I don’t give anyone digital files. They’re always prints. All of my digital data stays in LR5 and my external drives.
Granted I’m not in this for profit but I won’t provide an easy path for any person to take my work and plaster it on the internet. If they want to scan the image and change it, be my guest. No one has though, I suspect it’s too much work for most.
When patients ask me to rx a certain drug for an ocular ailment, I ask them how they’ve heard of that drug. That catches most folks by surprise, and when I drill down with just 2 or 3 more questions, it usually becomes “Uncle Bob told me at a barbeque to ask for it.” I ask what med school Bob attended, and most people smile and nod and start listening.