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Wednesday
Mar112009

Patient Gagging & Your Plastic Surgeon?

Medical Spa MD hosts anonymous comments. I made the decision to allow that after some careful thought when I first launched the site. (Of course, almost all comments on the web are anonymous.)

There are both benifits and drawbacks to anonynimity. With the number of cease and desist letters I've received I'm aware that not everyone is happy when they're pilloried in public by namless commenters. Here's a story from the AP on doctors who are asking patients to sign what amounts to a gag order befor they'll treat them.

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 prevent 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.

Read the entire article here

So... where to come down? The right to criticize and protect yourself, or additional protections for individuals who may be the recipient of negative comments.

Sona, Solana, Dermacare, medical spa frachises and consultants, RealSelf.com, Cutera, Thermage, Lumenis... these companies have taken some heavy hits around here from disgruntled docs. Would you want unhappy patient to have a high profile forum like this one that they could use to damage your reputation and business?

Reader Comments (16)

Lets see here.... give up your constitutional rights, or see another doctor. Seems these doctors are more concerned with ego and reputation (= money) then pt positive outcomes. I would see another doctor.

On the other hand some complaints are planted by competition. Nothing stops doc from giving a rebuttal, even HIPPA. If a patient gives medical info to the public its fair game.

On any of this its a probability game, if you do 1000 procedures some % of pts will not be happy. Welcome to the real world, people complain the net just makes it easier.

Personally I would be embarrassed to ask a pt to sign a waiver. You might as well say "there is a good chance I will fu#k this up so please sign this". Things happen, isn't this what a consent form is for?

03.11 | Unregistered CommenterFlorida PA

But if you get a completely unfair review, done by a competitor, you will be stuck with it....and that's hardly fair, either.

03.12 | Unregistered CommenterTF

So its fair that some doctors have their publicists on speed dial so that they make it to publications that name them "best doctors", get them TV and magazine spots that imply that they actually know what they're talking about when actual patient experience is something entirely different? I find support groups and sites like ratemd invaluable.At least you get an honest opinion. Believe me, the patients on these sites can spot "pretenders" or people with unrealistic expectations prettty well and they jump on them without mercy.Also the doctor can always respond. Patients who have had a positive experience are also very quick to respond to negative reviews for doctors with whom they have had a good experience. I would also be suspect of any doctor who wanted me to sign a waiver.

03.12 | Unregistered Commenterms arlene

Treat people with respect.
Practice the golden rule.
Give great service and lose the arrogance and "no worries".

The master manipulators and the arrogant doctors are having a hard time with open communication.
I suggest that they change their ways (and stop trying to repress free speech).

03.12 | Unregistered CommenterJustMe

I have no problem with transparency and open communication. I certainly don't use "gag orders"!
But I have personally been the victim of a negative review on one of these anonymous sites - that we determined was posted by a competitor, who has never even met me, or been to my office, let alone have a consult or surgery with us. It was a complete fabrication.
Yes, my many happy patients "went to town" on it, pointing out how ridiculous it was, and making a rebuttle.

But that's not the same as being able to erase or delete that review, is it now?

Surely there should be some middle ground?

03.12 | Unregistered CommenterTF

TF

You are absolutely right, that's plain dirty business with no easy answer. Too bad there is no gag order for inferior competition. If you could prove this it becomes a serious civil matter.

03.12 | Unregistered CommenterFlorida PA

I am with TF

The way internet communications are, the system is set up to cause more potential damage to the physician than to provide customers with useful information.

03.12 | Unregistered CommenterMedhacker

ms arlene,

I appreciate what you say and i do not agree with gagging patients but there are 2 sides to the story.

I am previously a Family Physician and had a gentleman come in demanding that I give him antibiotics for a cold. As we all know antibiotics do not work for colds. This patient was upset that i would not write for antibiotics when he did not need them. He then went on multiple of the physician grading sites and put very negative comments about me.

This did not affect my clinic at all but it shows how easy it is to just place information on the web. I did have few patients that went on and "defended" me but most happy patients will not get involved.

03.12 | Unregistered CommenterLH

You can't throw out the baby with the bathwater.
A few negitive experiences with anom blogging should not overpower the tremendous good it has done.

A webmaster knows who the posters are, so they should step in at times to rectify a situation that TF relates.

In the past, doctors were not beholden to anyone. We have been arrogant and not very patient friendly. Now we have to worry about the blog as well as the lawyers. This should make us all better.

We will have to figure out how to deal with the unreasonable bloggers.

03.12 | Unregistered CommenterJEE

The guy who blogged about TF will have bad Karma and bad things will happen to him.
This type of guy will "get his" in the end.

If I was TF, I would just drive over to his office and kick his ass.
Sometimes you have to go back to old time justice even in this day and age of computers and the internet.

03.12 | Unregistered CommenterMAPA Man

I think its unrealistic to think that patients will not use boards to search for good doctors, and find out about bad ones. The internet has just made "word of mouth" easier.If we can't mention a doctors name on the board we are able to send a personal message to each other. Unfortunately, there will always be people who try to work any system to their advantage. Two support groups that I belong to have banned an individual who was once considered an expert in the treatment of a certain disease from posting any comments on their sites. Now he continually tries to pose as a patient that has had excellent results in order to steer patients to his "institute". Patients try to educate themselves about certain diseases treated by laser as well as cosmetic procedures in order to keep themselves from getting hurt. A physician may lose money, a patient can be permanently disfigured. Why assume that these sites will "damage" you. Your participation here is an indication that you care about the work you do. Positive postings attract patients. Some doctors should not be allowed to hold a laser and people need to be warned. Waivers just scare people- not the answer

03.12 | Unregistered Commenterms arlene

Mapa Man: You sound a bit like Dirty Harry...."feeling lucky today, Mr. blogger?"
:)

03.12 | Unregistered CommenterTF

One must use their superpowers for good and not evil :)

03.12 | Unregistered CommenterMAPA Man

are there any web sites blogs where physicians can go on and rate their patients ?

03.12 | Unregistered CommenterdrT

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What about those patients that just want the treatment for free. Once they get the treatment, then complain it isn't what they wanted or it wasn't perfect and demand their money back. When you say, no, the treatment was done, you signed the consent and you did get some results. Then they go online and bad mouth you. One bad apple spoils the whole basket.

08.22 | Unregistered Commenterskinertoo

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