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Dealing with Reputation Management, Without Violating HIPAA

Doctors are asked to provide the finest medical care possible, to each and every person they see, but they're also expected to run well-honed businesses that bring in new customers, retain old customers and keep the money flowing in. There are times when providing excellent medical care, and following all of the rules thereto appertaining, conflicts directly with a successful business model. Managing an online reputation, for example, often leaves medical providers in extremely dire straights. 

Consumer Power

In this online, interconnected world, consumers wield an impressive amount of power. Consumers who don't like the products they buy can post negative comments on review sites and drive down sales. Patrons who have a poor experience at a bar can write a scathing review, and perhaps cause a ripple effect that causes a closure. And patients who dislike the doctors they work with can write reviews of those providers at will. These comments can be devastating to the reputation of the professional in question. To provide an example, one consumer in Portland was moved to write this comment about a practitioner: "Dr. M is scatterbrained, disorganized, and forgetful. She consistently fails to focus on the issue or matter in question at any given time. She can be very rude. I suspect this is a well-meaning, but burnt out doctor; possibly one who could not work with others, hence the individual practice." It's easy to see how an attack like this could be devastating to the practice of the provider, and that provider's online reputation. As a business-minded professional, immediate action seems warranted. Here's where the situation gets sticky.

First Responses

Sites like Yelp encourage providers to respond diplomatically and publically to their reviewers, and repair their reputations through their polite defense and statement of their side of the story. Unfortunately, medical providers who respond in a public forum to a complaint by a patient bump right up against regulations put forth in the Health Insurance Portability and Accountability Act. This law protects private information about patients, and doctors commonly pay close attention to how their patients' medical records are stored as a result of this act. Doctors who think they've covered all of their HIPAA bases by monitoring their file storage might be wise to think again. As an article by the Texas Medical Liability Trust makes clear, even acknowledging in a public forum that a patient has seen one particular doctor is a violation of HIPAA guidelines. Doctors simply cannot acknowledge that the relationship exists, else they violate these guidelines. Names and relationships are considered protected information under HIPAA.

In order to improve an online reputation, doctors are sometimes encouraged to create their own websites, Twitter accounts and Facebook pages full of positive content. Unfortunately, there can be pitfalls here as well. People tend to write about what they know, and this means doctors tend to write about the cases they see and the patients they work with. In a study in the Journal of Surgical Education, 64 percent of residents and 22 percent of faculty members had Facebook pages, and 50 percent were open to the public. Of those public pages, 31 percent had work-related comments, and 14 percent referenced specific patient situations or patient care. Once again, this content could land a professional in a HIPAA investigation, as private information is being shared with the public at large.

Legal Issues

Faced with comments like this, providers might be tempted to ask the review site to remove the comments or face legal action. As mentioned in other blog entries on this topic, this is a losing proposition as review sites are protected by the Communications Decency Act. These sites aren't responsible for the comments users make, so the administrators of the site have no legal obligation to amend the comments in any way. As a result, they simply will not be moved to take down information, even if it's false. In one notorious instance, a Yelp reviewer claimed to be a writer for SF Weekly. When the editor of that publication pointed out the lie to Yelp, the organization responded with an email stating that the lie was a matter of "personal experience and opinions," and would stand as it was written.

If lies can stand, doctors seem to have no way to deal with half-factual truths written on their own pages. Lawsuits won't work, and neither will appeals to reason. Additionally, bringing up poor reviews to the staff of these review pages might also be construed as a HIPAA violation, as once again, the medical provider would be acknowledging the doctor/patient relationship with this action. 

Violation Costs

These violations are not small matters, as information that sits on the site is available for all to see. As a result, it might be considered a HIPAA penalty due to willful neglect. As a result, a practitioner could get fined up to $50,000, according to estimates published by ReferralMD. That provider's reputation might be further sullied, due to this violation. Consider this: According to a survey by Pricewaterhouse Coopers, 30 percent of consumers would choose one hospital over another if it had better privacy and security policies in place. If a provider had a reputation for violating privacy, even if that violation came about in a misguided effort to improve a reputation, the results could spell more disaster for that provider's business.

Good Options

The best solution for medical providers? Hire a reputation management company. These companies can create beneficial content that drives down negative results from Yelp and other review sites, and that content will not contain specific information about particular patients or medical cases. The negative content will be suppressed, but the risk of HIPAA violations will be minimized. has extensive experience in protecting and defending the online reputations of medical professionals, and can provide case studies that demonstrate this success. Visit to find out more.

Reviewed by author: Ashley Adams

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