Apparently, the state of America’s moral and ethical standards has declined to the point where it’s now not uncommon for a physician to be threatened. Yes, that’s right—threatened; with a bad patient review, a malpractice claim, a licensing board complaint, or even bodily harm. I don’t recall ever having a patient make such a threat to me, but it must happen somewhere because it generated an article on Medscape. The article was titled, “Patient Extortion: What Doctors Should Do.”
Extortion is an issue Family Doctors who have any semblance of rapport with their patients should rarely face. Most family physicians see their patients repeatedly and have a sense of when their patient is up to something. The idea of extortion happening in little ole Greenwood, Indiana seems highly foreign to me. But one never knows.
Extortion presents in several forms. It could be a negative post on social media or Healthgrades, the system patients use to rate/grade physicians. The patient threatens this action unless a refund or some financial concession is made. It could be the threat of a malpractice suit or a complaint to the medical licensing board over a perceived mistreatment or claim of medical negligence. Or it could even be a threat of bodily harm for similar reasons. (I recall over 30 years ago, a patient of Dr. R somehow saw her own medical record. It contained information that upset her enough that she stalked him and threatened to harm him. He had to get a restraining order for protection).
The article referenced here offers suggestions to counter extortion efforts, one of which is calling the police. However, the author said, “You can try that, but typically that’s not very effective. They don’t always take action, and rarely want to get involved.” You can ask social media platforms to remove a harmful post, but “many times you get no response at all.” If you’re threatened with malpractice, and the claim is unfounded, they recommend talking to your malpractice carrier and to their attorney for advice. If the threat is to the state licensing board, they will investigate it, and the doctor needs to present the investigator with all pertinent information. The final outcome, however, has a lot to do with the validity and veracity of the allegation.
If the patient’s complaint is purely harassment, there are two legal actions to be considered. One is a strongly worded “cease and desist letter” which threatens the second option, litigation for slander if the harassment continues. If the patient’s allegation is true, the letter should offer an apology and offer to negotiate a resolution. Usually this is a financial settlement or a refund of some amount.
As in all cases involving medical disorders, prevention is the best deterrent. The main action is to be very selective in who you accept as patients. If the patient has a history of changing doctors often, is abusive, is overly friendly, asks for drugs, or is always upset about something, he/she may be someone you prefer to dismiss from your practice. If a patient does threaten the doctor with any action and a resolution is reached, legal grounds exist for that patient’s dismissal from the practice.
Although the majority of physician practices today are NOT private practices, those that are still are private entities. It’s a private business operating publicly. It is still subject to the will of the owner, the doctor, and he/she is free to decide who is and who isn’t part of the patient panel. Dismissal happens rarely, but it does occur. You have to have that leverage or there would be constant unrest. Most patients of family doctors are pleasant and cordial, but the occasional sociopath appears and just wants to cause problems. I did my best not to encourage them or give in to their demands. Usually they would end up finding another more accommodating doctor eliminating potential problems.
Reference: Adler EL. Patient Extortion: What Doctors Should Do. Medscape 2025 December 24.
