The Role of the Internet in Doctor Performance Rating

Historically, if a patient was dissatisfied with care, he or she could tell his or her friendsand family. The criticism was limited to a small circle of people. If the patient was injurednegligently, he or she could hire an attorney to prosecute a lawsuit. The threshold for findingan attorney and prevailing posed a significant barrier for the patient achieving redress. Withthe Internet, if a patient is unhappy he or she needs do little more than access a growingnumber of Internet physician rating sites. Such criticism can be rendered anonymously. Theposts are disseminated worldwide, and once posted, the criticism rarely comes down. Whiletransparency is a laudable goal, such sites often lack accountability. More formal sites run byauthoritative bodies, such as medical licensing boards, also provide data about physicians, butsuch data is often unfiltered, making it difficult for the public to properly interpret.Given how important reputation is to physicians, the traditional remedy of suing fordefamation because of libelous posts is ordinarily ineffective. First, many patients who postlibelous comments, do so anonymously. Next, the Internet Service Providers (ISPs) hostingsuch sites are generally immune from liability for defamation. Finally, the law has a very formaldefinition for libel, and a negative rating does not necessarily equate to “defamation.”A novel method of addressing un-policed physician rating sites in the Internet age is described.The system embraces the use of mutual privacy contracts to provide physicians a viable remedyto anonymous posts. In exchange, patients receive additional privacy protections above andbeyond that mandated by law.Key words: Defamation, libel, Internet, physician, rating sites, Section 230, CommunicationDecency Act, anonymous