Should A Doctor Attempt To Gag A Patient?

DJ Smith / Mar 16th / Comments

In the age of consumer-driven healthcare, more Web sites are popping up that encourage patients to review and rate their doctors. These reviews can range from sheer rants to glowing recommendations. At the time of this writing, RateMDs.com, one of the more popular physician rating sites, claimed to have some 186,642 doctors rated among 704,314 posted ratings. The Web site also claims a little over 2,000 ratings were added the previous day. A search on Google using the terms “doctor, review” yielded a whopping 24,400,000 entries.

It’s little wonder why more physicians are looking to squelch the chatter of their patients.  A recent article by Associated Press medical writer Lindsey Tanner, titled “Docs seek gag orders to stop patients’ reviews,” created quite a buzz about the mutual censoring topic. It included a response from the Medical Justice, a membership-based group formed to help physicians avoid frivolous lawsuits and Internet defamation and developer of the agreement used by many physicians to deter patients from reviewing them. The group’s Web site states: “We are not, in principle, against physician ratings. Patients want good information. But, facts matter. Honest – and useful – ratings will require a sophisticated understanding of outcomes research, risk stratification, etc.” The Web site goes on to say, “Our mission is to promote a transformational healthcare system where patients can make informed decisions using the Internet as one means. Patients rely on the Internet information highway for this now – potentially to their detriment.” Here are some things to consider when looking at both sides of the coin:

1. Physicians risk creating unnecessary questions in the minds of their patients.

Often the patient comes in for an exam or procedure with no intention of giving the physician any sort of review, good or bad. They just want their exam or procedure done and go home. However, when asked not to review the care or the physician attending them there is a risk of placing questions into the patient’s mind that was not there. Cognitively, the patient starts rethinking the exam or procedure and calls into question all that occurred – good or bad. In short, as the physician attempts to control the answer to “Will they give me a bad review” they in essence made the patient ask, “Did the doctor do something to me that I need review?”

2. Patients need to own the reviews they make.

Physicians, nurses, and any other healthcare provider can have bad days like anyone else. However, in healthcare, a disruptive behavior by a healthcare professional can result in serious problem for a patient (see our blog post “Doctors Behaving Badly“). When a patient feels threatened or wronged by their caregiver in any way they’re going to talk about it be it online or off. Everyone knows that more people will talk about a negative event that happens to them or that they witness than about a good situation. There is no doubt people intend to provide their impression of the care they receive. However, the patients who write a review anywhere should actually own the review. The healthcare professional should have the opportunity to contact the reviewer and attempt to reconcile the incident. If anything such an opportunity would make for great patient servicing and good will. But when a patient doesn’t make their identity known and provide a way to be contacted then it is cowardice at best.

3. This demonstrates that physicians need a better marketing plan than simply word of mouth.

Medical Justice makes an interesting point about physicians and medical practices when they write on their Web site: “Most medical practices are built through word of mouth. It only takes one negative Internet posting to impact your livelihood.” If this is true, then why aren’t more light bulbs going off in the minds of physicians and practice managers? If word-of-mouth is all you have going for your marketing efforts then you are asking for trouble. Why let someone else do your talking for you when you should be more than capable of utilizing other means of communication to spread the word about what sort of healthcare provider you want to be known as? It makes no sense at all. Marketing built on such an eggshell strategy as word-of-mouth is doomed and should be reevaluated. You don’t need a no-review agreement; you need a marketing firm to build your brand – and like it or not you have a brand. It’s yours and it’s your responsibility to maintain that brand, not your patients’.

There was an interesting article from PR Newswire, dated February 24, 2009, titled “US Physicians Sharply Increase Their Negative Word of Mouth about Pharma, with EU Doctors Also Expressing High Dissatisfaction.” It’s about physicians who have grown disgruntled with pharmaceutical industry and, as a result, started a negative word-of-mouth campaign. It’s unclear if any of the physicians who are attacking Pharma are also making sure that their patients don’t do the same to them, but for the industry as a whole it might be good to practice what they preach to their patients. Perhaps Pharma should just get the doctors to sign an agreement not to say anything bad about them.