Response to Stone and Appelbaum Letter

To the Editor: I welcome the thoughtful suggestion by my two esteemed colleagues, Drs. Stone and Appelbaum. They note that we need to develop responses to patients’ Internet postings designed to tarnish the reputation of psychiatrists, and their suggestion of an ombudsman is one systematic approach to addressing the problem. Drs. Stone and Appelbaum have started a dialogue that needs to continue in the profession of psychiatry. While their approach should be seriously debated, I would argue that it has a drawback that may be unavoidable. Those who file complaints and the public in general might well be skeptical of the objectivity and fairness of the ombudsman, whom they would see as representing a veiled attempt to silence or dismiss patient complaints. Moreover, it might paradoxically bring greater attention to the original complaint and serve to publicize the negative comments about the psychiatrist to a wider audience of readers. Perhaps we can trust our existing professional networks as the principal source of our reputations and ignore the periodic random attacks from the web until further alternatives are considered.