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Wednesday, September 1, 2010

Being censored: by your OB?

Dovetailing on my last blog post, I received a comment from reader K, who said that many doctors are requiring releases be signed, among the mountain of other paperwork, that basically say you will not go on web sites like Rate MD's, etc. in order to leave bad reviews about them. I had no idea, but it makes perfect sense.

I've never seen such a release while filling out paperwork at any of my doctor's offices, but then again, I haven't really looked for it, either. K said that, tucked in between HIPAA regulations, this that and the other, is the form, which basically means you are effectively being censored - by your doctor.

This article basically states that if you sign such a release at your next visit and break that agreement, your doctor can effectively get your negative review removed, no matter how true it might be.

Now, I've never known anyone who's actually sued their doctor. Some lawsuits, for sure, are definitely warranted. I've known some patients who probably could stand to have sued - but didn't. Conversely, I also know that some physicians are sued when they shouldn't be, unfortunately. You will always have patients who, coupled with a shady trial attorney, will bring you up on ridiculous charges and somehow win. Perhaps that is less about the capabilities of our doctors but the state of our legal system. (Think lady who sued McDonald's for coffee that was 'too hot' and won, for instance.)

Instead of being able to silence patients, I think these doctors should perhaps take a look at their practices. Take Dr. Yacht, for instance, and his reviews. Judging from corroborated information from another physician, we know that there is probably some truth to those negative comments about his '8 to 5' delivery practices.

And I'm not sure what doctors are really worried about - yes, you will get a few wackos writing in who will always have something negative to say, no matter what. That probably can't be helped, but neither should their right to say something be removed. Doctors are concerned that ex-spouses, 'disgruntled employees' and others who are not truly patients will write something that could cause great harm to their reputations. However, for the few bad reviews there are million that claim "Dr. Yacht delivered all six of my babies by c-section and saved my life!", so it appears that no one is listening anyway. How easy would it be for a doctor to delete a dozen or so truthful comments about questionable medical practices, under the pretense that it's an angry former employee?

Interestingly enough, the blog post linked above mentions a trial lawyer who is developing a plan to countersue patients in a "three-pronged attack." I can see where this could benefit a physician who is being sued by a 'sue-happy' patient - there are lots of those out there. But in the case of obstetrics, this could present a problem. Many OB's get sued because the 'patient didn't get a perfect baby,' as they say. As a result, sometimes the OB's response to one problem is to implement measures to avoid future problems in all patients, which is no doubt where we've crossed the invisible line of necessary vs. harmful in obstetrical care. Too much care in the form of more monitoring, checking, etc. etc. has actually proven non-beneficial - but this is no doubt one of the reasons why. How can you prove your doctor was practicing unethically when he "pitted you (and all his patients) to distress"? When a certain percentage of doctors do this, is it considered mainstream behavior and therefore acceptable? Where do you draw the line?

All I can say is, read the fine print, ladies. Don't sign something before you've read it - which is easier said than done when you're contracting in labor and they shove a release form in your face. This is probably how many unwanted procedures happen - when they catch you at a moment where your guard is down and you are too distracted to read everything.

As one patient put it, "I would not be likely to even want to be treated by a physician that was so paranoid about what might be said about them by a patient so as to request that such a document be signed by them. For me, that would be a signal to get the hell out of their office asap and never go back."

My sentiments exactly.