A disgruntled patient posts a critical comment about a doctor on the Internet. The doctor is furious and wants to get the comment removed to make sure it doesn't harm his practice or reputation. What can he do?

He could have his lawyer send a letter threatening a lawsuit to get the offending remark taken down. But that rarely works. Or he may attempt to flood the site with positive comments. But what happens when these tactics don't work?

Most lawsuits filed against bloggers and hosting sites (ie, physician rating sites) by doctors for defamation (or other actions, such as claiming interference with a business contract) have failed. And filing these suits can lead to unexpected negative consequences. Really persistent bloggers may continue to post. Drawing attention to the negative comments can even attract others who don't know the doctor to post negatively as well.

Dr. David McKee, a neurologist in Minnesota, learned the hard way about the unintended consequences of filing a defamation lawsuit in response to online postings by a disgruntled patient.

After consulting on an 85-year-old stroke patient, the patient's son posted derogatory comments about Dr. McKee online and filed complaints with various medical associations. The doctor sued the patient's son.

Dr. McKee's lawsuit was dismissed. The judge stated that the comments posted online were not defamatory. Rather, they were an emotional discussion of the issues. The fact that they had been placed online did not make them defamatory. There was not enough information to form the basis of a lawsuit.

However, Dr. McKee's filing of the suit drew public attention to the matter. Afterward, more than 60 derogatory and negative reports were posted against him on medical rating Websites. Most of these came from people who were neither his patients nor had any personal knowledge of him. Knowledge of the lawsuit appeared to spur anger and revenge from some who didn't even know the doctor.

More Damage When Doctors Strike Back

In another case that backfired, Dr. Jonathan Sykes, a California plastic surgeon, sued a patient who put up a Website criticizing him and his work.

Sykes performed a series of facial cosmetic procedures on Georgette Gilbert in 2003. Gilbert was appalled by the results. She not only sued Sykes for medical malpractice but also created a Website relating her experiences with Dr. Sykes (including before-and-after photos), as well as information and advice for those considering plastic surgery.

Dr. Sykes was a prominent professor of plastic and reconstructive surgery at the University of California, Davis, Medical Center. He had been featured in local and national publications touting his expertise in plastic surgery. In the eyes of the court, this made him a "limited-purpose public figure."' As a result, the court dismissed his lawsuit.

When Gilbert refused to close down her Website, Sykes filed a cross-complaint for damages and injunctive relief based on publications appearing in the Website that were allegedly defamatory and caused Sykes emotional distress and loss of business. Sykes ended up paying his own lawyers, plus Gilbert's legal fees, estimated to be in the range of 6 figures. Her Website stayed up and he got more negative publicity.

Were You Really Defamed?

To save yourself trouble and money, it's important to know what constitutes defamation, how to prove it, and how to defend against it.

Defamation is the communication of a false statement purporting to be fact and that causes harm to reputation. Written defamation is known as libel, while verbal defamation is called slander. Statements of opinion are usually not defamatory. Opinion can be erroneous and malicious. However, opinion can cross the line and become defamatory.

Rude, insulting, or offensive statements are generally not defamation. The First Amendment provides wide latitude for free speech. Historically, US courts have always ruled in favor of free speech rather than find for defamation.

Typical defamation statutes require a plaintiff to prove that the defendant made a defamatory statement which a reasonable person would find harmful to reputation; that the statement was shared or transmitted to a third party; that the statement was false (true statements cannot be defamatory); and that the plaintiff experienced damages of reputation as a result of the statement. These could include some form of provable public hatred, ridicule, contempt, or degradation which led to damages.

Defamation per se. Some statements are considered defamation per se (by definition). Plaintiffs are not required to prove that the statements were harmful to the plaintiff's reputation (state laws vary).

Defamation per se typically includes false statements presented as fact concerning a plaintiff's trade or business (stating that the plaintiff is no longer in business, can't get credit, or is engaged in illegal activity); false statements presented as fact indicating that the plaintiff has a "loathsome disease"' (eg, leprosy, sexually transmitted diseases, HIV, hepatitis, tuberculosis, or mental illness); false statements that the plaintiff is unchaste or sexually impure; false statements that the plaintiff has been involved in criminal activity or convicted of a crime.

What Should You Do?

Consider the pros and cons, as well as alternative ways to deal with the situation, before deciding to bring a defamation lawsuit. One way is to place as many positive statements as possible on any Website containing negative comments. Another is to ignore the comments and practice good medicine. As with any business, a loyal following will counterbalance any negativity. Some patients have always made disparaging comments about doctors. The Internet only serves to amplify the level of the rhetoric.

Notice the EHR selection procedure to a doctor and you’re probably going to hear a moan. In the wake of spending a significant part of the previous five years executing the electronic therapeutic wellbeing records programming, many will say it’s as yet not satisfying its objectives.

The push to receive EHRs is being driven by the U.S. government with an end goal to improve the quality, wellbeing and effectiveness of patient consideration. By executing an affirmed EHR, medical clinics and doctors will expand care coordination, secure patient protection and improve the general wellbeing of the network, as indicated by an article on HealthIT.gov.

As per HealthIT.gov, the long haul objectives of the activity include:

•             Improving clinical results

•             Improving the wellbeing of the all inclusive community

•             Increasing straightforwardness

•             Creating progressively productive consideration

•             Empowering patients

•             Gathering progressively powerful information on emergency clinics and wellbeing frameworks

The same number of medicinal services frameworks work out through the reception procedure, they’re finding numerous open doors for development. While still a work in progress, effectively executing an EHR alongside custom arrangements can support emergency clinics and doctors get the full an incentive from the product.


A great part of the present accentuation on embracing EHRs originates from The Health Information Technology for Economic and Clinical Health Act (HITECH Act) made in 2009.

The enactment offered social insurance suppliers motivators to show “significant use” of EHRs from 2011-2015. From that point onward, social insurance frameworks and doctors who didn’t utilize EHRs or couldn’t show that they satisfied Meaningful Use guidelines would confront punishments.

The Meaningful Use measures were separated into three phases. To proceed onward, a supplier needs to show they’ve been in each phase for a long time. Each stage has a set criteria, with certain contrasts among medical clinics and doctor works on, as indicated by an article on HealthIT.gov.

So as to fit the bill for the motivators, social insurance suppliers and medical clinics must finish desk work to demonstrate they’ve consented to the prerequisites.


Those social insurance frameworks and specialists that have effectively executed an EHR have discovered numerous advantages to the electronic medicinal wellbeing records programming.

As indicated by an article on HealthIT.gov, an overview of U.S. specialists found that 75 percent said their EHR helped them give better patient consideration. The overview likewise found that 88 percent said their EHR additionally conveyed clinical advantages.

This is what to search for when picking an EHR framework:


EHRs should be adjustable to both the bigger needs of the emergency clinic or human services framework just as the individual needs of a division. Adjusting the work process in an EHR to the present clinic practices can spare time and anticipate disarray when preparing clients on the new EHR.

For explicit divisions, what the orthopedic office needs is fundamentally not quite the same as the information that the OB office may require. Designing an EHR to every division’s needs implies that clients aren’t sitting around idly navigating screens that don’t make a difference to their patients.

To take customizations a level further, EHRs ought to likewise enable clinics to modify the frameworks for various sorts of clients. Specialists, medical caretakers and other heathcare suppliers all utilization the framework. By making it simple for each kind of job to access, search and enter the most pertinent information for them, emergency clinics can improve both efficiency and client fulfillment.


By utilizing a progressively open, available and light-footed database structure custom programming can all the more effectively incorporate with existing frameworks like EHRs. This methodology enables information to stream effectively between applications that handle everything from patient booking to charging. It additionally makes it simple to include and alter applications as required.


Past having the majority of a patient’s information in one spot, EHRs additionally give a protect to patients by checking for any potential issues when another prescription is recommended that may struggle with the drugs that a patient is now on, as indicated by an article on HealthIT.gov.

This protect counteracts unfavorable responses and makes it simpler to anticipate clashes when a patient is seeing a few specialists. Patients aren’t constantly ready to give a full record of their therapeutic history and current medicines, so having this information in an EHR disposes of perplexity. It can likewise help control crisis treatment if a patient is oblivious or incapable to respond to a specialist’s inquiries.


When EHRs are hard to utilize, regardless of whether because of the absence of a natural interface or simply require such a large number of snaps to enter persistent information, numerous medicinal services suppliers will squander hours attempting to utilize the framework. Progressing dissatisfaction can prompt an absence of consistence, and the EHR won’t satisfy its potential advantages.

Making a versatile application can make EHRs simpler to utilize. With the instinctive structure and streamlined work processes, numerous applications make it straightforward for medicinal services suppliers to both enter and quest for quiet information on their telephone or tablet. This velocities up the information section process, a typical grumbling for some doctors.

Preparing additionally assumes a job in client reception. As indicated by an article on CareCloud.com, an investigation of family doctors found that lone 39 percent of specialists were content with the preparation their EHR sellers gave. Another basic method to improve client selection of EHRs is to guarantee that all staff individuals get careful preparing on the framework and approach continuous help when questions or issues come up. Giving fast help keeps clients upbeat and maintains a strategic distance from the dissatisfaction that uncertain issues makes.


Receiving an appropriately designed EHR can spare clinics noteworthy measures of cash.

EHRs help limit obligation activities by demonstrating that the clinic or specialist pursued proof based practices or by revealing verification that a patient gave educated assent for a treatment, as indicated by an article on HealthIT.gov. An EHR’s patient record can likewise enable the resistance to group set up together an unmistakable picture of what happened during a patient’s treatment.


EHRs are intended to fulfill HIPAA guidelines and give a spot to the consideration group to record patient notes in a protected domain.

With the expanding number of security breaks in medicinal services, ensuring tolerant information is a top need for some social insurance frameworks.

What’s been most useful for your medical clinic or practice as you’ve actualized EHRs? What highlight do you wish your EHR had? Have you considered making a custom answer for get more an incentive from your framework? Tell us in the remarks.

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