Should doctors be able to gag patients online?


One of the more frightening aspects of the ever more free exchange of information on the internet is the apparent impulse in many to stifle this open dialogue, particularly many who have a great deal of power, money or influence.

Censorship, of course, far predates the internet. But it seems every day there is a new venue where someone is trying to get someone to STFU. And while the internet is certainly used for spreading misinformation, accidentally or deliberately, should people be allowed to tell a story that is true and correct to their knowledge if the spread of that information stands to harm another individual?

The answer, of course, is yes. But Ars Technica writer Timothy Lee brings the issue of online reviews and medical reviews to the forefront again with his tale of an inadvertent almost-gagging when seeking a new dentist. Lee hadn’t planned on reviewing the dentist necessarily, but while filling out the stock-standard medical forms in the new patient intake, Lee noticed something out of sorts and investigated. What he found is a little disturbing and creates a few questions as far as the rights of private citizens to- well, speak. Lee explains:

Yelp says Dr. Cirka is one of the best in the Philadelphia area. The receptionist handed me a clipboard with forms to fill out. After the usual patient information form, there was a “mutual privacy agreement” that asked me to transfer ownership of any public commentary I might write in the future to Dr. Cirka. Surprised and a little outraged by this, I got into a lengthy discussion with Dr. Cirka’s office manager that ended in me refusing to sign and her showing me the door.

Lee explains that the agreement was supplied by a group called “Medical Justice,” purporting to aggressively defend doctors against frivolous malpractice claims. But on their site, buried in marketing-speak that can almost make you sympathetic to their free-speech objections, is a stance on net reviews that is chilling.

The practice also seems to rely heavily on both patients’ and doctors’ lack of understanding of laws surrounding these issues. Lee describes how the office was unable to explain some very simple implications of the agreement it enters into with patients on a daily basis:

I had a long conversation with Dr. Cirka’s office manager, who insisted that the agreement was not intended to censor the truthful reviews of Dr. Cirka’s patients. Rather, she said, it gave Dr. Cirka a tool to remove fraudulent reviews. She said they were especially concerned about non-patients (such as competitors, ex-spouses, or former employees) writing fake reviews to damage Dr. Cirka’s business.

She didn’t have a good answer when I pointed out that the agreement’s text didn’t say anything about fraudulent reviews. She also couldn’t explain how the agreement could bind non-patients, who by definition will not have signed it.

The conversation Lee recounts is really the crux of the issue here- it’s almost impossible to root out unethical negative complaints without stifling the many others who may have legitimate reason to post an unfavorable review. Recently, a doctor in Wisconsin brought a defamation suit against a patient’s son after the man posted a negative review online. The case was thrown out.

Do you find this practice unsettling? Should doctors be able to interfere with information you share outside their offices? Are the limits of HIPAA laws alone enough to place doctors into a protected class immune from online opinion that doesn’t apply to restaurants, nail salons, bars and other businesses?

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