Three Steps to Remove a Negative Online Patient Review

April 10, 2015

If you can't ignore an online review and it is extremely damaging to your reputation as a physician, there are steps you can take to try to remove it.

After reading a negative review about your medical skills or practice, your first reaction will likely be, "How do I get rid of it?" Unfortunately, removing a negative review is not easy - due to legal protections provided to the review sites and to patients themselves.

The first post in this series defined defamation and highlighted the challenges of winning this type of lawsuit. Most of the time, it is best to ignore the review. If the review is extremely damaging, you can try these three steps to have it removed.

Step 1: Contact the Website to Request Removal

You can contact the website yourself or have a lawyer do it for you. A lawyer can save you the time to contact the website but likely will not have any more luck than you. You should be aware that federal law (Section 230 of the Communications Decency Act) protects these websites from lawsuits even when the post is defamatory, so you cannot sue a review site to force removal of a negative review.

• Vitals.comWellness.com

Generally speaking, review sites will remove reviews that: 1.) are vulgar or obscene; 2.) are not written by your patient or concern another doctor; 3.) contain threatening language; or 4.) contain confidential information about you (such as your home address).

Physician review websites each have their own policy for removal of reviews and nearly all retain the sole discretion to remove a review. Vitals allows a doctor to request removal of two reviews, with no explanation. Other review websites such as RateMDs and Healthgrades prohibit defamatory reviews but then retain the sole discretion to remove them. RateMDs states that it "generally does not remove ratings," and Wellness, another site featuring a provider locator and comments, states that if you report a review for removal, it "may investigate the allegation and determine in our sole discretion to remove or request the removal of the material."

Step 2: Contact the Patient

You can also contact the patient directly to discuss your concerns with the review and ask him to remove it. This rarely will work; if the patient felt strongly enough to post the review, he may feel defensive about being contacted about it.

A more aggressive step is to have a lawyer write a demand letter to the patient, requesting that the patient remove the review or face a lawsuit. Unless you are serious about suing the patient, however, I would not suggest this step. Demand letters can go viral, leading to a backlash against you for "bullying" a patient.

Reviews may be posted anonymously, making it impossible to identify the patient. In some states, however, you can subpoena the website to obtain the name of an anonymous reviewer and then take the appropriate steps.

Step 3: Sue and Seek an Injunction

The most extreme (and expensive) step is to sue the patient and seek an injunction. An injunction is a court order that mandates a person take some action - such as remove a review. Winning an injunction is not easy, due to the free speech protections of the First Amendment.

You should first seek a "preliminary injunction" to immediately remove the review until the litigation is over. However, it is extremely difficult to obtain a preliminary injunction because: the legal standard is burdensome and courts usually wait until after a jury has concluded that the reviews are defamatory. Forcing a patient to remove the review before it has been declared defamatory infringes on a patient’s First Amendment rights.

In a rare example, the Texas Court of Appeals in 2010 upheld a preliminary injunction when an online reviewer accused a doctor of drinking alcohol while practicing medicine, stalking women, theft, and lying. It is an extraordinary, but possible, remedy.

Your next step would be to seek a "permanent injunction" after you win the case on the merits. Most courts will grant one once the jury has found that the review was defamatory. To get to this point, however, you must win the whole case - a time-consuming and difficult process.

Simply suing an online reviewer may be enough to encourage voluntary removal of the review. In one Massachusetts case, a doctor sued the husband of a former patient who posted an "open letter" about concerns with the doctor’s care. The doctor asked for $100,000 in damages. The defendant removed the post voluntarily, and the case settled last year.

Using Settlement to Encourage Removal

If you file a lawsuit, the patient may be willing to settle the case to avoid the burden of defending against it. The patient may agree to remove the review permanently in return for paying less (or nothing) in money damages. From your perspective, removal of the review may be worth relinquishing the possibility of money damages, particularly if the defendant is judgment-proof and the review seriously damages your reputation.