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Doctors Legally Silence Dissatisfied Patients

Physicians take measures to block patients from critiquing them online

This story falls under the heading of "Wow." I didn't have a category for that on this blog, until today. Yesterday, in my email blast from HealthLeaders, they directed their readers to a story by AP Medical Writer Lindsey Tanner. The article, which I found on Yahoo News, was titled "Docs seek gag orders to stop patients' reviews." The story is about the extreme steps some physicians are now taking to keep their dissatisfied patients from writing about them online - in blogs, social communities or through established outlets like These physicians have patients sign 'mutual privacy agreements' where the patient signs away his or her right to say anything critical about the physician in online venues. Wild! Have things gotten that bad for some physicians that they have to take these steps? Well, read on. (As a brief aside, as I read the article online there was a banner ad next to the story promoting "" - a service that collects patient reviews.)

There's a North Carolina neurosurgeon, Dr. Jeffrey Segal, who is now in the business of helping physicians track and preempt online criticism by patients (among other things). His company is called Medical Justice. On their website, they claim to be "relentlessly protecting physicians from frivolous lawsuits." They offer "deterrence, early action, and countersuit prosecution." They sound like a friendly group. Visit their website and go to the page on 'physician internet libel and web defamation.' It is an eye opening experience to learn what they are doing.

In response to the press coverage Medical Justice has received this week in the national media, they had the following to say on their website:

"This week, the national media continued its coverage of our services to protect physicians from Internet defamation. Several of these stories used the attention-grabbing headline of "gag order." This statement could not be farther from the truth."

"Mutual privacy agreements do not create a choice between healthcare and one's right to free speech (as some have erroneously claimed). We recognize that medical errors can and do occur. There are existing processes and viable venues where patients can report bad experiences with physicians. For example, other doctors, lawyers, friends, state licensing boards, civil court and more" (Source: Medical Justice Website, March 12, 2009)

So, talk to your doctor, your lawyer, or the medical board, but please don't talk about your physician on the Internet where others might hear about what a crappy job he did. That's the message. If my physician handed me a "mutual privacy agreement," I'd find another physician. There are better ways to protect your reputation, like delivering exceptional patient care. That's what most of the physicians I know do. And yes, there are crazy folks out there who will post negative stuff on the Web, but what I've seen is that most often the truth wins out (without lawsuits or privacy agreements). Social media in particular tends to be very democratic.

For me, the real problem with all of this (and there are several) is that many people signing these agreements may not realize (my conjecture) that they are giving away their right to openly discuss the care they received from their physician within any online venues. I'm sure that these physicians would never try to intentionally deceive a patient or have them sign a document they don't fully understand, but I'd love to see how this document is 'positioned' when it is placed in front of an unknowing patient. Imagine this: You're sick and you've waited weeks to get in to see a specialist. Finally you arrive for your appointment and you're handed this privacy agreement to sign, along with some insurance forms and other paperwork. My guess is it looks like another HIPPAA document and the patient signs it not realizing the implications (and possibly not worrying about the implications at that point in time).

I'm confident, given Dr. Segal's current choice of vocation, that he has Google Alerts set up to notify him when people write about him online. (From their website you can download their report titled "Avoid Being Defamed On The Web. Have You Googled Your Name Lately?") So, odds are, he'll see this post. If you do read this post, Dr. Segal, I've got some advice for you. Stop dabbling with physician practices. I think the real money for you is in doing consulting for the cable television industry. Just imagine how cable companies could boost their reputations and reduce criticism by having each new customer sign one of your mutual privacy agreements! Just an idea.

Here's the deal, most physicians are well-intended and do incredible work. They deliver exceptional care for their patients and don't need to have their patients sign 'gag orders' - as they have been called by the media. It's the exception to the rule, those few crappy physicians out there, who desperately need this protection. For these few, Dr. Segal and his firm are there to help silence the discontent and outrage of future dissatisfied patients. They probably see it as an insurance policy. However, I see it as permission to practice medicine poorly and delivery a low level of patient care.

Post by Dan Dunlop, The Healthcare Marketing Community and Blog

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