A recent Pew Research Center study indicates that 72% of all U.S. internet users looked online for health information in 2012; 30% of them have looked specifically at provider reviews, where anyone can write anything under a near guarantee of anonymity. More than 700,000 physicians are listed on Vitals.com, the largest of the patient review sites, which attracts more than 13 million visitors a month. ZocDoc.com, RateMDs.com, and Yelp.com maintain sizable directories of provider information. (RateMDs.com has logged over 2 million reviews since debuting in 2004.)
Liz Brott, a regional vice president at ProAssurance, a professional liability insurance company, says she’s seen a rise in the number of libel and defamation cases rattling doctors of all kinds. “It’s something that’s come up in the last year or two that we’ve never seen before,” she says. “We’ve had to figure out a strategy to address these complaints.”
It could be argued these sites have proliferated by being an alternative to costly and frustrating malpractice suits. Most cases aren’t even pursued unless a patient is demonstrably injured or died as a result of care; it can cost thousands just to have a hospital make copies of pertinent medical documents. The price of posting a negative review over frustrations with attitude, billing, or a diagnosis? Zero.
RateMDs.com takes a particularly flip approach to the law — and public — being heavily on its side. Its FAQ page cheerfully instructs health care providers how to issue subpoenas and cautions that review sites are not responsible for user comments. “It is not possible for us to verify which raters had which doctors, so always take the ratings with a grain of salt,” reads one disclaimer. “Remember, we have no way of knowing who is doing the rating — the doctor, other doctors, patients, dogs, cats, etc.”
It’s a fair warning. In the case of Dr. Blue, who requested her name be changed for this story, her roles as a medical director and operating room assistant meant she had no patients of her own. Consequently, there should be no reason to ever see her name appear on a review site. But she became curious after overhearing physicians discussing the sites in a hospital lounge one day. She went home and plugged her name into Vitals.
“Doctor Blue is a terrible doctor,” one anonymous poster wrote. “She is mentally unstable and has poor skills. Stay away!” The doctor was aghast and confused: She hadn’t directly seen a patient in three years. Her employer, which outsources Dr. Blue to surgeons, feared she might become difficult to market. Rather than calling or emailing Vitals, she visited its offices in Lyndhurst, N.J. — she was within driving distance. Upon arriving, she was told that locating an IP for the poster would be problematic.
It was not until Dr. Blue threatened litigation that she discovered the source of the post was a computer at New York University Langone Medical Center, a massive facility with thousands of possible culprits. She attempted to subpoena the hospital but was eventually dismissed on the grounds that the statute of limitations was up — she’d taken more than the allotted year to decide to pursue legal action and then try to squeeze both entities for information. In the August 2012 ruling, the judge who heard her argument found that the post constituted opinion: Vitals, she noted, has a disclaimer noting that the reviews should not be considered statements of fact.
Dr. Blue suspects a colleague from medical school was the perpetrator and eventually named her in the suit — she had not seen the woman in question for seven years, and the woman never denied she was behind the posting. Though Vitals allowed her to “hide” the message, anyone googling Dr. Blue is likely to stumble across mention of her case.
As a result — and with no positive reviews to offset the negative press — Dr. Blue wonders who among her potential surgical employers may be passing her by. “I will never know if that happened,” she says. “People I met who I thought I would be in touch with and wasn’t — it’s a huge degree of paranoia.”