Be careful what you sign at the doctor's office

One of our basic rights as United States citizens — to speak freely — is in jeopardy.

In a small, but scary trend, a growing niche of health care providers are requiring patients to sign away their rights to comment openly, anonymously, publicly and privately about the level of service they receive from physicians — good or bad.

Patients, especially first-timers, are often deluged with forms to sign when they enter a doctor's office. In our research, we've found some of these "mutual privacy" agreements conveniently located at the end of the stack.

So, even if you've had a great experience and you want to share that information on a forum where cancer patients or expectant mothers gather to chat — or even with your friends and family — you are prevented from doing so if you sign this waiver.

Well, we're completely against any attempt to stifle free speech. Consumers — or patients — should be free to discuss any experience they've had with a service provider.

One of the biggest concerns from some in the medical community is that online rating services are filled with anonymous and critical reviews of doctors. As an Angie's List member, you already know we take the integrity of our data very seriously, and we've invested a lot of time and resources into protecting it. We began rating health care providers in March 2008 in response to demand from members, and we have nearly tripled the number of medical categories we offer, from around 50 to more than 140.

We don't allow anonymous reviews and we hold you accountable to follow our reporting guidelines, which include an affirmative statement that the information you're sharing is your firsthand, truthful experience. We have technologies in place to continuously monitor for attempts to stack the deck for or against any provider. We encourage providers to respond to reports, and we have a complaint resolution process through which we intercede when there are problems.

One interesting note is that the majority of the medical reports we've received thus far — and we're averaging about 10,000 per month — are positive. Angie's List members are generally interested in sharing information that is useful for other members, and the fact that we don't allow unattributed reporting minimizes that "anonymous slamming" effect.

You turn to Angie's List to find good providers, and many providers have built their business on word of mouth from Angie's List members. Doctors should have a similar experience. If you're a good doctor and treat your patients with respect, there's more for you to gain — at least from a trusted and reliable source like Angie's List — than to lose.

For our part, we will continue to support your right to free speech and post the reports you want to give us.

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I needed surgery recently, and while filling out forms during my first visit, there was one form I had never seen before. It was clearly drawn up by an attorney, and was difficult to understand, but after reading it several times it basically said that if I took him to court, I agreed to have the case heard in arbitration and not by jury. I knew I needed the surgery, had heard good things about this surgeon and so I signed it. As I was signing it, I wondered what if I didn't sign it? Would they refuse to see me? Everything turned out fine, but I still regret signing that paper, and have promised myself I will NEVER sign anything like that again.

Now if there was only a way to find out which doctors are best on any given day. Doctors are human. They, like the rest of us, have their good days and their bad days. I've often wondered if its better to have a mediocre surgeon on his best day or a "star" surgeon on his worst day.

That is a very good analogy! You made my day! :) I think I'd rather have the mediocre surgeon on his best day, lol!

If you think the doctors who graduate at the top of thier class are good, you are mistaken. They are good acadamians and researchers my experience is that they have very poor bedside manners and tend to be paternalistic.

I think I'm usually stuck with the ones that just graduated at the very bottom of their class., passed with the skin of their teeth. If it walks like a duck, quacks like a duck, then it probably is a duck. Throw him to the curb, and look for another one pdq.

This reminds me of an old joke: What do you call the guy who graduated last in his class from med school? Doctor

i recently rcvd a paper asking for my permission for all of my medical information to be shared by the entire hospital organization, pharmacist and medicare and insurance agencies. i trust my individual doctors 100%; but the others i am not sure i should sign the agreement for. do you have any information on this matter at this time? thanking you in advance, nanci b.ward

If you have questions, you'd do well to call the office that sent it to you to ask exactly how they plan to use it. If you do not sign it, my sense is that your insurance company won't get the proper info in order to pay the bill. In some cases, hospitals are incorporating many disciplines one umbrella: this sometimes includes primary care practices, specialists, the pharmacy, social services, etc. This might be what you are seeing. Or it could be a generic, one size fits all form that your doctor's office uses so that they don't have to get you to sign a new consent form every time there is a change to be shared with other care givers. Note - unless you are using other services you listed, your records are not likely to be shared with them. In any event, your best bet is to ask, since the office who sent the form knows their forms better than any of us would. Good luck!

A few more specific details about medical records. HIPAA is the law that basically governns medical records privacy. It has severe penalties any sharing of medical records, without a patient's permission, so most places take it very seriously. However, it has exceptions. You are allowed to share records for the purposes of billing and to other health care providers for the purpse of treating a patient, without asking permission. Therefore, the hospital probably legally has the ability to share your records with the insurance company and with any other part of their network if you get treated at those other parts. They are asking you to sign the form, because they (reasonably) feel it is always better (for them) to have that written down and formalized so there can be no dispute later. On a practical level, if they use a network wide electronic medical record, anyone with access can look at your records at any time. If someone looks at records they shouldn't frequently, there is a decent chance they will get caught and fired. If they only do it occasinally there is virtually no chance they will be caught. If they have paper records, probably, no one is going to be looking at your records because it would be too much effort. If someone REALLY wanted to illicitly get your medical information, it would be very easy to simply forge your signature on a form and have the hospital fax over your records, If they only did that once they might well get away with it. The main protection from people at a hospital illicitly reading your medical records is that probably no one cares. The exceptions to that would be if you live in a small community and/or know numerous people who work in the hospital, if you have records of psychiatric treatment or if you are a celebrity. Pure psychiatric records are always given more security than regular medical records, but the details vary from place to place. Also if you go to the hospital for a medical reason (such as appendicitis_ and a psychiatrist also sees you there, then that note would be in the regular medical record, not the psychiatric section. When a celebrity goes to a hospital/office there is usually much more interest and correspondingly more security. In summary: 1) That form probably just formalizes what they can already do. 2) If someone REALLY wants to find your medical information they probably can But 3) Almost certainly nobody cares to make the effort. Unless 4) You know many people in the hospital/system, have psychiatric records or are a celebrity. In which case 5) It would be a good idea to ask about their information security practices.

I guess though one question I want to ask, after my long post lol, is if the receptionist asks you for an opinion on the doctor you are leaving, and you give an honest one (unsatisfaction, prefer other doc etc) why dismiss or ban the patient? Does that mean that the practices that ask those questions only want the patients who are completely satisfied then?

I live in a small town of less than 20,000 people where the average income is $23,000. Yet in a weak moment of poor decision making, my radiologist let it slip that he makes over $1 million a year. Did I mention he has every 4th week off? Furthermore to sidestep Medicare and other insurance carriers, and to enrich themselves more, many speciality physicians are forming incorporated "groups", where all same specialty docs form a group, so all billing is set at one high fixed rate for all providers in network. No competition. Patients are charged (bilked) for what increases the provider refuses to pay. These doctor groups are basically unions for doctors. State legislators look the other way, and vote for "Right To Work" which prevents anyone else in the hospital from unionizing. Plus, many physicians make six figures a year getting Big Pharma kickbacks in extra income by dispensing the latest "it" Rx, to patients who may not even need it. Also, the McCarren-Ferguson Act EXEMPTS insurance carriers from all U.S. anti-trust laws, so even though the ACA says they must spend at least 80% of premium dollars on healthcare costs, they are basically free to raise your premiums as high as they like, and fix prices with competitors (who are not really competitors at all, since they're in on the price fixing). To counter the 80% payment clause, insurance carriers are price gouging middle class families; and they actually sent out cancellation letters and premium hike letters, blaming their increase on "Obamacare" (ACA), which they all eagerly signed off on. Since most americans don't vote, my only hope is to watch the Vermont healthcare exchange GREEN MOUNTAINEER, set to open in 2017. GREEN MOUNTAINCARE will be a wholly single payer system. It will be america's only Canadian style healthcare system. The doctor's groups (unions) will be offered a take it or leave it payment structure. Some doc's will try to make the sick patient's pay the difference, but Vermont may try and put a stop to that as well. So until that happens in 2017, we'll just have to watch the Republicans and the Robert's Supreme Court, to see how much they gut ACA, while continuing to allow unregulated price hikes. Given a choice between your families health and untold riches, most U.S. physicians will sadly choose the latter. It's just human nature. Vote for publicly funded elections, to stop medical price fixing.

Unfortunately- the accreditation companies require that you have a form that should be filled out commenting on the services provided. in the medical equipment supplier field it is annonomous. This form is supposed to be completed by all people who are taken care of, reviewed by the supervisor each month to see what the responses are to try to be able to provide better service. This information is supposed to be documented as well. When there is an audit- this information is supposed to be available to show that the company is following policies that the accreditation company feels should be followed.

as a student almost done with her degree in Health information technology (billing and coding) there is no law broken for stating disatisfaction. Now you can't yell at your doctor but you can ask to be transferred to a different one in the practice, or ask for a different resolution or second opinion. But as I have stated in my posts in other articles even that may have consequences (as I just got dismissed from our family pediatricians practice for wanting to practice) we moved and the doctor ticked me off. He was pushing price juice and vitamins on us and he failed to diagnose my oldest daughters scalp/skin issues (which they now deny) I'd report them but after being dismissed I'm afraid of what else the doctor could do to us (maybe ban us from other practices I don't know) So I paid for an angies list membership, so I could read real reviews, and this time pick a better doctor. And in the practices defense (which I also wont name) the other doctors were great, it was just this one doctor, who got mad cause I complained on him to the receptionist who asked me for my honest info (which I will never give again) and after that the whole practice turned against me. People who were once nice to me are now Ice cold. So although i do agree in non anonymous reporting, I do want you all to keep in mind as I just now learned that some doctors can be malicous and ban you from an entire practice (or who knows maybe beyond) So i would only complain if you were totally leaving the ENTIRE practice. if you plan to stay with another doctor within the same practice i'd just keep it under your hat. it should not be that way but unfortunately it is.

Anyone who is naive enough to think that all doctors are equal in their skill level, is deluding themself. There are some who graduate at the top of their class, some in the middle, and some at the bottom. Yet we, their patients, are not privy to that information and so we must trust, blindly, that the doctor who we choose to see is good. Everyone knows that a doctor can lose his/her license in one state and set up practice in another. In the state of FL, a doctor can be in rehab for drug addiction/substance abuse, and is not required to disclose that information to his patients. Doctors would be doing a great service to their patients if they were as interested in protecting their patients from inept doctors as they are in protecting their own.

I had personal knowledge of a doctor who had his admitting privileges suspended, had one of the highest readmit and infection rates and when I went to check on him there is no reference attached to his license and I could find no negative information. I was satisfied with the doctor I had but the other doctor was a member of that practice and I didn't want to chance having him sub for my doctor in an emergency. I was lucky I knew this information but how many other patients were not aware until it was too late?

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