Health communication on social media is complicated, challenging, and multi-dimensional. Globally, the evolution of health communication has transformed rapidly from one-way to two-way interaction, with diverse audiences expressing limitless and often unconstrained commentary based on individual beliefs. This paper, a segment of a comprehensive doctoral study into the adoption and utilisation of social media within a large Australian health organisation, specifically Queensland Health, offers a snapshot of the research findings for managing negative commentary. This novel study interviewed social media administrators to understand their experiences and perceptions of social media use, underscoring the prominence of negative commentary as a notable drawback to the effective use of social media. Paradoxically, such adverse commentary also catalyses discussions and leads to helpful feedback. Effectively managing unacceptable commentary necessitates the implementation of a strategic response complemented by adequate resources and training.