The problem with patient reviews


Peter McDonnell
Online reviews

Online reviews can make or break a physician 

The problem with democracy-with patient satisfaction surveys and opinion polls-is that if you give people the chance to express their opinions or to register their complaints, they will invariably do so.

My favorite quote that speaks to this issue is that of Richard “Dick” Tuck, the American political consultant and political prankster for the Democratic National Committee in the 1960s and 1970s. When Tuck ran for the California State Senate in 1966 and lost, he famously began his concession speech with the words: “The people have spoken, the bastards.”

Nowadays, thanks to social media, people can share their views about anything with everyone. Sometimes the comments are thoughtful and honest, and the author identifies him or herself. And other times the comments might be mean and vindictive, with the complainant not revealing his or her identity.

Previously by Dr. McDonnell: Ars longa, vita brevis 

The First Amendment assures us Americans of freedom of speech, but there have been some limitations placed on that should the speech put others in immediate physical jeopardy (e.g., yelling fire in a crowded theater) or should that speech be considered “commercial speech.”

What does a doctor do if he or she believes an anonymous reviewer criticizes the doctor unfairly or untruthfully?

An alert Ophthalmology Times reader recently brought to my attention was the interesting case of a physician who feels he has been maligned by online reviews of his practice.

According to the article in MedPage Today, Muhammad Mirza, MD, practices in the New York area with a focus on Botox injections and sexual health services. Dr. Mirza has sued in federal court in Manhattan, asking the court to block four reviewers who have left one-star (bad) reviews on Yelp from leaving further reviews of his practice and is also seeking $1 million in damages.

The reviewers say very negative things, claiming that the doctor “waters down the Botox,” delivers less product than the customer paid for, or delivers poor outcomes-“my face looks worse than before.” The doctor’s complaint says the reviews are “knowingly and materially false.” 

Related: Top 4 reasons you need to read your online reviews 

Dr. Mirza says unregulated and anonymous speech on social media does not serve the interests of society. “These platforms need to be regulated in the same way we regulate other industries. Reviewers can’t just hide behind the screen.”

According to the article, Dr. Mirza has previously sued negative reviewers and prevailed in court. Earlier this year, two reviewers were prohibited from posting online comments and had to remove their posts about his practice.

Eighteen months ago, he sued Yelp in order to obtain the identities of the reviewers he is currently suing. The article points out that a federal court in Virginia ruled in 2014 that “anonymous users are not protected by the First Amendment if the review is based on false statements.”

Related: Blue-state blues 

How will it play out?
It will be interesting to see how cases like this play out in court. Complaining about doctor visits is a time-honored tradition in our country (“Why are magazines in the waiting room so old?”), but what is the obligation of someone complaining online to be truthful and accurate about their doctor?

For most physicians, suing patients is simply something we don’t do. Rather, people sue us. Will that change if physicians feel that they are the victims of untrue and malicious critiques by anonymous posters?

Comedian Dave Chappelle recently spoke to the issue of free speech and the anger it sometimes causes: “The First Amendment is first for a reason. Second Amendment is just in case the first one doesn’t work out.” 

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