Doctor's (Gag) Orders

[PLFXpert 0]

NPR

I found this a curious topic to debate: Should patients have the right to comment on care?

Just yesterday I searched Angie's List for a specific doctor. I have not been satisfied with my own for sometime. I am not about to post anything personal, but trust my issues were much more than (yet, in addition to) such common things as being late or seemingly not listening to me.

Much to my dismay, none of the doctors whom had requested to be member of Angie's List had reviews. There were three pages of doctors, zero with reviews. Angie's "lists" are mostly made up of companies which someone has submitted a review for and subsequently a listing for that company, upon approval, is established.

Apparently, businesses are permitted to request a listing without being reviewed. Why would all of these doctors do so and not have a single review?

I could argue both sides, however, obviously my initial opinion of whether or not one should be able to comment is: Absolutely!

Paint me in a corner, but my color comes back.

[quade 4]

Comments are good for the consumer, not the provider of services.

This is almost universally true as there are a LOT of people that are willing to take the time to write scathing reviews about almost any slight, but very few that are willing to write positive ones.

If you owned a business where people routinely sued for sometimes frivolous reasons, I'm nearly certain you'd want random comments blocked from the listings too.

quade -
The World's Most Boring Skydiver

[PLFXpert 0]

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Comments are good for the consumer, not the provider of services.

This is almost universally true as there are a LOT of people that are willing to take the time to write scathing reviews about almost any slight, but very few that are willing to write positive ones.

I tend to agree.

However, as a consumer--and present member of Angie's List--I have written all positive reviews.

I have found in my area far more positive than negative reviews. Far more "A" or "B" rated companies than anything less.

When I am delivered exceptional service, I want to share that experience and have as many people as possible be delivered the same. I truly want to support that particular service provider and have them reap the benefits of taking pride in their work and producing quality.

I have not commented negatively mostly due to my negative experience being "common" and unfortunately "accepted". Why is it acceptable when I make a doctor's appointment it will ALWAYS be at least an hour later when I am first moved to the room and than at least 15 minutes after that before I am seen? I do not comment about such experiences because, isn't that true for all doctor's offices? And such things might even be forgivable and a non-issue.

I want to hear about the issues and how someone was treated with respect to those.

Paint me in a corner, but my color comes back.

[PLFXpert 0]

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If you owned a business where people routinely sued for sometimes frivolous reasons, I'm nearly certain you'd want random comments blocked from the listings too.

Random or all?

Who is to decide what is random?

My hunny is a business owner--a contractor--who is subject to review online. His company is rated "A" and routinely voted best in the city by a local contractors' review by consumers. And I believe they are for good reason.

Paint me in a corner, but my color comes back.

[quade 4]

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Who is to decide what is random?

On thing is certain, if anybody decides, then it clearly isn't random.

That speaks to the first sentence of my first response as well.

quade -
The World's Most Boring Skydiver

[kbordson 8]

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Comments are good for the consumer, not the provider of services.

This is almost universally true as there are a LOT of people that are willing to take the time to write scathing reviews about almost any slight, but very few that are willing to write positive ones.

I tend to agree.

However, as a consumer--and present member of Angie's List--I have written all positive reviews.

I have found in my area far more positive than negative reviews. Far more "A" or "B" rated companies than anything less.

When I am delivered exceptional service, I want to share that experience and have as many people as possible be delivered the same. I truly want to support that particular service provider and have them reap the benefits of taking pride in their work and producing quality.

I have not commented negatively mostly due to my negative experience being "common" and unfortunately "accepted". Why is it acceptable when I make a doctor's appointment it will ALWAYS be at least an hour later when I am first moved to the room and than at least 15 minutes after that before I am seen? I do not comment about such experiences because, isn't that true for all doctor's offices? And such things might even be forgivable and a non-issue.

I want to hear about the issues and how someone was treated with respect to those.

Personal experience right here.

I like to think that I give compassionate and detailed care to my patients. I honestly research the less common diagnoses for my patients and print off information from pubmed or other reliable websites. I do a bit of teaching. The majority of my patients are medicaid... and I prefer that. But I do get some people that I CAN NOT please. You ask specifically about waiting for doctors....

Let me give you a day in the life.

As an employed physician (not a partner), I don't have as much control over my schedule, but generally I am double booked on 15min intervals. I am ADAMANT that new patients are NOT double booked (but it still happens). But... even a simple OB visit (pregnant patient) isn't always "simple" - what if she starts crying cuz her boyfriend just left her? What if she has a LIST of questions about epidurals and inductions and ....? What if you have to try to explain to a young 17year old about getting her first pap smear? Or a new diagnosis of HPV or Chlamydia? What if you wrote for meds on the last visit, but this time she has a long list of excuses about why she didn't get it filled... and now you have to stress the importance of treatment? What if the woman has gestational diabetes? What if the other patient was 15min or 30min or more late ... and she's is term so you can't turn her away? And YOU, as a patient, have a 11:15 appt.... so how many patients were ahead of you? 12 to 18 or so... and each one, if she took an extra "just a minute" would be added up to an hour by that late morning appt. There are days that I JUST finish my morning clinic to start the afternoon.... And that's not even counting having to leave for a delivery or an ER admit.... Yes, it sucks waiting... patients get mad, the nurses get mad.... but the patient that I'm with at the time is important too... and could YOU see yourself walking out of an exam room with a crying patient.... and it's only going to get worse.

But I have been burned on websites that are venting blocks for mad (and sometimes unreasonable patients). I had one patient that I helped her achieve pregnancy with the more basic ovulation induction medications. I monitored her closely, she had a normal progesterone (so I did not suppliment), but even with all of that she miscarried at 8-10w... and she claims that I "killed her baby." Another patient was one that transfered to me at 12w, I saw her three times... and one the first visit got the history that she had previously had a myomectomy (removal of a fibroid). So I tried to contact that physician, sent a letter, got her chart, but it didn't have the op note. Her next visit, I had her sign to get the op note from the hospital, got the op note, but the surgeon didn't specifiy whether it was displacing the endometrial cavity or not, so I had to contact him personally... Got that done the day before her third meeting with me. At her third meeting, I told her that she would not need a cesarean, but she had already gone on line (prior to visit) and slammed me for not having had the information... and then she transferred again to someone else.

You can not please everyone... and as stated above, TYPICALLY only those with an ax to grind take the effort to slander or malign.

[PLFXpert 0]

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That speaks to the first sentence of my first response as well.

Interesting.

I do not believe people more often speak negatively about services provided than positively, but rather it is the negative the listener tends to remember most.

Either way, your first sentence is correct, but...

what is your opinion?

Paint me in a corner, but my color comes back.

[quade 4]

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What is your opinion?

I'm a big fan of word of mouth, but not a big fan of anonymous (or lack of reprisal) reviews.

If the internet has taught me anything, it's that when people can hide behind a fake name or number, they're generally way more mean.

quade -
The World's Most Boring Skydiver

[PLFXpert 0]

But...what is your opinion? Should patients have the right to comment?

Karen, I said time might be forgivable and a non-issue. Time was not my point.

As for the second part of your post, I have to say this: From what little I know of you (enough to pm you once or twice regarding your expertise), I would recommend you take the $10k...

(Perhaps a bad analogy but...) Bill likes a TV show called "The Biggest Loser". I am usually reading or sleeping when he watches it. By proxy, I am semi-familiar with the contestants and this season a front-runner had the option to take a one-pound advantage or $10k. Bill was all "Take the one-pound!". He followed explaining he had seen seasons before and it ALWAYS was the best choice and one pound made a huge difference.

I countered if I were her (whom I had seen enough of) I would absolutely take the $10k. Winner gets 250k, mind you. But, if you bet on yourself and know you have done your best, then why bet on others instead?

To me, in part, that is what a gag order is doing. It is betting on how many people you do NOT do well for.

But, I concede I might not be aware of such sites you have potentially been "burned on" before.

Paint me in a corner, but my color comes back.

[PLFXpert 0]

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I'm a big fan of word of mouth, but not a big fan of anonymous (or lack of reprisal) reviews.

If the internet has taught me anything, it's that when people can hide behind a fake name or number, they're generally way more mean.

I agree!

Which leads me to believe--and understand--that your issue with commentary lies in the particular forum, rather than commentary itself.

What about Angie's List or something similar? One is only anonymous to other readers, but not to Angie's List. I have both recommended and been recommended for Angie's List. I had a rep from Angie's List call me and ask me questions, etc. As a member, Angie's List knows who I am. I know one of the service providers I recommended to them they called and asked specific questions...

Is it just anonymity you have issue with, or online commentary altogether?

My question is--Would you support a doctor's gag order? Secondary, would you sign one?

Paint me in a corner, but my color comes back.

[lawrocket 3]

I tend to thinks that review sites are good for limitesd purposes, such as service, responsiveness, etc.

On the other, "how good is this doctor" is an entirely different story. I trust nobody except other physicians to comment on the learned skill and abilities of other physicians. What is this physician's record of discipline? What is the experience in this area?

What do other doctors say about her?

Two types I trust completely: (1) the one that other doctors say is the best; and (2) the ones that have been around for a while in the area that other doctors don't know much about.

The latter don't have any bad stories - these spread rapidly. Malpractice? Unless there are multiple large judgments or discipline, then not a problem. There were only two doctors I ever defended I'm a med mal case that I would not use for myself or my family because they were too arrogant to admit they screwed up despite the case being indefensible.

What family and friends and anonymous online posts say doesn't mean much to me.

What other doctors say or don't say - good as gold. I'll put it this way - there are attorneys whom I hope to be on the other side. Not because they are easy pickings for me but because they are professionals, courteous, learned, skilled and worthy adversaries. Respect is mutual. And we can resolve issues quickly and easily.

"If you were getting a divorce, who would you want as your attorney?". And I'd respond, "my wife. Shed be unavailable, though, so John M. If my wife has him then Cathy D. Either way, I'd want them both to be the attorneys regardless of whether represented me or her."

A doctor who says, "she's my doctor" is the best.

My wife is hotter than your wife.

[PLFXpert 0]

OK, but...

Do you support a doctor's gag order, and would you sign one?

Paint me in a corner, but my color comes back.

[lawrocket 3]

A gag order? No.

A website that provides commentary on patients and their performance? I would strongly advise the physician not to participate.

"Joe Snuffy. Rating? 2.1.
Comments: Morbidly obese and diabetic. Noncompliant with management. Persistent complaints based on increasing neuropathy.

"ETOH. Tobacco. Recently fired me because I did nothing to help him. Good luck to any and all of you with him."

See, I'd have a problem with it. We in law are fortunate in that we can review histories. I will not take a person as a client who has been through two attorneys in a case already.

And if I see a client post on a website that I'm a horrible attorney because I successfully defended my client against him, or because I was simply unable to get the result she wanted, yeah, I'd have a problem.

Okay - short answer. Gag order? If they don't want to, then I'm cool. If they are otherwise pressured or ordered to put a sock in it then I have a problem with that.

My wife is hotter than your wife.