Doctors Placing Gag Orders on Negative Internet Reviews - Mothering Forums
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#1 of 57 Old 03-12-2009, 08:56 PM - Thread Starter
 
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Mods may move this to the appropriate place. I chose B&B because we talk a lot about OB care here, and many of us are promoting the rating site, www.thebirthsurvey.com.

Check this out:
http://www.philly.com/inquirer/healt...e_reviews.html

Can you imagine if a contractor you hired wouldn't do work for you unless you agreed to sign a pledge not to post a negative review on Angie's List?

I think that some doctors get threatened when patients behave as what they are, consumers. Frankly, if I ever encounter a doctor who's this anti-transparency, I will run, not walk, out of his/her office.

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#2 of 57 Old 03-12-2009, 09:30 PM
 
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Though I just got done reading Marsden Wagner's "Born in the USA" and he discusses inflated egos of some doctors at length, so I guess this shouldn't surprise me. I think (Wagner's) discussion of a sort of obstetrical omertà is fascinating. How can doctors believe that they're beyond reproach? I wish he'd write an editorial about doctors having a fit over negative online reviews. But then, the doctors would probably have it removed.

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#3 of 57 Old 03-12-2009, 09:36 PM
 
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I saw this article. Totally ridiculous and unenforceable. One positive thing, it is a great red flag...any doctor that asks me to sign it will not be a doctor that I use!

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#4 of 57 Old 03-12-2009, 09:56 PM
 
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This is what kills me:
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Segal said such postings told nothing about what should really matter to patients - a doctor's medical skills.
Um... no. An abusive doctor is still an ABUSIVE doctor. And hiding behind his medical degree doesn't change that. Everybody should be concerned about that. This is completely indicative of the prevalent attitude today that doctors don't have to be held accountable for anything, and can treat people like crap any time they want just because of the degree they hold. Talk about classism at it's worst. Losing sight of the underlying fact that when it comes right down to it they hold a customer service position.

In fact I just spoke to my grandmother today, and she told me she's been having episodes of a racing heart. She's been telling her doctor about this for YEARS and he told her he couldn't do anything (diagnosis, referral, etc.) unless she came in to his office during one of these episodes. She finally got in to see a cardiologist last week and it turns out she'd had a heart attack and now it looks like she'll need a pacemaker. How difficult would it have been to actually listen to her at the beginning and send her to a cardiologist then, rather than making her wait several years, for something that could have potentially killed her? That's the kind of abuse of power that needs to be reported. But of course she thinks anyone with an MD after their name walks on water.

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#5 of 57 Old 03-12-2009, 10:07 PM
 
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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.

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#6 of 57 Old 03-12-2009, 10:12 PM
 
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As if the horrible state of our medical system needed any more problems. Information is critical when choosing a care provider. You'd think everyone would care how they were treated.

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#7 of 57 Old 03-12-2009, 11:03 PM
 
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I think this is a complicated ethical issue.

The point of these anonymous reviews is to help patients choose a good doctor and avoid a bad one, correct?

What if doctors were to anonymously (but the patient would easily figure it out, of course) review patients to help each other avoid difficult ones? Imagine a site that contained statements like "Didn't listen to anything I had to say--I couldn't get in word in edgewise. Thought I was a nurse at first and asked to see a male doctor. Then asked me about my accent and indicated he wanted to see an 'American' doctor"? This doesn't breach patient confidentiality as it says nothing about the patient's condition but tells us only that s/he is racist, sexist, and obnoxious.

Wouldn't you, as a patient, ask the doctor to sign a pledge that she wouldn't post a negative review of you on a website?

I know there's a power difference to be taken into account, and I'm not saying these sites are wrong, just suggesting that the issue is complicated.
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#8 of 57 Old 03-12-2009, 11:18 PM
 
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If you had a lawyer who gave you bad advice, would you not complain. If your accountant screwed up your taxes, would you stand by quietly? People don't seem to remember that we have HIRED a dr. to do a job. If she/he does a bad job, I most certainly will not recommend them, and yes I will try to talk someone out of going to that dr. On the flip side, I love my ob/gyn, he is a HB support/backup and I send TONS of business his direction if a woman wants an OB. It works both ways.
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#9 of 57 Old 03-12-2009, 11:23 PM
 
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Originally Posted by Murihiku View Post
I think this is a complicated ethical issue.

The point of these anonymous reviews is to help patients choose a good doctor and avoid a bad one, correct?

What if doctors were to anonymously (but the patient would easily figure it out, of course) review patients to help each other avoid difficult ones? Imagine a site that contained statements like "Didn't listen to anything I had to say--I couldn't get in word in edgewise. Thought I was a nurse at first and asked to see a male doctor. Then asked me about my accent and indicated he wanted to see an 'American' doctor"? This doesn't breach patient confidentiality as it says nothing about the patient's condition but tells us only that s/he is racist, sexist, and obnoxious.

Wouldn't you, as a patient, ask the doctor to sign a pledge that she wouldn't post a negative review of you on a website?

I know there's a power difference to be taken into account, and I'm not saying these sites are wrong, just suggesting that the issue is complicated.
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?

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#10 of 57 Old 03-12-2009, 11:26 PM
 
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Originally Posted by JesiLynne View Post
If you had a lawyer who gave you bad advice, would you not complain. If your accountant screwed up your taxes, would you stand by quietly? People don't seem to remember that we have HIRED a dr. to do a job. If she/he does a bad job, I most certainly will not recommend them, and yes I will try to talk someone out of going to that dr. On the flip side, I love my ob/gyn, he is a HB support/backup and I send TONS of business his direction if a woman wants an OB. It works both ways.
Would I complain anonymously? I think if I'm complaining publicly about someone I've named, then I should sign my name to that complaint.

Maybe I'm coming at this from too Canadian a viewpoint, never having hired a doctor. I hate thinking of healthcare as a business.
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#11 of 57 Old 03-12-2009, 11:32 PM
 
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I don't like thinking of it that way either, but it is business. I don't mind complaining publicly about a bad dr. I have had a few. I've fired at least one, so far. I will most likely fire more down the road. Hell I signed one of my twins out the the NICU AMA b/c of a group of idiot drs. who wouldn't communicate with each other, let alone refer back to the head drs. orders. Ppl need to be more in charge of their own health desicions. I truly believe if ppl did that, healthcare costs would go down and quality would go up.
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#12 of 57 Old 03-12-2009, 11:48 PM
 
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Originally Posted by cristeen View Post
This is what kills me:

Um... no. An abusive doctor is still an ABUSIVE doctor. And hiding behind his medical degree doesn't change that.
I was going to post the exact same quote! I can't believe he was that transparent about it! That quote is nearly identical to saying, "Patients shouldn't care how rude we are to them! How condescending or obnoxious we are is not what matters."

Unbelievable.

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Wouldn't it be great if there was some sort of "official" review place for all medical professionals?
Part of the goal of The Birth Survey!
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#13 of 57 Old 03-13-2009, 12:31 AM
 
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Would I complain anonymously? I think if I'm complaining publicly about someone I've named, then I should sign my name to that complaint.
Doctors only get complained about if they do a bad job. These sites are not for the purpose of hosting complaints, they are for the purpose of helping each other find the best care provider for them. If doctors are being complained about to the point that they are losing business over these sites, then they are obviously doing something wrong and need to fix it.

As for The Birth Survey, there is currently no transparency in maternity care. Finding a health care provider is done by who your insurance covers, or in some other random way. Women walk blindly into a situation where they have no idea what this provider's intervention rates are or what their bedside manner is. Being able to find that out before selecting a provider is a step in the right direction.
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#14 of 57 Old 03-13-2009, 12:32 AM
 
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Wouldn't you, as a patient, ask the doctor to sign a pledge that she wouldn't post a negative review of you on a website?
But the doctor isn't paying me to be a patient, while I, on the other hand, am paying them to be a doctor.

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#15 of 57 Old 03-13-2009, 12:35 AM
 
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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.
No midwife can prevent you from giving anonymous feedback. Be careful in what you say not to identify yourself, and she will not know who it was. That is the weird thing about this situation, if doctors have their patients signing wavers, how will they prove that the anonymous comments on these sites are from those patients? They can't! If you live in a licensing state and your midwife is licensed, take The Birth Survey! You will be anonymous and she can't do anything about it - just don't give away any identifying info in the free text comments.
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#16 of 57 Old 03-13-2009, 12:55 AM
 
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Originally Posted by Murihiku View Post
I think this is a complicated ethical issue.

The point of these anonymous reviews is to help patients choose a good doctor and avoid a bad one, correct?

What if doctors were to anonymously (but the patient would easily figure it out, of course) review patients to help each other avoid difficult ones? Imagine a site that contained statements like "Didn't listen to anything I had to say--I couldn't get in word in edgewise. Thought I was a nurse at first and asked to see a male doctor. Then asked me about my accent and indicated he wanted to see an 'American' doctor"? This doesn't breach patient confidentiality as it says nothing about the patient's condition but tells us only that s/he is racist, sexist, and obnoxious.

Wouldn't you, as a patient, ask the doctor to sign a pledge that she wouldn't post a negative review of you on a website?

I know there's a power difference to be taken into account, and I'm not saying these sites are wrong, just suggesting that the issue is complicated.
Nope - the doctor isn't paying me to be his/her patient. Doctors should be competing for our business by performing their services well, not by threatening us. If I'm going to pay for a service, I should be able to do research and get reviews. Maybe one day this won't be anonymous, which certainly would hold a different credibility to it. But the Birth Survey is a much needed step in the right direction.

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#17 of 57 Old 03-13-2009, 10:28 AM
 
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Originally Posted by Murihiku View Post
I think this is a complicated ethical issue.

The point of these anonymous reviews is to help patients choose a good doctor and avoid a bad one, correct?

What if doctors were to anonymously (but the patient would easily figure it out, of course) review patients to help each other avoid difficult ones?
Totally different. You are paying a doctor for a service. A doctor's practice is a business.

A patient on the other hand is a private citizen.

OP, what can we do to oppose this legislation?

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#18 of 57 Old 03-13-2009, 11:03 AM
 
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Think how angry we get when a mechanic does a lousy job!!! When we get shotty work from anyone, we always tell people...and sometimes their business gets hurt by it. GOOD. Lousy work should be rewarded with lousy business...and the mechanic has never intentionally cut the leather seats of your car, stitched it up and asked you to thank him for it! know what I mean?

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#19 of 57 Old 03-13-2009, 11:12 AM
 
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Would I complain anonymously? I think if I'm complaining publicly about someone I've named, then I should sign my name to that complaint.

Maybe I'm coming at this from too Canadian a viewpoint, never having hired a doctor. I hate thinking of healthcare as a business.
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.

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#20 of 57 Old 03-13-2009, 11:17 AM
 
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Totally different. You are paying a doctor for a service. A doctor's practice is a business.

A patient on the other hand is a private citizen.
Well, I'm not paying my doctor for anything, but yes, in the States your statement is true.

However, anonymity is easily abused. What's to stop a doctor's ex-husband going to one of these sites and posting negative reviews in order to hurt her business? And my objection holds true of any anonymous review: of mechanics, plumbers, lawyers, teachers . . . all of whom are private citizens and human beings as well as service-providers.

And how do you defend yourself against libel when the libel is anonymous?

Still, anything good in this world is open to abuse, isn't it? I can see the good such anonymous sites do, too.
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#21 of 57 Old 03-13-2009, 11:31 AM
 
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Drs/mws can't expect to run a business and not have to abide by business standards ie treating their consumers with respect as well as good service. I don't care WHO pays them. They are getting paid for services rendered. Its a business. If a charity was accepting money from people and then the people they were meant to help they actually hurt would we accept that? No. And we don't. We have a HIGHER standard for charities than we do for businesses. I will not accept bad treatment just because the services were good. From anyone. And this is coming from a business owner. If I want respect from my clients and business from them I will treat them the same way I want to be treated.

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#22 of 57 Old 03-13-2009, 11:32 AM
 
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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.
Objectively true--subjectively a different experience. As a taxpayer, I feel like a partner with my doctor in my health care; if I paid him directly, I would feel like he was my employee. It's a difference to me of feeling like a citizen vs feeling like a consumer. YMMV.

ETA: My ethical question about these sites is not the reviews; it's the anonymous nature of the reviews.
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#23 of 57 Old 03-13-2009, 12:36 PM
 
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However, anonymity is easily abused. What's to stop a doctor's ex-husband going to one of these sites and posting negative reviews in order to hurt her business?
I think if they're actually a great doc, then those couple of reviews will stand out as strange and out-of-place among the positive reviews all of their other patients would be giving them. It would be obvious that they have someone with a grudge when there's 100 positives and maybe 5 negatives, especially if those negatives contradict things in all of the positives.

Perhaps what this review site can accomplish is showing the AMA/ACOG/government, whoever, that an official review system is needed, and they'll construct some sort of site where patients can log on with a number supplied by their doctor that allows the patient to stay anonymous to the doctor, but allows the organization to verify that it is, indeed, a review from a valid patient. That would be great, as it not only informs the public about the doctor, but also brings that doctor's flaws to the attention of the licensing board or what have you. Perhaps it could be done through the company that gives the doctors malpractice insurance----that would be interesting.
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#24 of 57 Old 03-13-2009, 12:38 PM
 
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I'll add that I myself have abused the anonymity awarded to me by such sites: on ratemyprofessor.ca I have given good ratings, positive comments, and a chili pepper or two to some friends and colleagues to cheer them up and make them feel happy if they ever check out their ratings.

So I lied and misled potential "consumers" of education.

I'm sure there are lots of lies on these doctor-rating sites too. Anonymous comments about named individuals should be treated with some scepticism.
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#25 of 57 Old 03-13-2009, 12:54 PM
 
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I'll add that I myself have abused the anonymity awarded to me by such sites: on ratemyprofessor.ca I have given good ratings, positive comments, and a chili pepper or two to some friends and colleagues to cheer them up and make them feel happy if they ever check out their ratings.

So I lied and misled potential "consumers" of education.

I'm sure there are lots of lies on these doctor-rating sites too. Anonymous comments about named individuals should be treated with some scepticism.
If yours were the only positive reviews among many negative ones, I don't think most people will pay much attention to yours. It will be kind of obvious that it's from someone they know or who likes them for non-educational reasons.

They might be awesome friends, but crappy professors, and students deserve to know that. Being bad at your job doesn't make you a bad person or a bad friend, it just makes you someone who should switch professions.
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#26 of 57 Old 03-13-2009, 01:01 PM
 
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Sounds like just one more profession that would like to turn back the clock on the internet. Not gonna happen. Doctors, lawyers, teachers, schools, celebrities, newspapers, magazines, on and on. We all have to learn to deal with the *reality* of the Internet. Just wishing the rabble will lose their new found publishing ability isn't going to help. The guy offering the insurance against these posting is basically running a scam on these doctors, as far as I can see, and preying on their lack of understanding about how the web works.
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#27 of 57 Old 03-13-2009, 01:07 PM
 
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I teach college classes and there are several websites which allow students to rate their professor. Thankfully I get good reviews but there is always one student in any large class who hates you. You have to get over it the first time you teach. You can't take it too personally (I've seen faculty who've been teaching for years cry over their reviews). When you see reviews for someone in any profession, you have to look at the overall direction of the comments. Looking at the extremes (positive or negative) isn't useful unless those make up the majority of the comments.

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#28 of 57 Old 03-13-2009, 01:14 PM
 
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If yours were the only positive reviews among many negative ones, I don't think most people will pay much attention to yours. It will be kind of obvious that it's from someone they know or who likes them for non-educational reasons.

They might be awesome friends, but crappy professors, and students deserve to know that. Being bad at your job doesn't make you a bad person or a bad friend, it just makes you someone who should switch professions.
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.
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#29 of 57 Old 03-13-2009, 01:16 PM
 
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Sounds like just one more profession that would like to turn back the clock on the internet. Not gonna happen. Doctors, lawyers, teachers, schools, celebrities, newspapers, magazines, on and on. We all have to learn to deal with the *reality* of the Internet. Just wishing the rabble will lose their new found publishing ability isn't going to help. The guy offering the insurance against these posting is basically running a scam on these doctors, as far as I can see, and preying on their lack of understanding about how the web works.
It's true--the internet is here to stay. New laws about issues like copyright and libel need to be formulated to deal with the new ethical issues raised by the internet. I never wanted to be a lawyer until I researched the copyright issues around fan fiction--and then I thought what a fascinating field that would be. Libel, I guess, would also be a fascinating area.
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#30 of 57 Old 03-13-2009, 01:29 PM
 
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I think it is a wonderful tool. I tried to interview obgyns and peds via phone before I assign them through my HMO, guess what, you get nowhere. It is so hard to get any information about doctors; so having an internet platform where other clients rated the doctors is awesome. You will always have someone who rates someone terribly; but as previous posters mentioned, you can weed through that. If there are 50 great reviews and 3 terrible ones, it seems it's still a fairly good choice.
Even in a country like Canada doctors do get paid to do their job, so you still are a client and have rights. I'm from Europe and still think it is a business, after all, that doctor works and needs to put food on the table too. I always had a choice in Europe and switched to doctors (word by mouth) who had a good reputation.
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