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Should people boycott surgeons forcing gag order contracts?

Re: Should people boycott surgeons forcing gag order contracts?

Postby Lynchic » Sat Oct 09, 2010 1:37 pm

I'm with you on that one, I would be weary of any doctor requiring to sign one.
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Re: Should people boycott surgeons forcing gag order contracts?

Postby Welness » Sat Oct 09, 2010 8:24 pm

I agree with Am/Pm! =D>
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Re: Should people boycott surgeons forcing gag order contracts?

Postby ml30 » Sun Oct 10, 2010 12:51 pm

It would make me wonder why they need it.
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Re: Should people boycott surgeons forcing gag order contracts?

Postby Alixs » Sun Oct 10, 2010 3:42 pm

I think that should be illegal. Does anyone know if Dr G does this? I could've sworn I saw a post a while back on a site from someone who was threatened with a lawsuit if she didn't remove her bad post. I hope this isn't true, as otherwise I'd be really interested in him. I think if surgeons make mistakes and do bad jobs they need to be accountable!
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Re: Should people boycott surgeons forcing gag order contracts?

Postby beautyandthebeast » Mon Oct 11, 2010 9:42 am

I recently had a rhino and was given one of these " gag contracts" to sign the day I booked my surgery. THe doctor assured me that if I didn't want to sign it, I was still his patient . I did end up signing it after I read it thoroughly at home. Now post op, I do wish I didn't sign it. Not that I have any real complaints yet, but I feel it was poor judgement on my part expecially since it wasn't forced. It was one of the stupidest things I have done. I consider myself a fairly intelligent person but for some reason I did a dumb thing.
Anyway, not sure what my point is, just wanted to share.
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Re: Should people boycott surgeons forcing gag order contracts?

Postby Welness » Mon Oct 11, 2010 10:33 am

We are not dumb boy!!!!! The contract is there and given to you for a purpose. I would be wary of surgeons using these contructs!

I agree with one of the posts. I noticed in other posts that only surgeons who are internet doctors use the contracts. I would nt trust a surgeon using a gag contract. Most probably the surgeon has something to hide.
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Re: Should people boycott surgeons forcing gag order contracts?

Postby ml30 » Mon Oct 11, 2010 10:50 am

So after a doctor started using those, ALL feedback should END. If positives are still cropping up, they are either fake reviews or the doctor rescinded the gag order in that case because they had an obviously happy patient. So, it is messed up if the positive reviews keep coming after we know a doctor started using these things.

Huh, wouldn't a doctor try to do a better job if the patient refused signing one of those things? Like, if there is one in place, the doc knows it's OK if they do a sloppy job since the person signed away their rights to talk about it.
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Understated doctor vs. Overstated doctor.

Postby MissJ521@aol.com » Mon Oct 11, 2010 4:17 pm

Understated doctor vs. Overstated doctor.

Understated Doctor:

From an ethics perspective, I'd say that 'gag contracts' would be appropriate for (understated) doctors who DON'T want to be in the public eye or make little effort to do so. For example, a doctor who does not even have a website or even a doctor who has a website BUT makes NO efforts in terms of publicity campaigns. In essence a type of doctor who has a good reputation, (usually among peers) and for the most part would be able to get direct word of mouth referrals in the absence of the internet. In essence, an UNDERSTATED doctor; a doctor who would rather not be discussed on the net, one way or the other.

Overstated doctor:

However, doctors who DO make efforts toward a lot of public exposure, e.g lots of videos on You Tube, publicists getting them magazine mentions, efforts to get on TV, efforts to get the search engines to call up their sites first, (for example doctors knowing that people will be plugging in words like: "rhinoplasty" and "expert" together or "plastic surgeon" and (what ever location) and then go on to create domain names that reflect what people are plugging into the search engines (other than the specific name of a doctor), so their sites come up FIRST in addition to also having a bunch of multi-star glowing reviews in places where you have no familiarity with the poster or posting history of the reviewer, are the ones you might want to give the 'hairy eyeball' to.

According to my observations, it is often what I call the "overstated" doctors who like to use those gag contracts and they are used to prevent a patient from challenging what very well could be a reputation that is 'constructed' by the doctor's publicity campaigns rather than a reputation earned by his/her peers.

So, in the case of a doctors who you see going to great lengths to garner (positive) public (internet) exposure, ethically, I would say it's 'unfair' for them to also require patients to refrain from discussing their experience if the experience can't be used for 'promotions'. The only way to really pre-empt or avoid the potential for that kind of 'unfairness' is to OPT OUT of using them.

With regard to patients seriously considering surgery with the type I call 'overstated' doctor, it would be PRUDENT for you to request copies of all legal contracts expected of you to sign and request those DURING your INITIAL CONSULT with the doctor. Like make it CLEAR to the doctor, you want to take home with you to study and review any legal papers before you sign them or book a surgery.

Keep in mind that when ever you are requested to sign legal documents, you also have the right to have a lawyer interpret them for you before you sign them. You are better off paying a lawyer conversant in contract or intellectual property law to read those things and interpret them for you BEFORE you sign them then doing so afterwards. So use your initial consult to request copies of all legal contracts you would be expected to sign before booking any surgeries or putting down deposits on them and don't commit until you've had time to read those things in the privacy and time in your own home or with the help of a lawyer who can explain what they mean.

Otherwise, you DON'T want to end up being in a situation where you actually BOOK surgery, pay deposits and then, at the LAST MINUTE, be handed some papers to sign. It will leave you ruing the day you ever selected that doctor and further frustrated that you signed away rights to discuss him/her.

If you have signed one of those gag contracts with an 'overstated' doctor, it's still not to late to seek out a lawyer well versed in contract law for guidance as to facts and circumstances that could sever the contract or invalidate it. Things like "undo influence" (something where the doc uses his influence to pressure you in some way to make a hasty decision) or a 'higher law' that could protect you from honoring the terms of the contract could be used to invalidate it.

Keep in mind that if a doctor is truly confident he/she can kick up a good result AND is NOT the 'type' to engage in a lot of web promotions just to get you in there to consult, it's pretty unlikely they will require you to sign that type of contract.
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Re: Should people boycott surgeons forcing gag order contracts?

Postby MissJ521@aol.com » Tue Oct 12, 2010 12:24 pm

AMPM wrote: I'm not sure why an 'understated' doctor would even want the 'gag contract' thing for their practice....
These seem like they would be old-school legit type doctors, and they may be more likely to feel uncomfortable with the potential reputation loss just from instituting 'gag contracts'....
Plus, if they're not on the internet, then there's probably little traffic for them anyway (?)...


2 good questions: The opening title question and this one.

An 'understated' doc would be less likely to actually request a gag order as they are not playing the 'double standard game'; reel patients in via hyped up internet promotions and then gag.

However, on an ethical level, what I'm saying is that the understated doctor would be more entitled to using the gag option if he/she wanted to. Why? Because:

A: The understated doctor is not using the internet as a key promotion tool. He/she is probably just wanting to get patient referrals in the same way doctors got them before the net.

B: The understated doctor is probably preferring NOT to be discussed on the net one way or the other; good or bad.

So, on an ethical level, I think that type of doctor would be entitled to having one of those orders because he/she is not really 'running interference' with the net on the promotional front and would rather not be discussed in that venue. For example, even if the doctor has accolades on the net, they are the type that don't even welcome that simply because it results in a barrage of queries to the docs office from people with no direct referrals and takes up a lot of office time. Like they may NOT want patients to 'advertise' for them on the net (positive accolades kind of do that for a doctor) because then the practice gets 'hit' with a bunch of queries that exceed what can be anticipated and puts a time burden on the office staff.

So, on that front, I think a doctor just wanting a 'quiet practice' in the ABSENCE of net is entitled to request such a gag order. In that way requesting one is CONSISTENT with the doc not using the net him/herself. However, I think it's true that the docs most entitled to use the contract are LESS likely to use it.

On an ethical level, the 'overstated' docs are LEAST entitled to use the gag order but MORE likely to use it.

So, in terms of which type of doc to "boycott", you would want to look for which one is being INCONSISTENT with some genuine reasons a doctor might be entitled to such a contract.

It's inconsistent and hypocritical for a doctor using the net as a key promotional tool to request a gag order.

It's consistent with an understated doctor who does NOT use the net for promotions and would also RATHER NOT patients even give him positive accolades. Since the doc is not running interference on the net on the promotional front or even wanting patients to do that for them in form of positive accolades, he's entitled to request a contract that helps maintain a 'quiet' practice; one with no internet 'noise'.

What I'm saying is that an understated doctor is more entitled to use a gag contract but less likely to use them and an overstated doctor is less entitled to use it but more likely to. So, in terms of "bocotting", one would not differentiate solely on the fact the doc has a gag order but rather the circumstances in which it would be either consistent or inconsistent to request one.
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Re: Should people boycott surgeons forcing gag order contracts?

Postby ssmj » Wed Nov 10, 2010 8:46 am

Medical Justice here. We’d like to weigh in and hope you will be open to listening.

First, we encourage online ratings. It's the best way to get continual improvement in performance and weed out the bad apples in the medical industry. Every industry has them.

But we believe that there needs to be a better (and different) way to rate doctors. Choosing a doctor on a rating site, where on average 1 in 3 doctors have negative ratings, seems misleading. Are 33% of doctors bad? Of course not. Most patients actually like and trust their doctors who are extremely competent in their profession. And most doctors have only 1to 3 ratings, yet they see between 1,000 and 3,000 patients a year.

As the system stands now, a doctor is legally forbidden to respond to ratings. They cannot even disclose that they actually treated a patient. But half a conversation does not inform and is unfair to the consumer reading it. If a patient says that two days after surgery his wound opened, you might think the doctor made an error. But, if you learn the doctor instructed the patient to avoid heavy lifting for six weeks, and the patient went back to construction work on post-op day number two, the conclusion would be different.

With that as backdrop, I hope to shed some light the doctor-patient agreements being discussed. The agreements explicitly state that online feedback is not only reasonable, it’s encouraged. The exact language is: “Nothing in this Agreement prevents a patient from posting commentary about the Physician - his practice, expertise, and/or treatment - on web pages, blogs, and/or mass correspondence.”

The agreements are only relevant if and when a fictional or fraudulent post goes up. An example: when a poster is a competitor, or not even a patient.

The label “gag order” just does not comport to what patients are signing.

Some of the most talented doctors in the country have embraced these agreements. These are doctors’ doctors. If you avoid seeing a doctor merely because he or she uses these agreements, of course that is your choice. But, you will be limiting your treatment based on something other than skill and talent. If you see one of these doctors and sign such an agreement, the vast majority of times your comments, good, neutral, and, yes, bad will stay exactly where you put it – on a rating site. Constructive feedback is fine. Erroneous feedback is not.

Thanks for taking the time to read.
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Re: Should people boycott surgeons forcing gag order contracts?

Postby ml30 » Wed Nov 10, 2010 10:02 am

ssmj wrote:Medical Justice here. where on average 1 in 3 doctors have negative ratings, seems misleading. Are 33% of doctors bad?


Cite for this? So you are saying that a doctor with 20 positive reviews and one negative would be "bad" by your reasoning?


ssmj wrote:As the system stands now, a doctor is legally forbidden to respond to ratings.


Cite? I have seen MANY doctors respond to ratings on RateMDs. They just can't reveal names or details. I have also seen very defensive staff respond WITH details.


ssmj wrote: online feedback is not only reasonable, it’s encouraged. The exact language is: “Nothing in this Agreement prevents a patient from posting commentary about the Physician - his practice, expertise, and/or treatment - on web pages, blogs, and/or mass correspondence.”



Then why have so many ratings been deleted? Why have patients been threatened with litigation for posting the truth?



ssmj wrote:The agreements are only relevant if and when a fictional or fraudulent post goes up. An example: when a poster is a competitor



Has this EVER happened, really? I do not think a DOCTOR would take the risk by posting fraudulent reviews on a competitor. It's way easier to have staff post fake positive reviews, and/or "settle" with the unhappy patients with a gag order attached, to get reviews deleted.
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Re: Should people boycott surgeons forcing gag order contracts?

Postby MissJ521@aol.com » Wed Nov 10, 2010 9:03 pm

To ssmj:

About this contract: I think it would be a great contract if it also offered the patient something of extra value.

Something along the lines of; 'If there is a problem, I will do my best to rectify repair, subsidize revision surgery with a colleague ect in exchange that you don't make the problem into a public issue.'

Consider that a lot of patients get up there complaining about the doc because they get no 'relief' when they take the issue to the doctor. So, maybe adding something of value to the patient in the contract. Just a thought.
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Re: Should people boycott surgeons forcing gag order contracts?

Postby ssmj » Thu Nov 11, 2010 12:53 pm

MissJ521@aol.com wrote:To ssmj:

About this contract: I think it would be a great contract if it also offered the patient something of extra value.

Something along the lines of; 'If there is a problem, I will do my best to rectify repair, subsidize revision surgery with a colleague ect in exchange that you don't make the problem into a public issue.'

Consider that a lot of patients get up there complaining about the doc because they get no 'relief' when they take the issue to the doctor. So, maybe adding something of value to the patient in the contract. Just a thought.


Thanks for the feedback. Truth is we are more closely aligned than many think. In fact, we agree with your general approach. The form currently states “We want your feedback. If our office gets it right, tell us. If we could do something better, tell us. We take quality improvement seriously.” If the doctor is seriously interested in quality improvement and patient satisfaction, that commitment should be reflected in tangible ways beyond just lip service. We are always seeking ways to improve and will take your feedback seriously. The Internet presents a lot of challenging issues for all involved. Our goal is to help shape a system that balances the legitimate rights and reasonable concerns of patients and physicians alike – not the us against them paradigm that is too prevalent now
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Re: Should people boycott surgeons forcing gag order contracts?

Postby MissJ521@aol.com » Thu Nov 11, 2010 1:34 pm

I have not actually read your contract. But will convey that some patients have said they get this thing after they book a surgery and put down a deposit for it. Like even if they get it the same day they book and deposit, it's after the booking. If the deposit is non refundable after 2 days, then they only have 2 days to read all the papers. Worst case if the papers are slipped to patient day of surgery.

From a legal perspective, the patient would have to get the doctor to commit in some way to promise to show the contract to him at a time before the patient books a surgery so that the booking is contingent on the patient having had enough time to read what is ever in them, agree to the contract and then book.

If doctors have 'wiggle room' as to WHEN to give contract, they will want to present it after a booking in which a non refundable deposit time is there or worse case, after they made full payment.

So,
What I'm seeing is this:
Patients are signing 'some papers' and are signing them after they book a surgery and put deposit on them because the timing of introducing the 'papers' is that way. Although, I myself think it's pretty dumb for a patient to put a deposit and booking on a surgery and then afterwards be given some 'continuation' of the contract, if something like that CAN be done by your doctors, you will have patients complaining about the 'timing' in which these papers are introduced. Once they start talking about feeling they were 'pressured' or 'rushed' to sign these things or the 'papers' were later used as 'leverage' to continue a contract that the patient did not know ahead of time these 'papers' were to be part of the contract, the appearance is given that a continuation of a contract with no added value to the patient is being introduced as leverage or to influence in some inappropriate way.

That said, I would suggest you tell your members (or even make it a requirement) for them not to book a surgery or accept payment on any booking UNTIL they are sure the patient has had some time to read those things and perhaps also be willing to address any questions the patient has about the contract.
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Re: Should people boycott surgeons forcing gag order contracts?

Postby JoanBoo » Thu Nov 11, 2010 2:02 pm

ssmj wrote:Medical Justice here. We’d like to weigh in and hope you will be open to listening.

First, we encourage online ratings. It's the best way to get continual improvement in performance and weed out the bad apples in the medical industry. Every industry has them.

But what about the bad apples that hire reputation management firms to whitewash their reputation and implement gag orders? If the patients aren't allowed to speak up about who the bad apples are, then how would Medical Justice know who they are in the first place?

ssmj wrote:The agreements are only relevant if and when a fictional or fraudulent post goes up. An example: when a poster is a competitor, or not even a patient.

But how would a gag order on an actual patient prevent this in any way? It doesn't. There are already libel/slander laws in place that make this sort of thing illegal. Denying everyone the opportunity to express their views online, because a doctor is paranoid that his competitors are posting false information about him, is wrong.

ssmj wrote:If you see one of these doctors and sign such an agreement, the vast majority of times your comments, good, neutral, and, yes, bad will stay exactly where you put it – on a rating site. Constructive feedback is fine. Erroneous feedback is not.


But the crux of the problem is defining the difference between "constructive" and "erroneous". Some doctors think that any feedback that is short of glowing is "erroneous", and they will pay someone money to manage their reputation and get rid of it. The "gag orders" exist in order to allow the physician to get any feedback removed that he doesn't agree with.

Yelling "fire" in a crowded theater is illegal, expressing one's dissatisfaction with a cosmetic procedure should not be illegal.

And frankly, common sense tells me that if a doctor wants me to sign a gag contract, he only has something to hide.

Hopefully, these "gag orders" will not hold up in court:
Such contracts haven’t been tested in court, and Internet law experts say they’re unlikely to prevail. Still, proponents argue that the waivers are necessary to protect doctors hamstrung by medical ethics and privacy laws. Critics say they’re nothing short of censorship.

http://www.msnbc.msn.com/id/34794632/ns ... alth_care/

Censorship, indeed.
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