Dissed by Unhappy Patients? Here's What to Do

by Roger Sergel
Senior Executive Editor
MedPage Today Video
Originally posted January 04, 2017

Ethical ways for psychologists to counteract negative reviews online

Pauline Wallin
The National Psychologist
Originally published March 9, 2016

If you Google your name, the first page of search results may show ratings from Healthgrades, Yelp and similar sites. Sometimes these ratings are less than kind. And sometimes they’re not even posted by real clients.

Upon seeing a negative review, your first thought might be, “How do I get this removed?” Check the website’s Terms of Service. Many rating sites stipulate that reviews must be based on facts and must not include inflammatory, racist, sexist or other prejudicial content.

Thus, if someone posts a scathing review, calling you “scum of the earth,” that would likely violate the rating site’s terms of service and your request for removal of that review will be granted.

If the review is obviously factually inaccurate and does not reflect your mode of practice – e.g., a complaint that you didn’t clean your stethoscope – you can probably get it removed.

The article is here.

Vignette: 29: A Blog Attack

Psychologist Dr. Shermer learns from a colleague that she has been described in very unfavorable terms in a blog posted by an individual who publicly identifies herself as a patient of Dr. Shermer.

Dr. Shermer reviews the blog information.  The author is likely not a current patient.

The blogger insults Dr. Shermer’s appearance, her style of dress, and her office.  In essence, the blogger combines factual and inaccurate information into a well-formed, yet highly erroneous, description about Dr. Shermer’s role in the community and in the legal system.

There are many descriptions of Dr. Shermer that are blatantly false or misleading. Some of the falsehoods on the blog would be serious violations of the Ethics Code.

Upon reviewing the charts of several possible candidates as the offensive blogger, Dr. Shermer believes the blogger to be someone she evaluated in the past for a national security position.  The likely blogger can be emotionally labile and frequently feels a victim of “the system.” Dr. Shermer indicated a number of pathological characteristics in the report.  Dr. Shermer does not make the determination for the security clearance, but serves as a consultant for the government agency.

Dr. Shermer has a presence on social media and fears how her online reputation may be adversely affected by these ongoing blog posts.  She also fears that if she draws too much attention to the blog, then the blogger will gain greater traction.

Dr. Shermer fears the risk that the information could go to a licensing board and result in an investigation.  Although completely unwarranted, an investigation would add unnecessary stress in her life.  There is also a risk that her reputation could be ruined if the former client’s blog posts gain a larger following.

The psychologist wonders how she can take proactive action.

Dr. Shermer considers hiring an attorney.

Dr. Shermer also considers hiring an online reputation management company.

Dr. Shermer calls you for a consultation.  What are some recommendations that you would make to Dr. Shermer?

How would you feel if you were Dr. Shermer?

Doctors and Their Online Reputation

By Pauline Chen
The New York Times
Originally published March 21, 2013

When a doctor I know recently signed up for a Twitter account, his colleagues began teasing him. “Are you going to tweet what you eat?” one joked.

Their questions, though, soon turned serious. How often was he going to tweet? What would he do if patients asked for medical advice on Twitter? Did he make up a name or use his real one?

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Since starting his blog, KevinMD, nearly 10 years ago, Dr. Pho has become a rock star among the health care set, one of the few doctors recognizable by first name only. A primary care doctor, Dr. Pho presides over a social media empire that includes his blog, now a highly coveted publishing place for doctors and patients, a lively Facebook page and a nonstop Twitter stream that has become must-follow fodder for the medical Digirati.

The entire article is here.

Ethics Education and Psychology has highlighted a number of articles from Dr. Pho's blog.

High court rules online posts didn't defame doctor

The closely watched case tested the boundaries of First Amendment rights vs. reputation.

By ABBY SIMONS
Star Tribune
Originally posted January 30, 2013

Dennis Laurion fired off his screed on a few rate-your-doctor websites in April 2010, along with some letters about what he saw as poor bedside manner by his father's neurologist. He expected at most what he calls a "non-apology apology."

"I really thought I'd receive something within a few days along the lines of 'I'm sorry you thought I was rude, that was not my intent' and that would be the end of it," the 66-year-old Duluth retiree said. "I certainly did not expect to be sued."

He was. Dr. David McKee's defamation lawsuit was the beginning of a four-year legal battle that ended Wednesday when the Minnesota Supreme Court ruled the doctor had no legal claim against Laurion because there was no proof that his comments were false or were capable of harming the doctor's reputation.

The unanimous ruling reverses an earlier Appeals Court decision and brings to an end the closely watched case that brought to the forefront a First Amendment debate over the limits of free speech online.

It's a frustrating end for McKee, 51, who said he's spent at least $50,000 in legal fees and another $11,000 to clear his name online after the story went viral, resulting in hundreds more negative postings about him -- likely from people who never met him. He hasn't ruled out a second lawsuit stemming from those posts.

"The financial costs are significant, but money is money and five years from now I won't notice the money I spent on this," he said. "It's been the harm to my reputation through the repeated publicity and the stress."

He said he offered to settle the case at no cost after the Supreme Court hearing. Laurion contends they couldn't agree on the terms of the settlement, and said he not only deleted his initial postings after he was initially served, but had nothing to do with subsequent online statements about McKee.

Opinion vs. reputation

The lawsuit followed the hospitalization of Laurion's father, Kenneth, for a hemorrhagic stroke at St. Luke's Hospital in Duluth. Laurion, his mother and his wife were also in the room when McKee examined the father and made the statements that Laurion interpreted as rude.

After his father was discharged, he wrote the reviews and sent the letters.

On at least two sites, Laurion wrote that McKee said that "44 percent of hemorrhagic strokes die within 30 days. I guess this is the better option," and that "It doesn't matter that the patient's gown did not cover his backside."

Laurion also wrote: "When I mentioned Dr. McKee's name to a friend who is a nurse, she said, 'Dr. McKee is a real tool!'"

McKee sued after he learned of the postings from another patient. A St. Louis County judge dismissed the lawsuit, saying Laurion's statements were either protected opinion, substantially true or too vague to convey a defamatory meaning. The Appeals Court reversed that ruling regarding six of Laurion's statements, reasoning that they were factual assertions and not opinions, that they harmed McKee's reputation and that they could be proven as false.

The Supreme Court disagreed. Writing the opinion, Justice Alan Page noted that McKee acknowledged that the gist of some of the statements were true, even if they were misinterpreted.

Page added that the "tool" statements also didn't pass the test of defaming McKee's character. He dismissed an argument by McKee's attorney, Marshall Tanick, that the "tool" comment was fabricated by Laurion and that the nurse never existed.

Whether it was fabricated or not was irrelevant, the court ruled.

"Referring to someone as 'a real tool' falls into the category of pure opinion because the term 'real tool' cannot be reasonably interpreted as stating a fact and it cannot be proven true or false," Page wrote.

The entire story is here.

The Ratings Game

Online physician-review sites pose legal challenges

By Andis Robeznieks
ModernHealthCare.com
Originally Posted: November 10, 2012

People who sue people may receive more undesired attention than anyone else in the world.

That is the general idea behind the “Streisand Effect,” a phenomenon that occurs when an attempt to stifle publicity creates more publicity for something that might never have received much attention in the first place.

According to legend, the term was coined when singer Barbra Streisand tried to have a photo of her home—one among thousands of pictures that were part of an online display showing coastline erosion in California—deleted from that site. The ensuing publicity essentially guaranteed the image will never disappear from the Internet.

It could be unlikely that combative efforts to counter negative profiles on physician review websites will lead to a similar occurrence known as a the “Dr. McKee Effect,” but no one can predict how these things turn out.

Dr. David McKee, a neurologist from Duluth, Minn., is suing a patient's family member for defamation after the man posted negative reviews of him online. The case was argued in September before the Minnesota Supreme Court and, while its legal precedent-setting impact might not extend beyond the state's boundaries, attorneys for both sides say it could serve as a guide in future legal proceedings—wherever the jurisdiction may be.

The entire article is here.

New Orleans psychologist sues over negative Angie's List comments

By Michelle Keahey
The Lousiana Record
Originally published May 28, 2012

A New Orleans psychologist has filed a lawsuit against a Florida doctor for negative comments posted on the website Angie's List.


John C. Courtney, Psy D., MP filed the lawsuit against Dr. Bartholomew Vereb and Angie's List Inc. on March 9 in federal court in New Orleans.
 
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Angie's List is accused of negligence for failing to follow its own procedures that would have prevented Courtney's damages, for breaching its duty to Courtney, and for acting with reckless disregard for the truth.

The entire story is here.

Thanks to Ken Pope for this information.

Plastic surgeon suing 10 patients for posting anonymous complaints online

The Palm Beach News

WFTV.com
Originally published May 23, 2012

An Orlando plastic surgeon has posted his explanation on the Internet as to why he's suing several of his patients.

WFTV learned Dr. Armando Soto is suing 10 patients who he said anonymously posted comments online about their bad experiences inside his office in the Dr. Phillip’s neighborhood.

The entire story is here.

Thanks to Ken Pope for the above link.

Dr. Soto's blog is here.

Here is a portion of his blog post.

"In sum, a previously unhappy patient is now on the road to a better outcome, with restoration of a healthier doctor/patient relationship. To us, that’s a great outcome."

Clinical Challenges in the Internet Era

By Glen O. Gabbard, M.D.
American Journal of Psychiatry

Here's a central passage from the initial case presentation:

[begin excerpt]

Much to the treatment team's surprise, within a week of Mr. R's first outpatient appointment, Mrs. R had begun posting disparaging comments on various web sites about the quality of her son's care, specifically naming the treating resident.

The comments described the treating resident as well as other members of the treatment team in derogatory terms. 

In addition, Mrs. R made comments that were vehemently antipsychiatry, including a statement that psychiatrists collude with pharmaceutical companies to generate profit rather than treat illness.

She posted multiple comments in the days following certain clinic visits; the comments could be found easily by anyone who did a Google search using the treating resident's name.

The comments initially appeared on both a personal blog and a highly popular web site, later cropping up also on web sites that serve as general forums for consumer dissatisfaction and on news outlets as user-generated content.

(cut) 

Two main concerns arose from the ensuing dialogue. Foremost was the potential for the mother's online comments to undermine Mr. R's care. For example, awareness of his mother's comments could exacerbate Mr. R's paranoia, leading to a disruption in his trusting relationship with the resident and a possible interference with his adherence to treatment. Moreover, the tone of the mother's comments suggested a fundamental disagreement with the treatment team's approach to her son's care, one that could potentially lead to an impasse. In the absence of a satisfactory working relationship with Mr. R's mother, the team would need to consider discharging him with a referral to another provider. Were they to do so, however, apart from feeling disappointed at not being able to continue providing Mr. R's care, the team would risk appearing either to be punishing him for his mother's actions or abandoning him for no clear reason. Either interpretation might fuel the paranoid perceptions he had regarding mental health care providers.

The second concern was that the mother's comments could damage the reputation of the treating resident. The resident initially did not think to be worried about his reputation, since he felt confident that he was well regarded by those who knew him and had observed his work with patients. Once this concern was raised, however, the resident thought of the potential impact the mother's public comments might have if he sought employment or further training outside his current institution. Given the fact that there is only limited public commentary concerning residents, a few negative Internet postings might adversely affect the opinions of potential patients, peers, or employers. Hence, the situation presented a quandary regarding how to respond to the comments posted online by Mr. R's mother while trying to avoid both potential harm to the patient and potential harm to the resident.

 (cut)

 Discussion: 

When I was asked to consult on this case, I felt a good deal of empathy for the resident.

Here he was, delivering good psychiatric care to a young man with severe illness, but receiving criticism rather than appreciation from the family. 

I recognized that there is now a public exposure inherent in psychiatric practice that can be daunting even to experienced clinicians but may be especially painful to vulnerable residents who are striving to become competent psychiatrists. 

[end excerpt]

Here's how the article ends:  

What can we do as a profession in the face of these challenges? The proliferation of Facebook, Internet forums, Twitter, blogs, and chat rooms is a juggernaut that cannot be stopped. We must live with these new intrusions into our professional lives and develop creative solutions. Institutions can develop policies so that ad hoc groups do not have to be assembled whenever delicate situations with potential liability arise.

Psychiatrists and other mental health professionals can do periodic Internet searches of themselves to keep abreast of any personal or professional information about them that may have implications for their reputation. In some cases, web site administrators may be contacted who will remove what is posted. Those who use social networking sites like Facebook should probably use all available privacy settings so that personal information about them is not available to the public.

The education of psychiatric residents and other mental health professionals should include discussions of common challenges that occur in the Internet era so that clinicians have some preparation for dealing with them when they emerge. Finally, guidelines regarding how to continue the treatment and how to respond to the attacks should be developed. Academic psychiatry has a long tradition of establishing protocols to deal constructively with difficult events in the trainee's life, such as patient suicide or assault. Similar forms of support and assistance can be brought to bear to assist with challenges stemming from the Internet."

 Thanks to Ken Pope for this information.

 The entire article is here.

Membership is needed to acces this information.

Gabbard GO. Clinical challenges in the internet era. Am J Psychiatry. 2012

May;169(5):460-3. PubMed PMID: 22549206.

Company withdraws contracts controlling online comments by patients

The move comes after a complaint alleged that Medical Justice's business practices are unethical.

By ALICIA GALLEGOS, amednews staff. Posted Jan. 2, 2012.

Medical Justice Inc. is retiring its "vaccine against libel," a set of contracts providing authority to doctors over online comments posted by patients.

The contracts' demise follows a complaint made to the Federal Trade Commission alleging that Medical Justice is engaging in unethical business practices. A dentist is being sued for using one of the agreements.

The complaint and the lawsuit were filed on Nov. 29, 2011.

A day later, Medical Justice announced it will end its use of the contracts, said neurosurgeon Jeff Segal, MD, CEO and founder of Medical Justice. The company has informed its 3,000 physician and dentist members that the contracts are retired. Medical Justice recommends that doctors use its latest online tool -- the eMerit system -- to combat false posts and protect their reputations. But Dr. Segal said members are "free to do what they want to do," which includes continuing to use the contracts if they see fit. He said the company has not suggested that doctors call their patients to inform them of the contracts' retirement.

The entire story can be read here.

5 ways to manage your online reputation

By Pamela Lewis Dolan amednews staff. Posted Sept. 12, 2011

Even if some physicians themselves are not online, their names, comments on their style of practice, and complaints or compliments about them probably are.

All of the online content devoted to a particular physician could negatively impact his or her reputation, and subsequently his or her business, if steps aren't taken to manage that content and -- when necessary -- defend it. This is often referred to as online reputation management.

Online reputation management has become big business, as evidenced by the number of radio and online ads offering to help physicians. But physicians can manage their own reputations, help build positive ones, and prevent negative content from turning into a crisis that needs to be dealt with professionally.

As quickly as online content can spread, especially in the age of social media, experts say online reputation management should be a key component to any business plan.

"The best defense in these cases is good offense," said Scott Sobel, president of Media and Communications Strategy, a Washington-based public relations firm specializing in crisis management.

Christian Olsen, vice president of Levick Strategic Communication's digital and social media practice, said social media has changed the dynamics of reputation management, because in addition to physicians communicating with their patients, their patients are now communicating with one another on social media websites.

For most physicians, there are five simple steps they can take to manage and maintain a good reputation online. For others, managing their online reputations may require more time and expertise than they have available.

One: Google yourself

Olsen said many make the mistake of thinking that because they don't have a website or are not involved in social media they are not online. "It just means your voice is not being heard in a conversation about you," he said.

The first step in managing a reputation is knowing what there is to manage. Reputation management experts recommend that physicians conduct Google searches on themselves at least once a month, preferably more often. Things can spread quickly online, so seeing what content is there on a regular basis will help doctors stay ahead of a potential crisis. It's also a good way to see what positive things are being said about you, which you may be able to build on.

Steven Wyer, managing director of Reputation Advocate Inc. and author of the book Violated Online, said physicians should set up alerts on Google and Yahoo. These alerts work by registering keywords, such as a name, that the search engines will use to comb the Internet looking for any new mention of those keywords on blogs, websites, online forums and other sites. When it finds a new mention, it will send an email detailing where the keywords were mentioned, what was said and a link to the website.

The mistake many physicians make, however, is to not include all reasonable variations of their name in an alert, Wyer said. For example, John Smith, MD, could have several variations, including Dr. John Smith, Dr. John C. Smith, Dr. John Smith, MD, etc. Alerts for a handful of those variations should be set up.

Two: Correct mistakes and false information

The easiest places to start are websites that show up high in Google searches. Those sites are likely to be physician finder or rating sites or health plan physician finders. The sites often include wrong or outdated contact information and incomplete biographical and educational history.

The entire story can be found here.