[G]etting in the faces of the previously untouchable professional class has inevitably led to legal threats. He says he gets about one each week over negative reviews and receives subpoenas every month or two for information that can help identify reviewers, who believe they are posting anonymously.
Over at Angie’s List, service providers have sued reviewers, whose names are known to the company, “a handful” of times, according to the company. Angie’s List has paid their legal fees in the past, but a co-founder of the site, Angie Hicks, said she could not commit to doing that in every case in the future.
None of the litigants at Angie’s List have been doctors so far, but that doesn’t mean they are thrilled with her health reviews. “They told me that ‘patients aren’t smart enough to figure out whether I’m a good doctor,’ ” she said. “But I told them that these conversations have been happening all along.” The only difference with the site, she pointed out, is that the doctors get to listen in.
Some doctors have silenced patients anyway. Several years ago, a physician reputation management service called Medical Justice developed a sort of liability vaccine. Doctors would ask patients to sign an agreement promising not to post about the doctor online; in exchange, patients would get additional privacy protections.
This struck me as the height of audacity, and when I shared my feelings with the company, I was informed that the agreements had outlived their usefulness. What neither its vice president of marketing, Shane Stadler, nor its founder and chief executive, Jeffrey Segal, told me, however, was that the company had retired the agreements in the wake of a lawsuit related to them and a complaint filed with the Federal Trade Commission.
Medical Justice has now turned 180 degrees and embraced the review sites. It helpfully supplies its client doctors with iPads that they can give to patients as they are leaving. Patients write a review, and Medical Justice makes sure that the comments are posted on a review site.
Health services industries need to be reviewed. Patients would benefit tremendously by getting more high quality information about how doctor’s offices work (e.g., how long is the wait? do you see a different doctor every time?). I remember when my family moved to Evanston finding it really difficult to locate a good doctor’s office that met all of our family’s needs. I’m still not completely happy with our doctor, but the switching costs are sufficiently high that behavioral inertia has taken over.
Accountability in the medical field is a problem, especially now that doctors offices have begun to fully embrace the market logic, which means that from the patient’s perspective you’re treated more as a customer and less as an individual. But doctor’s resistance to monitoring, as could be had with anonymous review sites, is completely understandable from their perspective. They want the profits that the market logic/business model brings, but they also want to maintain their professional autonomy and discretion. Once you introduce patient feedback into that process, the profession begins to lose some of its autonomy.