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Doctors Silencing Online Patient Reviews Via Contract

Condiment writes "Next time you're sick, take five and actually read the pile of contracts your doctor dumps on your lap, because it's becoming more and more likely that your doctors are banning patients from posting reviews on the Web. You heard that right: as a prerequisite to receiving medical care, patients are in many cases required to sign away their First Amendment rights!"

25 of 324 comments (clear)

  1. non-issue by Em+Emalb · · Score: 5, Insightful

    see subject.

    You can't ban free speech, at least not in this country.

    Although they're working on it.

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    1. Re:non-issue by Arthur+B. · · Score: 5, Insightful

      Freedom of speech includes the right to waive that freedom in particular cases. NDA's for example.

      This is not censorship or a ban on free speech.

      This is a questionable practice, it's doomed to fail because anonymity makes it unenforceable, it's counter productive, it's idiotic, but it is not a violation of freedom of speech.

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    2. Re:non-issue by fm6 · · Score: 4, Informative

      The government can't ban free speech. (In theory, anyway.) Private individuals have more latitude.

      I once lost a job after disagreeing with a political rant a customer was making. (I thought I was polite and respectful; the customer disagreed.) Abridgment of my free speech rights! But no, two different lawyers assured me that employer was well within his rights in regulating workplace discourse.

       

    3. Re:non-issue by neapolitan · · Score: 5, Insightful

      As a doctor, I would just add that doctors that are nice, and doctors that are skilled, are weakly correlated. Patients are, in general, able to evaluate the first trait, but not as well the second. It is a shame, because misunderstandings happen -- you see every permutation: very good doctors that don't have excellent people skills, very good doctors that are jerks because they think they are so good, (technically) bad doctors that are really nice, doctors with substance abuse problems, patients that are completely unreasonable and on their fifth physician whom they will shortly badmouth, and good doctors that told the patient something honestly that they didn't want to hear, who subsequently leave and badmouth the doctor.

      It's a very complex issue, and difficult to sum up in a little pithy paragraph or two.

      What I would counter to this particular 'problem,' is, make a list of doctors who make you sign such contract, and post it for everybody to see. That would surely not be illegal, and just do not go to any of these doctors. It is like a prenuptial agreement -- I can see how it would be useful / essential for some people, but I wouldn't want to be anywhere near a situation that requires this.

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    4. Re:non-issue by Em+Emalb · · Score: 5, Interesting

      Dude, been there, done that, except for the getting fired part.

      Had a guy go off one time on the phone about Clinton's "cigar" and "I didn't have sexual relations" thing when I was on the phone with him. He asked me my opinion and I said I didn't really care, as his getting (or not getting) some nookie didn't have anything to do with the state of the country. He got really irritated that I thought that (should have said I have no opinion, in hindsight) and then started lambasting democrats, Clinton, etc, complete with f-bombs and all that. I just hung up on him. Not because I'm a Clinton apologist, but because I didn't care.

      When they asked me about it, I said I accidentally hit the release button on my headset. They wanted to punish me for pissing off the customer, but since they couldn't prove the hangup was intentional, they couldn't. Win-win. I got to hang up on a butthead and received no punishment for it. (I quit that company not long after that) :)

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    5. Re:non-issue by DrLang21 · · Score: 5, Insightful

      As a patient, I would just like to add that to any reasonable person (I know the existence of these patients can be rare) it's generally assumed that most negative feedback is first exaggerated, and second, not necessarily linearly proportional to the negative experiences. People are a lot more likely to go out of their way to write feedback when they are emotionally moved (ala, being pissed off). Good experiences don't often strongly move people emotionally... at least not like bad experiences can. So the point to take here is, don't worry too much about the negative feedback. Once enough doctors around you have feedback, it will not matter unless you really have a disproportionate amount of negative feedback, which should make you consider the possibilities that you really do deserve it, or that you are a victim of libel slander.

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    6. Re:non-issue by ColdWetDog · · Score: 5, Funny

      A++++++

      Would get my prostate check there again!

      --
      Faster! Faster! Faster would be better!
    7. Re:non-issue by frank_adrian314159 · · Score: 4, Funny

      Win-win. I got to hang up on a butthead and received no punishment for it. (I quit that company not long after that) :)

      But you should have know better than to take the job with the RNC if you didn't expect that sort of thing.

      --
      That is all.
    8. Re:non-issue by syousef · · Score: 4, Insightful

      As a doctor, I would just add that doctors that are nice, and doctors that are skilled, are weakly correlated.

      I'm tired of doctors on slashdot saying STUPID things like this. I am troubled and angered that a doctor can be so incredibly blind that they'd make such awful statements.

      Being "nice" is a PRE-REQUISIT to a doctor being skilled. A doctor who can't build a rapport and trust with the patient is not going to be able to get ALL the pertinent information. They will make mistakes ignoring and misdiagnosing the patient. If their people skills are so poorly developed they are likely to allow their own biases to cloud their judgement. I've seen this first hand. Doctors insisting there is nothing wrong with a patient that's showing clinical symptoms that can't be faked.

      Also doctors that aren't "nice" and don't genuinely care about their patients are more likely to be sloppy with their diagnosis and treatment because it just doesn't matter to them. For example I've seen 3 doctors fail to check the contraindications on a patient's medicine while each one upped the dosage and caused the adverse reaction to increase until it was life threatening. Then when brought to the specialist's attention he said "oh okay...maybe you should stop then" failing again to check that suddenly stopping said medication makes people suicidal.

      It is a shame, because misunderstandings happen -- you see every permutation: very good doctors that don't have excellent people skills, very good doctors that are jerks because they think they are so good, (technically) bad doctors that are really nice, doctors with substance abuse problems, patients that are completely unreasonable and on their fifth physician whom they will shortly badmouth, and good doctors that told the patient something honestly that they didn't want to hear, who subsequently leave and badmouth the doctor.

      You and I define "good doctor" differently. As long as people skills and clinical skills are seen as separate and distinct, the medical profession will continue to decline.

      What I would counter to this particular 'problem,' is, make a list of doctors who make you sign such contract, and post it for everybody to see. That would surely not be illegal, and just do not go to any of these doctors. It is like a prenuptial agreement -- I can see how it would be useful / essential for some people, but I wouldn't want to be anywhere near a situation that requires this.

      The trouble with this is most people are so apathetic that they'll just see you as some trouble maker on a holy crusade. If a doctor tried to make me sign something like that I'd simply look for another doctor. If all doctors available to me did this I'd be double checking everything they did and getting second opinions all over the place because I would realize the doctors don't even come close to being interested in my well being.

      --
      These posts express my own personal views, not those of my employer
    9. Re:non-issue by Wandering+Wombat · · Score: 4, Funny

      What confuses me is... your doctors give you contracts? To HEAL you?

      ...

      I think I've found a flaw in your medical system. In Canada, doctors give us medicine.

      --
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    10. Re:non-issue by ColaMan · · Score: 4, Funny

      C- Whilst *vigorously* checking prostate, he reached forward with one hand to pick up my file and had to use his other hand to steady himself on my shoulder. He knew that shoulder hurt from an old sports injury yet still he leaned on it - very unprofessional.

      Exam took a while too, but he said he had to be sure everything was ok, so I suppose that's one good thing in his favour.

      --

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    11. Re:non-issue by bitrex · · Score: 5, Insightful

      It's difficult for any doctor to be nice when they're overworked, and as a patient with a neurological illness that has not been conclusively diagnosed in the past 3 years who has seen 9 specialists in that time, I've seen my share of good and bad physicians. All of them have been overworked, it goes without saying. Interestingly, the physicians who have been able to shed the most light upon the possible causes for my suffering and do the most to relieve its symptoms all were physicians who had their own essentially private practices and answered to nobody but themselves. They always run an hour to two hours late in seeing their patients. Nobody in the waiting room cares, because they know they'll get at least a half hour of time with the physician to work through everything. The last time I was at Super Huge Specialist Head & Neck Neurological Hopsital That Advertises a Lot in Big Northeastern City I timed how long my appointment took - 8.5 minutes. How can one possibly hope to make it through all the issues that come up with neurological problems in that time?

      I have to say that when the symptoms of this illness first came on after the "fever of unknown origin" I had in 2006 I thought to myself: "I'm screwed." Neurological symptoms aren't like a sucking chest wound - but I was still consistently amazed at the number of physicians who seemed incapable of believing that I was in excruciating pain because there was no physical evidence. However, being at one point a student of science myself, I understand the position that they're in - and in my circumstances the only physicians I would rate negatively were the ones (one) who said things such as "I'm not interested in your medical history, I've got a lot of people to see today, I just want to know symptoms." One physician I saw told me straight out - "I don't know what's wrong with you. There are a lot of things that can go wrong with people that medical science doesn't understand: you might get worse, you might eventually get better, you might stay the same the rest of your life, but I could help 20 people who have things wrong that I DO understand in the time that it would take to work on you and think up some treatment that may or may not have any effect." The latter would not get a negative review from me.

      Television shows like House, M.D. always make me chuckle, having been too close to the subject matter for suspension of disbelief to work. When something serious goes wrong with one's body that cannot be diagnosed with first-line test results and (revenue-generating) treatment prescribed in 8.5 minutes, you are no longer an asset to the healthcare industry. You are a liability. There is no genius physician who will ponder over your case in his or her downtime. There are no attractive residents who will hold conferences in well-appointed conference rooms where they will discuss your case and argue over the possible diagnoses on whiteboards and through video teleconferencing. If you have something go terribly wrong with your body, hope that it's a chronic condition, because otherwise you'll die admiring the 1970s airport style furniture in the emergency room waiting area as the 2 physicians on staff at 3 AM chat up the nurses.

  2. First Amendment by Jon_Hanson · · Score: 4, Informative

    The First Amendment doesn't cover speech between two private parties. It covers speech that the government may not oppress. Please stop claiming First Amendment rights when the government is not involved.

    1. Re:First Amendment by Anonymous Coward · · Score: 5, Insightful

      Ain't so simple as you make it. Courts have also ruled that free speech may not be banned by contract where there is a significant public policy interest in preventing this from occurring.

      Whether this would be included would likely be decided in court, and indubitably appealed to the first court of record in the jurisdiction where the case was brought.

    2. Re:First Amendment by Chris+Burke · · Score: 5, Interesting

      Please stop claiming First Amendment rights when the government is not involved.

      No, and I'm not going to stop until the government passes a law saying I can't. :P

      --

      The enemies of Democracy are
  3. Signatures not required by dave562 · · Score: 4, Interesting

    I'm not sure about the laws in other states, but here in California I refuse to sign a lot of the paperwork all of the time. I always refuse to sign the waiver that asks me to give up my rights to sue over medical malpractice.

    I think that as Americans we get conditioned to sign everything and rarely think about not doing it. Every time I refuse, I get weird looks, but I've never once been denied service.

    1. Re:Signatures not required by SoundGuyNoise · · Score: 4, Informative

      IANAL....No matter how many forms you sign, you are legally protected from ever waiving your right to sue. Putting in a "no sue" clause is merely a formality that you recognize the seriousness of what you are about to do.

      I have a company where my participants have to sign a release form. It's really more for our liability insurance. I'll even tell them they can't sign away the right to sue.

      --
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    2. Re:Signatures not required by Eil · · Score: 5, Informative

      IANAL....No matter how many forms you sign, you are legally protected from ever waiving your right to sue.

      Bzzt. You can effectively sign away your right to sue and many people do, routinely, without realizing it. (The most common are cell phone, cable, and other service contracts.) The culprit is called a mandatory binding arbitration clause and when you try to sue the company, the court will require you submit to arbitration since that's what you and the other party agreed upon when you signed the contract.

      Now, arbitration doesn't really sound all that bad, does it? It's just like court only less expensive and with fewer gavels, right? Well, yes. For the company you're in a dispute with. The average person would still need a lawyer to properly interpret the terms of the contract (let alone contract law itself). Oh and by the way, the company gets to pick the arbitration firm. And they get to decide where the arbitration is held. And if by some chance you can make it the arbitration location with lawyer in tow and make a convincing case, you still only have about a 5% chance of the arbitration firm ruling in your favor.

      Okay, so appeal the arbiter's decision in court, right? Nice try, but unless you somehow got permission to record the arbitration proceedings (unlikely, since companies try to keep arbitrations strictly non-public), you've got no evidence to make a case with. And in any event, courts have historically said, "sorry buddy, you agreed to an arbitration in the contract so now you're stuck with it."

      Arbitration clauses are another thing that need to be outlawed, IMO.

  4. According to my business law prof... by imemyself · · Score: 5, Interesting

    This was actually brought up my commercial law class this morning. Our professor's opinion was that it was probably legal if just a few doctors were doing it. But, if all doctors in an area were doing it and it was not possible to obtain medical care without agreeing to this, it's possible that courts may not recognize the contract, because it was a "contract of adhesion".

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  5. Reality check. by girlintraining · · Score: 5, Insightful

    Everyone, repeat after me; "Some Contracts Are Not Legally Enforceable."

    Many of us have had to sign non-compete clauses, sign documents stating to hold ex-employers harmless so a prospective employer can ask them whatever, etc., etc. See though, most contracts have some language to the effect of "if some of this is declared crap, the rest shall remain in effect." They put that in there because they know there is crap language in there and are hoping you just go along with it because it "looks legal". It's the same way RIAA, the MPAA, and all those cease and desist orders we keep hearing about operate; Make it look official and chances are good people will go "Oh Noes! Legal Mumbo Jumbo! Aieeeeeee. thud."

    My advice? Sign it. Get treated. If s/he does a good job -- great, say so. If they do a crap job though, tell the whole damn world (but have proof). If that doctor wants to come after you for it; "Hello? Channel 9 news? I'm being oppressed." He might get you for breach of contract, but you'll make sure it's the last time anyone signs it. Think someone wants to risk their career, after spending 10 years just getting started in it, trying to prosecute someone who told the truth? Get real.

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  6. Re:a word about contracts by Savage-Rabbit · · Score: 5, Insightful

    Just because it's on paper and signed, doesn't mean it's enforcible in court.

    Yes, but just because something isn't enforceable in court that doesn't mean it can't be used to bludgeon somebody into submission. Lawsuits are expensive. Theoretically justice is the same for everybody but in practice only the rich can afford a court case if it drags on for too long so de-facto the justice system mostly favours the rich.

    --
    Only to idiots, are orders laws.
    -- Henning von Tresckow
  7. How to lose clients and alienate patients. by Stealth+Dave · · Score: 4, Informative

    This is why the movie Sicko! was so popular and why the idea of health care reform is becoming more and more popular, despite attempts to categorically dismiss it as a "socialist" idea. People have enough problems getting proper medical care without having to worry about whether your doctor is going to require you sign away your rights in order to get treatment.

    On one occasion when going to see a specialist for the first time, I was presented with the usual stack of paperwork before I was allowed to see the doctor. Luckily, I have an annoying habit of reading a document before I sign it, as one of the documents was (as another reader has described) an agreement to waive my right to sue for malpractice, and to instead agree to arbitration of their choosing. I signed the other documents and told the receptionist that I would need to have my lawyer look over the waiver before I would sign it, and she responded "Oh, okay. Just bring it in whenever; it's optional, anyway." Optional? Then why was it buried in this stack of required paperwork?!? (Yes, that question is rhetorical.) Needless to say, I opted not to sign it, and I got to see the doctor anyway.

    This is the last thing that the health care industry needs right now as it battles a PR campaign against movies like Sicko! and all the various "investigative reporters" for everyone from your local news to CNN. My wife and I even made our own short film about it. (Go ahead; mod me a Troll, I don't care.)

    - Dave

    --
    Evil is as eval("does");
  8. different question: could it be binding? by boombaard · · Score: 4, Interesting

    I mean, how likely are you to be able to refuse to sign this, if your health is at stake?
    How likely is it period to expect your physician to put this form under your nose before being willing to help you? It seems somewhat comparable to a EULA in that regard, seeing that there is no way to test the product other than by 'buying' it first. Can that be binding?
    the NDA comparison doesn't seem to apply, since you don't generally sign NDAs in life-threatening situations, or situations in which you are perhaps intentionally kept uninformed of the consequences of signing such a thing.

    And what happens then? Can your physician refuse to treat you? Can he do so always, only in 'non-life-threatening' cases, or never? It seems very murky, medical ethics-wise.

  9. Arrogance is lethal by jeko · · Score: 5, Insightful

    very good doctors that don't have excellent people skills, very good doctors that are jerks because they think they are so good

    There's a reason why "bedside manner" has been considered an important skill since Hippocrates. Until we have a Star Trek medical tricorder that can tell us ABSOLUTELY everything that's going on inside a patient's body, then you're going to have to rely on patient reports for much of your diagnostic information.If your people skills are so bad that you can't hear your patients, or you engender so little trust that they don't tell you what you need to hear, then you aren't getting the whole picture, and that by definition makes you a bad doctor.

    There's a reason why Gregory House works with four other doctors.

    Beyond that, arrogance in a physician is LETHAL. Arrogance makes you secure in your first conclusion. Arrogance makes you resistant to disproving your own hyptheses. Arrogance means you don't consider new information, or information that contradicts your first assumptions. I wouldn't be surprised to find out physician arrogance was a leading cause of malpractice suits.

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  10. Re:When you don't have a choice by Overzeetop · · Score: 4, Interesting

    I pay for employer provided healthcare through my hard work, so I'm not getting it for free.

    This is a reason I'd like to see government mandated group status for individuals. I was drawn to Obama last summer because one of this thoughts on healthcare was to open up the FEHB (federal employees) group to all Americans. Now, don't get me wrong, the federal full-service plan is expensive - but it is very good, and there are some HDHP options (I think). I am an employer (a small one), and I provide benefits for my employees, but for a while I was on my own. My rates were good (great, really, but I was thirty-something and healthy), but any year I became too expensive for my insurer I could have been dropped. Give people group status with such a large group has benefits primarily for the consumer, but the federal market of 2M+ insured is too big a chunk for most major healthcare companies to write off entirely.

    If nobody got healthcare from their employers, and there were competition (as there is in FEHB) on the open market the system would be a bit more flexible. I don't think a single payer system will make healthcare better or more efficient. It's true that, to a certain extent, if you don't pay for top rate healthcare you don't get first rate healthcare. This is straying a bit for from the topic, as the ability to write reveiws or not does not (or should not) affect the rates you pay at the doctor's office, but it does speak to the breadth of choice. With more expensive coverage normally comes greater freedom of choice - which would allow you to vote with your feet. As with just about everything in life, the more you pay the more you can choose your path. I am not at the top of the money pile, so this is a bit of my own dogfood, but as mother used to say, "beggars can't be choosers." *shrug*

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