In addition, physicians should maintain official social media policies for his or her practice because these policies are essential to physicians maintaining a dual identity and appropriately engaging with social media. A practice ideally would seek legal counsel to assist in drafting a social media policy to ensure compliance with all pertinent laws, especially HIPAA, and general common law and medical principles of confidentiality. Pediatric physician practices must also structure their professional and practice’s social media accounts to restrict posting privileges to persons older than 13 years to comply with the Children’s Online Privacy Protection Act. A physician should also determine whether the practice’s insurance covers social media claims and, if not, consider adding such coverage.
When a patient posts a negative comment online
When a patient posts a negative comment online, physicians should never respond publicly. A physician could breach his or her HIPAA obligations and perhaps other legal duties by publicly refuting a negative review online.
A physician should also reflect before immediately suing a patient for his or her negative online comments. A lawsuit for defamation of character is often costly and difficult to win. A physician is also unlikely to win a suit against a website for defamation because these sites are generally immune from such suits under federal law. Most importantly, suing a patient for nasty comments online often has a greater negative impact on the physician’s reputation in the community, because the negative comments and underlying reason for them receive a great deal of attention.
Rather than replying online, a physician who receives negative comments should instead attempt to identify which patient posted the negative comment. After identifying the patient, a physician could review the patient’s chart and discuss the patient’s care with staff to determine whether any of the patient’s allegations are true. A physician should contact legal counsel before reaching out to the patient. Anecdotal evidence suggests that the best solution may be to meet with the patient and seek to resolve his or her concerns. If legal counsel agrees, the physician should reach out to the patient immediately to demonstrate respect for the patient’s opinion and a genuine desire to respond to the patient’s concerns.
Physicians could also determine whether the website on which the patient posted the negative comments has removal standards for comments. If applicable, a physician could request that the negative post be removed. This approach is rarely successful. Websites have no obligations to check the veracity of negative reviews and are almost never held liable for defamatory comments made by private parties. The websites have no reason to stifle negative comments; indeed, these negative comments may make the website’s overall rating or review of a physician appear more balanced and thus credible.
Update: Regulatory Developments Regarding Social Networking
There has been little clear guidance for physicians regarding the details of what is appropriate behavior in the new world of online activity involving social networking, professional and personal websites. While some physicians and regulators believe that the traditional rules of behavior and professionalism suffice, many others (including the senior author of this article) believe this a very new medium and expected norms of behavior are neither agreed upon nor generally understood.
There has been new guidance form the Federation of State Medical Boards6 regarding expected online behavior, and the Rhode Island State Medical Board appears to have used this to codify expected online behavior7. Other states will likely follow in the near future. Even in states without published regulations, physicians have disciplined8; disciplined in one case for performing an internet search of publically available information on a patient, but for non-clinical purposes (Googling for non-clinical purpose)9. Caution, seeking guidance, and perhaps review of the new model policy guidelines, is indicated in the social networking and online arenas.
Summary and conclusion
Physicians should actively monitor their personal or professional information that patients can access online because this information can affect patients’ opinions. The Internet can be used as a tool to inform patients and the community about a physician’s qualifications, certification, and background as well as reviews by current patients. Negative reviews can quickly surface and injure a physician’s reputation. Thus, physicians should remain vigilant in monitoring all aspects of their online reputation.
Takeaway Points
1. Physician activity on social networking can benefit patients and your practice, but has liability and licensure risks. New guidance from the Federation of State Medical Boards may be adopted by state regulatory agencies, which could result in physician discipline for noncompliant Internet activity.
