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Fairness to doctors or ‘gag order’ on patients?

 By Carol Gentry
2/13/2009 © Florida Health News

As many as 300 Florida doctors now require patients to sign a promise that they will not post Internet comments about them without permission.

Patients promise they “will not denigrate, defame, disparage or cast aspersions upon” the doctor and will do all in their power to prevent friends or family members from doing so.

“Published comments on web pages, blogs, and/or mass correspondence, however well intended, could severely damage” the doctor’s practice, the agreement says. The ban applies whether the patients identify themselves or remain anonymous.

That means it applies even to Angie’s List, which launched its health-care ratings service in March 2008 and has no anonymous postings. Angie Hicks, founder, said in an e-mail: “As a consumer advocate, I would oppose this practice as nothing short of an attempt to steal the consumers’ right to free speech.”

Titled “Mutual Agreement to Maintain Privacy,” the document promises not to provide lists of patients to anyone for marketing purposes. While federal laws forbid doctors from receiving money for such activities, there are loopholes that the doctor will not use, the contract says.

A woman who sent Florida Health News a copy of such an agreement used by a Brandon neurosurgeon suggested it be called a “gag order.” She said her mother decided to seek another surgeon rather than sign it.

The surgeon, Larry Fishman, referred questions to Jeffrey Segal, founder of Medical Justice, the North Carolina company that was organized in 2002 to prevent frivolous lawsuits. It launched the effort against Internet libel in 2007 and updated it last October, according to the Web site.

Segal said he now has 2,000 doctors in his organization, including about 300 in Florida. It’s not clear how many of those are using the document.

People who post comments under the cloak of anonymity can wreak havoc on a doctor’s reputation and practice, Segal says. “There’s no accountability,” he said. “Anyone with an ax to grind – a disgruntled former employee, a competitor, an ex-spouse” – can pose as a patient and make statements that the doctor has no opportunity to refute.

Of course, the contract covers comments by patients who identify themselves, too.

“We’re not opposed to free speech,” Segal said. “The problem is the whole notion of being able to post anything you want. The physician can’t defend himself.”

Medical Justice reviews high-profile Web physician-rating sites to verify there are no postings on members. When they find one, the service’s site explains, the agreement gives the doctor a tool to get the posting taken down.

The agreement is in force for five years after the doctor’s last date of treatment for the patient or three years after either ends the doctor-patient relationship, whichever is longer.

Angie’s List founder Hicks said she goes to great lengths to ensure accuracy and fairness in the member reports. The vast majority, she said, have been positive, which indicates doctors’ fears are unfounded.

“Doctors should stop underestimating their patients' ability to measure the quality of care they receive and focus instead on providing good care and treating their patients with respect,” she said.
--Contact Carol Gentry by e-mailor at 727-410-3266.