CNN Takes on Doctor Ratings… And Gets it Wrong

CNN has recently published an article about what to look for in a doctor rating website. Unfortunately, they repeat some misconceptions and errors about these services.

The most serious error is the claim that the greater volume a website has of doctor ratings, the more reliable or statistically valid it will become.

It’s a matter of statistics: The more reviews you read, the more likely you are to get an accurate assessment. “I would check a lot of different Web sites,” says Carol Cronin, executive director of the Informed Patient Institute. “Look across them, not just within one.”

Speaking of volume, a common concern about doctor rating sites is that one angry patient can make multiple nasty comments, using a different name each time (or, conversely, that the physician herself could go on and make multiple glowing comments).

But Martin Schneider, chairman of the Informed Patient Institute, says these sites have ways of detecting when one person is making several comments under different names. Back in the 1990s, Schneider was president of a now-defunct doctor rating site called thehealthpages.com. “Even back then, we had to the technology to stop that from happening,” he says.

These claims are commonly made, but they are largely incorrect. Here’s why…

In survey research (which is basically what a doctor rating site is trying to be), you need a sample that is both large and randomized. That is, you do not go out and post an announcement saying, “Take our survey if you think you have depression” if you’re looking for an unbiased data sample on depression in the general population. You need to have a group of people that both have and don’t have depression in order to obtain generalizable results.

The same is true with ratings sites. They may get the volumes needed, but none of these sites have any way of addressing the biased sample problem. People who rate their doctors are likely to fall into one of two categories — they either had a horrible experience with them and want others to know, or they had a wonderful experience with them and want others to know. But most people who fall in between these two extremes and have run-of-the-mill experiences with the doctor will likely never rate, because they have little incentive to do so.

You will also need a humongous number of patients rating each doctor — at least 20 to 30% of their entire patient list — in order to for the ratings to start gaining enough power to be reliable and valid (notwithstanding the population sample bias issue).

CNN admits as much later on in the same article quoting Dr. Robert Wachter:

While patient reviews might be useful, they have several clear drawbacks, our experts say. First, many doctors have just a few reviews or none at all. Second, even if a doctor has 20, 30, 50 or 100 reviews, that’s still only a small fraction of his entire patient population — and a warped fraction at that.

“The person most likely to write is the one who’s most enthralled with the doctor, or the one who’s most pissed,” Wachter says. “You’re getting a skewed view.”

The other advice — decide what’s important to you, look for patterns in the ratings, look for specifics in people’s ratings of their doctor and put more weight onto detailed reviews rather than general comments, and consult objective data already available — is generally solid, but still doesn’t address the foundational statistical problems with these types of online ratings systems. All the business people gloss over these problems, but if a rating isn’t scientific, its value is diminished substantially.

And honestly, Martin Schneider is a bit naive if he thinks it isn’t a simple thing to rate one doctor multiple times on all of these sites. Simply by clearing one’s cookies, using a few webmail addresses and using a Web proxy, you can register as many accounts as you would like on any of these services in a matter of minutes.

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13 Responses to “CNN Takes on Doctor Ratings… And Gets it Wrong”

  1. I couldn’t agree more. I know here on this blog we’ve considered the topic of “rate your doctor” sites but I don’t think it’s comparable to the value of Consumer Reports car ratings.

    I hadn’t thought about the randomization issue. I had, otoh, thought about the broader issue of self-selection bias: flaming idiots (and upset people) might be far more likely to post a rating than others, or not – who can tell.

    Completely agreed re repeat raters. Didn’t I hear that TV talent shows gave up and now let you vote as often as you want? Otherwise, the vote would be biased in favor of more devious citizens – just as you suggest about doctor ratings. Not good.

  2. David says:

    Consumers need to take back control of their patient satisfaction, and as in other industries, only the consumer can effect change. So in the case of MyDocHub.com, patients rate their doctor based on waiting room times, total wait time including the time in the patient room with the doctor, and a simple rating of 1 to 5, 5 being the highest on how satisfied they were with that appointment. The doctor ratings are averaged out, so one poor score does not hurt the doctor, but on the other hand, various poor ratings may indicate poor performance by the doctor, since the wisdom of crowds determine a more accurate assessment of the doctor.

  3. Darren says:

    The only site I found to have more detailed physician information (including physician ratings) would be http://www.mdnationwide.org. I used several other “free” services, however information generic, and I never did find his rating until I ordered a report from this site mdnationwide.org. The report also showed two malpractice judgments, which I never found anywhere else.

    I think consumers should browse the Internet and not solely rely on free information, after all – you get what you pay for.

  4. benny says:

    the mydochub.com post above has also been posted on another discussion board under a different name> ignore it.

  5. EH says:

    John, I think you are missing the point. Rating web sites are not about generating scientific data. People don’t care about unbiased scientific data unfortunately. They care about what other people say, good or bad, but not neutral. You hire or don’t hire people based on recommendations from friends. You buy a food items because your buddy says he likes it. You avoid or try a vacation spot because your neighbour said she did or didn’t have a good time there. It’s all about the social connection and the weight it carries with people. People don’t want to listen to neutral ratings. What’s the point of that? Yawn.

    In the restaurant industry, they say that one satisfied customer tells 3 friends, and 1 unsatisfied customer tells 7 friends. The neutral customer generally doesn’t tell anyone. It’s word of mouth marketing mostly for restaurants, so you have to make sure to prevent unsatisfied customers.

    Sorry to disappoint you if it isn’t scientific, but that is just the way people think. These sites do have value, but not the value you think.

  6. Reddit Reader says:

    Judge tosses Duluth doctor’s suit against patient’s family

    By Mark Stodghill, April 28, 2011, Duluth News Tribune

    A judge threw out a lawsuit today filed by a Duluth physician who said he was defamed by a man who publicly criticized his bedside manner.

    Dr. David McKee, a neurologist with Northland Neurology and Myology, alleged that Dennis Laurion of Duluth defamed him and interfered with his business by making false statements to the American Academy of Neurology, the American Neurological Association, two physicians in Duluth, the St. Louis County Public Health and Human Services Advisory Committee and St. Luke’s hospital, among others.

    Laurion was critical of the treatment his father, Kenneth, received from McKee after suffering a hemorrhagic stroke and spending four days at St. Luke’s hospital from April 17-21 last year. Kenneth Laurion recovered from his condition.

    Dennis Laurion claimed that any statements he made about the doctor were true and that he was immune from any liability to the plaintiff.

    In his 18-page order dismissing the suit, Sixth Judicial District Judge Eric Hylden wrote that looking at Laurion’s “statements as a whole, the court does not find defamatory meaning, but rather a sometimes emotional discussion of the issues.”

    Hylden addressed the fact that Laurion posted some of his criticisms of McKee on websites. “In modern society, there needs to be some give and take, some ability for parties to air their differences,” the judge wrote. “Today, those disagreements may take place on various Internet sources. Because the medium has changed, however, does not make statements of this sort any more or less defamatory.”
    Hylden concluded his order by stating that there wasn’t enough objective information provided to justify asking a jury to decide the matter.

    Laurion was relieved by the court’s ruling.

    “My parents, who are now 86, my wife and I have found this process very stressful for the past year, since my father’s stroke. There was never just one defendant,” he said. “We’re grateful that Judge Hylden found no need for a trial.”

    In his suit, McKee alleged that Laurion made false statements including that McKee “seemed upset” that Kenneth Laurion had been transferred from the Intensive Care Unit to a ward room; that McKee told the Laurion family that he had to “spend time finding out if [the patient] had been transferred or died;” that McKee told the Laurions that 44 percent of hemorrhagic stroke victims die within 30 days; that McKee told the patient that he didn’t need therapy; that McKee said it didn’t matter that the patient’s gown was hanging from his neck with his backside exposed; that McKee blamed the patient for the loss of his time; and that McKee didn’t treat his patient with dignity.

    According to the Minnesota Board of Medical Practice website, McKee has had no disciplinary actions brought against him.

    “I’m very disappointed by this court’s decision because as far as I can see the only avenue that I can see that I had to respond to this overwhelming attack was through the courts, and for the time being it appears that avenue has been closed without me ever getting a chance to present my evidence,” McKee said.

    McKee said he hadn’t had a chance to confer with Marshall Tanick, his Minneapolis attorney. He said he will do so before he decides whether to appeal the decision. Tanick told the News Tribune he had not yet seen the decision and couldn’t comment on it.

    “Dennis Laurion is a liar and a bully and a coward,” McKee said.

    More: http://www.duluthnewstribune.com/event/article/id/197679/publisher_ID/36

    Ruling: http://www.onpointnews.com/docs/Mckee-v-Laurion.pdf

  7. Reddit says:

    Doctor rating site online defamation case scheduled for appellate court hearing

    Source:

    http://macsnc.courts.state.mn.us/ctrack/view/publicCaseMaintenance.do?csNameID=71108
    (case # 111154)

    The Minnesota Court Of Appeals has scheduled the online defamation case of David McKee MD v Dennis Laurion for a hearing by a panel of three judges. The oral hearing will be November 10, 2011, at 10:00 AM in the Sixth District Court House of Duluth.

    Sources:
    http://www.duluthnewstribune.com/event/article/id/202704/
    http://minnesota.cbslocal.com/2011/06/25/duluth-doctor-appeals-judges-decision/

    Dr. David McKee, a neurologist with Northland Neurology and Myology, said he is still being targeted in online attacks related to the lawsuit he filed in June 2010 against Dennis Laurion.

    McKee, who treated Laurion’s father after he suffered a hemorrhagic stroke, alleges that Laurion made false statements about him to neurological associations, other physicians, St. Luke’s Hospital and the St. Louis County Public Health and Human Services Advisory Committee, among others. He is seeking more than $50,000 in damages.

    Dennis Laurion claimed that any statements he made about the doctor were true and that he was immune from any liability to the plaintiff.

    McKee said a sudden concentration of unfavorable critiques about him cropped up online before Sixth District Judge Eric Hylden dismissed the suit.

    “It appears that Mr. Laurion made over 100 adverse postings on the Internet once he became aware that he was going to receive a favorable decision on the motion for summary judgment,” McKee said. “Appealing seems to me the only way to curb the activities of this malicious person.”

    Laurion said he has not posted anything on the Internet about McKee since the lawsuit was filed last June. He said his lawyer advised him not to. But, because the case was thrown out, technically he could if he wanted to, he said.

    Laurion said he was aware there was an influx of Internet chatter about McKee after a link to a story about McKee appeared on the high-traffic website reddit.com.

    Kenneth Laurion spent four days at St. Luke’s hospital in April 2010. John Kelly, Dennis Laurion’s lawyer, told the News Tribune last summer they didn’t feel McKee acted appropriately toward their father, and they reported it to the hospital and Board of Medical Practice.

    Hylden wrote in his 18-page order dismissing the suit that the court did not find Laurion’s statements about McKee defamatory, “but rather a sometimes emotional discussion of the issues.”

    Hylden addressed the fact that Laurion posted some of his criticisms of McKee on websites. “In modern society, there needs to be some give and take, some ability for parties to air their differences,” the judge wrote. “Today, those disagreements may take place on various Internet sources. Because the medium has changed, however, does not make statements of this sort any more or less defamatory.”

    Hylden concluded his order by stating that there wasn’t enough objective information provided to justify asking a jury to decide the matter.

    In his suit, McKee alleged that Laurion made false statements including that McKee “seemed upset” that Kenneth Laurion had been transferred from the Intensive Care Unit to a ward room; that McKee told the Laurion family that he had to “spend time finding out if [the patient] had been transferred or died;” that McKee told the Laurions that 44 percent of hemorrhagic stroke victims die within 30 days; that McKee told the patient that he didn’t need therapy; that McKee said it didn’t matter that the patient’s gown was hanging from his neck with his backside exposed; that McKee blamed the patient for the loss of his time; and that McKee didn’t treat his patient with dignity.

    According to the Minnesota Board of Medical Practice website, McKee has had no disciplinary actions brought against him.

    “I’m very disappointed by this court’s decision because as far as I can see the only avenue that I can see that I had to respond to this overwhelming attack was through the courts, and for the time being it appears that avenue has been closed without me ever getting a chance to present my evidence,” McKee said.

    “Dennis Laurion is a liar and a bully and a coward,” McKee said. “He knowingly made false and malicious statements about me to a total of 19 different professional and medical organizations, regulatory agencies and websites.”

    Laurion’s attorney John Kelly was critical of McKee’s reaction to the decision. “I think it’s regrettable that somebody would choose language of that kind in commenting on a court decision,” Kelly said. “Secondly, this case has always been about Mr. Laurion’s reaction to what he perceived to be poor conduct on the doctor’s part in relation to his interaction with his father. And he stood up and said something about that and the judge has agreed that what he said was within the bounds that are permissible under our law.”

    References:

    http://boards.medscape.com/forums?128@659.iVYfaQ7qwue@.2a0e380e!comment=1

    http://www.techdirt.com/articles/20110629/03411314906/doctor-plans-to-appeal-ruling-that-said-complaining-about-his-bedside-manner-was-not-defamation.shtml#comments

    http://jonathanturley.org/2011/05/16/minnesota-doctor-loses-effort-to-sue-patients-son-for-defamation-about-his-allegedly-poor-bedside-manners/

    http://www.onpointnews.com/NEWS/Judge-Dismisses-Suit-Over-Bad-Review-of-Doctor-s-Work.html

  8. Court Watch says:

    State Supreme Court Hears Online Doctor Rating Defamation Suit SEP 2012

    Excerpted from Star Tribune, September 4, 2012, Maura Lerner

    Two years ago, a Duluth neurologist, Dr. David McKee, sued the son of an elderly patient for defamation over some negative comments that were posted on rate-your-doctor websites.

    On Tuesday, the state’s top court was asked to decide whether the lawsuit should finally go to trial, after the case was thrown out by a lower court and reinstated on appeal. The lawsuit is one of a growing number of legal battles testing the limits of free speech on the Internet.

    A good portion of the oral arguments were devoted to the meaning of the words that Dennis Laurion, 65, used to describe his family’s encounter with McKee in April, 2010, when Laurion’s father, Kenneth, then 84, was hospitalized with a stroke.

    John Kelly, Laurion’s attorney, noted that Internet sites are a “free for all” for people to share opinions and that his client’s comments were perfectly appropriate. “We have a word, the word ‘tool,’” Kelly told the justices. “When you look at the word, you have to ask: Is it defamatory?” He argued that the phrase, while “it clearly is not a compliment,” is no worse than “calling someone an idiot or a fool.”

    During questioning, some of the justices seemed to agree. “Saying someone’s a ‘real tool’ sounds more like an opinion than a statement of fact,” Justice Christopher Dietzen said. Chief Justice Lorie Skjerven Gildea had a similar reaction. “The point of the post is, ‘This doctor did not treat my father well,’” she said. “I can’t grasp why that wouldn’t be protected opinion.”

    Full Article:
    http://www.startribune.com/printarticle/?id=168552176

    Video of hearing: http://www.tpt.org/courts/MNJudicialBranchvideo_NEW.php?number=A111154#

  9. Court Watch says:

    Article by: ABBY SIMONS , Star Tribune, Updated January 30, 2013 – 9:59 PM

    Finding no harm done, justices toss out lawsuit by Duluth physician.

    Dennis Laurion fired off his screed on a few rate-your-doctor websites in April 2010, along with some letters about what he saw as poor bedside manner by his father’s neurologist. He expected at most what he calls a “non-apology apology.”

    “I really thought I’d receive something within a few days along the lines of ‘I’m sorry you thought I was rude, that was not my intent’ and that would be the end of it,” the 66-year-old Duluth retiree said. “I certainly did not expect to be sued.”

    He was. Dr. David McKee’s defamation lawsuit was the beginning of a four-year legal battle that ended Wednesday when the Minnesota Supreme Court ruled the doctor had no legal claim against Laurion because there was no proof that his comments were false or were capable of harming the doctor’s reputation.

    The unanimous ruling reverses an earlier Appeals Court decision and brings to an end the closely watched case that brought to the forefront a First Amendment debate over the limits of free speech online.

    It’s a frustrating end for McKee, 51, who said he’s spent at least $50,000 in legal fees and another $11,000 to clear his name online after the story went viral, resulting in hundreds more negative postings about him — likely from people who never met him. He hasn’t ruled out a second lawsuit stemming from those posts.

    “The financial costs are significant, but money is money and five years from now I won’t notice the money I spent on this,” he said. “It’s been the harm to my reputation through the repeated publicity and the stress.”

    He said he offered to settle the case at no cost after the Supreme Court hearing. Laurion contends they couldn’t agree on the terms of the settlement, and said he not only deleted his initial postings after he was initially served, but had nothing to do with subsequent online statements about McKee.

    The lawsuit followed the hospitalization of Laurion’s father, Kenneth, for a hemorrhagic stroke at St. Luke’s Hospital in Duluth. Laurion, his mother and his wife were also in the room when McKee examined the father and made the statements that Laurion interpreted as rude. After his father was discharged, he wrote the reviews and sent the letters.

    On at least two sites, Laurion wrote that McKee said that “44 percent of hemorrhagic strokes die within 30 days. I guess this is the better option,” and that “It doesn’t matter that the patient’s gown did not cover his backside.”

    Laurion also wrote: “When I mentioned Dr. McKee’s name to a friend who is a nurse, she said, ‘Dr. McKee is a real tool!’”

    McKee sued after he learned of the postings from another patient. A St. Louis County judge dismissed the lawsuit, saying Laurion’s statements were either protected opinion, substantially true or too vague to convey a defamatory meaning. The Appeals Court reversed that ruling regarding six of Laurion’s statements, reasoning that they were factual assertions and not opinions, that they harmed McKee’s reputation and that they could be proven as false.

    The Supreme Court disagreed. Writing the opinion, Justice Alan Page noted that McKee acknowledged that the gist of some of the statements were true, even if they were misinterpreted.
    Page added that the “tool” statements also didn’t pass the test of defaming McKee’s character. He dismissed an argument by McKee’s attorney, Marshall Tanick, that the “tool” comment was fabricated by Laurion and that the nurse never existed. Whether it was fabricated or not was irrelevant, the court ruled. “Referring to someone as ‘a real tool’ falls into the category of pure opinion because the term ‘real tool’ cannot be reasonably interpreted as stating a fact and it cannot be proven true or false,” Page wrote.

    Tanick said the ruling could present a slippery slope.

    “This decision gives individuals a license to make derogatory and disparaging statements about doctors, professionals and really anyone for that matter on the Internet without much recourse,” he said.

    Jane Kirtley disagreed. The professor of media ethics and law at the University of Minnesota School of Journalism said the ruling stems from “an elementary principle of libel law. I understand the rhetoric, but this is not a blank check for people to make false factual statements,” she said. “Rather, it’s an endorsement that statements of opinion are protected under the First Amendment.”

    Laurion’s attorney, John D. Kelly, said the fact that Laurion’s speech was made online was inconsequential to the ruling, which treated it as a standard defamation case. “It’s almost as if things were said around the water cooler or perhaps posted in a letter to the editor,” he said. “I think the principles they worked with are applicable to statements made irrespective of the medium.”

    Full article:
    http://www.startribune.com/local/189028521.html?refer=y

    Comments: http://comments.startribune.com/comments.php?d=content_comments&asset_id=189028521&sort=E&section=/local&page_nbr=2&ipp=10

  10. Content Scraper says:

    Doctor David McKee, a neurologist with Northland Neurology and Myology, practicing at St. Luke’s Hospital, told the Duluth News Tribune he was disappointed and frustrated. “We need to change the law so someone with a personal vendetta who is going to use the Internet to make defamatory statements can be held responsible,” he said.

    The Star Tribune said it’s a frustrating end for McKee, 51, who said he’s spent at least $50,000 in legal fees and another $11,000 to clear his name online after the story went viral, resulting in hundreds more negative postings about him — likely from people who never met him. He hasn’t ruled out a second lawsuit stemming from those posts.

    “The financial costs are significant, but money is money and five years from now I won’t notice the money I spent on this,” he said. “It’s been the harm to my reputation through the repeated publicity and the stress.”

    McKee’s lawyer, Marshall Tanick, told the Associated Press that he and McKee plan no further appeals and that they were disappointed with the ruling. “We feel it gives individuals undue license to make disparaging and derogatory statements about these people, particularly doctors and other licensed professionals, on the Internet without much recourse,” Tanick said.

    Tanick told the Star Tribune that the ruling could present a slippery slope. “This decision gives individuals a license to make derogatory and disparaging statements about doctors, professionals and really anyone for that matter on the Internet without much recourse,” he said.

    In reply to an e-patients.net article “Minnesota Supreme Court sides with patient on social media defamation suit,” Attorney Marilyn Mann said, “I think McKee’s lawyer is incorrect. The case turned on standard principles of defamation law and doesn’t really break new ground.”

    Jane Kirtley, a professor of media ethics and law at the University of Minnesota School of Journalism, told the Star Tribune that the ruling stems from “an elementary principle of libel law.” She said that this isn’t a blank check for people to make false factual statements. She said, rather, that it’s “an endorsement that statements of opinion are protected under the First Amendment.”

    According to the Duluth News Tribune, Minnesota Newspaper Association attorney Mark Anfinson, who watched the oral arguments before the Supreme Court in September, said that the justices made the right decision. Anfinson also told the News Tribune, “What this case really exemplifies is not so much legal precepts in libel law, but the impact of the Internet on the ability to publish unflattering comments about people.”

    Anfinson was also interviewed by Minnesota Lawyer. He said, “Anyone who knew about the case, who observed the oral arguments, and who knows something about libel law is about as unsurprised with this result as they can be. It’s about as perfunctory and routine as the Supreme Court ever gets. It was a completely straightforward application of long-settled libel-law rules.”

    Anfinson said the case is more significant for social commentary purposes than for its legal analysis, noting that perhaps the justices only accepted the case to fix an error of the Court of Appeals.

    From the American Health Lawyers Association: In this case, the court found the six allegedly defamatory statements were not actionable because the “substance, the gist, the sting” of plaintiff’s version for each of the statements as provided in deposition and defendant’s version essentially carried the same meaning, satisfied the standard for substantial truth, did not show a tendency to harm the plaintiff’s reputation and lower his estimation in the community, or were incapable of conveying a defamatory meaning (e.g., when a nurse told defendant that plaintiff was “a real tool”) based on “how an ordinary person understands the language used in the light of surrounding circumstances.”

    From the Business Insurance Blog: The Minnesota high court said, for instance, that Dr. McKee’s version of his comment about the intensive care unit was substantially similar to Mr. Laurion’s. “In other words, Dr. McKee’s account of what he said would produce the same effect on the mind of the reader,” the court said. “The minor inaccuracies of expression (in the statement) as compared to Dr. McKee’s version of what he said do not give rise to a genuine issue as to falsity.”

    From the Duane Morris Media Blog: The doctor said in his deposition that with regard to finding out if Mr. Laurion was alive or dead, “I made a jocular comment… to the effect of I had looked for [Kenneth Laurion] up there in the intensive care unit and was glad to find that, when he wasn’t there, that he had been moved to a regular hospital bed, because you only go one of two ways when you leave the intensive care unit; you either have improved to the point where you’re someplace like this or you leave because you’ve died.” The court said the differences between the two versions of the statements about death or transfer by both plaintiff and defendant were so minor that there was no falsity in the website postings. In other words, the court indicated that the allegation about the statement was true.

    Laurion’s attorney, John D. Kelly, said the fact that Laurion’s speech was made online was inconsequential to the ruling, which treated it as a standard defamation case. “It’s almost as if things were said around the water cooler or perhaps posted in a letter to the editor,” he said. “I think the principles they worked with are applicable to statements made irrespective of the medium.”

    Commenting about this case on his own blog, February 8, 2013, Aaron Kelly, internet law & defamation law attorney, said “Thanks to the First Amendment, free speech is the law of that land, and that means being able to communicate our views publicly – no matter how offensive.”

    The Mankato Free Press said in February 2013: “It’s puzzling why McKee’s defamation lawsuit — filed nearly four years ago — was still in court. It’s long been established that people may spout any opinion they want without fear of being sued . . . It’s unsettling that the Appeals Court earlier ruled to allow the suit to continue.”

    Mark A Fischer of Duane Morris LLP, a full-service law firm with more than 700 attorneys in 24 offices in the United States and internationally, said on February 11, 2013, “For those who are under criticism, one of the practical consequences of bringing a defamation action is that more publicity for the accused statements is almost an inevitable result, whether the statements are ultimately found libelous or not. In other words, in weighing the pros and cons of initiating a lawsuit, all potential defamation and privacy claim plaintiffs should consider the rule of Hippocrates applicable to physicians, ‘First do no harm.’”

    In his Technology & Marketing Law Blog, Eric Goldman said on February 4, 2013, “I’ve been tracking doctor v. patient lawsuits for online reviews. . . doctors usually lose or voluntarily drop these lawsuits. Indeed, with surprising frequency, doctors end the lawsuit by writing a check to the defendant for the defendant’s attorneys’ fees where the state has a robust anti-SLAPP law. Doctors and other healthcare professionals thinking of suing over online reviews, take note: you’re likely to lose in court, so legal proceedings should be an absolute last-resort option–and even then, they might not be worth pursuing.”

  11. Dennis says:

    Doctor David McKee, a neurologist with Northland Neurology and Myology, practicing at St. Luke’s Hospital, told the Duluth News Tribune he was disappointed and frustrated. “We need to change the law so someone with a personal vendetta who is going to use the Internet to make defamatory statements can be held responsible,” he said. The Star Tribune said it’s a frustrating end for McKee, 51, who said he’s spent at least $50,000 in legal fees and another $11,000 to clear his name online after the story went viral, resulting in hundreds more negative postings about him — likely from people who never met him. He hasn’t ruled out a second lawsuit stemming from those posts.

    “The financial costs are significant, but money is money and five years from now I won’t notice the money I spent on this,” he said. “It’s been the harm to my reputation through the repeated publicity and the stress.”

    Five years from now, I will notice the money I spent on this. The plaintiff’s first contact with me was a letter that said in part that he had the means and motivation to pursue me. The financial impact of being sued three years to date has been burdensome, a game of financial attrition that I haven’t wanted to play. The suit cost me the equivalent of two year’s net income – the same as 48 of my car payments plus 48 of my house payments. My family members had to dip into retirement funds to help me.

    This entire experience has been distressing to my family. We were initially shocked and blindsided by “jocular” comments made so soon after my father’s stroke by somebody who didn’t know us. We were overwhelmed by my being sued after posting a consumer opinion, and we were shocked by the rapidity with which it happened. It has been the 800 pound gorilla in the room. My parents would be 88-year-old witnesses. My mother and wife prefer no discussion, because they don’t want to think about it. Conversation with my father only reminds him of his anger over this situation. My siblings and children don’t often bring it up, because they don’t know how to say anything helpful. I have been demoralized by three years of being called “Defendant Laurion” in public documents. While being sued for defamation, I have been called a passive aggressive, an oddball, a liar, a coward, a bully, a malicious person, and a zealot family member. I’ve been said to have run a cottage industry vendetta, posting 108 adverse Internet postings in person or through proxies. That’s not correct. In reality, I posted ratings at three consumer rating sites, deleted them, and never rewrote them again.

    Medical peer newsletters or magazines that interviewed the plaintiff did not approach me. Websites maintained by doctors for doctors or lawyers for lawyers often caused an inference that I was a zealot family member or somebody who had asked about my dad’s chances and then shot the messenger. Generally, however, those websites echoed other websites in advising public relations responses other than a lawsuit – for fear of creating the “Streisand Effect.” As a retired layman, I brought far less resources to the battle of financial attrition.

    I’ve learned that laws about slander and libel do not conform to one’s expectations. I’ve read that online complaints are safe “if you stick to the facts.” That’s exactly the wrong advice. I did not want to merely post my conclusions. I wanted to stick to my recollection of what I’d heard. I don’t like to read generalities like “I’m upset. He did not treat my father well. He was insensitive. He didn’t spend enough time in my opinion.” However, such generalities are excused as opinion, hyperbole, or angry utterances. If one purports to say what happened, factual recitations can be litigated. The plaintiff must prove the facts are willfully misstated, but the defendant can go broke while waiting through the effort.

    I feel that defamation lawsuits are much too easy for wealthy plaintiffs. If I were to attempt suing a doctor for malpractice, my case would not proceed until I’d obtained an affidavit from another doctor, declaring that the defendant’s actions did not conform to established procedures. In a defamation suit, there’s generally no exit short of a judge’s dismissal order – which can be appealed by the plaintiff. Being called “defendant” is terribly personal, but the civil suit path is totally impersonal. During the three years that I went through depositions, interrogatories, a dismissal hearing, an appellate hearing, and a state Supreme Court hearing; I never once spoke to a judge. At depositions, the plaintiff and I sat opposite each other, while I answered his lawyer’s questions, and he answered my lawyer ‘s questions. We were not to speak to each other.

    Minnesota and two other states allow “hip pocket” lawsuits. The plaintiff can start a suit by sending the summons and complaint to the defendant without filing the documents in court. The plaintiff enjoys complete anonymity from public awareness. The defendant has 20 days to respond, but the court is unaware that the suit exists. The plaintiff can conduct interrogatories and depositions while the court is unaware that the suit exists. The plaintiff can send settlement demands to the defendant ‘s insurance company while the court is unaware that the suit exists. Until the suit is actually filed, the plaintiff’s lawyer orchestrates everything as the officer of the court. If the defendant files his answer, in order to publicly get onto the docket and under the supervision of a judge, the defendant pays the filing fee. In Minnesota, if the plaintiff loses his effort at rule by law, the rule of law generally allows the defendant no remuneration. The plaintiff can lose the suit while winning the battle of financial attrition.

  12. McKee v Laurion cited as precedent by UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT upon Appeal from the United States District Court for the Eastern District of North Carolina.

    Page 13 of http://www.ca4.uscourts.gov/Opinions/Unpublished/121287.U.pdf says “McKee v. Laurion , 825 N.W.2d 725, 729 – 30 (Minn. 2013) A defamation claim cannot be based on a true statement. “True statements” include statements that are “true in substance” and contain only “minor inaccuracies of expression or detail.” In articulating this standard, the Minnesota courts explain that “substantial truth ” means that “the substance, the gist, the sting , of the libelous charge [is] justified” and the statement “would have the same effect on the mind of the reader or listener as that which the pleaded truth would have produced.”

  13. Court Watch says:

    This is extracted from:

    TWIN CITIES BUSINESS
    The Top Lawsuits Of 2013
    by Steve Kaplan
    December 20, 2013

    Never Shout “He’s a Tool!” On a Crowded Website?

    Dr. David McKee, a Duluth neurologist, was not laughing when he saw what one former client wrote about him on a doctor-rating website. The reviewer, Dennis Laurion, complained that McKee made statements that he interpreted as rude and quoted a nurse who had called the doctor “a real tool.” As these statements echoed through the Internet, McKee felt his reputation was being tarnished. He sued, and so began a four-year journey that ended this year in the Minnesota Supreme Court.

    Laurion was unhappy with the way McKee treated his father, who was brought to the doctor after he had a stroke. Laurion went to several rate-your-doctor sites to give his opinion. That’s just free speech, isn’t it?

    It sure is, says Laurion’s attorney, John D. Kelly of the Duluth firm Hanft Fride. “The court held that what my client was quoted as saying was not defamatory,” he says. “I do think the Internet makes it much easier for persons exercising poor judgment to broadcast defamatory statements, however… a medium… doesn’t change the quality of a statement from non-defamatory to defamatory.”

    But McKee’s lawyer, Marshall Tanick, of Hellmuth & Johnson, says no matter where it was said, defamation is defamation. “The thing that’s often misunderstood is that this was not just about free speech, but about making actual false statements,” Tanick says. “The problem is today’s unfettered opportunity to express opinion, whether or not the substance of what’s said is true or not. We need some boundaries.”

    But boundaries were not on the minds of the Minnesota Supreme Court. Free speech was. Chief Justice Lorie Gildea wrote, “The point of the post is, ‘This doctor did not treat my father well.’ I can’t grasp why that wouldn’t be protected opinion.” As to referring to the doctor as “a real tool,” Justice Alan Page wrote that the insult “falls into the category of pure opinion because the term … cannot be reasonably interpreted as a fact and it cannot be proven true or false.”

    The takeaway from this case might be the knowledge that behind any rating service lie real people with real feelings. McKee spent more than $60,000 in the effort to clear his name, as he saw it. Dennis Laurion told the Star Tribune he spent the equivalent of two years’ income, some of which he had to borrow from relatives who supplied the money by raiding their retirement funds.

    See rest of article: http://tcbmag.com/Industries/Law/2013-Lawsuits-Of-The-Year

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