Legal and ethical considerations for managing your online reputation

With statistics showing that patients are increasingly going online for healthcare information, managing a physician’s online reputation within the confines of the law and policies regulating professional behavior is becoming more important than ever.

Social media and the proliferation of online physician rating sites have made it incumbent on healthcare providers to monitor their online reputations. While patient satisfaction is not always a reliable indicator of quality medical care, it is the new reality that providers face. It is advisable for physicians to be proactive and establish a protocol for requesting patients to provide online reviews of their experience on provider rating sites.

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Developing a positive online reputation through reviews posted by satisfied patients is the single best way to defend against any online negative reviews that may ultimately befall a practitioner. Indeed, when a negative review is one of no more than a handful of reviews, it can carry a disproportionate amount of weight to the present or prospective patient. However, the negative review appearing in a sea of hundreds of positive reviews is more likely to be seen by the world as an aberration.

If a provider’s reputation comes under attack from a patient’s use of social media or a negative online review, and the provider decides that a response is needed, the method should be driven by analyzing a variety of factors, including the extent of the harm that could be done by responding to the reputational attack.

If the provider knows the patient, he or she can try to reach out to the patient privately try to address any concerns. If the provider doesn’t know the patient, often the best course is to work with an attorney to craft a fair, broad, and general response to the patient’s claim to post on the social media or online review site.

The response should focus attention on the physician’s experience and policies with regard to such situations, express surprise and concern regarding the claim, and assure the public that the physician does not manage his or her practice in the manner the patient is alleging in the online review.

Next: If all else fails...


Depending on the contents of the review and the website on which it appears, there are various other options open to the physician beyond calling a patient in hopes of resolving any issue. These include sending a demand or “cease and desist” letter to the patient, or contacting the website in a manner consistent with the website’s terms of service.

If all else fails, physicians can pursue the “nuclear option” of a defamation lawsuit against patients who make particularly unfair or inaccurate online postings. In certain cases, the cost and uncertainty of litigation provides both the physician and the patient with the impetus to resolve the issue and can help to have it taken down or otherwise amended.

Recognizing that social media use by physicians and their patients presents unique challenges for physicians, medical associations and medical boards have developed guidelines to help physicians navigate their roles online. The guidelines urge practitioners to proceed cautiously, act professionally, and avoiding any personal connections to patients online. Failing to do so entails certain risks, including a claim of professional misconduct.


Kevin G. Donoghue, JD, is a partner, and Stacey P. Klein, JD, is an associate at Garfunkel Wild, P.C., in Great Neck, New York. Send your legal questions to

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