[Talk Host]

I read this morning that there is a move among doctors to require patients to sign a waiver stating that the patient "will not" post negative comments about that doctor on blogs and forums like this one. The story went on to say that if the patient refuses to sign, the doctor will tell the patient to find another physician.

Patients have begun fighting back when they feel that they didn't get the care they deserved or when the doc's attitude was lousy. Doctors are feeling the pinch and they don't like it. As I understand the story, the doctors position is that comments about "service or attitude" are not a fair reflection on his or her medical skill.

To my way of thinking, they all come in the same package. Attitude, service, responsiveness, bedside manner, care, concern and medical skill are what we pay for.

You can read the full story here http://news.yahoo.com/s/ap/20090304/...gging_patients

[Bryan]

If presented with such a waiver by any doctor, I would probably sign it IF I really needed the services of that particular doctor. I would still feel like that was a minor form of blackmail - sign a waiver or I won't treat you. If things did not work out and I was unhappy with the "service", I would not hesitate to complain and post to a web site such as RateMDs.com in spite of the waiver. For one thing, if what you say (or post) is truthful and factual, you are covered (prevarications are a no-no). For another, as the referenced article pointed out, it is sort of doubtful if a doctor would even prevail in a lawsuit over this unless he could prove you lied and slandered him.

Originally Posted by Bryan

If presented with such a waiver by any doctor, I would probably sign it IF I really needed the services of that particular doctor. I would still feel like that was a minor form of blackmail - sign a waiver or I won't treat you. If things did not work out and I was unhappy with the "service", I would not hesitate to complain and post to a web site such as RateMDs.com in spite of the waiver. For one thing, if what you say (or post) is truthful and factual, you are covered (prevarications are a no-no). For another, as the referenced article pointed out, it is sort of doubtful if a doctor would even prevail in a lawsuit over this unless he could prove you lied and slandered him.

This sounds like a contract between the patient and doctor with respect to treatment. It could be construed as an illegal contract under the freedom of speech clauses in state and the US Constitution. That would be an interesting case though about whether this kind of contract would pass constitutional muster if a patient signed this contract, then wrote something bad and the aggrieved physician sued the patient.

Looking it at this in a contractual light I do not believe the truthfulness of the statements would matter all that much.

[collie1228]

There is no constitutional right of freedom of speech between individuals. Only the government has to observe such rights. If you work for a major corporation, they have all kinds of speech restrictions that are enforceable under the law. I'm reasonably certain that the doctor's restriction is enforceable if you willingly agree in writing - but he would have a hell of a time determining who, in fact, was complaining about his service on an internet site (unless the complainer was dumb enough to use his name and address). And if the doctor, by some miracle, was able to determine who wrote the offending comment about him, I can't believe much damage could be substantiated to a jury. I'd sign the paper, and if the doctor ended up being incompetent enough to deserve a negative review, I'd do it anyway.

[serenityseeker]

Originally Posted by Talk Host

I read this morning that there is a move among doctors to require patients to sign a waiver stating that the patient "will not" post negative comments about that doctor on blogs and forums like this one. The story went on to say that if the patient refuses to sign, the doctor will tell the patient to find another physician.

Patients have begun fighting back when they feel that they didn't get the care they deserved or when the doc's attitude was lousy. Doctors are feeling the pinch and they don't like it. As I understand the story, the doctors position is that comments about "service or attitude" are not a fair reflection on his or her medical skill.

To my way of thinking, they all come in the same package. Attitude, service, responsiveness, bedside manner, care, concern and medical skill are what we pay for.

You can read the full story here http://news.yahoo.com/s/ap/20090304/...gging_patients

The unfair and dangerous part of this is that anyone is able to write anything inflamatory about any physician as their "opinion". As in all other parts of life there are unreasonable people that be come disgruntled for unreasonable reasons. Defaming a physician, even if its only your "opinion" is hurtful and dangerous, and potentially damaging to professionals that deal with difficult people in some of the most difficult circumstances life has to offer. Many of these patients may in fact have emotional problems that affect their ability to give or receive communication normally, or to honestly and accurately portray the situations they deal with. Who is going to be able to tell the difference?
Should we all be held accountable? Certainly, just as the patients should (non compliance, obesity, smoking, missing appointments to just name a few). Medicine is difficult enough and has become too much of a battlefield as it is today without having to deal with sometimes wild, unfounded, and misplaced accusations. There are accepted channels to go through to deal with complaints regarding physicans, from actually sitting down to voice your concerns with the doctor to speaking with hospitals to going to the state medical board.
Let's try to remember that physicians are human too, and sometimes may have an off day and a "lousy" attitude. Our parents die, our children become sick, our patients die despite our greatests attempts, we carry the weight of a lot of peoples problems in our hearts and souls every day.
You want to "fight back"? Then do so in a fair and equitable way. Life in medicine is hard enough. Practicing today is a virtual minefield. Take a look at the statistics of the mass exodous from medicine that is gathering steam. I abhor medical professionals that do not have compassion, empathy and respect for their patients, I also know that this is a relative minority. Let's offer respect to those that sacrifice personal life and family every day for what they do, and avoid putting them in yet another defensless position.

[Talk Host]

Originally Posted by serenityseeker

Many of these patients may in fact have emotional problems that affect their ability to give or receive communication normally, or to honestly and accurately portray the situations they deal with.

99.9% of patients are able to give or receive communication normally. I would hate to think that doctors would label a person as "having emotional problems" just because the patient takes issue with the way they are treated. As you point out, doctors are human too and I think its important for doctors to remember than they are mere mortals.

[chelsea24]

I think this is just awful! There NO WAY I would sign a waiver like this no matter who the doctor is. They already have the "Cover For Each Other" Club.

There are tons of bad doctors out there, mostly on the golf course just when you need them! If you personally feel you have not received the treatment you deserve, they should be outed!

Well, guess we'll just have to put up Soap Boxes in the town squares. Because I would be the first to step up! Last time I looked, we still had Freedom of Speech!

[diskman]

I once complained to my doctor about waiting 1 1/2 hours, he told me maybe you need to find a new doctor. If i was on the internet at that time i sure as hell would have blogged it.

[serenityseeker]

Originally Posted by Talk Host

99.9% of patients are able to give or receive communication normally. I would hate to think that doctors would label a person as "having emotional problems" just because they take issue with the way they are treated. As you point out, doctors are human too and I think its important for doctors to remember than they are mere mortals.

You may have expertise in some areas but you are way out of your element in this. Your 99.9% statistic is unfounded and and at the very minimum innacurate. Also, nowhere in my post did I suggest that anyone would be "labled" as "having emotional problems" just because they took issue with how they were treated. That is an unfair and twisted representation of what I posted. Often times when emotions run high, particualry in health care situations, physicians bear the brunt of the anger, knowing it is a normal reaction even on those occassions when the issues are beyond their control. This is part of the profession we are blessed to be in and we strive to work within it with compassion and understanding.
Most physicians are quite aware that they are "mere mortals" as they deal with mortality on an everyday basis, along with some of the tradgedy associated with it. You should take the time to spend a 36 hour or so day with a physician sometime to getter a better appreciation of what one goes through for and with their patients. Attitudes like this amounting to blanket condemnation have become part of a system that is sucking the life out of dedicated physicians everywhere. This is not a rant, just an honest recognition of the situation, backed up by thoousands of physicians.
No good and caring physician fears constructive criticism or accountability, they are among the tools we use as we strive to maintain and improve every single day. As I said above, there are several ways to with deal problems before handling it in a way that leaves no recourse for the physician, who is bound by confidentiality laws. I am not talking about about a freedom of speech issue, simply talking about mutual respect and a resonable way of handling things instead of using an Amazon or eBay type of feedback that may not be fit many of the parties and situations ultimately involved.
You recently felt that issues posted on this board were unfair and hurtful to you, both personally and potentially financially. This is likely the same type of situation that many physicians might find themselves in, but with no way to way to rectify it. I just ask that you give thought to it in the same light.
"I "pointed out" several other things in the post also, I'm dissapointed they didn't warrant some consideration also.

[serenityseeker]

Originally Posted by chelsea24

I think this is just awful! There NO WAY I would sign a waiver like this no matter who the doctor is. They already have the "Cover For Each Other" Club.

There are tons of bad doctors out there, mostly on the golf course just when you need them! If you personally feel you have received the treatment you deserve, they should be outed!

Well, guess we'll just have to put up Soap Boxes in the town squares. Because I would be the first to step up! Last time I looked, we still had Freedom of Speech!

Chels I think the world of you from what I have come to know from these boards but I really am kind of bothered by all of the negative blanket statements. We don't all( or even most) for that matter spend our time on the golf course (kind of hard to when working 60-70 hr weeks), nor do most of us "cover" for one another. Not angry but I do feel the need to stick up for my colleagues that are so far removed from the negative characterizations. Physicians are not the enemy. By and large they are hard working people that sacrifice their own emotional and physical health, even their relationships to a degree for doing what they consider to be a privledge.
I truly wish people could spend every minute of a week or so behind the scenes, you would be shocked and overwhelmed, as we aften are.

[Talk Host]

Originally Posted by serenityseeker

You should take the time to spend a 36 hour or so day with a physician sometime to getter a better appreciation of what one goes through for and with their patients. .

You shouldn't automatically assume that I am without some experience in this matter.

From 1995 to 1998 I ran "MedLink" the worlds largest independent international medical and surgical referral company. I had over 200 doctors working for me and patients on three continents. I spent hours and hours and days and days with doctors and patients in countries all over the world, inlcuding the United States.

I have lectured at the famous Federov Clinic in Moscow and the Lontock Clinic in Novosibirsk, Siberia. I worked closely with the top heart surgeons in Brazil and Armenia. I have not only hosted groups of US doctors on trips abroad, I have hosted foreign doctors on educational trips to the US.

Every single day, I had a stack of applications for surgery and treatment from patients all over the world. Every single day, my staff would "try" to work with doctors and hospitals to secure treatment for these people. Many of the doctors were personal friends of mine and were a joy to work with. Some those those that I had dealings with were the most arrogant individuals I have ever met in my life.

The larger hospitals, I dealt with personally. I had a laundry list of patients who wished to be refered to a famous medical facility in Maryland. Even though I met with them face to face and received assurance that they would provide service, THEY DID NOT RETURN MY PHONE CALLS. It is my opinion that all those people in that international department at that hospital were totally incompetent.

It was me that had to contact our patients in, say, Brazil and tell them that we could not provide service for them.

After two and a half years, I walked away from the job. Not because of the patients. I am fully aware that was 11 years ago and times change.

I have a great deal of respect for some doctors.


OOPS, I forgot to mention. I spent the majority of my career in the broadcasting business. Some radio station general managers are also among some of the most arrogant individuals I have ever met. Some of the air personalities are in the same club. Probably me too.

[KathieI]

Serenity, I agree with all your posts on this subject. I appreciate all of my doctors, because without them, I wouldn't be here today. There are some that are not as intuitive as others and maybe not as friendly as others, but I research my doctors and select the ones I am most comfortable with. There are many out there that are wonderful and do not take long vacations or spend time on the golf courses, they work long and difficult hours under tremendous stress. I especially love dedicated and smart nurses, they are sometimes more attune than the doctors (and they can find veins better anyday than the doc!)

[serenityseeker]

Originally Posted by Talk Host

You shouldn't automatically assume that I am without some experience in this matter.

From 1995 to 1998 I ran "MedLink" the worlds largest independent international medical and surgical referral company. I had over 200 doctors working for me and patients on three continents. I spent hours and hours and days and days with doctors and patients in countries all over the world, inlcuding the United States.

I have lectured at the famous Federov Clinic in Moscow and the Lontock Clinic in Novosibirsk, Siberia. I worked closely with the top heart surgeons in Brazil and Armenia. I have not only hosted groups of US doctors on trips abroad, I have hosted foreign doctors on educational trips to the US.

Every single day, I had a stack of applications for surgery and treatment from patients all over the world. Every single day, my staff would "try" to work with doctors and hospitals to secure treatment for these people. Many of the doctors were personal friends of mine and were a joy to work with. Some those those that I had dealings with were the most arrogant individuals I have ever met in my life.

The larger hospitals, I dealt with personally. I had a laundry list of patients who wished to be refered to a famous medical facility in Maryland. Even though I met with them face to face and received assurance that they would provide service, THEY DID NOT RETURN MY PHONE CALLS. It is my opinion that all those people in that international department at that hospital were totally incompetent.

It was me that had to contact our patients in, say, Brazil and tell them that we could not provide service for them.

After two and a half years, I walked away from the job. Not because of the patients. I am fully aware that was 11 years ago and times change.

I have a great deal of respect for some doctors.

I am well aware of your experience as noted above, and recognize that part of it give you your due respect. I thought I was being relatively clear in what I was refering to, with regard to doctor patient relationships and difficulties of not only practicing in today's environment, but the difficulties of dealing with the type of "feedback" situations described above. I have a hard time standing by as near blanket condemnations and innacurate portrayals of physicians at large are bandied about, but that is my problem.

You give me some of your experiences, let me give you some of mine.
I am the one that has to tell people they are dying.
I am the one that has to tell families there is nothing more I or anyone else can do as they become angry and frustrated and scream at me.
I am the one that has to miss ball games, dinner at home, a decent nights sleep, when things don't go as planned or a patient deteriorates (much more often than not).
I am the one that will sit with my patient whose family won't come so they don't die alone.
I am the one that will deal with upset, angry or sad families during the day while keeping my attention focused on the other 15 patients I have in the hospital.
I am the one that divides my time between the patients and families that can talk while answering 30-40 calls and pages a day, treating the heart attack in the E.R., while my patient in ICU goes into respiratory failure, and still making constant decisions by phone and with nurses.
Every day I have to work with "arrogant" administrators and insurance company representatives that are far removed the the real world of patient care, some..the most arrogant people I have ever met in my life.
I have lectured in hospitals, to medical students, and do bedside teaching with patients and families every day.
I call teaching institutions for transfer of patients and they don't return my calls. Who wants a "no-pay" patient with a rare condition that has been in my hospital for weeks and likely has many more weeks to go if he survives.
I am the one that does all of the above, tries to sort though proper billing and procedure codes each day for every patient, and attends comittee meetings that some refuse to and others dodge.
I am the one that has to make the split second decisions as someone deteriorates in front of me and pray to God my instincts and knowledge are accurate.
I am the one that will face the lawsuits EVEN if there is no malpractice invloved when the outcome is poor.
I am the one that bears the brunt of anger and frustration for long waiting times that are beyond my control in every way.
I am the one that takes care of the alcoholic in for his third admission this month for liver failure, his family having forsaken him, with him doing the same thing over and over and slowly dying but wanting to be "fixed" again. I am his last advocate, no matter my level of frustration or sadness.
I am the one that will go the home of a terminal patient so they dont have to trudge in to be seen.
I am the one stopped in the store, at the ballgame, in the restaraunt, or in the halls of the hospital to discuss personal issues and get a curbside consult.

This is a snapshot (not all inclusive) of my day. I would never recommend anyone else go into medicine in this environment without their eyes wide open, and then take great pause before proceeding. Why do I do it? Because at the end of the day I still feel it has been a privlege to be able to do nearly all that I outlined above. And you know what, there are thousands just like me, many in more demanding situations, many better at it than me. They are not all in it for the money ( a laughable thought at this point) or somehow angry because they are "feeling the pinch". They do what they do because they are blessed eonough to be able to. I just wish they got the same attention as the bad guys. As I said, all I ask is that you give the same courtesy and thought process to them that you ask for yourself.
Thank you for indulging me.

[serenityseeker]

Originally Posted by KathieI

Serenity, I agree with all your posts on this subject. I appreciate all of my doctors, because without them, I wouldn't be here today. There are some that are not as intuitive as others and maybe not as friendly as others, but I research my doctors and select the ones I am most comfortable with. There are many out there that are wonderful and do not take long vacations or spend time on the golf courses, they work long and difficult hours under tremendous stress. I especially love dedicated and smart nurses, they are sometimes more attune than the doctors (and they can find veins better anyday than the doc!)

Kathie, a BIG ditto on the nurses, and thank you for discussing the other side of the coin.

[dillywho]

Originally Posted by serenityseeker

I am well aware of your experience as noted above, and recognize that part of it give you your due respect. I thought I was being relatively clear in what I was refering to, with regard to doctor patient relationships and difficulties of not only practicing in today's environment, but the difficulties of dealing with the type of "feedback" situations described above. I have a hard time standing by as near blanket condemnations and innacurate portrayals of physicians at large are bandied about, but that is my problem.

You give me some of your experiences, let me give you some of mine.
I am the one that has to tell people they are dying.
I am the one that has to tell families there is nothing more I or anyone else can do as they become angry and frustrated and scream at me.
I am the one that has to miss ball games, dinner at home, a decent nights sleep, when things don't go as planned or a patient deteriorates (much more often than not).
I am the one that will sit with my patient whose family won't come so they don't die alone.
I am the one that will deal with upset, angry or sad families during the day while keeping my attention focused on the other 15 patients I have in the hospital.
I am the one that divides my time between the patients and families that can talk while answering 30-40 calls and pages a day, treating the heart attack in the E.R., while my patient in ICU goes into respiratory failure, and still making constant decisions by phone and with nurses.
Every day I have to work with "arrogant" administrators and insurance company representatives that are far removed the the real world of patient care, some..the most arrogant people I have ever met in my life.
I have lectured in hospitals, to medical students, and do bedside teaching with patients and families every day.
I call teaching institutions for transfer of patients and they don't return my calls. Who wants a "no-pay" patient with a rare condition that has been in my hospital for weeks and likely has many more weeks to go if he survives.
I am the one that does all of the above, tries to sort though proper billing and procedure codes each day for every patient, and attends comittee meetings that some refuse to and others dodge.
I am the one that has to make the split second decisions as someone deteriorates in front of me and pray to God my instincts and knowledge are accurate.
I am the one that will face the lawsuits EVEN if there is no malpractice invloved when the outcome is poor.
I am the one that bears the brunt of anger and frustration for long waiting times that are beyond my control in every way.
I am the one that takes care of the alcoholic in for his third admission this month for liver failure, his family having forsaken him, with him doing the same thing over and over and slowly dying but wanting to be "fixed" again. I am his last advocate, no matter my level of frustration or sadness.
I am the one that will go the home of a terminal patient so they dont have to trudge in to be seen.
I am the one stopped in the store, at the ballgame, in the restaraunt, or in the halls of the hospital to discuss personal issues and get a curbside consult.

This is a snapshot (not all inclusive) of my day. I would never recommend anyone else go into medicine in this environment without their eyes wide open, and then take great pause before proceeding. Why do I do it? Because at the end of the day I still feel it has been a privlege to be able to do nearly all that I outlined above. And you know what, there are thousands just like me, many in more demanding situations, many better at it than me. They are not all in it for the money ( a laughable thought at this point) or somehow angry because they are "feeling the pinch". They do what they do because they are blessed eonough to be able to. I just wish they got the same attention as the bad guys. As I said, all I ask is that you give the same courtesy and thought process to them that you ask for yourself.
Thank you for indulging me.

My mother was an RN and one of the best so I am not a stranger to the world of medicine. For those who complain about long wait times, medicine is not an in and out at your convenience profession. That same one complaining aboutthe long wait might be heard to complain that the doctor is always in a rush, doesn't take time to listen, etc. You can't have it both ways. If I am the patient taking more of the doctor's anticipated time in an office visit or have an emergency that gets him behind in his schedule, then you bet your sweet bippy that is exactly the doctor I want for my care. Serenity, you're my kind of professional and I thank you for your service, even if I don't know you personally. Maybe when we can get back to the point where doctors can be doctors and not the insurance companies, more like you will return. Medicine needs to be about the patient, not the bottom line.