14 ms·

I was nodding along until this: > They posted my entire medical record, including notes about my mental health, my bills, my insurance info, my driver’s licens

I was nodding along until this: > They posted my entire medical record, including notes about my mental health, my bills, my insurance info, my driver’s license, birth date and home address,” she said. wow. That violates HIPAA law. The counter-sue is going to be huge. Also, I had a related issue where a doctor threatened to sue based on my yelp review. I cut the review back to verifiable facts instead of opinion and asked if that compromise was ok, he said it wasn't and started claiming it was defamation. I cut off contact and that was that. I wondered if it was possible to be dragged into court by something like this, apparently I may have dodged a bullet. Scary stuff.

unethical_ban 8y ago
That is awful, and they should be punished severely for that. This reveals a predicament for businesses that have to protect customer privacy. If a restaurant owner thinks a customer is lying, they can call the person out on all kinds of media and say they're a liar. Alamo Drafthouse made a set of videos to play before movies making fun of a customer complaint call, telling her to eff off. If a doctor believe a patient is lying or doing a detriment to their business, they can't call them back out on social media. Their only remediation, if they think the statements are false, is a lawsuit to have the force of law take lies down.
- dm319 8y ago
  This is why, at least in the UK, there are several pathways to resolve disputes - both in the hospital trust and above it, which is in part to avoid this kind of scenario. If that doesn't resolve it the patient usually approaches a lawyer to seek compensation, and most times this is settled out of court and in private. When patients and family hit social media, the hospital/doctors are not able to publicly talk about the grievances, or can only put out a very limited public statement with permission (like the recent Alfie case). I had a friend of mine who refused a request by a patient out of the country, while on-call one weekend. I'll leave out the details apart from it involved shipping a large quantity of a very expensive medication to another country - as the hospital did not have this medication available. He had already sent enough of this medication to cover for at least a week (at huge cost to the NHS, as the medication had to be couriered by plane) when a second request was received 2 days later. A huge internet hate-mob appeared on Facebook saying all sorts of things about this doctor by name, to which he had no ability to respond. I'm for making healthcare more transparent, but I wonder if, as a doctor, we'd be pressurised into pleasing the patient more than treating the patients correctly, with the threat of negative yelp reviews, though that's obviously a risk with any sort of profession and review system.
  - deleted 8y ago
    [deleted]
- SOLAR_FIELDS 8y ago
  Not to discount your point, because it's mostly relevant, but in the Alamo Drafthouse case I don't ever think they reveal the name of the girl who makes the call. Though I guess if a phone call had protected HIPAA information and you could tell who it was through their voice it might be a violation?
leeter 8y ago
Reviews are protected speech, this has been litigated multiple times and has precedent in the US. If you live in an area with a SLAPP law I would suggest getting an attorney to file a SLAPP motion for you. The onus is then on the plaintiff to prove they aren't suing you to stifle your speech. If they can't then they have to pay full court costs and your attorney's fees as well as a penalty in many jurisdictions. In this case the subject is in NY state which has an Anti-SLAPP law and she should apply it and HIPAA. https://en.wikipedia.org/wiki/Strategic_lawsuit_against_public_participation https://en.wikipedia.org/wiki/Strategic_lawsuit_against_publ...
- ballenf 8y ago
  That's fine but they don't have to pay until after the case and appeals. Meaning you have to be able to front the litigation costs in order to have a chance at recovering them. There is a non-zero risk of losing. I would suggest using a pseudonym and VPN for any review written on a potentially litigious business unless you have the funds to litigate. Problem is Yelp is much more likely to mark the review as spam.
  - matte_black 8y ago
    What if you win but they immediately go bankrupt and cannot pay you back?
    - leeter 8y ago
      Courts have a tendency to look on this as criminal contempt and refer the lawyer and the client to the various AGs when this happens.
    - joering2 8y ago
      They can go bankrupt the second judge handles verdict, but this would definitely be out of scope of said person bankrupcy proceedings similar to your education loan cannot be included into bankrupcy. the judge proceeding in bankrupcy claim will clearly see whats this is about.
    - 8y ago
Nadya 8y ago
>Wow. That violates HIPAA law. The counter-sue is going to be huge. Basically an open and shut case too. Assuming they were smart enough to "correct" the mistake it may not be a Tier 4 ($50,000+) violation, but instead a Tier 3 violation ($10,000 - $50,000 per violation) of willful neglect. I'm not sure if each violation above would be considered a single large violation or multiple small violations ( 1 violation vs 7 violations is a major difference in penalty cost). There's also SLAPP. If litigation has gone on long enough to cost her $20,000 in legal fees I can't help but feel there is a lot more to this story or my understanding of the legal system is completely out of touch...
- avn2109 8y ago
  Twenty grand in legal fees in Manhattan is about four days of attorney time, if you're lucky.
- leesalminen 8y ago
  $20,000 is nothing for litigation these days. Most advise planning for a minimum of $50,000 or $100,000 to fight something out with a judge.
  - simonbarker87 8y ago
    Serious question that I feel I already know the answer to but, how do people afford to defend themselves if the costs are that high?!
    - dmitrygr 8y ago
      Serious, and depressing, answer. They don't. This is why plea bargaining is rampant in America. It isn't necessarily very fair, because for many people this ends up ruining their lives. But facing the choice of POTENTIALLY going to prison for a number of years, and to jail for weeks awaiting trial, or pleading guilty to something that does not put them jail at all, they choose the latter (since a few weeks of absence from the world messes your life up quite a bit if you didn't prepare - you'd lose your job, maybe apartment). Even if that plea forever taints them in the eyes of employers
heisenbit 8y ago
Deliberately writing bills for services not performed is fraud. Of course there can be billing mistakes and corner cases where it is not clear what exactly has been performed. Excessive billing that goes beyond what insurance pay can motivate people to fight back... There are so many things wrong in how the doctor behaved it is mind-boggling and a big red flag. Fighting angry and stupid people in court is best avoided but one does not always have a choice.
- tabtab 8y ago
  Re: Of course there can be billing mistakes and corner cases where it is not clear what exactly has been performed... This is where good lawyers know how to play. They have experience. Unless the consumer's layers are equally skilled/powerful, usually the deeper pockets win, I hate to say. It's why the rich get richer while the rest get [bleeped]. It's one of the reasons Hillary was unlikely to be jailed for being sloppy with email; the laws are fuzzy enough to milk. But this applies to all plutocrats, not just Hillary, including the current occupants at Washington DC.
  - dang 8y ago
    "Eschew flamebait. Don't introduce flamewar topics unless you have something genuinely new to say. Avoid unrelated controversies and generic tangents." https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
- conanbatt 8y ago
  You've heard only one side so far.
brightball 8y ago
My question around reviews in medical is always around how a physician is supposed to be able to respond because of HIPAA? It almost seems unfair to be able to review them since there is very little they can do to refute anything without violating it. It seems like there should be some special set of rules around medical reviews, in my opinion at least.
- ballenf 8y ago
  You can explain just that in the response and not much more. Even if the patient reveals PHI you should avoid confirming or acknowledging it as the "covered entity" under HIPAA. A confirmation of a diagnosis is different than a person discussing symptoms. I would argue that you probably should avoid even acknowledging that the person is a patient or has been seen in the office. The approach will reinforce to others how seriously you take privacy and you can taut your customer service policies, etc. I wouldn't call this unfair since all providers are in the same situation. (This isn't legal advice, obviously.)
  - SilasX 8y ago
    It's not unfair in the sense of "advantage over competitors", but it definitely seems unfair in the sense of "not being allowed to publicly refute public allegations against you".
- lazyasciiart 8y ago
  Reviews are opinions. Some of them are lies. Some of them are fake. It is almost never a good idea for a business to try a detailed rebuttal to a negative review, no different for doctors.
- b_t_s 8y ago
  If it's BS, call them on it with something along the lines of "We dispute the veracity of this claim. Further, the alleged conduct is a felony, so if the client genuinely believes their allegations, we encourage them to file a criminal complaint at their local police station." This conveys "client is a nut, we are professionals, and we can prove it" whereas arguing the details of a case with confidential info in a public forum is wildly unprofessional and sometimes illegal.
rokhayakebe 8y ago
Detailed anonymous review, no one can sue you.
conanbatt 8y ago
It cant be understated how a bad review on yelp can tear your practice down and put you on the street. Figure a physician sees 16 to 22 patients a day, and if one of them tanks you you can lose everything. Review wars are real in all retail businesses, its pretty sad. ----- I cannot imagine a lawyer would condone the HIPAA violation, I wonder if there are exceptions when the patient has made that information public before you (patient said she had x, and you say "We did not diagnose x") or smth.
dawnerd 8y ago
I've been threatened with a lawsuit over a review before. Even though I know I'd be in the right, just the processes of going to court and defending yourself is a huge pain. Not sure why a company would risk trying to sue someone over a review when it would undoubtedly backfire and be really bad pr for them. Definitely recommend checking out libel insurance. Shouldn't cost much to get and will help protect against companies trying to go after you.
- fencepost 8y ago
  Revision: "This review removed under threat of a lawsuit." And to be scrupulously neutral, 3 stars if that's an option.
danieltillett 8y ago
You are assuming this is true. I have read through the case records and I am not confident that anything the defendant says is true. If it is false then the defendant will have just increased their loss - judges tend not to look to favourably on running a PR campaign outside of the court process.
ikeboy 8y ago
>I cut the review back to verifiable facts instead of opinion Opinion is allowed, verifiable facts are allowed. False statements of facts are not.
xapata 8y ago
If you like to write reviews, buy umbrella insurance. It's cheap and covers all sorts of random stuff for millions.

unethical_ban 8y ago

That is awful, and they should be punished severely for that. This reveals a predicament for businesses that have to protect customer privacy. If a restaurant owner thinks a customer is lying, they can call the person out on all kinds of media and say they're a liar. Alamo Drafthouse made a set of videos to play before movies making fun of a customer complaint call, telling her to eff off. If a doctor believe a patient is lying or doing a detriment to their business, they can't call them back out on social media. Their only remediation, if they think the statements are false, is a lawsuit to have the force of law take lies down.

dm319 8y ago
This is why, at least in the UK, there are several pathways to resolve disputes - both in the hospital trust and above it, which is in part to avoid this kind of scenario. If that doesn't resolve it the patient usually approaches a lawyer to seek compensation, and most times this is settled out of court and in private. When patients and family hit social media, the hospital/doctors are not able to publicly talk about the grievances, or can only put out a very limited public statement with permission (like the recent Alfie case). I had a friend of mine who refused a request by a patient out of the country, while on-call one weekend. I'll leave out the details apart from it involved shipping a large quantity of a very expensive medication to another country - as the hospital did not have this medication available. He had already sent enough of this medication to cover for at least a week (at huge cost to the NHS, as the medication had to be couriered by plane) when a second request was received 2 days later. A huge internet hate-mob appeared on Facebook saying all sorts of things about this doctor by name, to which he had no ability to respond. I'm for making healthcare more transparent, but I wonder if, as a doctor, we'd be pressurised into pleasing the patient more than treating the patients correctly, with the threat of negative yelp reviews, though that's obviously a risk with any sort of profession and review system.
- deleted 8y ago
  [deleted]
SOLAR_FIELDS 8y ago
Not to discount your point, because it's mostly relevant, but in the Alamo Drafthouse case I don't ever think they reveal the name of the girl who makes the call. Though I guess if a phone call had protected HIPAA information and you could tell who it was through their voice it might be a violation?

leeter 8y ago

Reviews are protected speech, this has been litigated multiple times and has precedent in the US. If you live in an area with a SLAPP law I would suggest getting an attorney to file a SLAPP motion for you. The onus is then on the plaintiff to prove they aren't suing you to stifle your speech. If they can't then they have to pay full court costs and your attorney's fees as well as a penalty in many jurisdictions. In this case the subject is in NY state which has an Anti-SLAPP law and she should apply it and HIPAA. https://en.wikipedia.org/wiki/Strategic_lawsuit_against_public_participation https://en.wikipedia.org/wiki/Strategic_lawsuit_against_publ...

ballenf 8y ago
That's fine but they don't have to pay until after the case and appeals. Meaning you have to be able to front the litigation costs in order to have a chance at recovering them. There is a non-zero risk of losing. I would suggest using a pseudonym and VPN for any review written on a potentially litigious business unless you have the funds to litigate. Problem is Yelp is much more likely to mark the review as spam.
- matte_black 8y ago
  What if you win but they immediately go bankrupt and cannot pay you back?
  - leeter 8y ago
    Courts have a tendency to look on this as criminal contempt and refer the lawyer and the client to the various AGs when this happens.
  - joering2 8y ago
    They can go bankrupt the second judge handles verdict, but this would definitely be out of scope of said person bankrupcy proceedings similar to your education loan cannot be included into bankrupcy. the judge proceeding in bankrupcy claim will clearly see whats this is about.
  - 8y ago

Nadya 8y ago

>Wow. That violates HIPAA law. The counter-sue is going to be huge. Basically an open and shut case too. Assuming they were smart enough to "correct" the mistake it may not be a Tier 4 ($50,000+) violation, but instead a Tier 3 violation ($10,000 - $50,000 per violation) of willful neglect. I'm not sure if each violation above would be considered a single large violation or multiple small violations ( 1 violation vs 7 violations is a major difference in penalty cost). There's also SLAPP. If litigation has gone on long enough to cost her $20,000 in legal fees I can't help but feel there is a lot more to this story or my understanding of the legal system is completely out of touch...

avn2109 8y ago
Twenty grand in legal fees in Manhattan is about four days of attorney time, if you're lucky.
leesalminen 8y ago
$20,000 is nothing for litigation these days. Most advise planning for a minimum of $50,000 or $100,000 to fight something out with a judge.
- simonbarker87 8y ago
  Serious question that I feel I already know the answer to but, how do people afford to defend themselves if the costs are that high?!
  - dmitrygr 8y ago
    Serious, and depressing, answer. They don't. This is why plea bargaining is rampant in America. It isn't necessarily very fair, because for many people this ends up ruining their lives. But facing the choice of POTENTIALLY going to prison for a number of years, and to jail for weeks awaiting trial, or pleading guilty to something that does not put them jail at all, they choose the latter (since a few weeks of absence from the world messes your life up quite a bit if you didn't prepare - you'd lose your job, maybe apartment). Even if that plea forever taints them in the eyes of employers

heisenbit 8y ago

Deliberately writing bills for services not performed is fraud. Of course there can be billing mistakes and corner cases where it is not clear what exactly has been performed. Excessive billing that goes beyond what insurance pay can motivate people to fight back... There are so many things wrong in how the doctor behaved it is mind-boggling and a big red flag. Fighting angry and stupid people in court is best avoided but one does not always have a choice.

tabtab 8y ago
Re: Of course there can be billing mistakes and corner cases where it is not clear what exactly has been performed... This is where good lawyers know how to play. They have experience. Unless the consumer's layers are equally skilled/powerful, usually the deeper pockets win, I hate to say. It's why the rich get richer while the rest get [bleeped]. It's one of the reasons Hillary was unlikely to be jailed for being sloppy with email; the laws are fuzzy enough to milk. But this applies to all plutocrats, not just Hillary, including the current occupants at Washington DC.
- dang 8y ago
  "Eschew flamebait. Don't introduce flamewar topics unless you have something genuinely new to say. Avoid unrelated controversies and generic tangents." https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
conanbatt 8y ago
You've heard only one side so far.

brightball 8y ago

My question around reviews in medical is always around how a physician is supposed to be able to respond because of HIPAA? It almost seems unfair to be able to review them since there is very little they can do to refute anything without violating it. It seems like there should be some special set of rules around medical reviews, in my opinion at least.

ballenf 8y ago
You can explain just that in the response and not much more. Even if the patient reveals PHI you should avoid confirming or acknowledging it as the "covered entity" under HIPAA. A confirmation of a diagnosis is different than a person discussing symptoms. I would argue that you probably should avoid even acknowledging that the person is a patient or has been seen in the office. The approach will reinforce to others how seriously you take privacy and you can taut your customer service policies, etc. I wouldn't call this unfair since all providers are in the same situation. (This isn't legal advice, obviously.)
- SilasX 8y ago
  It's not unfair in the sense of "advantage over competitors", but it definitely seems unfair in the sense of "not being allowed to publicly refute public allegations against you".
lazyasciiart 8y ago
Reviews are opinions. Some of them are lies. Some of them are fake. It is almost never a good idea for a business to try a detailed rebuttal to a negative review, no different for doctors.
b_t_s 8y ago
If it's BS, call them on it with something along the lines of "We dispute the veracity of this claim. Further, the alleged conduct is a felony, so if the client genuinely believes their allegations, we encourage them to file a criminal complaint at their local police station." This conveys "client is a nut, we are professionals, and we can prove it" whereas arguing the details of a case with confidential info in a public forum is wildly unprofessional and sometimes illegal.

rokhayakebe 8y ago

Detailed anonymous review, no one can sue you.

conanbatt 8y ago

It cant be understated how a bad review on yelp can tear your practice down and put you on the street. Figure a physician sees 16 to 22 patients a day, and if one of them tanks you you can lose everything. Review wars are real in all retail businesses, its pretty sad. ----- I cannot imagine a lawyer would condone the HIPAA violation, I wonder if there are exceptions when the patient has made that information public before you (patient said she had x, and you say "We did not diagnose x") or smth.

dawnerd 8y ago

I've been threatened with a lawsuit over a review before. Even though I know I'd be in the right, just the processes of going to court and defending yourself is a huge pain. Not sure why a company would risk trying to sue someone over a review when it would undoubtedly backfire and be really bad pr for them. Definitely recommend checking out libel insurance. Shouldn't cost much to get and will help protect against companies trying to go after you.

fencepost 8y ago
Revision: "This review removed under threat of a lawsuit." And to be scrupulously neutral, 3 stars if that's an option.

danieltillett 8y ago

You are assuming this is true. I have read through the case records and I am not confident that anything the defendant says is true. If it is false then the defendant will have just increased their loss - judges tend not to look to favourably on running a PR campaign outside of the court process.

ikeboy 8y ago

>I cut the review back to verifiable facts instead of opinion Opinion is allowed, verifiable facts are allowed. False statements of facts are not.

xapata 8y ago

If you like to write reviews, buy umbrella insurance. It's cheap and covers all sorts of random stuff for millions.