You may have recently read an article about doctors and online Yelp Reviews.1 Just like restaurants, movies and hotels, physicians are being reviewed online. At times we receive calls on our psychiatry risk management line indicating that a patient posted a negative review online. It is certainly a difficult issue. But can the psychiatrist do anything about this?
Internet sites such as Yelp, Citysearch, vitals.com and ratemds.com, combine local reviews and social networking functionality that then allows people to contribute their own reviews. Often these statements are not true, and there is no proof that the “poster” was indeed a patient. Unfortunately, at this point, the options are limited. HIPAA and state privacy laws prevent physicians from posting responses. Further, many states have heightened protection for behavioral health and substance use information. It is not necessarily fair, but it is the current reality. The 1996 Communications Decency Act protects ratings websites from liability for publishing third-party content. Most sites will tell a business owner that they are free to post a response to the review. However, psychiatrists are not typical “business owners”; they are obligated to adhere to patient confidentiality/HIPAA rules and regulations, and posting a response can potentially expose the psychiatrist to a lawsuit. The mere acknowledgement of the relationship without patient consent is a HIPAA violation and could potentially result in the patient reporting the psychiatrist to the Board of Medicine and/or filing a lawsuit for breach of privacy. The American College of Physicians and the Federation of State Medical Boards suggest creating a professional profile so that it appears first when a search is performed, in order to provide some measure of control of the information read by patients.2, 3 Also, routinely “Google” yourself and try to correct any misinformation.
There are a number of lawsuits that have occurred where a physician sued a patient who posted information online. Suing the person who wrote it may cost you more in the end. It is an evolving issue and the results have been mixed. Some doctors have had their suits outright dismissed by the courts, and one doctor who was successful and obtained a multimillion dollar verdict against a former patient in turn received publicity, lost hundreds of patients and was forced to sell his home.
It is a difficult issue to encounter; it is not recommended that you respond to the post or confront the patient. Although the psychiatrist may believe he knows which patient posted the information, there is always the risk that if it is not that patient, privacy could be compromised. Additionally, confronting the patient could upset him further and the risk of reporting to the Board of Medicine or filing a complaint could increase. Should you have questions about these issues, contact your risk management professional or attorney for advice.
1 Ornstein, Charles, “Doctors fire back bad Yelp reviews- and reveal patients’ information online.” Washington Post, May 27, 2016.
2 American College of Physicians, “New recommendations offer physicians ethical guidance for preserving trust in patient-physician relationships and the profession when using social media,” https://www.acponline.org/acp-newsroom/new-recommendations-offer-physicians-ethical-guidance-for-preserving-trust-in-patient-physician
3 Federation of State Medical Boards, “Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice,” April, 2012.