Protecting a Plastic Surgeonʼs Reputation

Sir:FigureWith the increased use of social media for selecting physicians, the importance of online physician reviews for both private and academic practices cannot be overstated.1 Here, we present our recent experience with a defamatory online review (Appendix) from a disgruntled former patient. A scathing review, posted on five different physician review Web sites, was brought to our attention by many patients and included phrases such as “He is a Hack,” “Tried to revise it … but he made it worse,” and “Beware Stay Away.” Host Web sites were contacted, but to no avail. One of the posts was associated with a nondescript two-word user ID. Using this ID and persistent Internet detective work, a tremendous amount of detailed personal information about the anonymous poster was amassed, including male-to-female transition start date. Finally, a year later, the poster's e-mail address was discovered, which led to discovery of the poster's name and residential address. The person who posted had been a patient 4 years previously and had good surgical results and postoperative photographs contradictory to online claims. After a letter threatening legal action was mailed to him, he quickly removed the reviews and sent an apology letter. Based on successfully obtaining both the identity of the libelous reviewer and the removal of the defamatory online reviews, we recommend the following: Monitor. Routinely monitor your online reputation (Table 1). Report. Report abuse through the hosting Web site's established procedure (often unsuccessful). Crosscheck. Crosscheck your patient database according to the details of the scathing post and review former problematic patients. Investigate. Maximize search results by using all available search engines and social media sites. Search within a specific site by placing site: between Google search query and the Web site of interest. Purchase. Purchase information-finding services, such as reverse e-mail finders. Reputation protection companies were not used, but such companies may provide another avenue of support. Contact the reviewer. If the reviewer is identified, hire an attorney to send a letter threatening litigation unless dishonest posts are removed. File a lawsuit. If the reviewer will not remove his or her postings, or if the reviewer cannot be identified, file a lawsuit, which will enable a subpoena to be issued to the Internet service provider hosting the Web site. A subpoena will require the Internet service provider to reveal all identifying information regarding the reviewer or the Internet protocol address of the post for anonymous reviews.2 Dilution. In the meantime, encourage your happiest patients to review you online to dilute the malicious, defamatory comment. Table 1: Physician-Rating Web SitesThe prevalence of Web sites that permit anonymous physician reviews is particularly troubling for surgeons seeking to protect their good reputations. A formal assessment of 33 physician-rating Web sites found only 61 percent that required an e-mail address to post a review (data collected, spring 2009).3 Online ratings are a permanent and rapidly growing fixture of health care.4 In one study, 91 percent of surgeons had online numerical ratings and 64 percent had online comments.5 We hope our recommendations will assist those who fall victim to dishonest reviews in the future. Melissa A. Mueller, B.A. Vanderbilt University School of Medicine, Nashville, Tenn. Tim S. Glassett, J.D., M.B.A. Plasticos Foundation, Huntington Beach, Calif. Sean M. Burke, J.D., M.B.A. Law Offices of Sean M. Burke, Irvine, Calif. Larry S. Nichter, M.D., M.S. Pacific Center for Plastic Surgery, University of California Irvine, University of Southern California, Irvine, and, Plasticos Foundation, Huntington Beach, Calif. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article.