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At the Connected Health conference in Boston last year, where I spoke with my physician Danny Sands, I heard the visionary Clay Shirky speak. He gets it in spades about patient empowerment. In passing, he cited one of the most absurd ideas I’ve ever heard :–) … a company called Medical Justice wants to help doctors avoid consumer ratings, by getting patients to sign an agreement saying all their conversations are the doctor’s property, trade secrets, so the patient isn’t allowed to tell anyone what the doctor said.

How disempowering is that?

And absurd, because as Shirky pointed out, even if the patient signed such a contract, the spouse could spout.

But it appears the idea hasn’t died: today Lindsey Tanner writes in the Associated Press Docs seek gag orders to stop patients’ reviews. I don’t know if they’ve changed their strategy – this piece doesn’t mention trade secrets, it says the company will simply force ratings sites to remove those ratings.

Good luck with that, because (among other things) patients can just go to sites like where ratings are anonymous. From the article:

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.

He said he’s planning to post a “Wall of Shame” listing names of doctors who use patient waivers.

Personally I’m not thrilled about the inevitable advent of doctor ratings. Anyone who reads book reviews on Amazon or has used Angie’s List knows there are a lot of “U R dum” commenters. I’m sure the doctors I highly respect will get insults from some idiots. Bad ratings aren’t certain, nor are good ratings: I’ve had two consecutive experiences where a highly rated vendor on Angie’s List (non-medical) turned out to be horrid; I have no idea how they got good ratings.

But the truth (in my view) is that as empowered patients in this new world, we’ll need to learn to interpret ratings from others, and eventually things will improve. And in any case, at least we’ll have more information than we have now as we make our choices.

Meanwhile, as I said, good luck to Medical Justice. They strike me as an almost comical attempt to hold back the tide.


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