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February 18, 2014

A 52 year old diabetic man was urgently referred to me for cardiac clearance because of an abnormal electrocardiogram.  He had fractured his shoulder in a motorcycle accident and needed emergency surgery.

We took him in promptly as a walk-in patient.  After the consultation, I performed a stress test which he passed.  He was cleared for the surgery with an hour!

Four weeks later I received a call from him that the testing was unnecessary, that in fact, we never did a stress test, and that he was not willing to pay the $500 which was part of his deductible.  He refused any discussion.  He, then, very clearly threatened my biller that if we did not write off his bill, he would leave us horrible reviews all over the internet.

And he did!  An extensive, detailed, Yelp review that made me even doubt my own legitimacy.

Terrorism is defined as the use of threat or fear to intimidate or coerce a certain desired result.  In this case,  as often seen in medical practices, the patient did not want to pay a bill and retaliated, not against the insurance company, but against the accommodating physician.

Doctors are now dealing with a new form of terrorism.  My patient is the Yelp terrorist.  Your patient may be a Facebook terrorist.

There is tremendous power that comes with the dissemination of online medical information.  However, there is also abuse of this power.  Yelp gives voice to the objectionable patient.  Unfortunately, satisfied patients rarely leave positive reviews, as they expect nothing but the best from their doctors.  But mentally unstable patients are given priority because the forums are looking for passionate reviews!  This problem is so prevalent that Yelp has an entire section dedicated to businesses who have unsuccessfully tried to sue Yelp for what they believe to be character assassination.

Should a doctor’s twelve years of post graduate schooling and years of scientific and medical training be reduced to a Yelp review much like a plumber or restaurant?  A search for Yelp reviews on some of the highly respected and well known iconic physicians and surgeons is embarrassing. 

Perhaps it is time doctors have a patient screening site where we report patients that have been abusive, in collections for refusing to pay bills, or have left unjust on-line reviews.  By entering the patient’s social security number into this screening system, we would have a powerful tool to refuse access to those who have terrorized others!

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