The Threat of Nuclear VerdictsIn the operating room, Dr. Katharine Roxanne Grawe was always the star of the show. With the surgical lights casting a dramatic glow, she’d set up her phone just right, ensuring the perfect angle for her latest TikTok live stream. Her followers knew her as “Dr. Roxy,” the plastic surgeon with a flair for the theatrical, someone who made tummy tucks and breast augmentations appear as routine as a visit to the dentist. Between incisions, she’d banter with viewers, answering questions about body contouring, cracking jokes about post-op recovery, and winking at the camera. For a while, the internet loved her.
But her livestreams, which at their height drew thousands of viewers, weren’t as benign as they seemed. Behind the ring light and polished performance, something far darker was happening. In July 2023, the Ohio State Medical Board revoked Dr. Grawe’s license, accusing her of prioritizing social media engagement over patient safety. At least three patients suffered severe complications following surgeries at her practice, and 12 lawsuits were pending by the time she was forced out of medicine.
For Dr. Grawe, the cost was her career—but for the clinic she operated out of, the stakes were even higher. As the lawsuits mount, they expose the practice to potential nuclear verdicts: massive payouts that threaten not just reputations, but the financial survival of the entire facility. Dr. Grawe’s story is more than a cautionary tale about ethical missteps—it’s a grim reminder of the devastating malpractice risks that can arise when medical professionals blur the lines between healthcare and performance.
Social media offers doctors an unprecedented opportunity to connect with patients, dispel health misinformation, and build their brands. Platforms like TikTok, Instagram, and X (formerly Twitter) have opened the floodgates for healthcare professionals to become influencers, engaging directly with audiences in real-time. A quick search of #DocTok on TikTok reveals over 284 million posts, with physicians offering advice, showcasing procedures, and even, as in the case of Dr. Grawe, livestreaming surgeries.
But with that visibility comes significant risk, and not just for the individual doctor. The casual nature of social media can invite legal liabilities that endanger the entire practice or hospital behind the doctor. The healthcare facility where a doctor practices can be implicated in malpractice claims, particularly when social media missteps result in patient harm.
A US study on online professionalism violations among doctors identified the most common offenses: inappropriate patient communication, inadvertent prescribing, and breaches of patient confidentiality. In an age where a single tweet can go viral, a momentary lapse in judgment can have lasting—and costly—consequences. With the rise of nuclear verdicts in medical malpractice cases, these liabilities don’t just threaten a doctor’s license—they can put the financial health of entire hospitals at risk.
In recent years, the medical malpractice landscape has shifted. While malpractice lawsuits have long been a reality of practicing medicine, a growing trend of nuclear verdicts—jury awards in the tens or hundreds of millions—has taken the industry by storm. For practices or hospitals already navigating the complex healthcare market, a single malpractice suit tied to a doctor’s social media activity could result in a payout large enough to shutter operations.
For example, when Dr. Jason Campbell, a Portland-based anesthesiology resident known as the “TikTok Doc,” faced sexual harassment allegations in 2021, his employer, Oregon Health & Science University, settled for $585,000. While this case involved off-screen behavior, the online fame that initially bolstered Dr. Campbell’s reputation amplified the fallout from the scandal. As digital profiles grow, so too do the financial risks that hospitals and practices must shoulder.
For the facilities that employ social media-savvy doctors, these risks extend far beyond PR nightmares. Every misstep, from violating patient confidentiality to inadvertently prescribing medication online, exposes not just the physician but the entire institution to the possibility of staggering legal penalties. Even minor infractions can spiral into full-blown lawsuits when patient harm is involved.
The Ohio State Medical Board’s decision to revoke Dr. Grawe’s license was swift, but it’s the legal battles that may ultimately have the most lasting impact. With 12 lawsuits already pending and more likely to follow, the financial burden on her clinic could be catastrophic. And while Dr. Grawe’s live-streaming may seem like an extreme case, her story reveals how quickly a social media presence can spiral into malpractice risk.
Hospitals and medical practices need to adopt strict guidelines when it comes to social media use by their physicians. This is especially critical as the line between personal branding and professional responsibility becomes increasingly difficult to distinguish.
Consider the case of Dr. Lara Kollab, a Cleveland Clinic resident whose anti-Semitic tweets led to her permanent removal from the field of osteopathic medicine in Ohio. While Kollab’s comments were personal and pre-dated her employment, they resulted in a public relations and legal nightmare for the clinic that employed her. For healthcare institutions, such incidents can pose not only reputational damage but also costly legal exposure.
Malpractice brokers are now playing a crucial role in helping healthcare providers navigate this new digital terrain. Coverage for social media-related malpractice claims is becoming a growing concern, as doctors and facilities face the threat of nuclear payouts that could bring entire practices to their knees.
As healthcare shifts further into the digital age, malpractice insurance has evolved to cover new, and often unforeseen, risks. For practices and hospitals employing physicians with an active social media presence, comprehensive coverage is no longer just about traditional patient care—it’s about guarding against the unique liabilities that come with digital visibility.
Doctors who engage in live streaming or frequent social media interactions are exposing themselves—and their employers—to unprecedented risks. Whether it’s a HIPAA violation from inadvertently revealing patient information or a career-ending scandal like Dr. Kollab’s, the financial consequences can be severe. Nuclear verdicts don’t just end careers—they threaten the very existence of the institutions that employ these doctors.
For medical facilities, malpractice coverage is an essential safeguard. But more than that, it’s a strategic defense against a future where a single tweet or live-streamed surgery could lead to claims large enough to shut down a practice or hospital. Brokers who specialize in this type of coverage are becoming essential partners for healthcare providers navigating these uncharted waters.
The digital age has reshaped every corner of society, and healthcare is no exception. Social media has revolutionized how doctors communicate with the public, but it has also opened the door to unprecedented risks—both for individual physicians and for the facilities they work for.
As medical malpractice brokers, the task is clear: help doctors and healthcare institutions recognize the enormous potential for legal liability that comes with social media engagement. Protecting against these risks means more than just providing coverage—it means understanding the shifting landscape of healthcare in the digital era and preparing for the nuclear verdicts that may come.
The stakes have never been higher. For doctors, the decision to go live is no longer just a moment of connection with the public—it’s a moment that could end their careers and threaten the survival of their practice or hospital.