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Online Patient Reviews: 6 Strategies For Doctors

Healthcare practices can't control what patients write, but they can control how they respond to increasingly popular review sites like Yelp and RateMDs.

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Patients are starting to diagnose their doctors via online review sites, so it's important for healthcare practices to maintain their digital reputations. 

After all, a one-star drop in a rating can reduce a business's revenue by almost 10%, a Harvard Business School study has found. 

Twenty-three percent of those surveyed for the Journal of the American Medical Association use rating sites such as Healthgrades, Vitals, RateMDs, and ZocDoc. Of those, about one third either chose -- or shunned -- a physician because of these online ratings, the survey of 2,137 adults discovered. Since the poll was taken in September 2012, it's probably safe to assume the number of those using and relying on web reviews has only grown: In 2010, more than 112,000 individual doctors were reviewed, compared with 2,475 in 2005, according to RateMDs.

In addition, 19% considered a doctor's ratings "very important," versus 46% who deemed a physician's experience to be very important, the survey found. The majority (89%) said the office's acceptance of their insurance was very important.

[Are doctors too busy to fill out electronic health records? Read Do Doctors Need EHR 'Scribes'?]

These statistics indicate consumers are far less likely to visit a doctor-rating site than one that ranks hotels, restaurants, or movies. Yet the inclusion of practitioners on sites like Yelp, as well as medical-only sites, is likely to encourage an increasingly aware public to post opinions, often anonymously, about doctors.

Like other public-facing businesses, doctors will have to address angry comments, fake reviews, and other downsides of the digital age. Unlike many other industries, however, healthcare providers are constrained by HIPAA regulations. Fortunately, they do have some options available that allow them to leverage or control online reviews.

1. Ask for raves. When one patient writes a negative review, some offices ask favorite patients to combat that post with their own thoughts on the doctor's services, waiting room times, and courtesy. Because scores typically are based on averages, satisfied patients' reviews will balance out the lone malcontent.

2. Contact the complainer. If a patient posted negative feedback after a visit, contact him to see if the office can do anything to improve the situation. Many review sites allow a service provider to privately message a reviewer without revealing the identity of the person who complained. If the person doesn't respond or is unreachable, accept fault, apologize, or explain. An unusually long wait could have been because the doctor was called to the emergency room for a critical patient or for an early delivery, for example. 

3. Gag orders. Some practices have tried to contractually prevent patients from posting online comments or give doctors the right to veto any comments patients publish online. Turning to service providers like Medical Justice, they can take patients to court if consumers breach these contracts. Some review sites, such as Yelp, are ignoring these agreements, arguing they go against individuals' right to free speech. 

4. Reputation management. Several businesses specialize in providing reputation management services to healthcare organizations. Others, such as WebiMax, Brand.com, and Reputation Management LLC, generalize across markets. Reputation management firms monitor online posts; help build a brand; provide search engine management; deliver content management; and have online self-service tools for staff. Most of these services help medical providers repair bad online reputations caused by name confusion, ancient posts, or other problems. In addition to responding to malcontents, they improve practices' rankings, ratings, and standings across a slew of online sites.

5. Fake posts. Some reviews and comments are not the work of dissatisfied patients. They are fictional work by disgruntled ex- (or current) employees, competitors, or others with an agenda. In these cases, the best approach might be to hire an outside expert to find the source of the lie, then sue in court.

6. Learn and move on. If criticism was warranted -- many complaints are about wait times, brusque bedside manners, or rude office staff -- use what patients say to improve the practice. Consider new tools to cut waiting times. Brush up on office etiquette or go to bed a little earlier. Next time, patients might be pleasantly surprised at the improvements.

Medical data breaches seem to show up on the 6 o'clock news almost every week. If you think it won't happen to you -- or the financial impact will be minor -- think again. Download the Healthcare Data Breaches Cost More Than You Think report today. (Free registration required.)

Alison Diana has written about technology and business for more than 20 years. She was editor, contributors, at Internet Evolution; editor-in-chief of 21st Century IT; and managing editor, sections, at CRN. She has also written for eWeek, Baseline Magazine, Redmond Channel ... View Full Bio

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PeterH649
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PeterH649,
User Rank: Apprentice
8/6/2014 | 5:05:37 AM
Defamation lawyers use the same script - and get similar feedback?
 

McKee's lawyer, Marshall Tanick of Hellmuth Johnson, told the Associated Press that he and McKee plan no further appeals and that they were disappointed with the ruling. "We feel it gives individuals undue license to make disparaging and derogatory statements about these people, particularly doctors and other licensed professionals, on the Internet without much recourse," Tanick said.  Marshall Tanick of Hellmuth Johnson told the Star Tribune that the ruling could present a slippery slope. "This decision gives individuals a license to make derogatory and disparaging statements about doctors, professionals and really anyone for that matter on the Internet without much recourse," he said.

 

In reply to an e-patients.net article "Minnesota Supreme Court sides with patient on social media defamation suit," Attorney Marilyn Mann said, "I think McKee's lawyer is incorrect. The case turned on standard principles of defamation law and doesn't really break new ground."

 

According to the Duluth News Tribune, Minnesota Newspaper Association attorney Mark Anfinson, who watched the oral arguments before the Supreme Court in September, said that the justices made the right decision. Anfinson also told the News Tribune, "What this case really exemplifies is not so much legal precepts in libel law, but the impact of the Internet on the ability to publish unflattering comments about people."

 

Anfinson was also interviewed by Minnesota Lawyer. He said, "Anyone who knew about the case, who observed the oral arguments, and who knows something about libel law is about as unsurprised with this result as they can be. It's about as perfunctory and routine as the Supreme Court ever gets. It was a completely straightforward application of long-settled libel-law rules."

 

Anfinson said the case is more significant for social commentary purposes than for its legal analysis, noting that perhaps the justices only accepted the case to fix an error of the Court of Appeals.

 

Jane Kirtley, a professor of media ethics and law at the University of Minnesota School of Journalism, told the Star Tribune that the ruling stems from "an elementary principle of libel law." She said that this isn't a blank check for people to make false factual statements. She said, rather, that it's "an endorsement that statements of opinion are protected under the First Amendment."
HerbRice
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HerbRice,
User Rank: Strategist
8/2/2014 | 3:23:06 AM
Defamation lawyers use the same script?
 

Professor Sally Vogl-Bauer's lawyer, Timothy [[ Edwards released a
statement: "Students have a right to express their opinion, but when you go so
far beyond that, into a concerted effort to attack somebody's reputation
because things didn't go your way, that's much different." ]]

 

[[ "When you make false statements of fact repeatedly about another
person with the intent of harming them, that's over the line," said Tim
Edwards, attorney for UW-Whitewater communications professor Sally
Vogl-Bauer. "If you truthfully say, 'In my experience, this isn't a good teacher,
I didn't have a good experience, she was late' and that's your opinion,
that's fair," Edwards said. ]]

 

Timothy Edwards comments about Ms. Sally Vogl-Bauer's intentions to welcome
criticism but sue defamation cause me to think he's as programmed and tendentious as the plaintiff's lawyer during David McKee MD V. Dennis Laurion, Minnesota Supreme Court Case A11-1154, 2010 - 2013.



A Duluth News Tribune article of June 2010 quoted Marshall Tanick, now employed by Hellmuth Johnson law firm, who in a phone interview alleged that Laurion defamed his client in several ways, including posting negative reviews of McKee on various websites. "The basis for the lawsuit is the defamatory statements that were made on websites and to other sources," Tanick said. "However, by no means does Dr. McKee want to in any way prevent or affect any kind of communications that may be made to the Board of Medical Practice or any other regulatory agencies. The purpose of the lawsuit is to prevent defamation being made on the websites and through other sources."

 

From BuzzFeed, 2014: But McKee's lawyer, Marshall Tanick, of Hellmuth & Johnson, says no matter where it was said, defamation is defamation. "The thing that's often misunderstood is that this was not just about free speech, but about making actual false statements," Tanick says. "The problem is today's unfettered opportunity to express opinion, whether or not the substance of what's said is true or not. We need some boundaries."


Taken from videotaped comments to Minnesota Supreme Court: "He may have been upset at how Dr. McKee treated his father. Apparently he was, and he's entitled to say that. He can say that "I'm upset. Doctor McKee did not treat my father well. He was insensitive." He can make statements like that: "He didn't spend enough time in my opinion." He can make factual (sic) statements, he can make them on the Internet, he can make them in letters, he can write a letter to the editor, he can stand in front of St. Luke's Hospital with a placard saying those things if they are opinions . . ."

All comments sound like a primer for plaintiff remarks in Sally Vogl-Bauer v. Anthony Llewellyn, in my opinion.

 

Defamation Plaintiff 


Defamation Plaintiff

 

Defamation Plaintiff's Lawyer

Defamation Plaintiff's Lawyer
HerbRice
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HerbRice,
User Rank: Strategist
7/21/2014 | 2:45:46 AM
Re: “From now until the end of time, I’ll be the jerk neurologist who was rude to a World War II veteran,”
 

[[ QUOTE ]] McKee sued Laurion for defamation. A local Duluth newspaper picked up on the story, favoring Laurion's interpretation of events. McKee claims the writer called him shortly before close of business Friday to solicit a quote; the story ran the following day. "The article was written like I was being reviewed for misconduct," McKee says. In fact, no action had been taken against him by any of the organizations Laurion had written to. [[ /QUOTE ]]

Patient's son complains; Duluth doctor sues

Duluth News Tribune, Saturday, June, 12, 2010

A Duluth physician is suing the son of a former patient for publicly criticizing his bedside manner. Dr. David McKee, a neurologist with Northland Neurology and Myology, filed the lawsuit, which was made public Friday, in St. Louis County District Court. McKee alleges that Dennis Laurion of Duluth defamed him and interfered with his business by making false statements to various third parties, including the American Academy of Neurology, the American Neurological Association, two physicians in Duluth, the St. Louis County Public Health and Human Services Advisory Committee and St. Luke hospital, among others.

Laurion claims that any statements he made about the doctor were true and that he is immune from any liability to the plaintiff. He referred questions to his Duluth attorney, John Kelly.

McKee is asking for more than $50,000 in damages. The doctor was paged Friday but did not return a call seeking comment. He is being represented by Minneapolis attorney Marshall Tanick, who in a phone interview alleged that Laurion defamed his client in several ways, including posting negative reviews of McKee on various websites. The basis for the lawsuit is the defamatory statements that were made on websites and to other sources, Tanick said. However, by no means does Dr. McKee want to in any way prevent or affect any kind of communications that may be made to the Board of Medical Practice or any other regulatory agencies. The purpose of the lawsuit is to prevent defamation being made on the websites and through other sources.

Kenneth Laurion, 85, a Navy combat medic in the Solomon Islands during World War II, suffered a hemorrhagic stroke and spent four days at St. Luke hospital from April 17-21. He recovered from his condition.

McKee also alleges that the defendant made false statements about him to others including: McKee seemed upset' that Kenneth Laurion had been transferred from the Intensive Care Unit to a ward room. McKee told the Laurions that he had to spend time finding out if [the patient] had been transferred or died. McKee told the Laurions that 44 percent of hemorrhagic stroke victims die within 30 days. McKee told the patient that he did not need therapy. McKee said that it didn't matter that the patient gown was hanging from his neck with his backside exposed. McKee blamed the patient for the loss of his time. McKee didn't treat his patient with dignity.

Defense attorney Kelly said it was a tense and emotional situation for the Laurion family. They were worried about Dad and the doctor comes along and, from their point of view, of what they saw and what they heard, they felt that the doctor didn't act appropriately toward the father, Kelly said. So, among other things, they saw fit to report it to the hospital and to the Board of Medical Practice, which they have every right to do under the patient Bill of Rights, and they get sued.

Kelly said his client did post ratings of McKee on some websites but said he asked to have them removed, and they were. The defense attorney thinks that the lawsuit is without merit. "I think it is an unfortunate incident of someone attempting to punish a person who has spoken out of concern for a family member," Kelly said.

According to the Minnesota Board of Medical Practice website, McKee has had no disciplinary action brought against him.
anon2241971485
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anon2241971485,
User Rank: Apprentice
7/9/2014 | 3:24:40 AM
Follow the court case of Professor Streisand
To follow the court progress or for information about the plaintiff and defendant - Sally Vogl-Bauer V. Anthony Llewellyn, not David McKee MD V. Dennis Laurion -

 

1. Visit http://wcca.wicourts.gov/index.xsl .

2. Click "I agree" .

3. You'll be taken to http://wcca.wicourts.gov/simpleCaseSearch.xsl;jsessionid=640964EA587D052C62E1CAF493A883FA.render6 .

4. Name = Llewellyn .

5. County = Walworth .

6. Case Number = 2013CV001140 .
Alison_Diana
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Alison_Diana,
User Rank: Author
5/27/2014 | 9:38:57 AM
Re: Paging Professor Streisand
Stifling someone's right to free speech and to sharing their opinion via a common media is frightening because of the infamous slippery slope it creates. On the other hand, you can certainly see how a professor would be upset by one student ripping apart her classroom performance, abilities, and grading. Many professionals across specialties have one dissatisfied client/student/customer, but the squeaky wheel tends to get the oil -- and attention.

If I was that professor, I'd take some of the steps outlined in the story I wrote -- after consulting with my attorney, since this has escalated: For one thing, facts fight one person's opinion, so I'd share the percentage of students who got As, Bs, etc., and the (if small!) percentage of students who failed. The professor should be prepared to share all her interactions with this student, particularly those related to his grades, attendance, and prior discussions about the possibility he would fail. She might also want to encourage current and former students to post their own comments and videos on this ex-student's comments to demonstrate how much others like her classes. 

Individuals and organizations must learn how to combat bad reviews. They are going to appear and I'd suggest professionals document their processes so they are well-armed to combat any disparaging online remarks they believe are unfair. 
anon5076539934
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anon5076539934,
User Rank: Apprentice
5/26/2014 | 6:27:25 AM
Paging Professor Streisand
 

WHITEWATER, Wis. (AP) — A University of Wisconsin-Whitewater professor is suing a former graduate student who posted online comments and videos that the teacher considers defamatory.

 

Anthony Llewellyn took a class last year from communications professor Sally Vogl-Bauer, but the experience didn't go well, the Janesville Gazette reported (http://bit.ly/1hcjNmn ) Thursday.

 

Llewellyn posted comments on professor-rating sites accusing the teacher of criticizing his academic abilities, grading him unfairly and causing him to fail out of school. He said he spoke with her in April about his concerns, two months before he was told he had failed her class.

 

Vogl-Bauer contends the comments amount to defamation, while Llewellyn says his goal was simply to inform the public about how the professor treated him.

 

Tim Edwards, the attorney representing Vogl-Bauer, said the comments could be especially damaging to someone in a small professional community. He said he and Vogl-Bauer agree that students should be allowed to express their opinions, "but when you go so far beyond that, into a concerted effort to attack somebody's reputation because things didn't go your way, that's much different."

Edwards and Vogl-Bauer asked Llewellyn to take down his online comments and videos. They filed the lawsuit after he refused.

 

Llewellyn said it's important for the videos and comments to stay online so the public can remain informed.

 

"I don't feel I've (gone) too far with my videos and comments because everything posted basically communicates exactly how Sally Vogl-Bauer treated me," Llewellyn said.

 

The lawsuit seeks punitive damages and attorney and trial fees. The case is scheduled to go a jury trial in September.

 

It's not clear how successful the lawsuit will be, but a similar case in Minnesota ended with a ruling in favor of the person who posted the online rating. In the case (David McKee MD vs Dennis Laurion), a doctor took offense when a patient's son went on a rate-your-doctor website and called him "a real tool," slang for stupid or foolish. The Minnesota Supreme Court ruled in January 2013 that the comment wasn't defamatory because it was an opinion protected by free-speech rights.

___

Information from: The Janesville Gazette, http://www.gazetteextra.com
Alison_Diana
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Alison_Diana,
User Rank: Author
5/22/2014 | 11:29:19 AM
Re: “From now until the end of time, I’ll be the jerk neurologist who was rude to a World War II veteran,”
Complaints about bedside manner are legitimate and patients should definitely take them into account when considering a doctor, if that's important to them. I've looked at those comments when trying to find a new doctor or specialist. In some cases, bedside manner is a minor issue; in others - such as a pediatrician - it's a huge concern. Physicians (like any other service provider) should realize how they deal with clients is part of their offering. If they are brusque, then they need to recognize some people won't want to go to them. 
Alison_Diana
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Alison_Diana,
User Rank: Author
5/22/2014 | 11:18:33 AM
Re: Sceptical Scalpel questions the patient
Wow. I'm surprised some of the freedom of speech groups - ACLU, for example - didn't get involved in this case, given its apparent repurcussions across a broader spectrum than the individuals involved in this particular instance. Review sites are a fact of online life and physicians, hospitals, and other healthcare providers will have to deal with them in a manner other than lawsuits. Hopefully the courts will agree and will stop allowing people to destroy others' livelihoods. Of course, some ratings are totally wrong. They are driven by all sorts of mean-spirited nonsense, and that goes on across all sorts of professions. Typically, the nonsensical bad review gets voted down by people who up vote the provider (be it doctor, painter, or restaurant) based on their genuine respect for the service. 
anon9383186833
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anon9383186833,
User Rank: Apprentice
5/22/2014 | 3:29:16 AM
Sceptical Scalpel questions the patient
"DOC'S DEFAMATION LAWSUIT: THE PATIENT'S SIDE"

PHYSICIANS WEEKLY  BY SKEPTICAL SCALPEL

 

Are you familiar with a case in Minnesota where a doctor sued a patient's son for defamation over a negative review he posted? Dr. David McKee's defamation lawsuit recently came up again because BuzzFeed posted an article entitled "Insult And Injury: How Doctors Are Losing The War Against Trolls." (The Jake Rossen article - http://www.buzzfeed.com/jakerossen/insult-and-injury-inside-the-webs-one-sided-war-on-doctors - would appear here but is deleted because somebody else posted it above.)

 

I tweeted a link to that article, and Dennis Laurion, whose father was the patient in the Minnesota, case wrote to me. (Laurion's reply to Jake Rossen's article would be here, but it was posted above.)

 

Correspondence of Skeptical Scalpel and Dennis K. Laurion:

 

[Scalpel] I very much appreciate your email and the clarification of your situation. I hope you realize that I personally took no side in the dispute you had with Dr. McKee.

 

[Laurion] Thanks, Doctor, for the courtesy of your reply. I do realize that you just tweeted the existence of the article.

 

[Scalpel] Most of the stories about your case tended to sympathize with the doctor and, his defamation suit brought far more attention to him and his behavior than if he had simply let it go. Is the litigation completely over?

 

[Laurion] Yes. For a while, the plaintiff threatened in settlement demands, to sue me for 500+ remarks made on Reddit.com. His "proof" was that most of the remarks came from Duluth, and I live in Duluth; he also lives and works in Duluth. He threatened to subpoena IP numbers and sue every poster, presumably all my relatives and friends, if I didn't settle. I hadn't posted to Reddit, I don't know anybody who did, and nobody ever asked my ISP for my IP number or browsing history.

 

[Scalpel] Did you win the case?

 

[Laurion] I won dismissal from the Minnesota Supreme Court; he won the right to make me spend $56K I didn't have. Minnesota allows "hip pocket lawsuits." The plaintiff served me but didn't file in court. He almost immediately asked my insurance company for a settlement, apology, and confidentiality agreement. This lawsuit was apparently supposed to last 3 weeks and never be filed in court; however, my insurance company doesn't offer me defamation coverage, and I filed my reply through the court, putting the suit into public record and the attention of newspapers.

 

[Scalpel] Do you have any recourse as far as say, counter-suing Dr. McKee?

 

[Laurion] No. In Minnesota, each party is responsible for their own legal fees. Dr. McKee had to reimburse me about $2000 of filing fees and printing costs. I'd have contemplated a suit for abuse of process, but the Appellate Court's decision not to dismiss tended to dilute my complaint.

 

[Scalpel] Are you familiar with strategic lawsuit against public participation lawsuits? If I recall correctly, your case took place in Minnesota which has an anti-SLAPP law.

 

[Laurion] I wanted my lawyer to file a SLAPP motion, but Minnesota SLAPP law only applies to actions that are wholly or in part government petitions. The plaintiff' only charged me for my internet rating site reviews and mention of my letter to the Medicare Ombudsman, the County Health Department, or the Minnesota Board of Medical Review; however, my comments to those sources were quoted in briefs and newspaper comments.

 

Reference: http://www.physiciansweekly.com/docs-defamation-lawsuit-patients-side/

 

Skeptical Scalpel is a retired surgeon and was a surgical department chairman and residency program director for many years. He blogs at SkepticalScalpel.blogspot.com and tweets as @SkepticScalpel.
DennisLaurion
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DennisLaurion,
User Rank: Strategist
5/7/2014 | 3:35:15 AM
Re: “From now until the end of time, I’ll be the jerk neurologist who was rude to a World War II veteran,”
BUZZFEED: "Insult And Injury: How Doctors Are Losing The War Against Trolls"

 

As one of the "trolls" detailed in the article, I have no issue with the accuracy of the text - at least as it pertains to me - but the tone of the title fails to distinguish sincere complaints about bedside manner from attacks on mental stability, attacks on medical prowess, fake websites, allegations of dangerous injections, and use of multiple identities. The author said "McKee and Laurion agree on substance..." 
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