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Physicians' Online Reputations Under Attack from Turned-away Drug Seekers


Savvy prescription drug seekers who are denied by physicians have found a new venue for retaliation - social media.

Savvy prescription drug seekers who are denied by physicians have found a new venue for retaliation - social media. Negative postings on social media sites, including ratings on physician ranking sites, are becoming a platform of choice for written “justification” to change physicians in an attempt to circumvent doctor-shopping restrictions. These comments also help to alert others to avoid uncooperative doctors.

Until a few years ago, there was little reason for concern, but times have changed. How big is the problem? No one has measured, but the real question may be: How big will it get? My firm believes it is growing enough to pay close attention to our reputation management capabilities. Statistics and a flurry of legislative actions tightening access to prescription drugs of abuse suggest there is very good reason to begin to pay close attention to your reputation, even with existing patients. That is because 20 percent of the American public - over 60 million people - have abused, or are abusing, prescription drugs according to the National Institutes of Health’s National Institute on Drug Abuse (NIDA).

The number of emergency room visits attributed to prescription drug problems more than doubled in 2008 (the most recent statistical year) to over 305,000 from 2004’s count of 145,000.

Prescription drug deaths exceeded traffic deaths for the first time in 2009 (the most recent year statistics are available), according to Bob Anderson, who heads up the Centers for Disease Control’s mortality statistics division; the rate continues to rise.

The bulk of these deaths and ER visits are from opioids, but drugs of abuse also include tranquilizers, sleeping pills, stimulants and even diet pills. All can be addictive. States have responded with drug databases and increased restrictions and penalties, particularly criminalization, for both users and prescribing physicians, and it’s only the beginning.

As the supply tightens, many people with dependencies and addictions have become more aggressive - and creative. The Internet is not only a venue of opportunity; it is a public and permanent record.

Here is a real life example:

A few weeks ago, I met with an anesthesiologist board-certified in pain management saying he needed help with strategic direction and marketing his practice. Before meeting in person, I did some quick Internet homework - triple boarded, seven added certifications, associate professor at a large medical school, a philanthropist, active in his community and two decades in practice - a lot to work with. Then his name started popping up on social media sites; Facebook, Healthgrades.com, then one after another with sometimes anonymous, negative postings. These rankings were half a star out of five. One or two can be anomalies. Ten or more is a five alarm fire to most prospective patients - and an advisory to go somewhere else to others.

What did such a highly trained, accomplished, and personable physician do to earn such vitriol from so many people?

He said, “No” - prescribing more appropriate drugs when opioids and other drugs were not needed.

People are far more likely to take the time to complain, vent, and publish their negative experiences in these public forums than to post a positive one. Addiction is a powerful motivator.

Further, this is a challenge uniquely faced by physicians and dentists because they have the prescription pads. It will grow as legislated remedies in the form of penalties continue to proliferate, forcing gatekeepers such as physicians, dentists, and pharmacies to take on front-line enforcement roles with a responsibility to report infractions.

So, what can you do if or when you have been unjustly criticized? Think before you act. Most social media websites allow for rebuttals, but this is a minefield of potential liability for HIPAA violations. Consult an attorney before posting anything, including what may appear to be a generic statement. Use a professional marketing and public relations firm that understands reputation management and is experienced in health care matters for more severe problems. And, remember, libel and defamation claims are exceedingly expensive to prosecute and difficult to win except in the most egregious and damaging of circumstances.

What can you do to rebut negative postings on social media? Preparing by quantitatively measuring patient experience with a good score (95 percent positive or above) is the best defense, and is the best rebuttal.

As for the rest, just make sure to Google your name and practice name regularly and leave the rest to professionals.

Find out more about James Doulgeris and our other Practice Notes bloggers.

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