Some physicians asking patients to sign 'gag orders'

Some physicians have begun to ask patients "to agree to what amounts to a gag order that bars them from posting negative comments" on Web sites where patients can rate their doctors anonymously because of concerns about the fairness of such reviews, the AP/Contra Costa Times reports.

In response to such concerns, Jeffrey Segal, a neurosurgeon, in 2007 founded Medical Justice, a company that charges physicians a fee for use of a standardized waiver agreement under which patients promise not to post on Web sites comments about the doctor, "his expertise and/or treatment." Medical Justice advises physicians to have all patients sign the agreement and refuse care for those who do not sign. Medical Justice also informs physicians when negative comments appear on Web sites, and physicians can use agreements to prompt the sites to remove those comments and possibly take legal action against patients. Medical Justice currently serves about 2,000 physicians.

Segal said, "Consumers and patients are hungry for good information" about physicians, but many comments posted by patients on Web sites provide the opposite, as some sites "are little more than tabloid journalism without much interest in constructively improving practices." He added that many such comments do not address the most important issues, such as the medical abilities of physicians. In addition, he said that physicians cannot address such comments directly because of the Health Insurance Portability and Accountability Act and medical ethics.

The American Medical Association has not taken a position on agreements under which patients promise not to post comments about their physicians on Web sites. However, AMA President Nancy Nielsen has said that Web sites where patients can rate their physicians "have many shortcomings." Comments posted by patients on Web sites "should be taken with a grain of salt and should certainly not be a patient's sole source of information when looking for a new physician," she said.

John Swapceinski, co-founder of RateMds.com, said of such agreements, "They're basically forcing the patients to choose between health care and their First Amendment rights, and I really find that repulsive" (Tanner, AP/Contra Costa Times, 3/3).