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    Safety net: Doctors contract with patients to avoid negative Web publicity


    Dr. Segal
    National report — If you Google the word "dermatologist," you'll get 6.78 million results. Add the word "ratings," and you'll still get more than half a million matches.

    Visit HealthGrades, Ratemd, PhysicianReports and WorldHealthWeb — some of the Internet sites where patients can review their physicians — and read what patients say about other doctors.

    Many of the sites list quick comments — usually as many (if not more) positive as negative.

    But other sites also exist where patients have developed entire blogs to berate and lash out against physicians from whom they claim to have received inadequate, harmful or just plain poor care.

    How can doctors protect themselves from such attacks? With the unregulated status of the Internet and the protected right of freedom of speech, it's hard to know if untrue information can be removed from the Web.

    Medical Justice

    Medical Justice, a company started in 2002 to help doctors protect themselves from frivolous lawsuits, has expanded its programming to help prevent physicians from being libeled on the Internet.

    Founder Jeffrey Segal, M.D., a former neurosurgeon in Greensboro, N.C., explains why the program was developed.

    "We started looking at this a couple years ago and recognized that the conventional ways of dealing with this problem, such as trying to sue someone for defamation, were totally inadequate, ineffective, expensive and unpredictable, etc.

    "For litigation, some threshold must be met before people can sue a physician. Many doctors believe that although litigation may be a problem in general, they will never be sued.

    "If you look at the notion of being blogged about on the Internet, however, that takes no effort at all. All it takes is a computer and a mouse to make something happen.

    "It doesn't even necessarily require a disgruntled patient — it can be a disgruntled employee or a competitor down the street who actually try to defame a doctor on the Internet," Dr. Segal tells Dermatology Times.

    Patient contracts

    Medical Justice now has contract language physicians are licensed to offer their patients, in which the doctor promises added privacy, plugging holes left by the Health Insurance Portability and Accountability Act (HIPAA) and by state laws.

    In return, the patient promises not to publish information about their experience with a doctor on the Internet or broadcast stations without the doctor's permission.

    Dr. Segal says the contract gives physicians ammunition to go to Internet service providers to request information be removed — not just because the content is untrue, but because the provider is assisting a patient in violating a privacy contract.

    Doctors can also trace the identity of anonymous bloggers because of the contract violations.

    Cosmetic plastic surgeon Larry Schlesinger, M.D., who practices in Hawaii, signed up for the privacy contract when it came out a year and a half ago.

    "I saw articles about plastic surgeons who had defamatory blogs set up about them, and their state supreme courts ruled there was no way to take the blogs down post hoc.

    "I like Medical Justice's theory that it's like trying to close the barn door after the cows are out. The way to deal with the problems is a priori."


    Karen Nash
    Print and broadcast media medical reporter based in Sioux Falls, S.D.

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