How a doctor’s online reputation survived a front page newspaper story

The Boston Globe recently had a front page story on how a neurosurgeon sued a patient’s husband for a blog critical of the physician.

According to the story, the patient underwent a complicated back operation as a result of her bone cancer. She tragically had a stroke post-operatively, and that’s where the situation between the family and doctor deteriorated. On the advice of his psychiatrist, the patient’s husband wrote a blog post describing his ordeal (it has since been removed).

The neurosurgeon then sued the patient’s husband for $100,000 claiming the blog did damage to her career. According to the doctor’s lawyer, one reason for the lawsuit was that the “blog popped up on the first page of Google search results.”

Although this post isn’t about the patient-physician aspects of the case, I do want to emphasize that the neurosurgeon clearly should have met with the patient’s husband, which could have avoided this situation altogether. In fact, the whole adversarial nature of the malpractice process is a topic that I’ve written about before, and it drives a wedge between doctors and patients. When it comes to bad outcomes, we need a non-adversarial, transparent process that promotes open communication between doctors and patients.

With that said, let’s see how this news the story affected the doctor’s online presence.

As I wrote in my book on online physician reputation, lawsuits are the last answer when it comes to responding to online posts. That’s because they take time, money, and are only rarely successful. More commonly, doctors suing patients leads to extensive media coverage, which can make a bad online situation even worse. Bryan Vartabedian covered this story recently, citing the Streisand effect.

So I was mildly surprised when I Googled this neurosurgeon’s name:

How a doctors online reputation survived a front page newspaper story

The Globe story is nowhere to be found on the first page. In fact, you have to scroll to page 7 of the search engine results to find it:

How a doctors online reputation survived a front page newspaper story

What shows up instead? The neurosurgeon’s social media presences. A LinkedIn profile, which is the first result. Also on the first page is her Twitter and SlideShare profile, along with an entry about her on the Brodsky Blog. In fact, if you scroll through pages of search results, you will see she has a huge digital footprint, including .com and .net websites, Flicker, Quora, Tumblr. and about.me among others. It is very likely she hired an reputation management firm to construct such a coordinated online presence.

Now let’s compare this to a famous case of a neurologist who sued a patient’s son for a negative online review.

How a doctors online reputation survived a front page newspaper story

On the first page of his Google results, there are already 3 mentions pertaining to that case. He does have a social media presence, including profiles on LinkedIn and Quora, but the amount of such proactive content pales in comparison to the media coverage surrounding his lawsuit. Granted, this story garnered national media attention, while the first case was confined to the Boston area.

But there are interesting observations from each doctor’s online presence.

In the first case, the physician insulated herself against a front page newspaper story with a much stronger, proactive, online presence comprised of various social media profiles.

In the second case, which I had been following since its inception several years ago, the doctor allowed himself to be defined by critical news stories, and then had to reactively build his digital footprint, with mixed final results.

It’s inevitable that doctors will eventually have something critical written about them. It could be a newspaper or television story, or more likely, a negative patient review. Generating content and claiming social media profiles is an effective way to push down the visibility of such comments and articles that can hurt a doctor’s online reputation.

But the ultimate lesson is one in prevention. Doctors should always keep the lines of communication open with patients, listen to their reviews, and use their comments to constructively improve their practice.

And above all, don’t sue patients in the first place.

Note: The physician names have been purposely omitted in the text, so that this article won’t appear in a Google search for their names.

How a doctors online reputation survived a front page newspaper storyKevin Pho is co-author of Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices. He is founder and editor of KevinMD.com, also on FacebookTwitterGoogle+, and LinkedIn.

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  • http://twitter.com/riotofcolor1 riotofcolor

    I wonder if you will be getting a note from a lawyer since you have just effectively blown the hard work of the reputation managers, if the doctor hired reputation management company to insulate herself from this publicity?

  • http://twitter.com/ZansD94 Dana

    You won’t please everyone this is true but my experience is that when doctors make a mistake they outright REFUSE to admit it even when they are so obviously in the wrong. To make matters worse they then refuse to do anything that addresses the issue in any way. Frankly if they don’t want to address the issue then they deserve what they get. It is starting to come out folks, lies, falsification of records, drug abuse anything to make a buck at the expense of a patient or whoever and cover it up no matter the cost.

    Now having said that, there are BAD people in any given field or trade, if I were the GOOD doctors and yes I admit there are many, I would be livid at the ones that are destroying my chosen profession, a profession that used to be held in high esteem. Defend your profession and maybe there would not be such a problem. Hold your peers accountable don’t stick by them when you know what they are doing is wrong.

    • Scott

      And this has to do with the article how? This doctor didn’t make a mistake but still got the finger point at her by the patient/family. I would argue that this is a great example of the REAL reason that physicians aren’t held in as high esteem. People these days just can NOT accept responsibility for things and most doctors these days just roll with the punches. Politicians, patients (and insurance companies join in) want to point the finger at someone when it comes to the cost of health care…and who are the ones who take the blame? Physicians. Easy to blame the ones who have the toughest job, yet are expected to be perfect. Nobody else on earth gets held to the same standard, not even the president. The fact is, for the most part, physicians as a whole don’t have a selfish enough agenda or the time to stand up for themselves and look out for their own interests to band together and push back. So here I am like you asked, defending my profession against ranters like yourself. We do a pretty damn good job, and most of us are looking out for our patients. Back off.

      • http://twitter.com/NYCPatient NYC Patient

        The guy in the article is more concerned over not having the simple opportunity to meet with the surgeon to have an honest discussion regarding the matter for closure during his grief process MONTHS after her death.

        Regardless of what is noted in the article, who knows if it was the doctor who declined it or the hospital’s counsel or other administrative officer. That is another matter.

        • southerndoc1

          There’s no such thing as “closure.”

    • Suzi Q 38

      The doctors that refuse to communicate effectively with their patients are making a huge error.

    • Mengles

      Thank you for fanning the flames and not actually addressing the issue in the actual article and ranting against a strawman scenario that doesn’t exist.

  • ninguem

    The unfortunate lady had a rare bone cancer according to the article. There is also mention the doc spent 12 hours in meetings with the husband after her death.

    So far, what i read about this story, I can just as easily see a husband with grief that’s gone pathological, as easily as I can see an arrogant doctor.

  • http://twitter.com/NYCPatient NYC Patient

    The reality is that not everybody gets along. Every company has at least 1 disgruntled employee and or client. The same is true for doctors. The red tape, hospital politics, and hospital admin have fostered an environment where if there is any perceived (yet alone actual) unsatisfied patient, the guarded walls go up. In most cases if there was more effort on clarity, transparency, etc., there would be a much better outcome for both the doctor and patient.

    As for a a bad review, it’s life. Most reasonable people who read doctor reviews aren’t necessarily swayed by 1 or two (depending on overall # of reviews) negative reviews. It’s when there are several negative reviews that will lead one to think there must be something wrong…

    It’s usually the evasive behavior and lack of follow through on the doctors part that leads a patient to write a bad review, etc.

  • southerndoc1

    A surgeon performs two difficult procedures on a complicated (hypercoagulable) patient who suffers a non-surgical complication, and years later the husband still chooses this one doctor on whom to focus his anger?
    I think it is more than likely that meeting one more time with the spouse would absolutely not “have avoided this situation altogether,”as the OP states, but only exacerbated a bad situation.
    Could the fact that the surgeon is female have been part of the reason why the husband is attacking this particular physician? I don’t know.

  • Suzi Q 38

    This is a very timely article for me.
    I have to decide whether or not to submit a grievance with patient advocacy
    for two doctors that delayed and withheld care for me. I complained about nerve problems with the first doctor, after a hysterectomy. He delayed referring me to a neurologist. I had to come in a couple fo times and demand a referral. I also had to call his nurse a couple times. After that I called one of those nurse navigators, and then I finally got my appointment..5 months later. The neurologist on staff was a friend of the first doctor. He did the minimum for me, and since my symptoms came and went, time passed. I asked for more tests and so did my PT, but he did not want to order them.
    In the end, I overexerted myself in Europe (30th wedding anniversary trip) and was in pain most of the time and could barely walk.
    Came back and a 3rd doctor (a gastro of all people who happened to be chief of staff) demanded that I get the full MRI that I should have had when the PT and I asked for it a year prior.

    Boom! Spinal stenosis with signal changes causing permanent damage.

    why isn’t it my right to complain on the internet about the doctors that failed to treat this?

  • Mengles

    According to the story, the patient was mad at the surgeon for “not visiting his wife at Spaulding”, and that the “surgeon called their home once after her discharge but did not offer to help coordinate her care” (at a place where the surgeon doesn’t even have privileges) and said that he lost his wife “not to cancer but to indifference and egotism”. The surgeon apparently spent nearly 12 HOURS with previously written emails complimenting on the surgeon’s care. Sorry, but it’s pretty clear that the patient is more trying to resolve his feelings and anger at a very sad, but inevitable outcome. I would say the husband’s twitter feed is also quite eye-opening as well as to his/her feelings and leanings in general.

    • ninguem

      Not to mention the guy’s purple beard.

  • ninguem

    Yes, the tension was pretty bad and blatant sex discrimination. She won her case in court.

    Defending yourself in a sex discrimination case, the accused party is going to say the woman was treated badly, not because she was female, but because she was a bad doctor, a bad human being, had mental health issues, etc.

    Given the verdict in her favor, I would believe the allegations were false.

    Those allegations were picked up by Votour, who wrote in the blog post as follows:

    “….I see you found the time to sue your hospital and win almost two million dollars in a lengthy court battle over sexual discrimination in your workplace. How much money do you make a year, Sagun Tuli, as a neurosurgeon at The Brigham? How much is enough? And didn’t this law suit begin when your supervisor suggested you needed psychiatric counseling during your review?

    You seemed to have the time for that… but decided it was not in your best interests to allow me the opportunity to have one hour in exchange for my wife’s life…..”

    So, she’s getting a beating from her hospital because of her sex (and likely as a foreign national as well). in a situation not much different from what Carol Warfield was going through across town. She got asked to perform a very dangerous and unusual surgery for a very rare and dangerous disease. An unusual presentation of a rare disease no less. Patient does not do well and spends years in a rehab facility.

    The husband is making what really are unreasonable requests, her neurosurgical expertise is not going to help the rehab. People there shot off their mouths and allegedly said fairly slanderous things about her, while superiors in the institution make allegations about her, allegations that look like bad faith allegations (i.e., they were lying).

    Votour picks up on the bad faith allegations and compounds it by his blog posts.

    • http://twitter.com/NYCPatient NYC Patient

      Undeniably the lawsuit between Tuli and Brigham triggered Votour.

      When one has surgery, there is typically much focus on collaboration with others for recovery, etc. The reality is there isn’t.

      The only communication between physical therapists and surgeons is typically the order, nothing else.

      When Votour’s wife was sent to the rehab facility, it is likely that since the doctors likely said it’s a good facility, we send patients there all the time, etc., he had the impression that Tuli would continue to follow her at least through some of the recovery period. Instead, she was nowhere to be found.

      The average person does not have a clue as to the intricacies and time doctors go through to be granted privileges at a facility.

      A littler clarity and communication never hurt anyone.

  • trinu

    In other words, patients aren’t the only ones filing frivolous lawsuits.

  • azmd

    If you actually read the husband’s blog post in its totality, it is clear that this is no ordinary case of a medical complication that could have been addressed by the doctor meeting with the patient. For one thing, it is apparent that the doctor did in fact meet with the patient’s husband, and advocated for him after the surgical complication that affected him and his wife so significantly.

    The patient’s husband wanted to meet with the doctor again long after his wife had left her care, and clearly had expectations that the doctor would arrange for free medical care for his wife and possibly offer them financial assistance. It seems likely that the husband looked into suing the doctor for malpractice, but because no malpractice occurred, was not able to find a lawyer who would take the case on. He then chose to vindictively besmirch the doctor’s online reputation.

    Not a good example to illustrate the importance of open communication with patients and their families. That works with patients who are reasonable, but as we all know, not all patients and not all families have reasonable expectations of their medical providers.

    • azmd

      And thinking more about it, this case is actually a great illustration of something we doctors should do more of, but don’t: set clear and explicit limits with families on their wishes to have us to act as therapists to help them process their feelings about the patient’s illness. We live in a society where people are hungry to talk things through, because there is so little time for any of us to listen to each other. I personally could spend several extra hours a day listening to families vent about their past experiences and frustrations with the medical system. But honestly, that’s not what I am there for. I am there to take care of their family member and treat his or her illness. And I can’t do that effectively if I am spending hours a day making myself available for families to vent to.

      What Mr. Votur expected was that the neurosurgeon who had heroically operated on his wife months and months ago would meet with him for AN HOUR to help him process his feelings about his wife’s poor surgical outcome. It was probably a mistake for the surgeon not to respond to this request, but what she should have said was something along these lines: “I am so sorry about how the surgery turned out for your wife. I very much wish that things had turned out differently for her and for you. I hear that it has been a tremendous burden for you to care for her these many months. I wish there were something more I could do, but there isn’t. It sounds like you could benefit from having a support group or therapist to help you with processing your feelings. Could we make a referral for you?”

      • southerndoc1

        We’re only getting Mr. Votur’s side. The surgeon may very well have tried to set limits previously and failed. Mr. Votur was expecting a meeting YEARS after the surgery and after the surgeon was no longer involved in his wife’s care. That he is now promoting himself as a patient advocate is somewhat disconcerting.

        • azmd

          Yes, just a little. Although on the bright side, it appears that some of his angst was related to the fact that his wife had been the primary breadwinner for the family but he has since gone back to school, gotten a masters’ degree, and found a vocation for himself.

          • ninguem

            Did you see his new vocation?

            A master’s degree in hospital administration.

            Lord help us all.

  • ninguem

    I can’t say I know any of the personalities involved. She may well have been abusive to people, such personality traits are not exclusive to males.

    At the same time, I’ve seen bad-faith peer review, and know the character assassination that can take place. Based only on what’s been written, and buried well in the archives now, I tend to believe the surgeon in this case, because she won the lawsuit……the court got to hear both sides…..and Warfield went through the same thing across town.

    • http://twitter.com/riotofcolor1 riotofcolor

      I agree with the court’s decision. Dr. Day was clearly beyond the pale. I just wanted to include a broader version of the story which leads me to believe Brigham is better off today because both of them are gone, Dr. Tuli also having contributed to a hostile work environment. Both staff and patients filed complaints against her. That in no way excuses Dr. Day.

  • ninguem

    From the Globe article:

    “…..Doctors feel they are at a disadvantage in responding to negative
    reviews because medical privacy laws forbid them from discussing a
    patient’s care in public — a limitation that hotels, restaurants, and
    other often-rated businesses and professionals don’t face…..”

    I suspect as more cases like this pop up, the courts might consider whether certain privacy rights are forfeited if the patient chooses to discuss the doctor’s practice in public. Otherwise, what is to prevent someone from….just plain lying about the doctor?

    “Doctor Smith botched my hernia”…….posted online…….and privacy laws prevent Dr. Smith from saying if the author was even Dr. Smith’s patient in the first place.

  • LBENT

    I was an expert witness in the defense of a physician who had a child die after a “routine” operation from a relatively common, but potentially lethal, complication. The case was defended and a settlement was reached “without fault” and for 10% of what was asked. The defense attorneys were thrilled. I now see that the mother of this deceased child is all over the internet with “her” story which really bears no relation to the situation. She is exploiting the situation and making claims about “doctors” and the “safety of the system” when her child (unfortunately) died because of an unforeseen anatomical abnormality–not the doctors and not the system.
    My point is that patients have been given a mouthpiece, i.e. the internet, and use it to vent their angers and frustrations to the detriment of hard working, sometimes extraordinary physicians. This has to be stopped. The neurosurgeon you wrote about may have been trigger happy with this lawsuit. But she has had to fight with legal methods before and has been successful. The system doesn’t always respond to other methods of “persuasion”. The post is down. This will soon be forgotten. She has made her point. Since no one can vet what is on the net, then we are all targets no matter how much time, empathy, explanation, or earnest care we give.

  • http://twitter.com/ReviewPROXY Review PROXY

    Concur with everything Dr. Pho says, and will add a note concerning reviews, which are indeed the “more likely” source for negative criticism. A lawsuit is not likely to produce any better results. Third-party websites enjoy strong legal protections, and review sites such as Yelp and Google cannot be intimidated; they will not remove negative reviews unless they clearly violate their own content guidelines.

    You won’t get much help from the courts, either, even in situations of near-certain defamation. If you doubt this, research the recent case of Virginia woman Jane Perez who posted reviews on Yelp and Angie’s List against contractor Christopher Dietz that not only trashed him for a terrible job, but implies he stole jewelry from her. Dietz sued for defamation and got a judge to issue a preliminary injunction ordering Perez to remove the reviews. But the ACLU and Public Citizen jumped into the case and filed an appeal on First Amendment rights, and the Virginia Supreme Court overturned the preliminary injunction.

    And the publicity! It’s hard to imagine anyone checking out this contractor on the Web ever hiring him.

    Also know that Yelp is a special case. Google loves Yelp and you cannot buffer against it or lower its ranking in Google search results with all the social media pages in the world. So when negative reviews show up on Yelp, respond with professional confidence, concern and dignity. It also helps if you sometimes respond to “positive” reviews, to show you’re engaged and part of the community and not just “reacting” to negatives. Then you have more credibility when there is some unpleasantness to address.

    And make sure the positive reviews greater outnumber the negative.

  • http://cfpphysiciansgroup.com/ Adult Medical Care

    Impressive issue for the physician doctor who are unknown of the facts
    “How A Doctor’s Online Reputation Survived A Front Page Newspaper Story”

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