How physicians should respond to a fake or defamatory online review

A patient review calling a physician rude, or complaining about a long wait, is opinion, and Michael Pelagalli, J.D., says there is no practical way to litigate it. A review claiming the physician was intoxicated during surgery is an assertion of fact, provable or disprovable through the medical records and the accounts of others who treated that patient. That line is the first thing he looks for when a practice calls.

Pelagalli is a partner at Minc Law, a Cleveland firm that works exclusively on internet defamation and online reputation matters. He began his career defending physicians and medical facilities in malpractice cases.

Related content: What physicians can actually do about a fake or defamatory online review

Document it before it disappears

Screenshots first, he says, plus a contemporaneous note or an email to someone else at the practice, because a fake review can come down as fast as it went up, whether the poster removes it or the platform does. Only then does the practice decide what kind of response is warranted.

Reviews from someone who never appears in the patient records can be flagged to the platform, and Pelagalli says his clients have the most success reporting repeatedly, a couple of times a week, from different accounts within the office. Removal is entirely the platform's decision, with no deadline it has to meet. When the reviewer is a real former patient, his advice is to call a lawyer before anything happens publicly, and before anything happens privately.

What HIPAA leaves a practice able to say

Very little, by his account. A practice can post a generic line inviting the patient to call, and that is close to the end of it. The public reply cannot confirm that the person was ever a patient, even after the patient has posted under a real name and volunteered treatment details. The Office for Civil Rights has penalized practices that said more. Pelagalli contrasts his restaurant clients, who answer accusations with security footage showing exactly when a customer arrived and left.

How an anonymous reviewer gets unmasked

The firm files a John Doe lawsuit naming the account rather than a person, subpoenas the platforms for basic subscriber information and IP addresses, then follows those addresses to the internet service provider. Burner emails and fake names defeat the first step often enough that the IP data does most of the work.

Sometimes the poster is not a patient at all. Pelagalli recalls a family physician who woke up to dozens of fake reviews across several platforms, posted by a family physician in the next county. Competitor cases open the door to unfair competition and tortious interference claims and to arguments for actual malice, which raise the potential damages.

Private resolution remains the goal in nearly every case, he says, and the odds improve sharply when the practice makes contact within days of the review rather than letting months of them accumulate.

Related content: Patients turn to AI, social media when choosing doctors, survey finds