Service of Noses Out of Joint: Are Online Reviews by Patients on the Line?

September 25th, 2017

Categories: Blame, Defamation of Character, Lawyers, Medical Care, Unintended Consequences



Plastic surgeon Dr. Bahman Guyoron’s patient wasn’t pleased with the job he did on her nose to “alleviate nasal congestion,” according to Wall Street Journal reporter Joe Palazzolo, and while at it, he was to cosmetically tweak her beak. So she shared her thoughts about the outcome on a range of online review sites from RealSelf, Yelp to, and Dr. Guyoron sued her.

The patient said she now must sleep with a breathing aid because her nostril collapses and that her nose is wider than it was before surgery. A second surgery by the same doctor didn’t fix the problems.


Her lawyer said “her reviews were ‘substantially true or were her opinion,’” and that they didn’t harm the doctor’s reputation.

Palazzolo explained that the doctor would have to prove they were false and that he was damaged. “If the jury deemed him a public figure, he would have to show that [the patient] knew the information was false or showed reckless disregard for the truth.”

In email correspondence with the newspaper the patient wrote that her purpose was to inform others and that she didn’t expect to face financial ruin as a result. According to lawyers who handle such cases, wrote Palazzolo, “a negative comment can diminish a doctor’s business in short order.” And because doctors’ hands are tied due to privacy laws to discuss details of procedures, to get patients to erase such reviews some opt to sue.


“‘Given how few defamation cases go to trial—and cases involving doctors are even more rare—any trial would be an important signpost for future litigation,’ said Sara Kropf, a lawyer in Washington, D.C., who provides legal advice to doctors regarding patient reviews.” This trial is scheduled for February.


At first Dr. Guyoron wanted the patient to remove the reviews and pay him $700,000, which she said she didn’t have. He now wants $1.8 million.

Knowing the risk to your wallet, would you think many times before posting online a negative review about any doctor? Doctors aren’t infallible: they make mistakes as we all do. Should review sites investigate/vet patient complaints before posting them? What are other effective ways to warn other patients about a doctor you’ve found faulty?


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10 Responses to “Service of Noses Out of Joint: Are Online Reviews by Patients on the Line?”

  1. ASK Said:

    This is a poser: the internet brings out all kinds of complaints. My first questions: Do the websites she posted to require self-identification?

    Certainly the woman has the right to complain, especially since the doctor no doubt had to be paid upfront before the surgery (at least, most plastic surgeons operate like that). We have no idea what her expectations were, nor do we know what he told her he believed he could fix.

    Her lawyer’s comment that her allegations were “substantially true” leaves me puzzled. He’s qualifying her statements, isn’t he?

    No amount of money is going to mitigate the damage to his practice, but I wonder if asking the websites to “vet” complaints is really a feasible option: expensive and time-consuming for the website, and maybe in most cases, asking the website to act as judge and jury in what might often turn out to be a “he said, she said” confrontation.

    While I am of the opinion that too many frivolous law suits are filed today, I can’t figure out a reasonable way to handle this in any other way.

  2. Jeanne Byington Said:


    All true. In my 20s I went to a hair stylist on East 57th Street that in the day gave every customer the same hairstyle regardless of face, hair type etc. My boss, an editor, went there and I thought it was important to do so. My stylist was sane [the owner drank wine all day so imagine what happened by 6 pm]. I clearly remember my stylist tell me that overweight women would complain that they didn’t look thinner once they’d been cut and dried. And I suppose that a plastic surgeon would have similar complaints–that the wrinkle removal work didn’t make the patient look young enough.

    But apparently there was a medical reason this woman had her nose operated on and while he was at it, the doctor was to do something to improve her nose.

    It is a dilemma…I agree a site that vetted each posted complaint would have to charge a ton of money but it might cut down on the frivolous claims. Every business must deal with nuts out to get them and readers must deal with unscrupulous PR people and business owners who stuff reviews with exaggerated friend’s postings. Reviews are a potential problem for every industry.

  3. Lucrezia Said:

    The woman was screaming to be sued. Couldn’t she just have incriminating pictures taken of the lousy nose job, and gotten another doctor’s written evaluation of the allegedly faulty work, submit the evidence to a good lawyer, and attack?

    Not only has she given the doctor (unskilled as he may be) the opportunity to sue, but in a “brilliant” move, admits to going to him a second time rather than seeking superior care.

    Failure to launch a serious case of malfeasance, and going online with a clear intent of damaging someone’s reputation, gets nowhere in my court.

    Doctor: $1.8 million
    Dopey woman: $0.00

  4. Jeanne Byington Said:


    Your strategy is more sound than the one the patient used.

    I think people should think carefully before posting negative reviews unless they mention things that are easily fixed such as “the restaurant was too dark” or “the sales staff was ill informed.”

  5. JBS Said:

    I’d love to know what the patient wrote about the doctor, wouldn’t you? If I were unhappy with a surgeon, I’d tell him, not post on line.

  6. Jeanne Byington Said:


    The reviews weren’t in the article but I, too, would love to know the tone and language.

    The fact is she went back to him for a repair which is nuts if he did such a bad job. I have a friend whose sister fell on a newly “fixed” nose [for cosmetic reasons] and had to go through the procedure again and painful didn’t nearly describe what she went through TWICE. In fact, in the day, I wanted to have my nose enhanced but this story was all I had to hear. A glutton for punishment this woman must be to go back to someone who messed up the first time!

    And you are right–why post her feelings online in three places yet!

  7. HB Said:

    I have deep, critical misgivings about suing anybody and about anybody who sues anybody else. This is because I have yet to encounter a case where I have seen justice done by the court, and I have been involved in many of them. Cases have been settled, trials rendered judgements and money paid, but never fairly, at least in my opinion.

    As to reviews of doctors, I remember one in particular involving a great, world famous specialist who sees patients twice a week, is now over 70, and gets backed up by the demand for his opinion to the point where starting at 8:15 AM, he is often still in his office at ten at night. One often waits an hour or more before seeing him. Keeping track of all this traffic is his extremely able, but somewhat authoritarian, nurse/assistant who has been with him for 30 plus years and is a true gem.

    Seven years ago, in a review on the first page of Google, a female patient vehemently panned his medical care because she had to wait to see him and didn’t like being bossed around by his nurse. Now, years later, when you google him the review is still there. Unfairly, it is still there.

  8. Martha Takayama Said:

    I am very cautious and cynical about medical care based on serious life experience. I know that there is a very strong tendency on the part of the medical profession to close ranks on any suggestion of inappropriate or substandard care. Whistle blowing can prove disastrous even when the person making the claim is proven correct. However, I really am uncomfortable posting responses to requests from hospitals or medical practices for reviews or evaluations of my experience. I consider them a combination of shopper services and marketing tools, as well as a demand on my time. In view of everything or almost everything in print or on the computer being vulnerable to hacking I certainly don’t trust that any response will remain confidential. I generally ignore all requests for feedback and review. I also find them sort of sneaky and not very professional.
    With regard to lawsuits, I tend to agree with HB and really don’t look favorably on them or generally on people who bring them except in extreme cases. They are also terribly time consuming and costly. On the other hand serious violations of doctor/patient relations should be the subject of formal complaints and lawsuits can be contemplated afterwards.
    I think, without risking being sued with slander it is possible to share one’s opinions informally. It also would be appealing if medicine was more concerned with healing than public relations and marketing than at the present.

  9. Jeanne Byington Said:


    That is so horrible–and few can get rid of such nasty reviews/comments on Google. The most they can do is move the bit down the list. If you don’t have time to deal with it you can pay for someone to post a zillion things that are placed on bigger and better sites, hoping to move the bad comment, usually in a high profile place, to the second search “page” on Google. Imagine what damage an angry ex boyfriend or jilted spouse could do to any business. I think that there should be an accessible department at Google or on review sites where people can plead their cases for copy removal.

  10. Jeanne Byington Said:


    I would post only positive comments about a service or product on a review website. And I would fear retaliation if on one of the so-called queries from a hospital or medical facility were I to complain. On my record might be something to indicate that I was a cranky fussbudget and good luck should an emergency happen. Speaking of emergency, a real horror was in triage in the emergency room at one hospital I went to with a friend. I didn’t say boooo as I couldn’t tell if she would be there had I had to visit the place again.

    You are right about the expense and time involved with a law suit and in many cases the only winners are the lawyers on either side paid handsomely for their time.

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