty Ltd (HealthEngine) (2020), in which Health Engine was found to be liable for onselling of non-clinical personal information to third party private health insurance brokers, as well as non-publication or editing of patient reviews, which misrepresented the quality of businesses to potential clients. Both of these are violations of s18 of the Australian Consumer Law (ACL), s29(1)(b) of the ACL, s34 of the ACL, and s29(1)(e) of the ACL. The Australian Physiotherapy Association also concluded their relationship with Health Engine as a result of these findings. This case is an illustration of how the combination of advertising, testimonials and client-facing health practice can lead to undesirable outcomes. We still use Health Engine to advertise available appointments, but do not allow feedback to be offered on that site, and we keep our clinic and client information exposure to a minimum.

For Facebook Recommendations and Google Reviews, we are moving to remove and edit recommendations to bring them in line with AHPRA advertising standards, specifically Standard 4.3 (testimonials). While patients are allowed to offer information, express their views online, post reviews on review platforms and interact with these sites, the information that can be displayed by patients on review forums like Google skirts dangerously close to violating Standard 4.1 as a whole, and specifically Standard 4.1.3, and Standard 4.4. These standards and codes, both in professional best-practice guidelines like those published by AHPRA and enshrined legally within the Australian Consumer Law, the Goods Act, and the older Fair Trading Act, are meant to protect the rights of consumers. When we apply those laws to the advertising and promotion of health and like services, those laws protect a consumer's life and wellbeing.

So what will this look like?

Moving forward, you will be contacted if you have left a review on Facebook or Google. If you've left a review, you can either take it down, or edit it so that you're not commenting on the clinical aspects of your care. You won't face any penalties if you don't want to edit anything, and you haven't done anything wrong. The strong feedback we've received from our patients means the world to us, and we strive to do better every day. The fact that so many of you would give us such high praise is humbling. It's wonderful to know that we've made a difference, but we need to do it right. So we're not going to be doing review drives and we're not going to be asking for feedback to be posted in public-facing spaces. Ideally we'd turn off all my Google Reviews and Facebook Recommendations but that content is managed by those sites and out of our control.

In summary:

- If you've left a review on Facebook, Google, or elsewhere, you will be invited to either remove or edit your review to bring it in line with acceptable advertising content standards.

- Acceptable Content includes: discussing availability of services like late-night, public holidays or weekends, discounts like student discounts, no-gap bulk billing, no-gap worksafe or TAC billing, your ability to contact the clinic, our blogs, our clinic as a whole, or anything not related to treatments. You can even just leave a five-star rating with no words or content and that will be fine too.

- Unacceptable Content includes: details of therapy you received during your time with the clinic, conditions that we treated, the number of sessions it took to solve a problem, referrals or other procedures we undertook in the resolution of your problem, reference to any correspondence that was used, or any information that might suggest to someone else that we can solve their problem. I know it may seem counter-intuitive, but we need to make sure we're playing ball here.

- Photographs are okay so long as they don't make reference to any equipment, assets, spaces, therapeutic aids or specific material found at the clinic.

- You aren't legally obligated to do anything, and you haven't done anything wrong. This is a measure we as a clinic are taking to ensure that we're compliant to the letter and spirit of the law moving forward. We want to keep treating people and managing their conditions, so we need to toe the line.

- Facebook Recommendations will be removed once we figure out how to do that.

This may seem really weird and un-necessary but this is one of those things that we're obliged to do as a consequence of being a legally operating entity. Some may say we're taking it too far, but these laws are here for a reason - primarily to protect the consumer. The spirit of the law is such that it is meant to empower people and protect them from undue influence or enticement, specifically with respect to the exchange of goods and services. Clinicians and practice-owners hold almost all the power aside from that which is conferred to patients as a result of the law. We don't want someone to come and see us under the impression that we will always be able to solve their problem, because we're human and sometimes we won't be able to. We need the information we present to people who interact with the clinic to reflect that, and we want to take this seriously because at the end of the day it involves peoples' lives and their wellbeing, so the more proactively we do this, the better it will be in the long run.

If you've been keeping track of our social media (why though) you would have seen the number of google reviews drop from a high of 162 in early August of 2021 to 121 where they are at time of writing, on 2021/12/03 (I scheduled this article for later publication <3 ). That number will likely go down as people remove and edit their feedback. That's okay. We're still all-stars here and we're still going to give five-star treatment to anyone who walks through our door, regardless of what we present in advertising and in our star-rating. Maybe we'll get up past that number again, but we're going to do it in the right way.

So that's how it's going to be going forward. This was weird, long, and circuitous to write so the bottom line is this: offer feedback and reviews as formatted in the summary above, and all will be well. We may change our content standards moving forward as well, but you'll be notified if that's the case.

Have a fine week,

- Alex :)

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