Now that we live in a world where it seems everything can be rated — from your restaurant experience to your root canal — privacy issues are popping up in unexpected places. Like in health care providers’ responses to negative reviews from patients on Yelp, for example.

ProPublica teamed up with The Washington Post and found many situations where doctors and others zapped by negative reviews have replied to those patients’ negative reviews online, and in doing so, revealed details of medical treatment.

Yelp gave ProPublica access to its public reviews, totaling more than 1.7 million, and let the group research them by keyword. ProPublica identified more than 3,500 one-star reviews in which patients mentioned privacy or HIPAA (otherwise known as The Health Insurance Portability and Accountability Act of 1996 which outlines patients’ rights to privacy, among other things [PDF]).

There was a dentist’s reply to a patient who blamed him for losing a molar, which read: “Due to your clenching and grinding habit, this is not the first molar tooth you have lost due to a fractured root. This tooth is no different.”

Or a chiropractor who disagreed with a mom’s reviewing claiming that he’d misdiagnosed her daughter with scoliosis: “You brought your daughter in for the exam in early March 2014,” he wrote. “The exam identified one or more of the signs I mentioned above for scoliosis. I absolutely recommended an x-ray to determine if this condition existed; this x-ray was at no additional cost to you.”

Affected patients say they suffer doubly in theses cases: first there’s the poor service or care, and then the pain that comes with the disclosure of information they thought was private. Sometimes, the shock of having such details revealed works, and patients back off.

“I posted a negative review” on Yelp, a client of a California dentist wrote in 2013. “After that, she posted a response with details that included my personal dental information. … I removed my review to protect my medical privacy.”

The patient took their story to the Office for Civil Rights within the U.S. Department of Health and Human Services, which enforces HIPAA, ProPublica reports, and the office warned the dentist about posting personal info in Yelp reviews. It’s also currently investigating a New York dentist for disclosing personal info about a patient who complained about her care.

Health professionals responding online to reviews are allowed to speak generally about how they treat patients, but must get permission to discuss individual cases, HHS says. Rating your health provider doesn’t give them the right to rate you in return, basically.

“If the complaint is about poor patient care, they can come back and say, ‘I provide all of my patients with good patient care’ and ‘I’ve been reviewed in other contexts and have good reviews,’ ” Deven McGraw, the office’s deputy director of health information privacy told ProPublica. But they can’t “take those accusations on individually by the patient.”

For the most part, however, reviews of doctors and dentists stick to a few common themes that aren’t about health care delivered, but rather things like the office wait, the front desk staff, billing procedures, or bedside manner, according to Yelp’s senior director of litigation, Aaron Schur.

Many providers are appropriate in responding to online reviews, he says, while some don’t respond at all.

“There’s certainly ways to respond to reviews that don’t implicate HIPAA,” Schur told ProPublica.

For more on ProPublica’s report, check out the source link below.

Stung by Yelp Reviews, Health Providers Spill Patient Secrets [ProPublica]

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