Answer: Please See the Following Article from the Dallas County Medical Society on This Subject

Question: Is it appropriate for a physician to respond to a negative rating/posting that a patient may have posted on an online physician review Web site or Blog?

Answer: Please see the following article from the Dallas County Medical Society on this subject.

The February Business of Medicine column focused on the somewhat alarming trends in healthcare technology. Toward the end of the article, I touched on online consumer communities and technology’s role in medicine from a patient standpoint. In this issue, I will explore this topic a little more, specifically the physician rating tools.

Reviews are everywhere today and accessing this information is easier than ever. This especially is true in service industries. For example, I can search for barbeque restaurants based on my GPS location. I can then sort those restaurants by distance then further by review ratings all in less than three clicks of my mouse. One more click and I can read countless reviews from my peers as well as professional critics. This is not a new practice and it is very easily adapted in any other consumer-driven industry. It was only a matter of time before these practices were applied in the healthcare industry.

Health plans, for a long time, have been giving members directories and providing online physician finder tools. These helped consumers find physicians, but limited search criteria to location. Health plans then began publishing quality reports (mostly in the form of colored ribbons or stars next to the physician’s information in the directory) which were meant to offer a sort of “review” for members to consider, but they were not very descriptive. Consumers want to see explanations for quality reporting; and because that wasn’t given to them, consumers began to create their own tool, the physician rating website.

Word of mouth and general reputation in the community always have played an important role in how patients choose physicians. In this day and age the internet is an extension of the network of relationships that patients always have used to gather information on physicians. The physician rating website gives patients a place to express their opinions about medical practices.

Online physician review sites have been in existence for quite a few years now and are not necessarily a new tool for patients. However, as our industry develops, they seem to play a larger role in the marketplace. The key words here are “consumer driven.” Until rather recently, patients, as a whole, have not taken a very active approach to care. Now, with the growing popularity of consumer-driven health plans, a larger emphasis on preventive care, and a heightened sense of awareness of the benefits of wellness programs, patients are making more decisions based on the wealth of information becoming available. We are seeing the consumers really start to drive the market (on a small scale).

Just like I look for restaurants with good reviews, patients are looking for physicians the same way, and the information available on physician rating sites is put into a perspective to which they can relate. For example, some patients put a much larger emphasis on how much the physician seems to care than they do on how long they have to wait. Others will look for the physicians who are quick; the process of going to the doctor needs to be efficient for these patients. Consumers are looking at the experiences of others to help make their decisions.

Unlike other industries, though, there are some significant caveats. In any other industry, complaints can be specifically rebutted. However, privacy laws in health care will not allow physicians to defend themselves in the same manner. The fact that even a patient’s identity is protected information directly hinders the physician’s ability to refute a complaint. Simply acknowledging publicly that the complaining party is a patient likely breaches confidentiality and violates HIPAA laws. A physician cannot comment on a specific complaint about service made publicly by a patient without first acknowledging that the complaining party was a patient.

If you feel strongly that something should be said about a complaint, and I cannot recommend doing so, absolutely make sure to follow a few steps. Begin by stating that you can neither confirm nor deny that this person is or has been your patient. Speak only in generalities about what your practice offers and the goals you set for serving patients. Addressing the specific issues of a complaint in your response risks an accusation that you have made an inadvertent disclosure of confidential information. Simply state what kind of service patients should expect to receive from the medical practice.

This does seem unfair, but there are other remedies available. Legally, a physician can take action against someone if the complaint is false or elements of the complaint are untrue. This would be considered libelous and the physician can seek compensation for damages. This, however, can be costly and of no financial benefit to the physician. The second remedy involves the status of the patient. The relationship between a physician and a patient is based on trust; a patient who posts public complaints is communicating to everyone reading the complaint that he or she does not trust the physician. The physician should evaluate the patient-physician relationship and determine if the level of trust is enough to promote the highest quality of care or whether the physician can approach the care of the patient with the necessary dedication knowing that any misunderstanding may be posted publicly.

As healthcare embraces technology, physicians will be presented with numerous hurdles that often are slow to be addressed. DCMS will stay on top of these trends and keep you informed on their potential implications on how you practice medicine.

The author is not an attorney and the above article in no way constitutes legal advice. If you have questions about the legal aspects of physician rating tools, please contact an attorney.

NOTICE: This information is provided as a commentary on legal issues and is not intended to provide advice on any specific legal matter. This information should NOT be considered legal advice and receipt of it does not create an attorney-client relationship. The Texas Medical Association provides this information with the express understanding that 1) no attorney-client relationship exists, 2) neither TMA nor its attorneys or employees are engaged in providing legal advice and 3) that the information is of a general character. Although TMA has attempted to present materials that are accurate and useful, some material may be outdated and TMA shall not be liable to anyone for any inaccuracy, error or omission, regardless of cause, or for any resulting damages. Any legal forms are only provided for the use of physicians in consultation with their attorneys. You should not rely on this information when dealing with personal legal matters; rather legal advice from retained legal counsel should be sought.