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Doctor Fights Back Against Online Complaints

 |  By jcantlupe@healthleadersmedia.com  
   May 10, 2012

On neighborhood Internet community bulletin boards, like the ones I frequent, people write their joys, concerns, and gripes about everyday life, whether it's about a house painter, or the local school system. They also rave about doctors they are crazy about, and occasionally nix those they definitely wouldn't recommend.

But the physician talk is only sporadic, and generally not too specific. There seems to be an understanding that the physician probably lives nearby and might see the negative comments.

On national forums that focus on assessing physicians, such as RateMDS.com, a rush of comments cascade around-the-clock, reflecting patients' feelings about their doctors. The statements roll down the Web, with immediacy: The doc was "the best," (18 minutes ago!); "Very rude," (14 minutes ago!). The authors are anonymous, but the subjects of their commentary are sometimes identified, albeit only with a last name.

Indeed, physicians see their patients one-on-one, but what happens behind closed doors can quickly become open to debate on the Web, with patients telling all, if they want. That happens in the free market of ideas and conversation. And it's a reminder that there are some things a physician, or anyone, can't take too personally.

Then again, when you consider that your professional reputation and livelihood are at stake, you might decide to go to court.

That's what happened in Virginia when a plastic surgeon took umbrage at an anonymous patient's online comment on RateMDS.com, criticizing his liposuction and announcing his/her intent to sue the specialist for damages. The patient wrote that the surgeon's work was supposed to trim him (or her) down, but the targeted spot seemed to worsen after surgery. The patient was not identified as man or woman.

"I paid for Vaser HD and had very little fat around my abdomen," the patient wrote, according to documents filed in Virginia court. "I just wanted the sculpting look that is advertised." The patient added, "I paid almost $8K with misc stuff and I see absolutely 'no results' and feel that my love handles actually look bigger. Wasted money, bad experience."

The patient complained, in effect, that the physician's work did not live up to his/her expectations. Next to the patient's comment is a drawing of a frowning face, the court documents state. Another of the plastic surgeon's patients also was displeased with his work, writing, "run from him." But another declares, "I am thrilled with new body," the court records state.

Despite the mixed comments, the plastic surgeon, Armand Soto, of Orlando, Fla., apparently felt the tone of the criticism went too far. Last year, he filed a complaint in Henrico County Court in Virginia against 10 "John Does," whom he contended made comments on RateMDs.com that constituted defamation, "tortious interference" with contract rights, and business expectations. The "love handles" commentator was allegedly among the John Does.

So how much should a physician react to public, anonymous criticism, and how far should he or she go in self-defense? After all, there is a First Amendment guaranteeing freedom of speech, but how much criticism touches on one's work, and practice, especially from a patient who makes the complaint anonymously?

"Obviously, online forums create lots of interest on both sides," David Muraskin, an attorney who is in the litigation group of Public Citizen, the Washington D.C. based public interest group, which has opposed the physician's lawsuit, told HealthLeaders Media.

"With the perceptions of the public, certain things may cross the line as to what is acceptable or not." In this case, however, the physician has no grounds for defamation litigation against the unnamed commentators, Muraskin says. The litigation becomes a "weapon of retaliation and clearly these were nondefamatory remarks protected by the First Amendment," he adds. The legal action's intent is to prevent someone from speaking out the next time, "dissuading future speech."

In the legal papers, Soto's attorney claims that the patients who posted negative comments online conspired to injure Soto's trade, business, and reputation. Soto seeks $49,000 in compensatory damages, among other relief.

Neither Soto nor his attorney would comment for this story. The court papers say he describes himself as running a "premier" surgery practice and facility. His Web site says he's "known for his precision and expertise in performing a wide variety of procedures for patients."

The doctor's site lists testimonials from pleased patients, with one saying, "I just want to take a moment to let you know how thrilled I am and have been about all aspects of my experience as a patient under your care. Your warm, personable manner put me immediately at ease and nurtured a comfortable rapport."

A major concern of Public Citizen, in the view of its lawyers, is that Soto is taking steps in court to try to identify at least one of the anonymous commentators.

Soto's attorney prepared a subpoena directed to Comcast of Georgia/Virginia to release the identity of the individual associated with the particular IP address that was in use on Sept. 15, 2011 at 8:48 p.m., in a motion opposed by Public Citizen and the ACLU.

Soto's lawyer, Domingo Rivera, is familiar with these kinds of cases.

He filed a similar suit on behalf of a California doctor who apparently disputed comments made about her practice, according to Public Citizen. Once again, Public Citizen represented an anonymous critic of the physician, and legal action seeking details that could have led to the critic's identity was dismissed.

Those cases aren't likely to disappear anytime soon, and will continue—especially with the growing demand for plastic surgery. Vanity and pride issues compete for preeminence between patients and physicians.

If doctors plan to retaliate in court against patients, however, they must be careful to target the right ones. If the doctor in the "love handles" case loses, repercussions are likely. Public Citizen has already filed legal papers against the doctor because the physician's complaint is not "well grounded," and wants damages.

Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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