The board is finished with Dr. Roxy. The lawsuits are not, and they name the practice.

In the operating room, Dr. Katharine Roxanne Grawe was the star of the show. The phone was propped at the right angle, the TikTok live was running, and "Dr. Roxy" chatted with viewers between incisions about tummy tucks and breast augmentations as if they were a trip to the dentist. At her peak a stream drew thousands. The internet loved her.

The State Medical Board of Ohio did not, and its file on her reads like a warning delivered in slow motion:

  • 2018. A caution letter about patient privacy in her social media posts.
  • 2021. A second warning, this time citing "avoidable complications that required surgical revision."
  • November 2022. Her license suspended. The board found that her continued practice "presents a danger of immediate and serious harm to the public."
  • July 2023. The license permanently revoked, with a $4,500 fine, for failing to meet the standard of care. At least three patients had suffered serious complications, and county court records showed at least 14 women had sued her over the previous decade.
  • February 2024. Her associate at Roxy Plastic Surgery, Dr. Carlos Domingo, permanently surrendered his own license in a settlement with the board.

When we first wrote this in September 2024, a dozen lawsuits were pending. The board's part is over. The civil cases are the part that outlasts it, and they are the part that matters to anyone who owns a practice. A revoked license ends one career. A run of malpractice verdicts can end the business that employed her, because the claims name the practice as well as the surgeon.

Why the practice pays for the doctor's phone

A doctor's social media account is personal. The liability it creates is not. When a patient is harmed and the surgeon was splitting attention between the incision and the comments feed, the claim names the surgeon and the practice, and the practice's policy is the one with the limits worth pursuing. Three things make these claims expensive:

  • The video is evidence. A livestream of the procedure is discoverable. A jury that watches a surgeon joke with viewers mid-operation does not need an expert witness to form a view about attention.
  • The board's findings come first. A license action for failing the standard of care is public, and plaintiff lawyers read it before they file.
  • Verdicts have grown. Malpractice awards above $10 million, the nuclear verdicts, were rare a decade ago and are now a fixture of the market. Our 2026 rates update covers what they are doing to premiums. One verdict of that size is larger than most practices' policy limits, and the balance comes from the business.

It is not only surgery streams

The dramatic case gets the headlines. The ordinary ones cost money too.

  • Dr. Jason Campbell, the Portland anesthesiology resident known as the "TikTok Doc," was accused of harassing a social worker at Oregon Health & Science University. OHSU settled the federal suit for $585,000 in April 2021. The conduct was off camera. The following his videos had built is what turned an internal complaint into national news, and the settlement was the hospital's, not his.
  • Dr. Lara Kollab, a first-year resident at the Cleveland Clinic, was dismissed in 2018 when antisemitic posts she had written years earlier, including one about giving Jewish patients "the wrong meds," surfaced online. The Ohio board permanently revoked her training certificate in 2020. The posts predated her employment. The clinic still spent months answering for them.
  • The routine cases never make the news. When researchers surveyed state medical boards for JAMA in 2012, 44 of the 48 that answered had already dealt with a doctor's conduct online. The most common complaints were inappropriate contact with patients (69% of boards), prescribing over the internet to people who were not patients (63%) and misrepresenting credentials (60%). More than half the boards had restricted, suspended or revoked a license over it. That was 2012, four years before TikTok existed.

What a practice should have in writing

The answer is not to ban doctors from social media. Patients find practices there, and a clinician who corrects health misinformation is doing something useful. The answer is a written policy that everyone with a login has signed:

  • No patient-identifiable content without written consent. Identifiable includes a tattoo, a date and a procedure in a small town.
  • No filming in the operating room or treatment room unless the practice has approved it in advance and the patient has consented in writing to that specific recording.
  • No clinical advice to named individuals in comments or messages. A reply that reads as advice to one person can be read as the start of a doctor-patient relationship.
  • Credentials stated exactly as the license reads. Board-certified means certified by the board named.
  • A named person who reviews anything posted under the practice's name, and the right to take down anything posted under the doctor's.

Where the insurance sits

  • Professional liability responds to the patient who was harmed, and the practice's entity coverage responds alongside the surgeon's own policy. A surgeon streaming from the operating room is the kind of fact a carrier wants to know at application, not at claim.
  • A privacy breach from a post is cyber liability territory: regulatory defense, fines where they are insurable, and patient notification.
  • Harassment and discrimination claims, like OHSU's, fall under employment practices liability, not malpractice.
  • Defamation, copyright and the rest of what a busy account generates sit under media or general liability, and many malpractice policies exclude them outright.

A practice that employs a doctor with a large following should read all four policies side by side before the next stream goes live. Our page on managing malpractice risk covers the documentation side, and the surgeons' page has current pricing for the specialties most often on camera.

Associated Resources

Sources

  1. NBC News, July 2023: Ohio plastic surgeon who livestreamed procedures loses her license
  2. Fox News, 2023: the lawsuit count from Franklin and Delaware County records
  3. February 2024: Dr. Roxy's associate surrenders his license
  4. OPB, April 2021: OHSU settles the lawsuit involving the TikTok Doc
  5. Cleveland Jewish News, August 2020: former Clinic resident loses her Ohio certificate
  6. Greysen et al., JAMA, March 2012: physician violations of online professionalism