Doctors Placing Gag Orders on Negative Internet Reviews - Page 2 - Mothering Forums
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#31 of 57 Old 03-13-2009, 02:11 PM - Thread Starter
 
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Murkihiku, you're free to take issue with how a ratings site is structured. I admit that www.ratemds.com doesn't take into account ALL of the factors that make a good doctor. But the concept of consumer ratings is a fair one. And even if a site goes about it in an unsatisfactory way, that's no reason for these doctors to call for censorship. A site disclaimer, maybe, warning about potential abuses, but certainly not censorship and gag orders.

The strength of The Birth Survey is that it asks you detailed questions about your perinatal care, covering everything from whether or not you received evidence-based care to descriptions of your doctor or midwife's demeanor and attitude. So there's no way that somebody could make one glib and vile post denouncing a provider; multiple factors are taken under consideration. The Birth Survey also leaves room for freehand comments.

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#32 of 57 Old 03-13-2009, 02:13 PM - Thread Starter
 
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Originally Posted by Shelsi View Post
What's sad is there are midwives out there who will probably do this too. I had a midwife (hi there, I know you're reading this) who was terrible and yet I was prevented from ever being able to speak/type my mind about her on some sites, like this one. Others have had terrible experiences with her as well. I and the other moms who had a bad experience with her will PM people often when they are in FYT forum asking for home birth mw references but certainly we miss some, kwim? Of course I also sing the praises of the midwives I very luckily switched to mid way through my pregnancy.

Wouldn't it be great if there was some sort of "official" review place for all medical professionals? It would be nice to have it all together and easy to find, plus it could be formatted in a way that would encourage reviewers to really detail the problems instead of leaving vague negative feedback.
Like PP said, you're a great candidate for the Birth Survey. It allows you to rank both of your midwives--the one you started out with and the one you transferred to and liked better! It would be a tremendous help if you would contribute.

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#33 of 57 Old 03-13-2009, 02:14 PM
 
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No, they weren't, actually, they were positive comments following a negative one that followed positive ones by (presumably) real students. (But they were the only chili peppers! )

But I only wrote one comment per friend--I could have written fifty. If a friend had five negative comments and then I wrote twenty-five positive ones--that would mislead a reader. 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.
Then my point stands: your positive reviews weren't even needed, because there were plenty of other legitimate positive reviews. The one negative one wouldn't have swayed that curve very much. It sounds like the negative ones bothered you more than a normal reader, being that person's friend. As a PP said, when in a public profession like that, you have to learn to not take everything personally.

If you had the time and energy to write 50 fake reviews, and make sure your writing style was different for each one (to make it less obvious that they were all by the same person), then yeah, you could probably game the system. I don't think most people have the time or interest to write even one fake/illegitimate review, but if they do, there's usually (hopefully) a block on IP addresses writing multiple reviews for the same person. That's part of what would make one site more reliable than another----their policies on things like that. True, you could write a review on your home computer, then go over to your friend's house and write one there, then to an internet cafe and write one there, etc etc etc, but again----most people don't have that kind of time or interest.
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#34 of 57 Old 03-13-2009, 02:48 PM
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Well, I'm not paying my doctor for anything, but yes, in the States your statement is true.
Technically you are paying for it, but not directly. Canada has a higher tax rate than the US for a reason.
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#35 of 57 Old 03-13-2009, 02:58 PM
 
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But you ARE hiring a doctor - your taxes pay for your healthcare, and pay your doctor's salary. Your doctor's job is to be a good doctor, or get fired. It's still a business, even in Canada and Europe.
:

One cannot take that stance that government spending somehow isn't "purchasing". I'm paying my health care providers to provide me with certain services. I'm their customer. It doesn't matter if I write the cheque myself, or if a private insurance plan or government does it on my behalf. Comments like the post this one refers to worry me - I think it leads to a sense of helplessness and complacency among Canadian healthcare consumers.

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#36 of 57 Old 03-13-2009, 04:15 PM
 
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:

One cannot take that stance that government spending somehow isn't "purchasing". I'm paying my health care providers to provide me with certain services. I'm their customer. It doesn't matter if I write the cheque myself, or if a private insurance plan or government does it on my behalf. Comments like the post this one refers to worry me - I think it leads to a sense of helplessness and complacency among Canadian healthcare consumers.
I don't feel that way about taxes; if I did, I might start to think that because I pay more taxes, and hence a bigger proportion of my doctor's salary, than someone on social assistance that I somehow "purchased" better service than that person on social assistance, and I don't feel that way. I don't feel that I am purchasing less than someone wealthier than I who pays more taxes, either.

And if I said to my doctor "my taxes pay your salary," he could say "my taxes pay for your child to go to public school." In fact, since my doctor probably makes more than I do, he probably pays a higher proportion of his salary than I do.

Paying taxes for my healthcare rather than paying for it directly makes me feel like a citizen rather than a consumer. A consumer/customer "is always right"; a citizen balances her rights with her duties. When it comes to healthcare (and education too) I would rather construct myself as a citizen than a consumer.

However, I am in a minority of one, it seems, when it comes to the ethical issues debated on this thread, so I will go and rethink my ideas. (And I mean that partly sincerely.)
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#37 of 57 Old 03-13-2009, 04:43 PM
 
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I don't feel that way about taxes; if I did, I might start to think that because I pay more taxes, and hence a bigger proportion of my doctor's salary, than someone on social assistance that I somehow "purchased" better service than that person on social assistance, and I don't feel that way. I don't feel that I am purchasing less than someone wealthier than I who pays more taxes, either.

And if I said to my doctor "my taxes pay your salary," he could say "my taxes pay for your child to go to public school." In fact, since my doctor probably makes more than I do, he probably pays a higher proportion of his salary than I do.

Paying taxes for my healthcare rather than paying for it directly makes me feel like a citizen rather than a consumer. A consumer/customer "is always right"; a citizen balances her rights with her duties. When it comes to healthcare (and education too) I would rather construct myself as a citizen than a consumer.

However, I am in a minority of one, it seems, when it comes to the ethical issues debated on this thread, so I will go and rethink my ideas. (And I mean that partly sincerely.)
I totally get where you're coming from with this---and I feel much the same way as you. "Everyone works for everyone else" is really the only way we'll be able to make things right in the world, IMHO. And I don't like it when people moan about just paying taxes in general, because there's both give and take when it comes to being a citizen. Taxes are great, IMO, because they force me to be the altruistic person that my greed would otherwise prevent me from being.

I happily pay my taxes, but I also expect those who work for me (be they a congressperson, fireman, or maybe one day a Nat'l-healthcare-doctor) to do the best job they can do, just like I do the best job I can when I work for them (as a teacher, or policewoman, or mail carrier, etc). So while I agree that the "I pay your salary with my taxes" attitude often translates into unrealistic and irrational expectations of a person, I also think that no one, in any profession, should be beyond review and reproach. And if anonymity is needed to make a patient/customer/citizen feel comfortable in being honest and forthright about their experiences with a doctor, then so be it. We should take all precautions possible to be sure no one can abuse that anonymity, but the anonymity itself isn't a problem, IMO.
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#38 of 57 Old 03-13-2009, 05:26 PM
 
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I also think that no one, in any profession, should be beyond review and reproach. And if anonymity is needed to make a patient/customer/citizen feel comfortable in being honest and forthright about their experiences with a doctor, then so be it. We should take all precautions possible to be sure no one can abuse that anonymity, but the anonymity itself isn't a problem, IMO.
Thanks for your post. I agree with all of this--I think my new position could be summed up by rearranging your last sentence into "While the anonymity itself isn't a problem, we should take all precautions possible to be sure no one can abuse that anonymity." Cheers!
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#39 of 57 Old 03-13-2009, 11:19 PM
 
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If the survey is well constructed, even if it's anonymous, you can still tell if the reviewer is giving a bad rating for frivolous reasons (I'm thinking of the academic ones: "She assigns work!" or, my fav, "she made me think" -- this was grounds for a bad review ).
If bedside manner is important to you (and it is to me, especially when I am pregnant), then yeah, I'm going to avoid a dr who is an arrogant jerk, no matter how well s/he practices the medical aspects of her/his profession.
I'm not in Canada, but I do think that ratings by patients would be a good thing for doctors anywhere. We are the recipients of their care. Our opinions should matter to them.

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#40 of 57 Old 03-13-2009, 11:38 PM
 
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I don't feel that way about taxes; if I did, I might start to think that because I pay more taxes, and hence a bigger proportion of my doctor's salary, than someone on social assistance that I somehow "purchased" better service than that person on social assistance, and I don't feel that way. I don't feel that I am purchasing less than someone wealthier than I who pays more taxes, either.

And if I said to my doctor "my taxes pay your salary," he could say "my taxes pay for your child to go to public school." In fact, since my doctor probably makes more than I do, he probably pays a higher proportion of his salary than I do.
The major difference is that the doctor's entire income comes from tax dollars in the first place. I'm not objecting to the system. While I'm nowhere near as enamored of our "health care" as many Canadians, I do appreciate that there is no possibility of finding myself without medical coverage if I get hit by a drunk driver in a crosswalk.

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Paying taxes for my healthcare rather than paying for it directly makes me feel like a citizen rather than a consumer. A consumer/customer "is always right"; a citizen balances her rights with her duties. When it comes to healthcare (and education too) I would rather construct myself as a citizen than a consumer.
I'm a Canadian citizen, as well. I'm also a consumer. I wish I thought about it that way more often, because then maybe I'd have "fired" my OB before he cut me open unnecessarily again. It's a major failing of the Canadian system, imo, that "shopping around" for a new doctor doesn't tend to occur to us that often.

In any case, I don't care if people think of themselves as consumers or as citizens when it comes to their "health care" (and since when does "medical" equal "health"?). I do care if the system encourages them to think of doctors as being above them. I honestly think that, in some ways, the Canadian system is even worse than the US for this particular issue. OTOH, I haven't had to deal with a doctor threatening me with CPS for not vaxing my kid, so I could be way off base there.

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#41 of 57 Old 03-13-2009, 11:40 PM
 
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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.

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#42 of 57 Old 03-14-2009, 12:35 AM
 
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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.
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#43 of 57 Old 03-14-2009, 12:52 AM
 
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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.

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#44 of 57 Old 03-14-2009, 12:52 AM
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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.

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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.

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#45 of 57 Old 03-14-2009, 12:55 AM
 
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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.
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#46 of 57 Old 03-14-2009, 01:41 AM
 
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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.
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#47 of 57 Old 03-14-2009, 01:51 AM
 
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ETA: My ethical question about these sites is not the reviews; it's the anonymous nature of the reviews.
Why is that unethical?
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#48 of 57 Old 03-14-2009, 05:06 PM
 
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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.
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#49 of 57 Old 03-14-2009, 07:27 PM
 
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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.

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#50 of 57 Old 03-14-2009, 08:20 PM
 
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#51 of 57 Old 03-14-2009, 11:25 PM
 
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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.

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#52 of 57 Old 03-15-2009, 01:36 PM
 
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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.
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#53 of 57 Old 03-15-2009, 01:45 PM
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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.
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#54 of 57 Old 03-16-2009, 01:17 AM
 
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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!)
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#55 of 57 Old 03-16-2009, 03:26 PM
 
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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?

Lisa, lucky mama of Kelly (3/93) ribboncesarean.gif, Emma (5/03) ribboncesarean.gif, Evan (7/05) ribboncesarean.gif, & Jenna (6/09) ribboncesarean.gif
Loving my amazing dh, James & forever missing ribbonpb.gif Aaron Ambrose ribboncesarean.gif (11/07) ribbonpb.gif

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#56 of 57 Old 03-24-2009, 12:45 PM - Thread Starter
 
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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.

In God we trust; all others must show data. selectivevax.gifsurf.gifteapot2.GIFintactivist.gif
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#57 of 57 Old 03-25-2009, 06:41 PM
 
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drs try to silence negative reviews

Here's another article

and I did rate one of my MDs

 nak.gif Mommy to fencing.gifKai 2/03, hammer.gifCaden 1/08, energy.gif Kara 10/09, angel1.gif 3/21/13, &

rainbow1284.gif baby.gif  Cole 2/3/14 ♡ Happily unmarried to geek.gif Papa since 2002 ♡

~We may not have it all together  but together we have it all~ uc.jpgsaynovax.gifgoorganic.jpgintactivist.giflactivist.gif 

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