Doctors gag patients over Web critiques

Chicago —- Some doctors have started fighting back against ugly Internet reviews by asking patients to abide by what are effectively gag orders that bar them from posting negative comments online.

Physicians are taking action as online ratings services such as Zagat’s and Angie’s List grow in popularity and expand their reviews beyond restaurants and plumbers to include medical care.

“Consumers and patients are hungry for good information” about doctors, but Internet reviews provide just the opposite, contends Dr. Jeffrey Segal, a North Carolina neurosurgeon who has made a business of helping doctors monitor and prevent online criticism.

Sniping postings say nothing about what should really matter to patients —- a doctor’s medical skills —- and privacy laws and medical ethics prevent doctors from fighting back, he said.

His company, Medical Justice, is based in Greensboro, N.C. For a fee, it provides doctors with a standardized waiver agreement. Patients who sign agree not to post online comments about the doctor, “his expertise and/or treatment.” Since the company began offering its service two years ago, nearly 2,000 doctors have signed up, he said.

Medical Justice advises doctors to have all patients sign the agreements. If a new patient refuses, the doctor might suggest finding another doctor. Segal said he knows of no cases where longtime patients have been turned away for not signing the waivers.

Doctors are notified when a negative rating appears on a Web site, and, if the author’s name is known, physicians can use the signed waivers to get the sites to remove offending opinion.

Postings on the Web site RateMDs.com are anonymous, and the site’s operators say they do not know their users’ identities. The operators also won’t remove negative comments.

John Swapceinski, co-founder of RateMDs.com, said that in recent months, six doctors have asked him to remove negative online comments based on patients’ signed waivers. He has refused.

“They’re basically forcing the patients to choose between health care and their First Amendment rights, and I really find that repulsive,” Swapceinski said.

Angie’s List’s operators know the identities of users and warn them when they register that the site will share names with doctors if asked.

Lenore Janecek, who formed a Chicago-based patient-advocacy group after being wrongly diagnosed with cancer, said she opposes the waivers.

“Everyone has the right to speak up,” she said.

The American Medical Association has taken no position on patient waivers, but its president, Dr. Nancy Nielsen, has said previously that online doctor reviews “should certainly not be a patient’s sole source of information when looking for a new physician.”