Why Do Doctors Doing Medicolegal Work Get So Many Bad Reviews?

Understanding Why Online Ratings Don't Tell The Full Story

We recently had a client send us glowing report about one of our specialists who undertakes IMEs.

The client wrote, “I recently used (doctor name) for (patient name)'s IME. I received good feedback with regards to his professionalism, mannerism and communication style.”

A positive review is always welcome and by the same token, feedback where something is less ideal is also important. Receiving this feedback as an email is ideal as it enables us to review the matters raised and address these in a response - on the other hand responding to online reviews is a delicate balance.

Take a quick look at online reviews for medicolegal doctors and you might be surprised to see some of the reactions about this highly trained group of doctors.

Online reviews are a reality for anyone operating a business today – and the medical profession is no different.  The additional challenge that health professionals face is that it’s very difficult to counter a negative review – as we are bound by patient confidentiality.

All health professionals face these issues, with over 51%of GPs clinics reporting having negative reviews, yet we’d argue that doctors who undertake medicolegal work face a disproportionate number of negative online reviews.

So why is this happening?

The Nature of Medicolegal Work

Medicolegal doctors are often not treating physicians but are instead tasked with providing objective assessments for legal or insurance purposes. Their role is to evaluate, not to advocate, which can lead to dissatisfaction among patients who expect support or validation.

“These doctors are often caught in the crossfire between legal systems and patient expectations.”

Patient Expectations vs. Reality

Patients undergoing medicolegal evaluations may already be in distress - physically, emotionally, or financially. When the outcome of an assessment doesn’t align with their expectations (e.g., denial of a claim), they may perceive the doctor as unsympathetic or biased.

Research shows that dissatisfaction with a physician often stems from perceived lack of empathy, poor communication, or unfavourable outcomes.

Communication and Trust Issues

Studies have found that poor communication and a lack of perceived empathy are major drivers of complaints and negative reviews. Medicolegal doctors may not have the time or mandate to build rapport, which can be misinterpreted as coldness or indifference.

Systemic and Ethical Tensions

The healthcare system and legal frameworks can create ethical dilemmas. Doctors may feel pressured to remain impartial, while patients may feel they are being judged or disbelieved. This tension can fuel mistrust and lead to complaints.

“The medicolegal setting is inherently adversarial, and doctors often become the face of a system patients feel has failed them.”

Online Reviews: A Skewed Sample

Online reviews often reflect extreme experiences - either very positive or very negative. Since medicolegal doctors rarely have ongoing relationships with these patients, those with negative experiences are more likely to leave reviews, skewing public perception.

What Can Be Done?

Promoting the latest evidence-based approaches for treating health professionals

Helping treating doctors to understand that good work is actually good for your health is just the beginning. The Australasian Faculty of Occupational and Environmental Medicine’s (AFOEM)'s It Pays To Care policy also provides evidence-based strategies for managing work injuries effectively – including early active treatments - and details these on their website. When all health professionals are working from the best evidence, it limits confusion and poor outcomes for the people at the heart of the process.

Communicating well: Emphasising the importance of respectful, clear communication

‍IPTC Messaging Matters IECCC Framework helps personal injury professionals to improve their communication strategies, providing a flexible, adaptable approach to fostering clear, compassionate interactions with the aims of reducing psychosocial risks, focus on creating a culture of collaboration, and active and responsive management of individual cases. https://www.itpaystocare.org/resources-1/messaging-matters  

Clear explanation of roles

Giving patients who will be attending an independent medical examination information about the role of the IME doctor - that they are not there to treat but to assess. WorkCoverQueensland’s website details frequently asked questions about IMEs.

Systemic reforms

‍Better support for people navigating legal and insurance systems could reduce frustration directed at doctors in this area. The It Pays to Care policy paper calls for comprehensive, evidence-based reform of work injury management systems and approaches.

Doctors who perform medicolegal work are essential to the justice and insurance systems, but they often face negative reaction from patients. By understanding the root causes of dissatisfaction and working toward more transparent, empathetic interactions, we can begin to bridge the gap between objectivity and compassion.