Question: It was recently brought to my attention that a patient posted on the internet false and misleading information regarding treatment I provided to her. The posting also contains false and defamatory descriptions of me and others in my office.
I can tell from the details given in this posting exactly who this patient is. The fact of the matter is that she is upset because I am insisting that she pay (she has no dental insurance) for prior services before I undertake any future dental work. I initially extracted a tooth and provided other services, all of which were the result of her very poor dental hygiene and certain lifestyle choices. She has not yet paid in full for those services. I would like to respond with my own internet posting giving these facts and otherwise setting the record straight. Can I legally do this?
Answer: The internet and social media certainly make it easy for patients to broadcast their criticisms. This is especially true in the case of health care professionals, where there are a number of websites facilitating the posting of patient “ratings” and the publishing of patient comments regarding diagnosis and treatment received. Unfortunately, for dentists and other health care professionals the playing field is not level. Patients are free to provide whatever information they wish about either themselves or their dentist, and to post commentary (whether informed or uninformed) that is unrestrained by any privilege or other confidentiality restrictions.
This is not the case for dentists and other health care professionals. HIPAA allows the use of patient information only for treatment, payment, and health care operation purposes unless you have obtained an authorization from the patient allowing your use of information for some other purpose. Prior to HIPAA this was also the case due to Michigan’s Dentist-Patient Privilege Statute. Since it is doubtful in the situation you describe that the patient is going to provide you with a written authorization to use her patient record to refute what she has posted online, you thus are prohibited from doing so.
Making matters worse, legal recourse in these situations is usually difficult. First, it is typically an issue of proving who posted the information, since most online postings are anonymous. Second — even in your case, where you are sure of the poster’s identity — it is often difficult to prove whether the statements are factual (which are actionable) vs. statements of opinion (which are not actionable). Finally, even if you can prove the identity of the poster and that the statements are factual you still must prove how you have been specifically damaged by the posting. Tying the posting to a specific loss of patients can be difficult, as the loss of patients needs to be distinguished from other factors that also may be a cause of patient loss.
This is a frustrating situation for dentists and other health care professionals, with no satisfactory way to defend yourself using patient records. The best advice is not to respond to negative postings like this and instead manage your online reputation through your own internet advertising, your practice website, etc. Consider asking satisfied patients to provide online testimonials praising you for the care you provided. Most consumers will believe the majority of the opinions that they read and will disregard the minority of negative posts. If this negative posting stands alone among several favorable patient testimonials it’s likely that most observers will see it for what it is.
Whatever you do, do not disclose any patient information without first getting a signed authorization from the patient.
This article originally appeared in the June 2025 edition of the Journal of the Michigan Dental Association.
