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!"

Comments

non-issue

[Em Emalb]

see subject.

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

Although they're working on it.

Re:non-issue

[Arthur B.]

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.

Re:non-issue

[neapolitan]

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.

Re:non-issue

[Em Emalb]

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) :)

Re:non-issue

[DrLang21]

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.

Re:non-issue

[ColdWetDog]

A++++++

Would get my prostate check there again!

Re:non-issue

[bitrex]

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.

Re:First Amendment

[Anonymous Coward]

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.

According to my business law prof...

[imemyself]

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".

Reality check.

[girlintraining]

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.

Re:First Amendment

[Chris Burke]

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

Re:a word about contracts

[Savage-Rabbit]

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.

Re:Signatures not required

[Eil]

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.

Arrogance is lethal

[jeko]

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.