Take Two STFU and Call Me In the Morning

Here's an interesting note I ran across this morning. It seems physicians are starting to get their little feelings hurt by people who comment about them on rate-my-MD-type websites. To the extent that some of them are starting to ask their patients to sign agreements promising not to make any such comments on the interwebs "without prior consent."

Some doctors advocate an aggressive response. Retired neurosurgeon Jeffrey Segal of Greensboro, N.C., is the founder of Medical Justice, a company that for a fee starting at $495 provides sample privacy agreements and monitors online comments for its 2,000 members. He said the agreements enable doctors to ask Web sites to remove comments by patients who have signed privacy agreements, and to take legal action against patients.

I smell a lawyer somewhere!

Are you seriously going to refuse treatment to a patient if they won't agree to a gag order? Isn't that kiiiinda in conflict with the Hippocratic Oath?

Look, I totally get the argument that there are a handful of whackos out there who will set their sights on someone for arbitrary reasons and try to "ruin" them by making whackadoodle comments all over the internets. And I understand that doctors are somewhat hamstrung in their ability to respond because of doctor-patient confidentiality (indeed, a doctor may not even be able to acknowledge whether a particular individual was or was not his patient due to confidentiality concerns). But c'mon. Trying to control what people say about you on the web is an abjectly worthless endeavor.

First of all, in addition to violating the Hippocratic Oath, the kind of confidentiality agreements some doctors want to require are probably unenforceable. Particularly in regards to patients seeking primary or emergency care. A court would look at the imbalance in bargaining power in those conditions and determine that the gag "order" was unconscionable, or signed under duress. Doctors specializing in more elective type of medicine - dermatologists, plastic surgeons - might have a better chance of getting away with it. But do we really want some doctors to be above reproach and others not?

Secondly, you're crazy if you think you can silence someone who has an agenda (rational or not) against you - unless and until that person runs afoul of civil or ciminal law in what they're saying about you. Your typical web-based whackadoodle is savvy enough to know how to mask her identity. And finally, people with valid complaints have a right to air their grievances.

Eventually, the general public will also become internet savvy enough to see through most of the frivolous complaints. If someone anonymously posts that a health professional committed a grievous act or omission, the same complaint should appear in that doctor's publicly-available record with the medical board in the state where that doctor practices. Doctor-ratings websites could also step up to the plate and monitor those kind of allegations, looking for corroboration in medical board records. If you have truly been mistreated by a health professional and you want to take action to make sure it doesn't happen again, you should take your case to the authorities rather than just making an ass of yourself on the internet. Same goes for the conditions of your doctor's office - it it's dirty to the point of being unsanitary, you should file an official complaint. When you choose only to go the anonymous web route, people should be very suspicious of what you have to say. And I think that, eventually, most folks will figure that out. Similarly, the general public will eventually recognize the phenomenon of "nutburger with an axe to grind and an unmonitored platform on which to grind it" and will scrutinize anonymous comments accordingly.

Yes, it's going to take a while. And in the mean time I'm sure it's a bitter pill for your doctor to swallow (bah dum pum!). But society will catch up. Until then, if a doctor asks you to promise to keep your mouth shut, refuse to sign the agreement and REPORT REPORT REPORT (to the medical board) any doctor who won't give you treatment for your refusal to do so.