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Doctors seek gag orders to stop patients' reviews on Web sites


Published March 4th, 2009 | 12 Comments


 

CHICAGO — The anonymous comment on the Web site RateMDs.com was unsparing: “Very unhelpful, arrogant,” it said of a doctor. “Did not listen and cut me off, seemed much too happy to have power (and abuse it!) over suffering people.”

Such reviews are becoming more common as consumer ratings services like Zagat’s and Angie’s List expand beyond restaurants and plumbers to medical care, and some doctors are fighting back.
They’re asking patients to agree to what amounts to a gag order that bars them from posting negative comments online.

“Consumers and patients are hungry for good information” about doctors, but Internet reviews provide just the opposite, contends Dr. Jeffrey Segal, a North Carolina neurosurgeon who has made a business of helping doctors monitor and prevent online criticism.

Some sites “are little more than tabloid journalism without much interest in constructively improving practices,” and their sniping comments can unfairly ruin a doctor’s reputation, Segal said.

Segal said such postings say nothing about what should really matter to patients — a doctor’s medical skills — and privacy laws and medical ethics leave doctors powerless to do anything it. His company, Medical Justice, is based in Greensboro, N.C. For a fee, it provides doctors with a standardized waiver agreement. Patients who sign agree not to post online comments about the doctor, “his expertise and/or treatment.”

“Published comments on Web pages, blogs and/or mass correspondence, however well intended, could severely damage physician’s practice,” according to suggested wording the company provides.
Segal’s company advises doctors to have all patients sign the agreements. If a new patient refuses, the doctor might suggest finding another doctor. Segal said he knows of no cases where longtime patients have been turned away for not signing the waivers.

Doctors are notified when a negative rating appears on a Web site, and, if the author’s name is known, physicians can use the signed waivers to get the sites to remove offending opinion.
RateMd’s postings are anonymous, and the site’s operators say they do not know their users’ identities. The operators also won’t remove negative comments.

Angie’s List’s operators know the identities of users and warn them when they register that the site will share names with doctors if asked.

Since Segal’s company began offering its service two years ago, nearly 2,000 doctors have signed up. In several instances, he said, doctors have used signed waivers to get sites to remove negative comments.

John Swapceinski, co-founder of RateMDs.com, said that in recent months, six doctors have asked him to remove negative online comments based on patients’ signed waivers. He has refused.

“They’re basically forcing the patients to choose between health care and their First Amendment rights, and I really find that repulsive,” Swapceinski said.

He said he’s planning to post a “Wall of Shame” listing names of doctors who use patient waivers.
Segal, of Medical Justice, said the waivers are aimed more at giving doctors ammunition against Web sites than against patients. Still, the company’s suggested wording warns that breaching the agreement could result in legal action against patients.

Attorney Jim Speta, a Northwestern University Internet law specialist, questioned whether such lawsuits would have much success.

“Courts might say the balance of power between doctors and patients is very uneven” and that patients should be able to give feedback on their doctors’ performance, Speta said.

Angie Hicks, founder of Angie’s List, said her company surveyed more than 1,000 of its consumer members last month, and most said they had never been presented with a waiver; 3 percent said they would sign one.

About 6,000 doctors reviewed on the Angie’s List site also were asked to comment. Only 74 responded, and about a fifth of them said they would consider using them.

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Freedom of expression is a First Amendment right. Most of the comments that I've read on websites, including HERS Foundation's "Name That Doctor and Hospital", are not about human error. They are about high-handed doctors who are bullying, rude, snide, and sometimes outright abusive.

Some would try to excuse doctors with comments like "We all make mistakes". But I have not read comments about "mistakes", it's quite the opposite, the comments are about "deliberates", like removing the female organs from women without giving them the information that is requisite to informed consent.

CommentNora Coffey | 3/8/2009 - 11:31 PM - (CommentSuggest Removal )

Most people hear about the reputation of a professional by word of mouth; whether or not the professional is a physician, an attorney, a plumber, a contractor, or anyone else.

A "quality physician" has little to fear from online comments, because enough people are recommending him/her to their friends. Many physicians have a waiting list for this very reason.

If a physician is worried about whether or not an online comment might hurt his/her practice, perhaps they need to re-evaluate their bedside manor and offer their clients an anonymous survey to fill out, rather than a waiver.

CommentAngela Roberts | 3/5/2009 - 1:05 PM - (CommentSuggest Removal )

If you can’t handle 1 or 2 bad comments about your business than you need to quit and do something else. It’s all about protecting their profit and not the patient.

CommentJeff Adams | 3/4/2009 - 7:54 PM - (CommentSuggest Removal )

We are leagally permitted to voice our opionion about anyone or anything we want, good or bad. It's called freedome of speech. Why should a doctor that's probably trying to cover something up get a pass. I think not.

CommentJhonny Bravo | 3/4/2009 - 3:45 PM - (CommentSuggest Removal )

Well said Ms. Harrington.

CommentThe Mentalist | 3/4/2009 - 3:33 PM - (CommentSuggest Removal )

If the medical profession did a better job of policing itself all across the board and making sure that doctors who were barred from practicing medicine in one state were forbidden from practicing in any other state, we the public would feel less of a need for such a website as this one. Of course doctors object to this type of website and will do whatever they can to fight its existence. Most of them cannot admit to ever having made a mistake. The ones who object the most vociferously are going to be the ones who have the most to lose due to their own incompetence; their objections are just their way of expressing their possible guilt. One of my favorite jokes of irony is, what is the difference between doctors and God? Answer: God doesn't think He's a doctor.

CommentSusan Harrington | 3/4/2009 - 2:14 PM - (CommentSuggest Removal )

As a business owner, I've found that some complainers are chronic and impossible to satisfy even with the best of effort. RantMD (not a misspelling) is little more than a closed forum for the disgruntled. Closed forum as in non sanctioned by any bonified medical disciplinary board. Some complainers may use their names on these online driveby shootings though I suspect most don't, so the cloak of anonymity can be troubling. Though it remains to be seen what measure of damage these renegade forums can inflict to a doctor's practice, they seem, for now, to serve as little more than an online bitch outlet. I certainly would not utilize such an inefficacious resource in selecting a doctor. The inherent unfairness is also on disply as the article states: "John Swapceinski, co-founder of RateMDs.com, said that in recent months, six doctors have asked him to remove negative online comments based on patients’ signed waivers. He has refused." There is the occasional bad doctor out there but this RantMD thingy would not appear to be the best consumer tool in avoiding them.

CommentHelen Highwater | 3/4/2009 - 11:43 AM - (CommentSuggest Removal )

I agree Mr. Christian, there are many that have nothing but bad to say no matter what. I do like your suggestion about leaving good comments. The article stated that the doctors are alerted when a negative comment is left. Maybe then the doctor could give his patients information about the site (instead of signing a waiver), and ask them to give feedback. This way a good doctor would be defended, but the public would still be able to get information about the doctors that are truly bad.

CommentThe Mentalist | 3/4/2009 - 10:41 AM - (CommentSuggest Removal )

Well, there are some patients who would not satisfied and still complain if they had the world's best doctor. These are the same people who complain about service at a resturant when the service is really great. They also complain about flight attendants beacuse the attendent doesnt' devote 100 percent of their time to him/her. There are enough of these kind of people out there who can destroy even the best doctor's reputation. The only alternative is for those of us who receive excellent service to make ourselves known and provide good reviews.

CommentHarvie Christian | 3/4/2009 - 10:21 AM - (CommentSuggest Removal )

If these doctors would treat their patients better, the patients would have no need to post bad comments. I think these sites are great. Maybe some of these arrogant doctors will start at least pretending to care about their patients. It may also put a stop to this 10 minutes per patient rule that many are using. My doctor is wonderful, so I would only have great things to say about her on these web sites.

CommentThe Mentalist | 3/4/2009 - 10:07 AM - (CommentSuggest Removal )

When we relocated to area and had to find a Doctor we used the web. We felt it helped us make a good decision. We did struggle with several doctors as they were not taking new patients. We also had to fill out an application. I thought that was wrong. It should be the other way around. We should be able to see their record of service to make sure there is no abuse of power.

CommentMcKenna W | 3/4/2009 - 9:24 AM - (CommentSuggest Removal )

Wow -- this is so simple. When a Doctor takes the Hippocratic oath pertaining to ethical practice of medicine...they should do so in a fair and unbiased way - regardless of the patient. I always thought that doctors became doctors in order to "help" people. It is clear nowadays though that its all about the money. They are even taking applications now to determine if you are a worthy patient! And forget going to the emergency room -- you are treated like a hospital hopping junkie looking for a fix - its pathetic. There are actually people out here that NEED medical help and the doctors that discriminate or stereotype should be talked about on the web and abroad. People need to know who they can and cannot trust. Its also more common these days to see doctors on the front pages of newspapers for drug abuse, medicare fraud etc.....they shouldn't be allowed to hide from public views and opinions just because they are doctors. They certainly like to be seen cruising around in their Mercedes and BMW's.

CommentGreg Gilreath | 3/4/2009 - 8:56 AM - (CommentSuggest Removal )
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