Doctors Placing Gag Orders on Negative Internet Reviews - Page 3

[Storm Bride]

Originally Posted by ~Sarah~

Taxes are great, IMO, because they force me to be the altruistic person that my greed would otherwise prevent me from being.

I'm sorry, but this makes no sense at all. Nobody can force someone to be altruistic. If it's forced, it's not altruism.

[~Sarah~]

Originally Posted by Storm Bride

I'm sorry, but this makes no sense at all. Nobody can force someone to be altruistic. If it's forced, it's not altruism.

I think you understand what I was trying to say, right? Wrong term; my bad. I think most people got my point.

[Storm Bride]

Originally Posted by ~Sarah~

I think you understand what I was trying to say, right? Wrong term; my bad. I think most people got my point.

I sort of do, and sort of don't. I see taxes very differently from the way you see them. They're a necessary evil, but I've never "happily" paid my hard-earned and much-needed cash into government coffers, and they definitely don't make me more altruistic in any way. In fact, they make me hold onto what I've got more than I would, otherwise, because so much of my money is already going to things that I don't support.

[~pi]

I agree with Murihiku that there are ethical issues here. I'm also Canadian, and, FWIW, this is where I am coming from:

- I have rated many of my doctors on ratemds.com -- positive, negative and neutral experiences.

- I have been rated on ratemyprofessor.com, so I have a sense of how it feels to be on the receiving end, too.

- Out of pure nosiness, I read the reviews of some of my friends/colleagues who are doctors, and they all seemed very plausible to me.

- I would personally be very wary of a physician who wants me to sign a non-disclosure agreement.

- I think it's very satisfying that all this media attention is bringing more awareness to rating sites and increasing the chances that doctors will be rated/reviewed.

Having said all that, as I said, I do agree that there are some ethical issues. My personal instinct would be to allow physicians to post their own comments on their own reviews (e.g. Dr. So-and-so responds.) It would not be a perfect system, but no system is.

Originally Posted by Shelsi

I do not agree at all. Medical professionals work for us, they are hired by us, therefore we should have the ability to rate them. It's not unethical to rate your plumber, why should it be unethical to rate your doctor?

Well, for one, a plumber is totally free not to take you or keep you as a client. That is not always the case with doctors.

[~Sarah~]

Originally Posted by Storm Bride

I sort of do, and sort of don't. I see taxes very differently from the way you see them. They're a necessary evil, but I've never "happily" paid my hard-earned and much-needed cash into government coffers, and they definitely don't make me more altruistic in any way. In fact, they make me hold onto what I've got more than I would, otherwise, because so much of my money is already going to things that I don't support.

I think that's a whole different thread altogether.

[jennica]

Originally Posted by Murihiku

Now I had benign intentions--someone with malign intentions could seriously harm a doctor through one of these sites, am I right? I might be wrong because I am not very knowledgeable about safeguards built into the internet.

I don't know about these other sites, but with The Birth Survey, it would not really be possible for a consumer to seriously harm a doctor and here is why: First, there is no slander, profanity, etc. allowed and those comments will be taken out. Whatever is said should be truthful. Second, the free text comment fields are interspersed throughout a 15 - 30 minute long survey (depending on the circumstances of your birth) and it is highly unlikely that someone who is just out to be spiteful is going to go through that thing just so they can write a comment that we would probably flag and delete anyway. And even if they did it once, just to be spiteful, they aren't going to go through it more then that and one bad comment in a sea of good ones wont make much difference. Also, if a consumer actually gets bad service and tells her truthful experience in a comment, and this affects the provider's practice, well who really harmed that provider? The provider did by giving that woman bad service. If the provider does not want bad reviews, then the provider should not treat people badly. If someone is being dishonest and fills out a survey who did not actually receive care by this provider, then either their comment will be obvious and be flagged, or it will just be buried within comments that are from actual patients. I am not sure how many people actually would fill these things out for someone who did not provide them care, I think that would be a pretty low percentage.

[jennica]

Originally Posted by Murihiku

ETA: My ethical question about these sites is not the reviews; it's the anonymous nature of the reviews.

Why is that unethical?

[Murihiku]

Originally Posted by jennica

Why is that unethical?

I didn't (and don't) say it's unethical, but rather that there is an ethical issue at stake. What I mean by that is that we have a conflict not between right and wrong, but between right and right. Patients reviewing their doctors have a right to remain anonymous, but doctors have the right to know who their accusers are, if they want to mount a defense--or even if they want to learn from their mistakes and improve. But patients have less power than doctors in the traditional patient-doctor relationship so they need the safety of anonymity so that they feel safe to tell their story. I think it's a complex issue; I'd assign it as a topic for a debate, for example, to an ethics class if I taught an ethics class.

Thanks for explaining the safeguards built into The Birth Survey.

[Full Heart]

Originally Posted by ~pi

Well, for one, a plumber is totally free not to take you or keep you as a client. That is not always the case with doctors.

I guess in another country that could be the case but in america? Where women are dropped because they refuse the GTT. Where parents are forced to leave practices they have been at for years because they stop vaxing their kids? I think in many instances people forget or don't really realize the dr works for them. They fail to realize they don't have to put up with the mistreatment and can leave. While drs have no problem firing their patients.

Still if they run a business they should be held to the same standards as other businesses. No one should be beyond treating others with respect. Not to mention with medical accidents as high as they are perhaps finding out your dr had a string of them might be good.

[georgia]

Hi! I have removed posts that referenced or discussed other MDC members. Please avoid posting to discuss MDC members, even if you don't name names. We don't want to fuel speculation or discuss other threads. Thanks so much!

From the MDC User Agreement:

Do not start a thread to discuss member behavior or statements of members made in other threads or to criticize another discussion on the boards.

Please PM me with any questions

[Storm Bride]

Originally Posted by Full Heart

I guess in another country that could be the case but in america? Where women are dropped because they refuse the GTT.

I had my third c-section, because I caved in to a threat from my OB. He told me if I didn't have the surgery, he'd drop me from care. That's in Canada.

[jennica]

Originally Posted by Murihiku

I didn't (and don't) say it's unethical, but rather that there is an ethical issue at stake. What I mean by that is that we have a conflict not between right and wrong, but between right and right. Patients reviewing their doctors have a right to remain anonymous, but doctors have the right to know who their accusers are, if they want to mount a defense--or even if they want to learn from their mistakes and improve. But patients have less power than doctors in the traditional patient-doctor relationship so they need the safety of anonymity so that they feel safe to tell their story. I think it's a complex issue; I'd assign it as a topic for a debate, for example, to an ethics class if I taught an ethics class.

Thanks for explaining the safeguards built into The Birth Survey.

You know, I kind of agree with you here. But, our system is so flawed that this can not currently happen. If a care provider harms someone while they are giving birth, (emotionally - by doing unwanted and traumatic procedures that the patient did not want) there is currently no way for the patient and provider to have a discussion about this. The patient's only recourse is to try to sue, but lawyers will not even discuss a case like this if you pay them because there is no hope of winning. The patient is generally too traumatized to go see her provider again, and even if she does, the provider will generally not hear what she has to say and try to shift the blame or claim that he/she had to do what they did - the last thing you will get is an exchange of thoughts on the issue that would help either party. If she writes her provider a letter, it is extremely uncommon for her to ever get a response, and I have never heard of a provider apologizing, since admitting guilt could increase the chances of the provider being sued. So we have a system where providers can harm patients and patients can not do anything about it. They can not even arrange a meeting with the provider and a mediator where they could talk through the experience, which may benefit both parties, since the fear of litigation is so strong in the medical community that this would be a legal risk for them. Even if the provider wants to talk to a patient, it is advised against.

One of the only methods of recourse is giving anonymous feedback on sites like this (one can supposedly also file a compliant about a provider - though I have never been successful in figuring out how to do that after multiple attempts, or one can file a claim on their own without a lawyer - which is very time consuming and the statute of limitations generally clocks out before this is possible). Unfortunately there is no other way to be heard if you are a patient who was wronged by a provider.

[Talula Fairie]

I don't think a negative internet review makes someone an accuser. The right to confront an accuser refers to the court system. A negative review on a site is a far cry from that. And if someone was a really good doctor, their negative reviews would be infrequent if any existed at all.

Imagine if every review you've ever posted online had to be done under your real name. Would you want to do that? I actually think that would give us an imbalanced picture of things becuase most people don't want to give out their real names online. I want to be able to go to places like Amazon or doctor rating sites and see accurate reviews.

[doctorjen]

I have really debated getting into this conversation, being one of the few providers around. I've been thinking about this anonymous rating issue for a while, having had just a little bit of personal experience with it.

I think there is an awful lot wrong with most of the doctor patient relationships in our current system. Not just the types of examples we all think of with docs doing things against the express will of clients, but in many small ways as well. I know there is a legitimate problem with the sort of heirarchal system we have - physicians feel that they should prescribe and order and patients should comply. Not exactly the best kind of working relationship. On the other hand, having now practiced nearly 8 years, it's fairly scary how high folks expectations are of physicians. I should get the diagnosis right every single time, on the first try; I should order enough tests that folks feel reassured that every stone was overturned, but not too many so that you get a big bill and no satisfaction; I should have perfect interpersonal skills in every interaction, and never misunderstand what someone means - and often, I should be able to interpret what someone "really wants" even though they don't tell me what that is; I should never be too busy to answer a phone call immediately at the office, I should be able to fix their problem over the phone - and while I'm doing all this I shouldn't ever be tired or crabby or whatever.

I practice in a small town where their is a very active rumor mill and it amazes me sometimes what rumors about me get back to me, or how stories are interpreted or turned around. The rumor mill is kind of like these anonymous reveiws - it's always one sided, and often blown out of proportion, and rarely totally accurate. I once had a woman whom I'd never met tell one of my own loyal clients that she would never go to me because I won't let anyone have pain medicine! (Where that came from is a complete mystery since it is of course not the least bit true, but I've actually heard it numerous times)

The thing is, I think I'm pretty good at what I do. Being a family doc is my life calling. I try very hard to practice as collaboratively as possible, and to be transparent about my thought processes (by which I mean, when there is uncertainty about the diagnosis or the treatment, or whatever, I try to make sure my client can understand why we aren't sure, what we'll watch for, how we'd know if something more serious was developing, that kind of thing.) I stay up to date on the evidence as much as I can. I just reboarded passing my exam in the 94th percentile in the nation, so I feel like I'm staying up to date as much as I can. I eat, sleep and breathe my practice much of the time - I constantly worry about missing something, about not explaining something welll, about an unanticipated outcome, about a client being disatisfied. But the fact remains that I am human, and sometimes I blow it. Sometimes it isn't possible to know exactly what to do. Sometimes, clients aren't even fully sure what they want, or actually agree to things they change their minds about later. I am just a human being with a technical skill that I share - but the way the doctor-patient relationship is in the US, being human is not always acceptable. It is rare for someone to come back and say "I wish you had done this differently." The few times they have, have usually been good growth experiences for me, and usually the relationship is salvaged, but more often folks disappear and you hear something negative about yourself that doesn't seem to reflect what actually happen.

On the one hand, I wouldn't expect folks to promise not to say anything about me online. I think there has to be some way for potential clients to know something about your style and skills. On the other hand, while this is not yet a common thing, one or two reviews can be all that you have, and a really skewed view of the provider. I practice somewhere there isn't a lot of internet savvy, so I don't know how much this will actually affect me, or my practice (which continues so far to be if anything, too busy) but let me tell you, since I feel like I'm doing the absolute best job I can and pouring so much of myself into it, it's darn discouraging to look up your only review and find out it's negative, and worse than that, inaccurate! (which just happened to me after looking up one of these sites after reading this thread!)

[Storm Bride]

doctorjen: Thanks for your input. My usual GP is a bit like you, I think. I wish he still handled obstetrics "patients".

In my case, I won't be posting any internet reviews. I also won't be seeing doctors, anymore, unless I'm deathly ill (like delirious) or have been in a car accident. I'm done. I like my GP well enough, but I'm done. My "care" providers have made it very obvious that a good, or even acceptable, outcome for me is not on their agenda. Even the good OB I'm seeing right now works out of a typically snotty office environment. When I call to schedule an appointment, I don't need condescending lectures about how I "should" have done that already from people who have no clue why I didn't do so. (I don't need lectures at all.)

I'll take my kids to the doctor when it seems advisable, but I won't be going. I value my mental health at least as much as my physical health, and dealing with the medical community is very bad for my mental health.

I really wish doctors, as a group (I know there are exceptions), would get over expecting to be treated like gods, but being upset when someone blames them for a bad outcome. Maybe if they stopped promising what they can't deliver, people wouldn't be so angry when they don't come through, yk?

[Turquesa]

I'm bumping this up to thank Dr. Jen for her post, which has inspired me to go to ratemds.com and give a positive review of my family physician. I'm reminded to remember the positive instead of solely focusing on the negative. For those other posters who've found a good doctor--OB or otherwise--I strongly encourage you to follow suite.

[Serenyd]

drs try to silence negative reviews

Here's another article

and I did rate one of my MDs