Doctors fight back against Internet critics
Lindsey Tanner, Associated Press
Wednesday, March 4, 2009 (SF Chronicle)

  Some doctors have started fighting back against ugly Internet reviews by
asking patients to abide by what are effectively gag orders that bar them
from posting negative comments online.
  Physicians are taking action as online ratings services such as Yelp and
Angie's List grow in popularity and expand their reviews beyond
restaurants and plumbers to include medical care, joining dedicated Web
sites such as
  "Consumers and patients are hungry for good information" about doctors,
but Internet reviews provide just the opposite, contends Dr. Jeffrey
Segal, a North Carolina neurosurgeon who has made a business of helping
doctors monitor and prevent online criticism.
  Some sites "are little more than tabloid journalism without much interest
in constructively improving practices," and their sniping comments can
unfairly ruin a doctor's reputation, Segal said.
  For a fee, Segal's company, Medical Justice, provides doctors with a
standardized waiver agreement. Patients who sign agree not to post online
comments about the doctor, "his expertise and/or treatment."
  Segal's company advises doctors to have all patients sign the agreements.
If a new patient refuses, the doctor might suggest finding another doctor.
Segal said he knows of no cases where longtime patients have been turned
away for not signing the waivers.
  Doctors are notified when a negative rating appears on a Web site, and, if
the author's name is known, physicians can use the signed waivers to get
the sites to remove offending opinion.
  Postings at are anonymous, and the site's operators say they
do not know their users' identities. The operators also won't remove
negative comments.
  Angie's List's operators know the identities of users and warn them when
they register that the site will share names with doctors if asked.
  Since Segal's company began offering its service two years ago, nearly
2,000 doctors have signed up. In several instances, he said, doctors have
used signed waivers to get sites to remove negative comments.
  John Swapceinski, co-founder of, said that in recent months,
six doctors have asked him to remove negative online comments based on
patients' signed waivers. He has refused.
  "They're basically forcing the patients to choose between health care and
their First Amendment rights, and I really find that repulsive,"
Swapceinski said.
  Segal of Medical Justice said the waivers are aimed more at giving doctors
ammunition against Web sites than against patients. Still, the company's
suggested wording warns that breaching the agreement could result in legal
action against patients.
  Jim Speta, a Northwestern University Internet law specialist, questioned
whether such lawsuits would have much success.
  "Courts might say the balance of power between doctors and patients is
very uneven" and that patients should be able to give feedback on their
doctors' performance, Speta said.
  Angie Hicks, founder of Angie's List, said her company surveyed more than
1,000 of its consumer members last month, and most said they had never
been presented with a waiver; 3 percent said they would sign one.

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