Cyberspace can be a rough-and-tumble place,” says St Louis-based attorney Peter Yelkovac, JD. Through the years, Yelkovac has assisted physicians who have been unfairly portrayed on Web sites. “It can be highly upsetting and stressful for a physician to be the victim of nasty online critiques.” Most physician rating sites do not identify the person reviewing the physician. Yelkovac believes that “the anonymity of the Web presents both legal issues and emotional issues for physicians. A physician who receives an inaccurate and vicious review feels hurt and often helpless.”

Seattle-based, board-certified facial plastic surgeon William Portuese, MD, has been practicing for more than 21 years. He says online reviews are part of running a practice these days. “It is the new normal,” Portuese says.

“If you are a practicing facial plastic or plastic surgeon and you have a busy practice, you are going to get reviews—and some of them will be negative. You can’t keep everybody happy,” he says.

Portuese says the first time you get a negative review it is kind of devastating to your morale after training for so long. He takes it personally when someone takes a pot shot at his career and reputation.

“The first negative review that we had was from a patient we had refused to operate on. I was mad at first, then happy that I did not operate on her because then she probably would have written a worse review,” Portuese says.

What patients tend to not understand is rating a physician is different from rating the pizza parlor down the street. Patients need to separate their feelings from actual medical facts and procedures.

Michael J. Sacopulos

Michael J. Sacopulos

“When a restaurant has a whole stream of bad reviews, they can simply change their name. A physician can’t do that. My whole reputation is based on my name. A restaurant changes their name, and boom—all of the bad reviews go away,” Portuese says.

He says it is important for patients to go online and look at reviews, and remind themselves that one or two bad reviews is acceptable. If there is a pattern of 10 to 20 bad reviews, there may be an issue with that practitioner or that practice. It is also important for patients to know how to read between the lines.

“Even my current patients who read my bad reviews could tell, those often came from people who are not psychologically balanced,” he says.

In the end, Portuese elects to leave the bad reviews alone and move on. Others, especially newer physicians, may not be as able to walk away from a couple of isolated incidents that took place during 2 decades.

When determining whether to take action to address a bad review, physicians should consider the following:

  • Know what people are saying. You can’t know what people are saying about you if you aren’t taking the time to look for it. A simple way to know if you are being talked about is to set up a Google Alert with your name and your practice’s name. Also, keep a close eye on your Facebook and Twitter page.
  • Determine if a response is necessary. Not all negative comments are worth a response. There are going to be some patients you just can’t win over. If you do choose to respond, you should ensure that your comments are HIPAA compliant. Additionally, you should consider whether a response is likely to precipitate an online “shouting match” that will simply draw more attention to the aberrant poster.
  • Act in a timely manner. A patient posting a negative review may have done so just to get a reaction out of you. The longer you wait, the more tension that could build. Prepare a message for instances like this (assuming the post is anonymous). For example: “This is Dr ___, and I hear you. Please give me a call in our office so we can discuss this matter and work to come up with a resolution.” A message of this nature lets the ranter know he/she has your attention. There is less incentive for the patient to keep spewing anger once they know they have your attention.
  • Don’t give a canned response. If you make the choice to reply, keep it personal, aligning with HIPAA guidelines, and sound like you care about the patient’s individual situation.
  • Think before you ink. When you are first made aware of a negative review, your first response may be an emotional one. Step back. Take a deep breath.

Finally, there are professional services that assist physicians in dealing with online rating sites. “We founded eMerit to help physicians deal with the realities of the cyber world,” says Jeffery Segal, MD, JD, of Greensboro, NC. The eMerit service ( provides more than technical assistance to physicians. “By taking a proactive approach to online ratings, physicians take a step toward reducing stress,” Segal says.

Portuese and Segal are correct. Online reviews can be stressful. By acknowledging the situation and becoming proactive at some level, physicians will reduce their stress and feel more in control of their reputation.

Michael J. Sacopulos, JD, serves as national counsel for Medical Justice Services Inc. He is a partner with Sacopulos, Johnson & Sacopulos in Terre Haute, Indiana. He may be reached via [email protected].