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Some doctors try to squelch online reviews

By Dina ElBoghdady,January 28, 2012

Fuming about a billing dispute with his dentist, Robert Allen Lee posted his complaints on two consumer review Web sites, triggering a legal battle over a technique designed to snuff out negative online commentary.

In late August, a day after Lee posted his comments on Yelp and DoctorBase, he received a letter from the dental practice threatening to sue him for at least $100,000 for “defamation, slander and libel.” The letter reminded him that he’d signed an agreement with his dentist that barred him from publishing a critique of her or her office.

While extreme, such do-not-talk contracts underscore the struggle between consumers that are eager to share their thoughts online and companies that are looking for ways to protect their reputations in an environment in which social media helps shape opinions on just about everything.

In the political sphere, social media helped fuel the demonstrations of the Arab Spring. Everywhere else, online chatter informs our decisions on which hotel to book, what to read, which plumber to hire, where to eat — even who to date.

But rating doctors is another matter. While 80 percent of adults say they use the Internet to search for health information, only 16 percent use it to look for reviews of doctors and far fewer post such reviews, according to a Pew Research Center survey.

Consumers spend more time shopping for a refrigerator or car than they do for a health-care plan or doctor, according to a survey by the Altarum Institute, a nonprofit health systems research and consulting group. Although 60 percent of the respondents said they engaged in detailed research when car shopping, fewer than one in three devoted much time to vetting a doctor.

“There’s a case to be made that the average consumer has a good basis for judging if a meal is tasty or the plumber fixed the leak,” said James B. Speta, an Internet policy professor at Northwestern University School of Law. “But medical services are specialized. When you start talking about whether the treatment was the correct one, it’s highly technical. . . . One can ask: ‘What is the value of the consumer input?’ ”

That’s what consumers and the medical community are trying to figure out.

Michael Fertik said doctors are the fastest-growing client group at his company, Reputation.com, which helps its customers investigate their online reputations and suppress negative comments. Fertik said his firm does not remove reviews. But it provides doctors with tools to solicit and post comments from real patients — as opposed to a disgruntled former employee or ex-spouse who has an ax to grind.

“When you talk to doctors, they totally understand that they’re going to be discussed. They get it,” Fertik said. “They just want a fair shake. The deck is stacked against them because people tend to review stuff when they’re unhappy.” Maybe that doesn’t hold true for movies or hotels, he said. “But nobody says: ‘Oh my God, I have the greatest accountant in the world.’”

‘Gag orders’

The type of agreement Lee signed had become widespread enough that RateMDs.com posted a “Wall of Shame” on its site outing doctors who use “gag orders” to squelch online commentary. Angie’s List alerts its users about doctors who use these forms by posting a notice on a doctor’s profile. And Yelp said it notifies consumers and refers them to legal resources when a doctor demands that a review be taken down.

Consumer advocates say such agreements could not withstand a legal challenge. Still, they fear that the tactic or similar ones will intimidate consumers and undermine the free-flowing exchange of information on consumer review Web sites.

“It threatens to starve patients of the ability to get the information they need to know to make smart choices,” said Eric Goldman, a professor at Santa Clara University School of Law who has a Web site devoted to these types of contracts. “It’s a hack on the system.”

For Lee, the trouble began with an aching tooth while he was living in New York late last year.

Before treating him, the dental office handed him papers to sign, including an agreement that prohibited him from publishing his views of the dentist online or elsewhere. In exchange, the dentist agreed not to market Lee’s patient information to third parties.

“That struck me as strange,” said Lee, who now lives in Calvert County. But he signed, forgot about it and paid $4,766 to have an infection drained and his tooth filled, he said. About nine months later, frustrated by the runaround he got when he tried to file an insurance claim, Lee unloaded his grievances about the dentist online.