Doctor nondisclosures get gag reflex

I got a kick out of recent efforts by doctors who, stung by negative postings on the Web, have decided to get patients to sign a nondisclosure

I can see it now. I enter the office, sit on the exam table under a bright light and the doctor approaches with a clipboard. ""Sign ze papers, old man!"

It's a silly idea that not only won't work - it will backfire.

Welcome to the Web, M.D.s Everyone from innkeepers and plumbers to multinational corporations get handled roughly online, but some doctors, apparently, think they should be treated differently. Or perhaps a few are being misled. Dr. Jeffrey Segal is behind the idea. A North Carolina neurosurgeon turned entrepeneur, Segal founded Medical Justice, a reputation management service.

Doctors sign up, and get their patients to sign a waiver (good luck). Then for a fee, Medical Justice trolls the Web looking for negative comments. If it finds comments submitted by a person who signed a waiver, the company produces the waiver and asks the site to take the comments down.

So what happens when patients refuse to sign? When patients post comments anonymously or get proxies to post for then? And how will Medical Justice force sites (some, such as RateMDs.com, have already have turned down its requests) to take down postings?

Arguments that medical ethics and privacy laws prevent doctors from responding and defending themselves and that therefore they deserve special treatment don't hold water. Plumbers, lawyers, insurers and corporations face the same issues every day over everything from personnel matters to complaints of unsatisfactory performance. No organization is going to share its business relationship details on the Web in a tit-for-tat with disgruntled customers. There are other ways.

Doctors should remember the Hippocratic Oath: First, do no harm. Not only will the big stick approach not work, it will make matters worse, as patients will criticize participating doctors online (do they have something to hide?) and encourage prospective patients to look elsewhere for a doctor who is more open - and has a thicker skin. These doctors are shooting themselves in the foot.

Fortunately, only about 2,000 doctors have signed on for this silly idea.

A better approach would be to embrace technology. A preponderance of vitriolic postings could be an indicator that patients feel ignored and powerless - that the doctor doesn't listen.

Has the doctor done what's needed to empower the patient and provide a path for two-way communication? Doctors should  encourage direct feedback from patients - including posting their positive experiences online as well.

Patients who feel that their doctors are listening will be happier. And doctors can then reference positive rankings and testimonials in their practices. If the preponderance of postings are positive, a few negative complaints won't kill you.

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