Slashdot Mirror
Doctors Sue Patients for Online Complaints
Carl Bialik writes "'Several Web sites have sprung up that encourage patients to post anonymous reviews of doctors and dentists. Some frustrated patients have even created entire Web sites to criticize specific physicians. The Wall Street Journal Online is reporting that some doctors are, in turn, defending their reputation by suing the online critics."
Free speech does not give the right to libel. It never has, and that has not changed with advent of the Internet.
Remember the last election? We had "free speech zones." People who disagreed with the politicians' (both Right and Left) point of view were told to go somewhere else to protest. And furthermore, it was illegal for the press to enter those areas.
We no longer have real free speech in our country. Sure we can open a titty-bar. Sure we can show boobies on HBO. But if the status quo doesn't want the truth to be said, be it the government or the medical establishment, they'll stomp it out. Get used to it. The 60s are over folks.
If someone says he and his monkey have nothing to hide, they almost certainly do.
Sounds like more states need anti-SLAPP laws.
"It's the height of ridiculousness to say for those 9 lines you get hundreds of millions."
> so much that people feel the need to complain
I feel the problem is that lots of people tend to complain about everything.
Somewhere along the line, people took "the right to pursuit happiness" and changed it to "the right to happiness". People feel that are guaranteed certain things, by default, and if they aren't happy, then there is someone somewhere who's at fault. Certainly not themselves. So if they don't feel relief the moment the leave the doctor, they complain, or a doctor tells them they are fat, they sue because it's not what they want to hear, it's not them being happy. It's someone else fault, so join me in pointing the finger.
i don't care
Before i see a dentist or a doctor i like to get some opinions on who I should or shouldn't go to. Which can be difficult if you are new to the area. If it's constructive critism I see no reason why it shouldn't be posted online, but not outright slander. Last thing I want is some hack fixing my teeth or prescribing me meds.
Be it a blog, a forum or just a plain old web zine. Remember, just because someone wrote it on the web, doesn't mean jack that it's even vaugly true. Remember people, one thing people love to do on the web, is exagerate, boast and inflame. And just because it involves doctors doesn't mean it's any diffrent.
Some of the complaints may be true, but on the Internet, accountability is zero, so you don't know if a post is true or fabricated. ONe person can falsely generate thousands of complaints against a doctor or, appeal to only those who wish to complain about a doctor and provide steeply one sided evidence against the individual.
I know a lot of people here may not like Doctors and the fortunes they apparently gain. But it's not without cause and things like this aren't making it any easier for them. No I don't want to give them a free pass but don't judge everything by it's cover people. Be weary of complaints and get a second opinion before you start marching along side the vocal minority.
Sentack
Seriously though, if the patients are reporting on their experience, then that is not slander. Just stick to the facts and they should be fine.
There are two kinds of factual statemnts:
1) true statements, and;
2) false statements.
Unless the statement is inherently contradictory, there's no way to know whether a factual statement is true just by looking at it, on (for instance) a website devoted to doctor's reviews of patients.
You can't have meaningful, productive free speech with perfect anonymity, because there's no accountibility possible in that scenario. People must be ultimately accountible for their statements, if those statements are aired in public. Even though it rarely comes up on the Internet (most of what we say is nonsense, wnayway), an aggrieved party still needs to have the ability to unmask you in order to sue you for libel. If the big, bad mean doctors are protected, so are the rest of us good folks.
The core problem, in the age of the internet, is that anyone can say anything about anybody and be potentially accessible on a world stage. Thus, what some patient posts about a doctor can have a significant impact on that doctor. If I Google a doctor's name and some thisdoctorsucks.com entry pops up, I'm not going to visit that doctor.
As it stands, doctors have no recourse (except for lawsuits) to put in their side of the story. I'd bet that many cases of malpractice are actually cases of "malpatients" -- the patient's own stupidity, irresponsibility, lack of candor, or failure to follow the doctor's recommendations contributed to or even caused the problem. Add to that the simple problem of mismatch of social styles and one person's "uncaring" physician is another person's efficient doctor.
My point is that any system that potentially inflicts damage on a person's reputation should have a "due process" mechanism that lets that accused defend their actions or tell their side of the story. To avoid costs, this system needs to be automated so that if the patient can post their allegations online, the doctor can reply with their side of the story.
Two wrongs don't make a right, but three lefts do.
If what they are saying is not factual then it should be very clearly presented as nothing more than an opinion. The free flow of information like this is an integral part of capitalism.
IANAL but while I believe that the doctors can sue for false information posted online that can be shown to cause damages they would have to file a suit, prove that the information posted online is false and not solely an opinion. They have no grounds to prevent people from posting their comments and can only file a suit after the fact (that is, prior restraint is not allowed). Imagine if M$ decided to sue for every "Windows Sucks" or other anti-M$ comment on slashdot.
Unfortunately, lawsuits are expensive, but the most likely result will be some sort of disclaimer or the site simply removing the offensive (whether true or not) comments.
Bad programmer. He gets fired.
Bad Doctor. Nothing. But insurance rates go up.
Yah, the system seems fair.
IANAL, but I've seen actors play them on TV
I have a great doctor who has been retired for probably 15 years. He's old school and treats me and my family with respect and friendliness. He's available 24/7 by phone (home, office, cell, pager) and he's called me back at bizarre times when I've had problems. All my friends are blown away by the stories I have of his service.
Guess what - your doctor is probably behind the times and you'd get better outcomes if you were being treated by a whippersnapper from a good medical residency program with a couple years of practical experience.
the major advances in civilization are processes which all but wreck the societies in which they occur - A.N. White
I think these doctors have every right to sue, and win the cases against many of the online commentators. Sites like lasikfraud are misleading to the public and could lead to poor healthcare decisions. However, I ( and hopefully the judicial system ) have no problem with, and encourage, intelligent reasonable feedback on doctors and hospitals; that is useful to everyone. It seems most of the lawsuit targets are just unhappy people who start flames which intentionally mislead and unfairly damage reputation. Such things are definately and correctly NOT protected by the first ammendment.
-- Checking emails and kicking cheats `till the day I die.
... except by peer reviews. The only other way is to try out the services first, and some may want to view the reviews of others before 'trying' out a doctor's services.
Especially for expensive, risky or important procedures.
A bad haircut won't do you too much harm, but an incorrect diagnosis could be dangerous. Especially, if they are going to charge high rates and make you wait hours to see them for five minutes.
I'm not a lawyer, and I'm not a doctor, but I'm pretty sure that the Non-Disclosure agreement is entirely a one-way contract.
The Doctor is bound to not disclose information to 3rd parties (except within the pre-defined bounds of their privacy policy). The patient is certainly free to discuss the details of his or her healthcare with anyone they wish.
I really don't understand what non-disc agreement would ever be in place that would stop a patient from discussing his medical care with 3rd parties. The patient OWNS that information.
"if the Physicians will have to constantly watch their back against disgrunted people posting online, their quality of service might suffer."
If physicians know that their patients have limited access to recourse against them, I am certain that quality of service would suffer.
"If Patients who may be not be satisfied due to a combination of myriad factors start using the Web primarly as a means to get back at the doctors, what is going to stop the Doctors to retaliate likewise by releasing confidential health details about their patients if they are not satisfied with the patients for example? "
Ethics, and public outcry over lack of them.
How long do you think it would be before major news outlets report on a doctor releasing private medical information of a patient?
How long after that will it be until the doctor is penalized or has their license revoked by their state medical board?
'Most Importantly, if a patient visits a doctor, they enter automatically into a non-disclosure agreement although no legal documents need to be signed."
Not true at all. A treatment agreement != a non-disclosure agreement. There is no NDA unless it is expressly agreed. While a state medical board may require physicians to protect patient privacy, the patients themselves are under no such obligation. Many doctors' offices require you to sign an NDA before they'll treat you (often not each time, but rather, a blanket NDA to cover all visits). Also, these NDAs may not cover truthful criticism of a doctor's practice. I, for one, would never sign an NDA requiring me to keep my mouth shut if I have a bad experience.
If, as a physician, you believe you have an NDA covering all aspects of your practice with any patient you treat, you should get some legal advice.
"My end point is that this is a delicate issue and must be handled according to set protocols and procedures."
Often, a patient can have a bad experience with a doctor, even though no sanctionable behavior occurred. The patient should still have the right to inform others of their experience -- this is, after all, what word-of-mouth is.
Perhaps patients should not be allowed to recommend doctors to their friends and family? Instead, patients should have to check for formal commendations of good service.
Libel is still illegal, and is subject to prosecution. But honest communication of experiences, not covered by an NDA, are legal, just, and necessary for best consumer protection.
"Trolls they were, but filled with the evil will of their master: a fell race..." -- J.R.R. Tolkien on Olog-hai
"You can't have meaningful, productive free speech with perfect anonymity"
You can't have real free speech without anonymity.
If only because people speaking anonymously are often speaking anonymously because the other party/person is significantly more powerful.
You don't have freedom of the press if you can't anonymously criticize the government. Think about it... a thoughtful, representative government doesn't care, a corrupt one will crush anybody who says something they don't like.
If I put up a website that says my Chevy-Ford sucks, here's all the repairs its has, and don't buy one. Chevy-Ford may threaten to sue me. And because our legal system is geared heavily against individuals, I really have no forum unless I can be anonymous.
I am a CS-major-turned-medical student, so let me put in my opinions on this matter.
The business of medicine is quite unlike other businesses. A good doctor cannot turn away a patient that she is capable of treating, but a good lawyer/restaurant owner/shop owner is free to discriminate which customers he accepts. I understand that medical insurance being what it is, certain physicians will turn away "less-desirable" patients. Doctors need to make money too, and I can imagine how frustrating it might be to work for a half hour on a patient and get paid $10 in copayment.
If things were really fair, doctors would have the right to write internet blogs about their patients, warning other doctors that certain patients caused trouble or whatever.
What would be funny is a satire of asshat Farmers eating children.
That aside, there is some belief that we should go beyond the law and keep statements honest and constructive. I'm not saying that it's fair, there will always be people who go to the lowest common denominator (i.e. the law), and a corporation with a hoarde of lawyers will figure out how to push it to the limit. However, the good guys should be better than the bad guys, in every way.
Calling them a bunch of scum sucking assholes is not helpful. Similarly a bunch of opinions and misleading information that some people may interpret as fact by not reading carefully is, perhaps legal, but maybe not moral. Now saying Farmers did not deliver on the goods you thought were being delivered, even if they were technically legally in the right...that's perfectly acceptable and things people ought to be aware of. Corporations are often known to hold people to contracts or nit-picky letter-of-the-law statements, and people have a right to push back. If enough object, businesses that want to stay in business change (unless they're a monopoly, but I digress).
The point is by making a size xyzsucks.com, you're already in the grey area of good taste. You're only going to attract bad reviews, and you create an atmosphere where people may be inclined to less constructive criticisms and warnings than they ought. It's only natural that the victims of these sites are going to want them removed, and sue over anything they can find.
It is about time that the medical community was put in check. As far as I can tell there is a culture of protected ineptitude in the medical profession. There are many great doctors, and there are many poor doctors, and there isn't much a patient can do to determine which is which. The medical boards are more akin to a union or religion, and don't help to protect the public at all.
Most doctors I've seen practicing in recent years prescribe whatever new drugs that are promoted to them, usually in the form of free office pens and advertising leaflets. There doesn't seem to be much understanding of the patient or the underlying causes or anything like that. Maybe I'm confusing medical research with medical practice here, but there seems to be a bit of a disconnect. Some doctors I've encountered seem incapable of figuring things out. They can't explain their thought process or answer questions clearly. They're about as sophisticated as an average car mechanic. The medical community must be able to be improved.
If you have a terrible experience and you can't talk about it, then how will this ever get sorted out? If the claims were truly libelous (damaging and false) then the doctor's suit is reasonable... but I have a feeling that some doctors would like to avoid valid criticism. Sorry, but I think the patient's right's trump the doctor's. Hopefully enough of these anonymous sites can be successful that it shakes things up.
Cheers.
Yes, it is government's fault, partially.
When government sets the licensing standards, of course the wrong people will get a hold of a license to practice medicine. Why not allow independent licensing boards (as was the case in the past) offer licensing of their doctors? Underwriter's Laboratories does a great job of making sure lamps and toasters are safe, why can't Doctor's Underwriters compete with United Doctors League in licensing their members as "safe?"
A licensing board is only as good as its members. If the board doesn't revoke the license of a member for an error or a crime, the board is useless. Government licensing is much harder to revoke. I've been to my state licensing board (actually had a hearing today regarding a sales tax payment short I made a year ago) and I couldn't believe how easy it was for me to walk out of there with no penalty and no worry. They were so busy with other mundane problems that I just fell through the cracks.
Honestly, do you want the same people that take your driver's license photo be the people that hand out licenses to your doctors? Do you really think good doctors will give up their practices to be the licensing committee with government pay?
How ironic that without their takedown notice, I never would've seen your site. There's some pretty obvious legal karma in there. :)
_______
2B1ASK1
So, doctors shouldn't be sued by patients, but patients should not be allowed to sue doctors.
Gotta love the hypocrisy of the conservative agenda (tort reform).
The truth is, if it came down to a choice, I'd vote for the little girl who will need $15 million in medical care to keep her alive for 40 years over a doctor who's upset by a bad review. But I suppose a $250,000 cap on punitive damages that keeps her alive for.. a few months.. is good enough.
If conservatives truly cared about lawsuits and the medical community, they would work with Democrats to allow drug reimportation and bring drug prices down, which would create a more competitive market and lower the needs of those types of patients.
The truth is, $15 million is a lot. But believe it or not, that's how expensive our system is.
But of course, it's the health care industry and drug companies that contribute mostly to conservatives, so we need to make sure they make billions --- even if it's at the cost of people in need.
Sorry, doctors, my ears are plugged on this one.
The next comment I write will be ready soon, but subscribers can beat the rush and see it early!
If a doctor is always an hour behind...
Thats the point.
If someone is always late paying bills, showing up, or whatever, that is a psychological problem, obviously not a money problem or a time problem because if they are always behaving that way then the money and the time is a constant and the only variable is the person.
If they are stating *facts* or clearly stating that its a personal opinion, it should be clearly legal to post the information.
If the doctors prevail, its one more strike against freespeech.
Now, if they are *lies* then more power to the Doctors.. and no, i couldnt get to it to read the article.
---- Booth was a patriot ----
This is for the most part, completely and utterly false.
Hospitals can't turn away those in dire need of medical attention.
EVERYONE else can pick and choose who they treat. They can choose not to treat you if they think they will do more harm than good. They can choose not to treat you if you don't follow their advice.
A Pirate and a Puritan look the same on a balance sheet.
No, YOU are the asshole.
If there is some real emergency that's going to delay n+1 people and cause a mass of lost productivity and wages, THEN YOU SHOULD F*CKING TELL PEOPLE WHY AND GIVE A PROPER ETA.
Merely letting people languish in a waiting room or exam room is not acceptable.
If you are a real MD, you should be tarred, feathered and have your licence converted to toilet paper.
A Pirate and a Puritan look the same on a balance sheet.
The problem with doctors' "appointments" is you can only estimate how long a particular patient will take. With the advent of insane cost-cutting measures, we're under enormous pressure to see as many patients as possible, so we have to make best-guesses. And know what? Sometimes we're wrong. Sometimes, a patient has a more complicated or time-consuming case, and we have to go a bit "over". Yeah, that's built into an average day, but you never quite know. And if you don't like it, you're welcome to go to fee-for-service doctors who will clear their schedule for you... but leave you with a very high bill.
To rebut the ridiculous (and barely coherent) comparison to a doctor and "someone that makes up mnemonic rhymes to monty python songs for 4 years": you're a fricken' idiot. If you think rote memorization is all the skill it takes to be a good clinician and to pass all the hurdles involved in Allopathic (M.D.) or Osteopathic (D.O.) training, you're welcome to try yourself. You'll quickly find out you can't get through medical training on memory.
And there's nobody stopping you from being your own physician.
I welcome morons like you making insulting arguments about a profession you apparently can't comprehend. To me, they are basically big bags of hot air that shoot off their mouths without thinking.
I agree with you... there's definitely some really crappy doctors out there, who have no business being doctors at all. However, the profession has a way of weeding the truly awful ones out. They either lose their licence to practise, or are ousted by rising malpractice insurance costs. In PA, the situation is ludicrous: even a good doctor can pay up to $100,000 or more in malpractice insurance costs every single year!
My point, ultimately, is that being a doctor is an incredibly hard job, and it's easy for patients to overlook that. Anyone who's ever worked at any job has made some sort of mistake... for a doctor, even a tiny mistake could cost lives, or put him out of the medical profession for good.
And that's why this online complaints thing annoys me: as far as accountability is concerned, it's extremely one-sided. The doctor is always held fully accountable for whatever he says and does (and greedy lawyers are more than willing to twist words and actions to suit their case) while the online complainers share no such accountability. Though I agree there should be some sort of forum for public discussion, those public complaints about individual doctors should be verified with a real name and SS# on file at the site, and should sign the equivalent of an affadavit that they're telling the truth. That would cut down almost completely on the frivolous and untrue complaints. It's all about accountability.
Andrew Lenahan http://www.starblind.com/
Then it's not free speech. Duh.
True. However, there's a doctrine under the law that says that you're supposed to anticipate how other's will react to your statements.
I disagree with it, but the notion runs something like this:
"You should have known that people would do/believe/react like , based upon your speach. Even though each of those people chose their reaction as rational human being, we will blame you for influencing their choices towards a conclusion that was untrue/unjustified/bad".
Defamation law flies is based on this "negative influence on society" principle. So is trademark law -- you can't "confuse" people by making something too "similar". Damages for civil cases are usually factored in this way; "we think the world would have worked out according to this financial model, if you hadn't intervened, so we'll charge you the differential to restore things".
We don't have an absolute right to free speech in any country. The USA still censors anything it considers "obscene", as do most other countries.
In many countries, a failure to conform to some sort of dress code results in punishment: from the extremely harsh (burquas and headscarfs for women who don't want to be beaten or executed) to the relatively minor (fines for being naked while not on a nude beach).
In some places, such as Canada, other rights are stronger than rights of free speech and expression. Just because you can do something legally doesn't mean you can legally describe what you did. Actually having sex is legal by age 14; but depictions of people having sex who look younger than 18 are illegal.
There are lots of other examples: blasphemy laws in Canada and some of the states in the USA, myriad laws controlling marriage rituals, laws and regulations on who can practice certain professions, and who gets to decide, and so forth.
There is no freedom of absolute expression in any country; nor is it likely we'll ever find any. Most people just don't want it; they want doctors that are qualified, not just some guy saying: "Well, today I decided I'm a doctor". They want people who tell lies to go to jail. They want to control who can say they're married, how people can act, and how people can dress. And in a democracy, if the majority of the people want something, that's what they get.
--
AC
Are patients allowed to "badmouth" their doctors online? How is this different (apart from scope) from "word of mouth"?
Are doctors not allowed recourse to protect they "good name", particularly those with private practices where this would essentially equate to their livelihood?
There is merit to most of the comments made above.
However, keep in mind that there are many factors that are not immediately obvious to many of the posters here:
1) Medicine *is difficult*. You cannot become a doctor simply by memorising rules for 4 years (or 6 years in most countries). Unfortunately, human minds and bodies refuse to obey fixed rules and often there are more exceptions than there are rules. While many illnesses may be both straightforward and easy to diagnose and treat, invariably one has to deal with patients where things are not clear, where the diagnosis is not obvious, where the standard treatment for specified condition may do more harm than good; being supremely skilled at invasive procedures does not guarantee that a patient may not come to harm from a complication.
There is no "black or white", no definitive test to diagnose everything, not golden therapy to treat everything.Situations like these can only be dealt with using knowledge and drawing from personal and collective experience. That does mean unfortunately that it's not always possible to get it right - wrong diagnoses are made, wrong treatments are given, complications may occur from a procedure - but that does not necessarily make a doctor "bad". For the patient though this may be catastrophic, something which doctors are acutely aware of.
But if an error occured in good faith, should that doctor be splattered on a web page?
2) As with any profession, there are people in it for the money only and will stop at nothing to get it. However, in most cases this is not what affects patients. In many european countries (i can't speak for the USA) doctors are put in a position where they have to deal with rare and serious conditions outside of their expertise and/or are made to do so in extremely stressful environments (long hours, being paged by 6 different people simultaneously etc). Medical and para-medical staff do their best to cope, in most cases successfully, but occasionally problems will arise from this.
Just think: If you were trying to calculate your taxes after working for 36 hours and people kept phoning you and knocking on your door and your 3-year old kept screaming - how well do you think you'd do?
3) A surprising number of patients seek medical attention without any real physical disease; anxiety is a common theme and can lead to great problems in the patient-doctor relationship. It is tough for medical/nursing staff to deal with very anxious people, as they are treated as emotional punching bags and it can be tough for these patients as anxiety often cannot be "talked away"; they really feel unwell and cannot understand why. At the same time this does not mean that there is nothing wrong with the patient. To put it bluntly - just because they're mad doesn't mean there's nothing wrong with 'em.
But not infrequently it is people with high degree of anxiety that are the most vitriolic against medical staff, in spite best efforts from both nurses and doctors.
These are just a few points from a medical perspective. One of the greatest problems in patient-doctor relationships is communication. Problems here are what frequently will lead to litigation for various reasons. But the problem may not necessarily lie with the doctor, as communication is a 2-way street (for example, i make it common practice to repeat myself ad nauseam as it can be startling what some people just don't retain or refuse to take in [denial]).
Of course, there are doctors not up to the task and perhaps should not be practising medicine for whatever reason. But I believe that these should be investigated by a professional body to assess their
"i would add one to this: the concept of need. Lateness on the part of a patient is more inconsiderate than lateness on the part of a doctor."
I disagree. If you expect me to be on time to appointments then I expect to be seen on time. This does not count being shown into an exam room to wait even longer.
"A doctor who has made you wait will make sure that you get the care that you need, and if YOU'RE ever the one who's in need of the extra time, you'll be glad that they'll disrupt the schedule for it."
Well, you got it partly correct. Sure they will fit you in. Now getting the care you need is another matter altogether....
I don't have a problem if a doctor is late due to an emergency. But I expect to be told about it ASAP by the staff. Same if the doctor is running more than a few minutes late. I have been to offices that were typically an hour behind within an hour of opening and others that were rarely behind. I have had other doctors reshedule my appointment by mail because they had to leave town suddenly-pushing my appointment back another month (and people think Canadian medicine sucks?!?)
In summary, a lot of doctors are inconsiderate. And the doctor's time is NOT more valuable than my own.