Patients have finally become enabled to take a stand against doctors who are rude and/or provide sub-par services.  The quacks to whom I am referring are, of course, those who have taken the hypocritical (did I say that out loud?), I meant Hippocratic, oath.

Patients are using vehicles such as RateMDs.com, Angie’s List, and DoctorScorecard.com.  Soon, Angie’s list, the proverbial matriarch of online review sites, will start posting alerts that spotlight doctors who ask for what founder Angie Hicks calls “medical gag orders.”

Some doctors are requiring their clients to sign contracts that are tantamount to non-disclosure agreements (NDAs).  Others request their patients to sign over copyrights to possible future comments in the hope that they will gain the leverage needed to remove any undesirable tags.

Such contracts have not yet been tested legally, and the experts seem to believe that they are unlikely to win out in the end.  Doctors contest that the waivers are needed to protect them for ethical and legal reasons.  Critics hold that this is censorship.  Said John Swapceinski, creator of RateMDs.com, where hundreds of new ratings of doctors are being added every day, “Essentially, patients are being asked to trade in their freedom of speech for medical care,”.

Dr. Jeffrey Segal, a neurosurgeon and founder of Medical Justice Services Inc., a North Carolina-based corporation that endeavors to aid doctors to combat against defamation for a fee.  Patients are free to seek the services of any doctor who doesn’t require a waiver.  Regarding those who choose to sign, the NDAs are a means by which to balance the rights of both the patient and the doctor, said Segal.

“There’s no venue for physicians to get their side of the story out,” said Segal, who notes that doctors can’t respond to individual patients for legal reasons.

Although there are some sites, such as Angie’s List, who know who is posting, most don’t identify or validate commenters, said Segal, who is himself diametrically opposed to such anonymity.

“You don’t know whether it’s a patient, an ex-employee, an ex-spouse or even a competitor,” Segal said.

Approximately 1,000 of Medical Justice’s 2,300 members require their patients to sign privacy waivers, Segal said, making them part of a small but growing group of doctors attempting to silence harsh (read honest, the truth hurts, doesn’t it?) reviews.

“Patient will not denigrate, defame, disparage or cast aspersions upon the Physician; and will use all reasonable efforts to prevent any member of their immediate family or aquaintance from engaging in any such activity,” reads the “Mutual Agreement to Maintain Privacy” form posted on the site of Dr. Andrew Salzberg, a plastic surgeon and Medical Justice member in Tarrytown, N.Y.

“Published comments on web pages, blogs, and/or mass correspondence, however well intended, could severely damage Physician’s practice.”

The NDAs typically limit patient comments for five years from the last doctor’s visit and they imply that breaking the terms could land the patients in court.  Matthew Zimmerman, an attorney with the Electronic Frontier Foundation, which monitors digital rights, says it’s not likely lawsuits against patients or Web site providers would be successful.

“The doctor can’t legally go to the Web site and demand that the content come down,” said Zimmerman.

Web sites aren’t responsible for nasty comments…

Under the federal Communication Decency Act, Web site providers aren’t liable for the postings of those who comment, no matter what they say.  Even so, doctors and their lawyers routinely attempt to intimidate or encourage Web sites to remove offensive posts, said Swapceinski.

He said he’s deleted a very few, but only if they shouldn’t have been accepted in the first place.  The post about the doctor performing a pelvic exam for a sore throat was slanderous, for example, and should never have been allowed, he said.

As awareness grows, the waivers may be backfiring on doctors, drawing scathing attention – and possible government sanctions – to the very physicians who sought to avoid it most.

cf http://www.msnbc.msn.com/id/34794632/ns/health-health_care

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