We are the organization that first defined the problems created by now more than 40 mostly anonymous physician-rating sites. Medical Justice is the organization that detailed a way to slow the epidemic of online defamation. We read your March 16 editorial ( Thumbs down on this one). Guess what? We agree with much of what you wrote. You acknowledge that there are problems with many of the rating sites. In particular the Internet can be used for personal attacks and cyber-bullying. And freedom of speech ends with libel and slander. You also call for privacy, respect and an expectation of fairness. Agree, agree and agree. You close by stating that patients have much to say and doctors should listen. Agree again. However, remember, doctors are not free to respond. State and federal privacy laws impose silence upon doctors. So, the only way to make the sites marginally credible is by such self-policing. Heres how patients and their doctors can benefit from the Internet rating sites. Some sites are doing a better job than others. In fact, much better. The mutual privacy agreements have never asked that patients will not post negative comments. They state that if patients post, they do so with the doctors assent. Several sites have already approached us to define how they hope to make their sites credible, reasonable, reliable and fair. We ask the doctor rating sites to comply with four things:
Physicians will then encourage their patients to use those doctor-rating sites using these criteria. Then everyone benefits. Patients can express their views while physicians can use the feedback as a quality- improvement tool. A note on quality of care. The best way to measure quality of care is for physicians to take the lead. Gather data with all of the relevant variables. Benchmark performance and use the information in a collaborative, nonpunitive way to drive better performance. Without physician buy-in, measurement of outcomes will be difficult, if not impossible. That said, once the genie is out of the bottle, the best physicians will want to be paid more. And they will deserve to be compensated better. That is how the rest of the world works.
Jeffrey Segal, M.D.
Founder and chief executive officer
Medical Justice Services