North Carolina firm protects physicians' reputations online

Doctors worried about patients trashing their reputations online can now ask them to sign a waiver promising they won’t.

A North Carolina company, Medical Justice, is selling doctors a standardized waiver agreement they can ask patients to sign. Patients who sign effectively agree not to post online comments–good or bad–about their doctor’s “expertise and/or treatment” without the physician’s permission.

The waiver is a response to the explosion of doctor-rating internet sites, such as RateMDs.com and doctorscorecard.com. Physicians complain that the often-anonymous postings are inaccurate and unfair, and can destroy their reputations. A doctor who is the subject of critical postings has little or no recourse with the posters or the website.

Medical Justice monitors the websites and, if a negative comment appears, notifies the doctor. If the poster is identified as a patient who signed a waiver, the physician can use the document to ask the website to remove the posting. The doctor’s legal authority is a clause in the waiver giving doctors the copyright to any comment made by a patient who promised not to post. The doctor can argue that he or she owns the comment and wants it removed.

Not all websites cooperate. Many allow posters to be anonymous, while others argue that it’s a freedom of speech issue.

Still, comments in the “double digits” have been removed, says Jeffrey Segal, MD, a neurosurgeon and founder of Medical Justice. Approximately 2,000 physicians have signed up in two years, he says. The fee is $495 for the first year and $350 per year after that.

The waiver is not an oath of silence. Patients still have the right to complain to friends, attorneys, other doctors, medical licensing boards, hospital ombudsmen and others, Segal says.

Of patients who have been asked to sign the waiver, “99.99 percent” have complied, Segal says. If a patient refuses to sign a waiver, it’s up to the doctor to decide whether to go ahead and treat the patient.

Segal says his goal is to build a better doctor-rating site, one that verifies that posters are patients, requires a statistically valid number of posts to ensure ratings are significant, and limits comments to those subjects patients are qualified to judge, such as bedside manner, length of wait, etc.