How to Handle Social Media Retaliation

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“Dr Derm” is not only a successful dermatologist but is also social media savvy. He tinkers with his own posts and finds that many patients come to his office because of his quality of care but also his social media presence. In fact, he spends 10% of his annual gross earnings on social media marketing. He often finds himself telling his peers how wonderful this marketing is until one day when he finds out that a disgruntled patient has slandered his reputation on a well-known app. This patient not only accuses him of poor medical practice but has also video recorded his staff drinking cocktails in their staff lounge. The video and comments have been posted on Instagram by the vindictive patient. The post has gone viral and has been seen by thousands. Dr Derm is concerned this malicious act may ruin his career. The wonders of social media have now become a curse to him. What can he do?

Unfortunately, many review sites are as likely to misinform as they are to inform. If a patient complains online that his surgical excision opened only 2 days after dermatologic surgery, there is no way for anybody to know whether the patient has performed strenuous exercise. The reviewers of these sites are generally not patients. There are known instances of dentists being accused online by their competitors of being child molesters. Similarly, laudatory online comments can be written by the physician themself.

One way to try to work around such frivolous online statements is to have patients sign a waiver that has them promise that in a case where they are not happy with their care, they will not post online comments to that effect. The way such contracts are enforceable is as follows. In general, websites acting as platforms for outside commentary are not liable for defamation suits. They may be subject to copyright laws. Waivers can be written to assign copyright to the treating physician. If the treating physician asks the patient to sign such a copyright waiver, the physician can claim ownership of any anonymous review of the practice and demand that online review then be removed. There are now examples of websites removing such deleterious copyrighted comments. Needless to say, not all patients will agree to sign such a waiver. Some may feel such waivers are simply gag orders. The reality is that disgruntled patients are free to speak with family, friends, other physicians, lawyers, hospital peer review committees, or credentialing committees. There is a wide range of appropriate places where patients can express their views.

Barring anonymous sites would be ideal. However, barring anonymous sites is unlikely to happen. At the very least, it would be ideal if social media sites could verify that the reviewer is a patient of the physician they are criticizing or praising. Additionally, to prevent the extreme opinion—positive or negative—from skewing impressions, websites should hold off on posting such reviews until they have 10 or more representative views. In an ideal situation, reviews should focus on those aspects in which a patient would be expected to be knowledgeable. These would include issues such as waiting time, appropriate parking, or being treated rudely by the physician and/or staff. Commenting on physician technique or results is an entirely different issue. Unfortunately, without any signed waiver in place, Dr Derm is in no position to stop his patient from posting the negative online comments.

David J. Goldberg, MD, JD, is medical director of Skin Laser and Surgery Specialists of New York and New Jersey; director of cosmetic dermatology and clinical research at Schweiger Dermatology Group in New York, New York; and clinical professor of dermatology and past director of Mohs Surgery and Laser Research at the Icahn School of Medicine at Mount Sinai in New York, New York.