Oct 2016

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Oct 2016

Reputation Management For Doctors:Fight Bad Reviews Without Violating Hipaa

With the rapid proliferation of online reviews from patients, more doctors are feeling the need to fight back against criticism. But are providers going too far in revealing information about the patients who criticize them? The law says yes. So how are physicians, dentists, physical therapists and other health providers supposed to defend themselves and their practices against bad reviews – without violating HIPAA?

One of your patients writes a scathing review about your practice. The review is factually incorrect and misleading. It makes you angry. How do you respond?

Unfortunately, many providers respond emotionally and publicly on ratings sites like Yelp and Ratemds. Physicians, dentists, veterinarians and physical therapists too often divulge personal details of patients’ diagnoses, treatments and personalities. Here are some documented examples:

  • A Washington state dentist was blamed for the loss of a molar. The dentist responded with: “Due to your clenching and grinding habit, this is not the first molar tooth you have lost due to a fractured root. This tooth is no different.”
  • A mother claimed that a California chiropractor misdiagnosed her daughter with scoliosis. He responded with, “You brought your daughter in for the exam in early March 2014. The exam identified one or more of the signs I mentioned above for scoliosis. I absolutely recommended an X-ray to determine if this condition existed; this X-ray was at no additional cost to you.”
  • A patient accused a California dentist of misdiagnosing her. His response: “I looked very closely at your radiographs and it was obvious that you have cavities and gum disease your other dentist overlooked. … You can live in a world of denial and simply believe what you want to hear from another dentist or make an educated and informed decision.”

The Harsh Reality of Being Rated Like a Restaurant

Health providers are slowly adapting to the harsh reality of consumers rating them just as they rate restaurants, hotels, auto dealers or spas. The vast majority of online reviews are positive and do not engender provider responses. When responding to negatives reviews, some providers unwittingly violate the Health Insurance Portability and Accountability Act (HIPAA), as in the examples above. HIPAA strictly forbids the disclosure of patient health information without the patient’s permission.

Just because your patients have rated you publicly doesn’t give you permission to rate them in return. For example, there was a 2013 case in California where a hospital was fined $275,000 for disclosing a patient’s information to the media without permission – after the patient complained to the media about the hospital.

Address Negative Reviews, Avoid HIPAA Violations and Fines

To avoid problems with HIPAA, we advise reputation management for doctors. Doctors should respond to online reviews only to comment generally about their office policies or the way they treat patients, not to discuss personal details without their patients’ permission. Fortunately, most health providers are careful and appropriate when responding to bad online reviews. They encourage patients to contact them offline and apologize for any perceived slights.

Health providers have tried a host of ways to try to combat negative reviews. Some have sued their patients. While these lawsuits attract lots of attention, most fail and do more harm than good for the practitioners involved. Some health providers have even begged patients to remove their complaints.

Understand that most complaints about doctors and dentists aren’t about the actual healthcare delivered. They’re about long office waiting times, office staff, billing procedures or bedside manners. Despite this, doctors need to embrace online reviews. Reviews are valuable and health providers should encourage patients who are satisfied to post positive reviews. Providers should respond – very carefully – to negative reviews.

If you have a tendency to react and respond emotionally to negative reviews, you must first realize that your biggest problem is your ratio of good reviews to bad. If you only have three reviews and two are negative, the ratio is the problem. By learning how to cultivate more positive reviews from hundreds of patients instead of just a few, your problem will be solved.

When it comes to reputation management for doctors, your best option is to seek professional help. Learn more about reputation management programs and services by calling Practice Builders at (855).898.2710 or email

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Remember HIPAA When Responding to Reviews

Healthcare providers who have responded to poor reviews have run into trouble with the HIPAA privacy rule for addressing specific patient complaints. The rule prohibits the public release of any personal health information without the patient’s permission.

Many disputes have been related to online HIPAA privacy breaches rather than the quality of medical care. Some practitioners have even been reported to the Office for Civil Rights within the U.S. Department of Health and Human Services by disgruntled patients.

The most important thing to remember is this: Just because a patient makes specific public claims doesn’t mean you can respond to those specific claims publicly. Many doctors don’t respond at all, which is better than responding emotionally and inappropriately. Of course, the best strategy is to invite the patient to discuss the issue offline and give you a chance to take corrective action or merely apologize publicly.