First, a brief but necessary introduction: 

Negative patient reviews are a fact of life. You can’t avoid them, and you shouldn’t ignore them. Instead, deal with them by leveraging the techniques you’ve honed as a physician – diagnose the problem, synthesize a cure, and administer treatment. At Medical Justice, we’ve helped our clients respond to thousands of negative patient reviews. Today, we are sharing the essentials ingredients with the public – addressing reviews from anonymous patients slamming doctors online.

If you are preparing a response to a negative patient review, schedule a free consultation with our Founder and CEO, Jeff Segal, MD, JD. We offer complimentary consultations specific to patient reviews. We’ll help you defend your practice’s reputation and keep you from stepping on one of the dozens of regulatory landmines that catch doctors and practice managers off-guard. Use the form below to schedule your free consultation. 

Our hope is that physicians will exit this page having learned how to respond to negative patient reviews in a way that is effective, concise, respectful of their limited time, and HIPAA compliant. We’ll achieve this end by providing readers with several guidelines and real-life examples. Additional resources are available for download within the article. 

Now that you know the agenda – let’s start by reviewing the essentials…

How to Respond to Negative Patient Reviews: The 5 Golden Rules to Follow

Responding to negative patient reviews is a time-consuming process. There are also regulatory landmines doctors must avoid. Some are obvious: Never reveal information about a patient’s treatment without their written authorization. Never identify the author of a review as your patient. Never post billing information online. Others are not as obvious.  

When writing a response to a negative patient review, you must remember…

1. A model response shows the practice is reasonable and isn’t in a debate.

2. A model response educates the public.

3. A model response addresses the concerns raised in the review.

4. A model response takes the conversation offline.

5. A model response does not address the author directly.

Write these rules on a piece of paper and share them with your staff. The employee responsible for finding and responding to negative patient reviews should commit these to memory.

The next part of this lesson involves carefully dissecting several real-life examples; examples of negative reviews and examples of model responses. Consider how the examples incorporate all five of the principles outlined above. We’ve prepared a total of four examples, organized into sets of two.  

The first set teaches physicians how to respond to negative reviews that result from medical complications. The second set provides instruction on how to respond to negative reviews that result from unexpected costs.

Disclaimer: All examples featured in this piece were collected and posted online by our online reputation management platform, eMerit. The model responses were written by our account managers in collaboration with our clients.  We should mention most of the feedback our clients collect is positive. However, we have never filtered reviews. We believe the practice of filtering patient reviews is deceptive. Professional licensing boards regulate advertising and marketing. To such boards, filtering reviews can be perceived as false and deceptive advertising. Further, Google follows this guiding principle in its new E.A.T rules. If you are unfamiliar with E.A.T., we suggest reading this article published by SterlingSky. The penalties can be harsh. You’ve been warned. 

That said – let’s dive in…

So – How Do You Respond to a Negative Patient Review that Resulted from a Medical Complication?

Most medical/surgical procedures are completed without issue. The patient is satisfied with the results and renders payment in a timely fashion. The patient moves on, and so does the doctor. Other times the patient exits the practice feeling dissatisfied either because of objective or subjective concerns. An objective concern is a complication, expected or unexpected. A subjective concern is a mismanaged expectation.  This may spark exchanges like the example depicted below…

Most medical/surgical procedures are completed without issue. The patient is satisfied with the results and renders payment in a timely fashion. The patient moves on, and so does the doctor. Other times the patient exits the practice feeling dissatisfied either because of objective or subjective concerns. An objective concern is a complication, expected or unexpected. A subjective concern is a mismanaged expectation.  This may spark exchanges like the example depicted below…

“While we are sympathetic toward patients who do not see their desired results, we must emphasize that Dr. [BLANK] is board certified through the American Board of Plastic Surgery for plastic and reconstructive surgery in [BLANK], [BLANK]. We hope that readers understand that unfounded allegations like in the above review serve only to start harmful rumors.”

The practice has taken a defensive stance, but it is not an emotional one. They are simply stating facts. The practice acknowledges the patient’s dissatisfaction without divulging unnecessary information. They are content to keep “their side of the story” to themselves.  

At a glance, this sounds like a terrible tactic. There are, after all, two sides to every story. Sharing your side of the story may offer the public insight into the clinical aspects of your care. Your side of the story may vindicate you – if not in the eyes of patients, perhaps in the eyes of your fellow physicians.  

The temptation to tell all is strong. Still – don’t do this. You’ll get burned. 

Imagine a situation where a patient and a doctor are arguing. For the physician to tell his side of the story, what must he do? He must reveal details about the patient’s care. This is a potential HIPAA violation. 

Therefore – a physician should never attempt to tell “his side of the story” when responding to an online review unless the patient has provided the physician with expressed written consent. Unless his audience is clairvoyant, the surgeon can’t share his thoughts without creating a public record of the patient’s care. Irritating? Absolutely. Can you still demonstrate your clinical expertise to the public? Absolutely. But there’s an optimal way to do it. We’ll explain how – let’s return to the above example.  

When the patient calls into question the physician’s qualifications, the practice refutes the claim, as we saw above. But then they take an extra step…

“Additionally, his well-honed skills have earned him much recognition, such as being voted one of ‘America’s Top Surgeons’ in 2014 and 2015 by the Consumers Research Council of America.”

Perhaps this is more information than is necessary to refute the patient, but that’s the point. Use negative reviews as an opportunity to highlight your qualifications. The response also provides the public with some general insight into the medical complication that triggered the negative review. 

“Breast implants bottoming out, though uncommon, is serious and does happen from time-to-time. It’s hard to determine one reason why bottoming out occurs, but contributing factors can include weak breast tissue, smoking, large amounts of weight loss, or even exercising without a support bra.”

This is how you demonstrate your clinical expertise to the public. Be general, and do not address the author of the negative review. The practice never refers to the review’s author as “you.” In fact, the practice barely refers to the patient at all. This is by design. When drafting your responses, you must remember: The author of the review will read your response. Your goal is to resolve his/her concerns. But the author of the negative review is not the only patient who will read your reply. It may be seen by hundreds of prospective patients. So, it pays to respond to negative reviews in a genial manner. 

We’ll close our analysis of this example by examining the practice’s closing remarks: 

“Any patient who has experienced their implants bottoming out is encouraged to contact our office so we can discuss a revision surgery.”

The purpose of this closing statement is twofold. For one, it addresses the concerns that inspired the negative review. The patient is unhappy with her results and is seeking a remedy. The remedy the practice offers is a revision surgery. Not a free surgery, or a discounted surgery, but a surgery. Perhaps it will be free. Perhaps it will be discounted. But those are details to be worked out at the practice’s discretion. The point is the patient posted with a problem and presumably left with an answer. 

Lastly: the closing statement takes the debate offline. The patient’s instructions are clear. If she wants to schedule a revision, she must contact the office directly. Taking the debate offline puts the practice in control and reduces the likelihood the patient’s personal information will be spilled online. And if the doctor-patient relationship continues to sour, it may be best for all parties if doctor and patient parted ways. Our sibling article explains how this must be done in detail: Perfecting the Patient Dismissal Letter.

Let’s examine another example. Like the first, the exchange below depicts a patient who is not satisfied with their care. We suggest reading the response below and then reviewing the five “golden rules” described in this article’s opening paragraphs. Treat it like a test – see if you can identify how the response employs all five in order to achieve a positive end result. 

The response paints the practice in a rational light by explaining why treatment described in the negative review (functional capacity evaluations) is necessary. This is done without addressing the author of the review directly. Opening with a clinical truth will keep your emotions out of the response and your focus on educating the public. When you can, share a detail about your practice’s mission statement or payment protocols. In the example above, the practice educates the audience by including the following statement in their response:

“We certainly sympathize with our patients and the pain they have due to injuries or other conditions. It is our absolute duty to lessen pain whenever we can. But we do not perform tests without necessity or precaution.”

The benefits of such a statement are obvious. It sets a certain expectation. And that expectation is, paraphrased, simply this: “We do not perform needless procedures.” 

The next priorities are addressing the concerns raised by the review and taking the debate offline. The patient is seeking a solution to their pain. The practice addresses this concern by telling the patient to contact their office directly for assistance. 

Next, the cost of treatment is a common point of contention for patients. Let’s shift our focus and discuss the best way to respond to such reviews, starting with the example below…

So – How Do You Respond to a Patient Upset By the Cost of a Procedure?

For the sake of brevity, we’ve condensed our analysis into five key points – we trust you are now familiar with them. 

How does the response demonstrate to the public the practice is rational?

“We are sensitive to the costs of medical care and strike to provide care that is not only effective but also affordable.”

“Billing, while by no means our primary motivation, is simply what allows us to continue to serve our patients.”

We’ve said it before, and it bears repeating: The best way to sanitize your responses is to deal strictly with facts. Speculative statements are easily misinterpreted by patients and may inspire a string of toxic replies. Both above statements are facts. The first explains the mission statement of the practice. The second acknowledges a universal truth – services cost money to render. A hard point to argue. 

How does the response educate the reader?

“Additionally, as a demonstration of our commitment to our patients we often offer payment plans to fit their individual needs.”

In our first example, the practice educated the public by sharing information about a typical surgical complication: breast implants bottoming out. This information was relevant to the patient’s critique and could be shared without revealing specific information about the patient’s care.  

In this second example, the source of the complaint is not a medical complication. The patient is complaining about the cost of the procedure. If you receive a complaint like this, educate the public by revealing how you help patients pay for their procedures. In the above example, the practice educates the public by revealing that it allows patients to pay for their care through customized payment plans.  

How does the response address the concerns raised in the review?

“Any patient who has questions about their account balance should contact our office. We’d be happy to help.”

How does the response take the conversation offline?

See above. Any invitation to contact the office directly will achieve this end.

Does the response address to the patient directly?

No. Non-specific statements such as “our patients” and “any patient” should be your go-to substitutes for pronouns such as “You”, “She”, and “He.”

Let’s examine one more example. Like the example above, it depicts a patient who is dissatisfied with the cost of their care. There is one big difference, however. The dispute below involves a third-party: the patient’s insurance carrier.

Responding to this kind of negative review can be difficult, as it requires the practice to enter a space where neither the patient nor the physician has complete control. Attempt to manage the online narrative by presenting the patient (and the public) with facts about your practice – write what you know.

“When asked, we try to provide quotes that are as accurate as possible. Though our costs are transparent, consistent, and competitive, we cannot always speak definitively on how an insurance provider will cover a given procedure.

We understand how frustrating an unpleasant surprise like this can be and we often work with patients to find a solution that best fits their circumstances.”

When done thoughtfully, this information can be used to educate the public and position your practice as a business that is patient, rational, and sensitive to the needs of patients. This response also addresses the patient’s concerns and takes the debate offline. If the patient wants to discuss his/her circumstances with the practice, the best way to start that conversation is by getting off the internet and contacting the practice directly. The practice has not promised anything, which is wise, but it is not stonewalling, either. The outcome, favorable or unfavorable, will be determined by the private conversation that takes place between the patient and their care provider. 

And with that, we’ve come to the end of our list of examples. While we believe the above four analyses are detailed and insightful, we recognize they are not exhaustive. There are many more reasons why patients write negative reviews. If you are dealing with negative patient reviews, schedule a free consultation to learn how we can help you protect your online reputation. 

Learn how Medical Justice can protect you from medico-legal mayhem… 

Jeffrey Segal, MD, JD

Chief Executive Officer and Founder

Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. Dr. Segal is a Fellow of the American College of Surgeons; the American College of Legal Medicine; and the American Association of Neurological Surgeons. He is also a member of the North American Spine Society. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

Dr. Segal was a practicing neurosurgeon for approximately ten years, during which time he also played an active role as a participant on various state-sanctioned medical review panels designed to decrease the incidence of meritless medical malpractice cases.

Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.

In 2000, he co-founded and served as CEO of DarPharma, Inc, a biotechnology company in Chapel Hill, NC, focused on the discovery and development of first-of-class pharmaceuticals for neuropsychiatric disorders.

Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.

We have written extensively on how challenging it is to sue a patient for defamation based on a negative online review. Such a lawsuit will take time, be expensive, and deliver an uncertain outcome. And if it is just a single review, the effort will generally exceed the benefit. Further, it is not even clear that a one-star review, without more, is even considered defamatory.  

Defamation is a false fact, communicated to a third party which damages one’s reputation.  

A false fact is not an opinion. Opinion is a defense against an allegation of defamation.  

Onward to a recent appellate case in Colorado.  

Plaintiff Dr. Susan Schroeder and Perfect Skin Dermatology, PC sued “John Doe” alleging defamation and trade libel/product disparagement. 

The doctor alleged that in September 2019, she noticed a string of negative reviews on Vitals.com. More than 30 reviews from 2015 to 2018 consisted of similar negative reviews by a “self-verified patient of Dr. Susan S. Schroeder.” Some were just one-star ratings devoid of content. Others  

“purported to comment negatively on the ease of making an appointment; the friendliness of the staff; the accuracy of their diagnosis; and/or Dr. Schroeder’s promptness, bedside manner, time spent with the patient, and appropriate follow-up.” 

Dr. Schroeder and her practice filed a lawsuit against defendant “John Doe” whom plaintiffs alleged was “an individual, or a group of individuals acting in concert, whose identity, capacity, and residence is unknown to Plaintiffs.” 

Plaintiffs further alleged that Doe had “concealed [his] true identity and capacity while masquerading as dozens of patients purporting to express widespread dissatisfaction with the services and care provided by Plaintiffs”; that “the [r]eviews are false and defamatory, do not represent actual customer experiences, complaints, or opinions, and were published with the intent of harassing Plaintiffs and causing injury to their economic interests and otherwise good standing in the community and profession”; and that the reviews had caused plaintiffs to suffer reputational harm, loss of revenue, and other injuries. Based on these allegations, plaintiffs asserted claims for defamation and trade libel/product disparagement.” 

And away we go.  

Dr. Schroeder and her practice (the Plaintiffs) served subpoenas on Vitals.com to identify IP addresses.  

Vitals.com supplied records indicating that twenty-three of the reviews had been uploaded from the same three Comcast IP addresses: ten reviews in 2016 and 2018 from a single IP address; six in 2017 from another IP address within the same limited “net range”; and seven in 2015 and early 2016 from a third IP address. 

So, these were probably not 23 patients. Perhaps they represented one patient. Maybe three patients. Most likely one. 

Then, Plaintiffs served a subpoena on Comcast to get the actual identity of those who posted the reviews. In other words, Comcast was asked which account(s) was/were assigned those specific IP addresses on the identified dates/times when reviews were posted. 

Comcast alerted “John Doe” who filed a motion to quash the subpoena. Meaning, John Doe fought the subpoena. The trial court granted the motion. John Doe temporarily won and remained anonymous.  

The Plaintiffs appealed.  

One of the arguments John Doe asserted to avoid unmasking was this. The statements (reviews) were just opinions and they were not false statement of fact.  

The court responded: 

“Statements of pure opinion are constitutionally protected” and, thus, cannot support a libel or defamation claim. But “[t]o be entitled to full constitutional protection, the statement must not contain a provably false factual connotation or, if it does, it must not be such that it could reasonably be interpreted as stating actual facts.”  In determining whether a statement is one of pure opinion — and thus constitutionally protected — we consider (1) whether the statement is sufficiently factual to be susceptible of being proved true or false and (2) whether reasonable people would conclude that the assertion is one of fact. In considering the second question, we look to the phrasing, the context, and the circumstances surrounding the publication of the statement.” 

The court concluded that whether the reviews were even written by a patient could be demonstrably proven as true or false. If a non-patient posted as a patient, that would be false. Of course. 

Further, it was possible the reviews, in aggregate, could be proven demonstrably false.   

“And if the reviews purport to have been submitted by different patients (a question we needn’t and don’t resolve at this stage of the case) but in fact they were not, then they may not be protected.” 

So, opinions posted by a non-patient, posing as a patient, would not be protected.  

Also, opinions posted by one patient, posing as many patients, would not be protected. 

In other words, it depends.  

John Doe defended again, arguing that one-star ratings, without words, are constitutionally-protected expressions of opinion. The court responded: 

“But a series of dozens of reviews, if each purports to have been submitted by a different patient, may communicate an objective, potentially false fact: that the speakers are multiple separate patients who each had a negative patient experience with the provider.” 

Throwing everything including the kitchen sink into the defense, John Doe ALSO argued that Plaintiff was precluded from collecting on libel, because she was “libel-proof.”  

What’s that?  

It’s a widely criticized doctrine which asserts that a plaintiff’s reputation was so damaged prior to the recent publications, that there could not be any incremental damage to reputation based on new publications. It generally applies in cases with plaintiffs who have prior criminal convictions.  

The judges rejected this defense. 

Doe points to twenty-seven one-star reviews of plaintiffs on the Vitals.com site from 2009 through 2014, predating the reviews at issue in this case. But those negative reviews don’t conclusively establish that plaintiffs’ reputations were so irreparably damaged by prior publications that any further negative comments could not have damaged them any further. See Liberty Lobby, 746 F.2d at 1568; see also Guccione v. Hustler Mag., Inc., 800 F.2d 298, 303 (2d Cir. 1986) (“The libel-proof plaintiff doctrine is to be applied with caution, since few plaintiffs will have so bad a reputation that they are not entitled to obtain redress for defamatory statements, even if their damages cannot be quantified and they receive only nominal damages.)” 

And it’s possible John Doe was actually responsible for these earlier negative reviews. 

Colorado appellate court has spoken. Now the case goes back to lower court. Comcast will likely have to reveal John Doe(s) identity. Unless it gets appealed again. 

What are the take home messages? 

• A one-star review by itself, if purported to be by a patient, may be considered defamatory if ultimately proven to be written by a non-patient.  
• Multiple one-star reviews, purportedly written by many patients, may be considered defamatory if ultimately proven to be written by one patient. 
• Even if a doctor has a prior rotten reputation, it is possible for that bad reputation to be made even worse with new defamatory reviews. 

What do you think?

Jeffrey Segal, MD, JD

Chief Executive Officer and Founder

Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. Dr. Segal is a Fellow of the American College of Surgeons; the American College of Legal Medicine; and the American Association of Neurological Surgeons. He is also a member of the North American Spine Society. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

Dr. Segal was a practicing neurosurgeon for approximately ten years, during which time he also played an active role as a participant on various state-sanctioned medical review panels designed to decrease the incidence of meritless medical malpractice cases.

Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.

In 2000, he co-founded and served as CEO of DarPharma, Inc, a biotechnology company in Chapel Hill, NC, focused on the discovery and development of first-of-class pharmaceuticals for neuropsychiatric disorders.

Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. Byrd Adatto was selected as a Best Law Firm in the 2021 edition of the “Best Law Firms” list by U.S. News – Best Lawyers. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.

Medical Justice provides free consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a free consultation – or use the tool shared below.

In 2019, we alerted members to avoid the practice of “review gating.”

What’s that, you reasonably ask?

Review-gating is the process of filtering candidates before asking them to leave you a review.  Normally this is done by sending many or all customers an email or text message template and first asking them if they had a positive or negative experience.

If they had a positive experience, they are asked to leave a review on a review site, such as Google.

But if they had a negative experience, they are prompted to leave private feedback and are never sent the option to leave a review publicly. Negative reviews are buried.

Business owners have loved this feature because they are terrified of negative reviews and naturally prefer the opportunity to have only 5-star reviews. Of course.

In April 2018 Google clarified its guidelines stating that review gating is not permitted.

“Don’t discourage or prohibit negative reviews or selectively solicit positive reviews from customers.”

In 2019, we also believed that use of review gating by doctors could create issues with a Board of Medicine or Dentistry. The practice of medicine and dentistry are heavily regulated by these Boards. Marketing and advertising are allowed as long as the messages are not false or deceptive. Trapping negative responses from patients to keep them their reviews from posting on a third-party review sites, tilting the table in favor of positive reviews, arguably looks like false or deceptive marketing. A patient relying on third party sites, with no knowledge of filtering, will reasonably conclude a practice delivers stellar performance when, in fact, that may not be the case. That could lead to an allegation of unprofessional behavior, putting one’s license at risk.

There are scores of review-capturing processes that enable review gating. They tout review gating as a desirable feature. Such platforms are often ignorant of how regulated the healthcare space is.

Now, the Federal Trade Commission (FTC) has spoken.

The FTC announced that online fast-fashion retailer, Fashion Nova had agreed to pay a $4.2 million fine for selectively not publishing negative product reviews. Fashion Nova also agreed it will no longer suppress customer reviews.

The FTC complaint alleged that Fashion Nova had “misrepresented that the product reviews on its website reflected the views of all purchasers who submitted reviews, when in fact it suppressed reviews with ratings lower than four stars out of five. The case is the FTC’s first involving a company’s efforts to conceal negative customer reviews.”

The agency also notified 10 review platforms that they can no longer “avoid collection or publication of negative reviews.” [BTW, the list of these platforms was identified by a request filed under Freedom of Information Act.]

It is the first case focused solely on reviews with such a significant fine, and puts the world on notice that the FTC is finally putting a stake in the ground around abusive review practices. The vote was unanimous and non-partisan (4 – 0) in favor of issuing the complaint and accepting the consent agreement with Fashion Nova.

As Near Media reported, review gating is unethical and now clearly illegal.

The good news is that practices that deliver excellent service and great results need not worry excessively about an occasional negative review. An occasional negative review, amid a sea of positive reviews, makes the positive reviews look authentic and real. The public understands you cannot make everyone happy. The public is more interested in how you solve problems, rather than being perfect. You get points for solving problems.

The FTC is sending a warning shot across the bow. Expect anyone with an ax to grind to think about notifying the FTC. This list includes disgruntled patients whose voices are silenced, unhappy ex-employees, and jilted ex-spouses/lovers. And, yes, competitors. Most practices cannot handle a $4.2M fine, much less the negative publicity surrounding such action.

Finally, don’t be surprised in state Attorney Generals pick up the slack if the FTC limits its own responses. From NY Attorney General Website:

Carmel is a well-known car service based in New York City.  The investigation into Carmel found that between May 5, 2016 and July 27, 2016, the company sent 161,000 email messages to Carmel customers requesting feedback regarding their recent ride with Carmel.  Customers were asked to evaluate Carmel services by clicking “Perfect” or “Good,” listed with an opportunity for ten dollars ($10) discount off the next ride, or “Bad,” which did not offer any discount.  Upon clicking the “Perfect” and “Good” links, the customer was directed to a consumer-review website such as Yelp.com and provided a $10 discount off their next ride upon confirmation of the review. If a customer clicked on the “Bad” button, he or she was directed to a web portal at Carmel with the opportunity to leave feedback. However, in this case, they were not directed or otherwise told to post the review on a consumer-review website and were not offered a discount or any other form of compensation.

Negative reviews were buried and never saw the light of day. In 2016, Carmel paid $75k fine as per its agreement with the NY Attorney General.

What are the tea leaves saying?

A fine in 2016 for review gating plus “paying” for positive reviews was $75k. A fine in 2022 solely for review gating was $4.2M.

If you are using a platform that review gates, NOW is the time to get your house in order. We built our review capture system with compliance in mind. Schedule a free consultation to identify whether your system may be non-compliant.

Medical Justice provides free consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a free consultation – or use the tool shared below.

Jeffrey Segal, MD, JD

Chief Executive Officer and Founder

Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. Dr. Segal is a Fellow of the American College of Surgeons; the American College of Legal Medicine; and the American Association of Neurological Surgeons. He is also a member of the North American Spine Society. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

Dr. Segal was a practicing neurosurgeon for approximately ten years, during which time he also played an active role as a participant on various state-sanctioned medical review panels designed to decrease the incidence of meritless medical malpractice cases.

Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.

In 2000, he co-founded and served as CEO of DarPharma, Inc, a biotechnology company in Chapel Hill, NC, focused on the discovery and development of first-of-class pharmaceuticals for neuropsychiatric disorders.

Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. Byrd Adatto was selected as a Best Law Firm in the 2021 edition of the “Best Law Firms” list by U.S. News – Best Lawyers. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.

Medical Justice provides free consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a free consultation – or use the tool shared below.

Review bombing of a business is defined as influx of negative online reviews from non-customers due to public attention.

This August, Yelp added two new features businesses can list on their profiles. A business can publicize that its staff is fully vaccinated against COVID-19. It can also indicate if it requires customers to provide proof of vaccination to receive services. Businesses can highlight these vaccine “badges.” Those searching on Yelp can filter their queries using these parameters.

As of August 23, 26k businesses listed at least one of these two vaccine “badges” on their profiles.

Some of these businesses have been carpet-bombed with negative reviews, often from non-customers.

The company said it would proactively monitor the pages of businesses that chose to disclose their vaccine policies, read new reviews before they are published and remove those that violate its terms of service.…So far, 45 reviews have been taken down through proactive moderation.

The company began using proactive moderation to manage the rollout of new badges last summer, when Yelp added one to identify Black-owned businesses as part of the company’s response to the killing of George Floyd. Since then, the company has pre-emptively monitored the pages of any business using its identity-based attributes. 

Yelp didn’t use the strategy when it created filters to let businesses share their masking policies earlier in the coronavirus pandemic. Roseann Rostoker, owner of Red Gravy, a restaurant in New Orleans, said she received one-star reviews on Yelp from people upset about her mask policy.

Yelp created special Covid-19 content guidelines in March 2020 and has “removed more than 13,000 reviews for violating these guidelines.”

Yelp apparently monitors changes in traffic to a page. If some public controversy leads to more page views and more negative reviews, it temporarily freezes content on that page. So, no new negative reviews can be left. But no new positive reviews can be posted either.

The jury is still out whether adding these vaccine badges will be a financial net positive or negative for a business, or whether the results will vary depending on the type of business and what part of the country the business is based.

Still, one business summed up his internal accounting opinion of Yelp.

Mr. Frangiadis, executive chef and managing partner of Spork in Pittsburgh, started requiring proof of vaccination for guests at his restaurant. He has not updated his company Yelp profile to reflect that update. He opined Yelp’s proactive moderation policy is welcome, but he still doesn’t like the platform because it doesn’t limit reviews to people who have dined at Spork and it can be hard to reach people at Yelp. “We would be perfectly comfortable without having a Yelp page at all,” he said. 

He’s probably not alone.

What do you think?

Medical Justice provides free consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a free consultation.

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Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. Dr. Segal is a Fellow of the American College of Surgeons; the American College of Legal Medicine; and the American Association of Neurological Surgeons. He is also a member of the North American Spine Society. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

Dr. Segal was a practicing neurosurgeon for approximately ten years, during which time he also played an active role as a participant on various state-sanctioned medical review panels designed to decrease the incidence of meritless medical malpractice cases.

Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.

In 2000, he co-founded and served as CEO of DarPharma, Inc, a biotechnology company in Chapel Hill, NC, focused on the discovery and development of first-of-class pharmaceuticals for neuropsychiatric disorders.

Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. Byrd Adatto was selected as a Best Law Firm in the 2021 edition of the “Best Law Firms” list by U.S. News – Best Lawyers. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.