Open Season on Doctors in Private Practice

Good morning, Boys and Girls!?It’s always morning somewhere here in LinkedIn Land, isn’t it??

Today we’re going to talk about Character Assassination.?That’s right—killing the good name of another person or other persons before they even have a chance to defend themselves.?Specifically, we are going to look at the character assassination of Doctors, and specifically of Doctors in Private Practice.

It is said that we now live in a ‘cancel culture,’ a society in which, if we don’t agree with someone, we simply report them, and even block them just like here in LinkedIn.??In LinkedIn, we may react or reply to a post or an article, either in appreciation or in disagreement.?Occasionally a disagreement is so sharp that LinkedIn members will actually attack one another, though that has been very rare in my experience here.?Usually, mutual critics duel with each other by giving brilliant displays of their rapier wit which, if found witless by others, will be subjected to withering, sometimes even deliciously dark humor.??The purpose of the LinkedIn platform is not just to do multi-billion ruble business deals before breakfast, but to foster the exchange of ideas, of insights and knowledge, of a whole world of knowledge and experience in this little polyglot online university.?The ability to post short articles on LinkedIn can even foster the creation of great literature, such as what you are reading now.?No??Then write something better!

But, let us not quibble and let us turn to the heart of the matter, not the free exchange of ideas and knowledge, not the post and the reaction to it, with or without emoji, but rather the seemingly innocuous, but in actual fact potentially sinister genre of the online review.?A review implies judgement and the ability to make that judgment.?You have probably written many reviews as a consumer of commodities ordered online, reviews for Amazon.com, Walmart, Barnes & Noble and what have you.?These review requests come with a standard format, asking whether the item arrived on time, whether it was what you expected, etc., and how you would evaluate the service you received in general with suggestions for improvement.?On just a couple of occasions long ago, I panned a product and its manufacturer because, say, the product arrived late, when it actually showed up in my mailbox a day or two later.?I quickly forgot about my damning little review, but the vendor of the product did not forget about it and emailed me a very courteous, apologetic note requesting that I please revise my review.?Why??Because their livelihood depended on it, that’s why!?This brought home to me the lesson that there are real people out there who can be really hurt by my careless or exaggerated words in a public forum.?I no longer write such complaining product reviews.?If I complain, I write that complaint under the heading of suggestions for improvement.

Others draw a different lesson from the realization that their words can hurt people in business, whether that is a restaurant or a book seller, or whether that is someone who serves them in one of the helping professions.?Others conclude that the ability to hurt, to damage reputation, gives them power over, say, the physician or surgeon, the dentist or therapist who treats the patient-reviewer differently than desired, or who refuses to renew a prescription for a controlled substance where this is not medically indicated, or where the patient-reviewer is behind in paying a fee to the provider.?Such ‘consumers’ of medical services may use the online review, effectively for purposes of blackmail or simply for spite.?

Doctors working primarily at hospitals, universities or other large clinical settings are fairly immune to this sort of chicanery.?Where patient-provider communication is handled through a patient portal, as in large health care consortia, or even simply through a clinic’s answering service, a patient with concerns must have a patient account number or some other identification.?Criticism is not registered anonymously.?And if a patient-complainer decides to go public with a complaint directly to the state medical board or the malpractice insurance provider, that reviewer may be receiving communication from the clinic’s, consortium’s or university’s legal department in short order.?

It can be quite a different story for doctors and therapists in private practice, however, a high percentage of whom are women.?A provider in private practice will typically have a professional homepage so that patients may get in touch with the provider and so that the doctor or therapist, within the bounds of professional good taste and best practice, may advertise the services (including telemedicine) that are offered, often with images showing the physical surroundings and facilities available on site, giving as much information as possible to invite the prospective patient to make an appointment.?Because of the transient nature of US American society, private practices are constantly losing patients and constantly in need of recruiting new ones, just to enable the provider to meet the enormous cost of malpractice insurance, of office rent and utilities, of other office expenses, including payroll where an assistant or receptionist is on staff and, of course, the ability simply to make a living.?Professional homepages do not grow on trees and can be expensive.?Providers who have to economize where possible—meaning just about all providers—and who cannot normally afford to hire a webmaster to design and maintain a homepage will seek out services such as that provided by companies like ‘GoDaddy,’ an operation which partners with another company such as one of the social media giant platforms, whether in the Mark Zuckerberg Mega universe, such as Facebook or, for that matter, LinkedIn, or Google and Google’s very own ‘Google Maps’ and ‘Google Reviews.’?What could be better?

What could be worse??If you are a health care provider in private practice, and if yours is, just for example, a homepage linked to Google, you will open your homepage to see a window typically on the right-hand side with a Google Map showing your location and just waiting to be activated via GPS, and under that panel you will then see ‘Google Reviews.’?If your homepage is brand new, you will see either no reviews or just a couple of positive/neutral ones, with the invitation to ‘See more,’ which, of course, we all want to do.?Isn’t that right??Before long, there may be a lot more to see.?As soon as a complaint has been filed (or algorithmically fabricated?), usually anonymously, it will appear on the front page of the home page, alongside positive reviews of patients you recognize.?‘See more?’?

You betcha! Who doesn’t want to ’see more’ when that ‘more’ is a member of the medical profession being skewered in public??And here’s the thing, Doc: You, the provider, can’t change a negative review, no matter how unfair, how inaccurate, how self-serving and downright dishonest, no matter how disrespectful toward you as to your professional competence and qualifications, your gender, your sexual identity and/or personal life, your race, your ethnicity, your national origin or your religion. ??Nope!?In Google Reviews you can do only two things, those being to get a friend or colleague to ‘flag’ the negative and inaccurate reviews and/or to approach the reviewer directly, but only if they want to be approached.?Reviewers in that rare category are usually willing to pull their review this time in exchange for waived fees this time, though no guarantees for next time.??Though an acknowledgement that a review has been duly ‘flagged’ is sent by email to the friend or colleague doing the flagging, this is absolutely no guarantee that flagged reviews will be removed.?If they remain posted, this fact will, at the very least, dissuade new patients from asking for an appointment.?At the very worst, when combined with a campaign to report you the provider to the state medical board, when negative reviewers become board complainers, your renewal of certification, your malpractice insurance and your license to practice medicine could be revoked, your reputation and your ability to provide for yourself and your family destroyed.?In this country, where the likelihood of a private citizen’s ability to make a libel action stick in court is almost nil, hundreds if not thousands of doctors and other health care providers in private practice are living and working on the knife-edge of exactly this kind of catastrophe.?

Help may be on the way, but it will still likely be a long time in coming because The Social Network of Zuckerberg et al and the First Amendment equivalent of the NRA, the ACLU and Alan Dershowitz, will likely fight it tooth and nail.?Building on her announcement of last November, decrying an estimated shortage of nearly 60,000 PCPs, dentists, and psychiatrists?over the coming decade, addressing that shortage and expanding health care coverage during the pandemic and beyond through the American Rescue Plan, on Thursday, June 16th, Vice President Kamala Harris announced formation of a White House Task Force to combat online harassment and abuse (Vice President Harris Announces Historic Funding to Bolster Equitable Health Care During Pandemic, and Beyond The White House | Kamala Harris launches task force to combat online harassment, abuse - UPI.com | VP Harris launches task force on online harassment, abuse – Boston 25 News | VP Harris launches task force on online harassment, abuse | The Daily Cable Co). Backed up by US Attorney General Merrick Garland, Harris focused her remarks on the victims of misogyny, racism, sexual identity discrimination, stalking and political intimidation.?It may be hoped that the VP will see doctors themselves, especially those in private practice, as targets of that same harassment and abuse, on the verge of professional and financial ruin because of it.?

As night follows day, right-wing critics of the initiative such as Dana Loesch of ‘the Dana Show’, the New York Post and the Libertarian Party (https://www.audacity.com | National Task Force On Online Harassment - Bing video | Kamala Harris leads latest Biden 'disinformation' team (nypost.com)|https://reason.com/2022/06/17/kamala-harris-task-force-online-harassment/ ) bashed ‘Big Sister’ Harris as trampling on the First Amendment.

?2022 Guy Christopher Carter, Ph.D.