Doctors Fire Backs at Negative Yelp Reviews

Burned by negative reviews, some health providers are projecting their patients’ privacy aside and sharing intimate details on the internet as they attempt to rebut criticism. In the course of these arguments — that have spilled out openly on evaluations sites like Yelp — physicians, dentists, chiropractors and massage therapists, amongst others, have divulged details of patients’ diagnoses, therapies and idiosyncrasies.

One Washington state dentist turned the tables on a patient who blamed him for the loss of a molar:”Due to your clenching and grinding habit, this isn’t the first molar tooth you’ve lost because of fractured root,” he wrote. “This tooth is not any different.” You can also Buy Yelp Reviews

“The examination identified one or more of those signs I mentioned previously for scoliosis. I totally recommended an x-ray to decide whether that condition existed; this x ray was at no extra cost to you.”

“I looked very closely at your radiographs and it was evident that you have cavities and gum disease your other dentist has overlooked. … You can live in a world of denial and just believe what you would like to hear from another dentist or create an educated and informed choice.”

Health professionals are adapting to a harsh reality where consumers rate them on websites like Yelp, Vitals and RateMDs much as they do restaurants, spas and resorts. The huge majority of reviews are positive. But in attempting to respond to negative ones, some suppliers seem to be violating the Health Insurance Portability and Accountability Act, the national patient privacy law called HIPAA. The law prohibits them from disclosing any patient health information without consent.

Yelp has given ProPublica unprecedented accessibility to its trove of people testimonials — over 1.7 million in all — letting us search them by keyword. Using a tool developed from the Department of Computer Science and Engineering in the NYU Tandon School of Engineering, we identified over 3,500 one-star testimonials (the lowest) where patients cite privacy or HIPAA. In dozens of cases, responses to complaints regarding medical care turned into disputes over individual privacy.

The patients affected say they have been injured — first by poor care or service and then by the disclosure of information that they considered private.

The shock of vulnerability can be powerful, prompting patients to back off.

“Then, she published a response with details that included my private dental info. … I removed my review to protect my privacy.”

The office warned that the dentist about submitting personal information in response to Yelp reviews. It’s currently exploring a New York dentist for displaying private information regarding a patient who complained about her care, according to a letter reviewed by ProPublica.

The office could not say how many complaints it has received in this area since it doesn’t track complaints such a way. ProPublica has previously reported concerning the agency’s historical inability to examine its own complaints and identify repeat HIPAA violators.

Deven McGraw, the office’s deputy director of health information privacy, said health professionals responding to online reviews can talk generally about how they treat patients but must have permission to go over individual cases. Just because patients have rated their health provider publicly does not provide their health provider consent to speed them in return.

“When the complaint is about poor patient care, they could come back and say,’I supply all of my patients with good patient care’ and’I have been reviewed in different contexts and have great reviews,'” McGraw said. But they can not”take those accusations on independently from the individual.”

Yelp’s senior manager of litigation, Aaron Schur, stated most reviews of physicians and dentists are not about the actual healthcare delivered but instead their office wait, front office staff, billing procedures or bedside manner. Many health providers are cautious and appropriate in responding to online reviews, encouraging patients to get them apologizing for any perceived slights. Some don’t respond in any respect.

In 2012, University of Utah Health Care in Salt Lake City was the first hospital system in the nation to post patient testimonials and comments online.

“If you whitewash remarks, in case you only put those which are highly optimistic, the general public is quite savvy and will consider this to be only advertisements,” said Thomas Miller, chief medical officer at the University of Utah Hospitals and Clinics.

Unlike Yelp, the University of Utah does not allow comments about a physician’s medical competency and it doesn’t allow doctors to respond to comments.

In discussing their battles over online reviews, patients said they had turned to ratings websites for closure and in the expectation that their experiences would help others seeking care. Their suppliers’ responses, however, left them with a lingering feeling of lost trust.

Angela Grijalva attracted her afterward 12-year-old daughter to Maximize Chiropractic in Sacramento, Calif., a few years back for an exam. At a one-star review on Yelp, Grijalva alleged that chiropractor Tim Nicholl directed her daughter to”think she had scoliosis and desperately needed x-rays, which might be carried out in her next appointment. … My daughter cried all night and had a difficult time focusing on school.”

Nicholl responded on Yelp, admitting that Grijalva’s daughter was a patient (a revelation that’s prohibited under HIPAA) and discussing the procedures he performed on her condition, though he said he couldn’t disclose specifics of the identification”because of privacy and patient confidentiality.”

“The following day you brought your daughter back for a verbal review of this x-rays and I advised you that the x-rays had identified some issues, but the great news was that your daughter didn’t have scoliosis, terrific news!” he recounted. “I proceeded to correct your daughter and the modification went really well, as did the whole appointment; you made no mention of a’misdiagnosis’ or another concern.”

“I would not want another parent, another kid to go through what my daughter went through: the panic, the anxiety, the fear,” she added.

“It just does not seem like that is worth my time,” he said.

A few years back, Marisa Speed posted a review of North Valley Plastic Surgery at Phoenix following her then-3-year-old son received stitches there for a gash on his brow. “Half-way through the process, the doctor seemed flustered with my crying kid. “At this stage the physician was upset and he ended up throwing the tools to the ground. I understand that coping with children requires extra effort, but if you do not like to do it, do not even welcome them.”

“You might wish to remove any particular information regarding current or former patients from the Web-blog,” the Office for Civil Rights wrote in an October 2013 letter into the operation center.

In an email, a representative of the operation centre declined to comment. “Everybody that was directly involved with the incident no longer works . The nurse with this case left a year ago, the surgeon at the case retired last month, along with the secretary left a couple of years back,” he wrote.

Reviews of North Valley Plastic Surgery are blended on Yelp.

Health providers have tried a range of approaches to attempt and combat negative reviews. Some have resisted their patients, bringing a torrent of attention but scoring few, if any, legal successes. Others have begged patients to eliminate their complaints.

Jeffrey Segal, a one time critic of review websites, now says doctors will need to embrace them. Starting in 2007, Segal’s firm, Medical Justice, crafted contracts that health providers could give to patients asking them to sign over the copyright to some testimonials, which allowed suppliers to need that negative ones be eliminated. But following a litigation , Medical Justice stopped recommending the contracts in 2011.

Segal said he’s come to think reviews are invaluable and providers should encourage patients that are suited to post positive reviews and should respond — carefully — to unwanted ones.

“For physicians who have bent out of shape to eliminate negative reviews, it is a denominator problem,” he said. “If they only have three testimonials and two are negative, the denominator is the issue. …If you can find a way to cultivate testimonials from hundreds of patients instead of a few patients, then the issue is solved.”