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Health insurance and threats to free speech

We used to be deferent. Put us in a room with professionals or business leaders, and we were properly respectful, bowing and scraping for any crumbs falling from their buffet tables. It was socially acceptable to complain about the plumber. This was a working man and his reputation meant nothing. There were teams of high-powered attorneys lining up to threaten defamation actions if you were to suggest one of their high-status clients was anything less than perfect. Then along came the internet and, suddenly, there was an outpouring of complaints about everyone, regardless of their status. Although most people reserve their anger for the more popular services and products, an increasing number have been prepared to suggest equally poor standards from those offering more exclusive services. This has induced some degree of paranoia from the medical and dental professions and, with the help of attorneys, they have been working on a number of legal strategies to defend their interests. However, before we get to that, there has been some interesting research published by Tufts University School of Medicine in the Journal of General Internal Medicine.

The research examined thirty-three sites carrying reviews of doctors and dentists working in the Boston area. It found almost 90% of the reviews were positive. Where there were complaints, they tended to be about the administrative side of the practice, e.g. there were long waiting times, it was difficult to park nearby, and so on. Many doctors have been complaining they cannot respond to complaints because of doctor/patient confidentiality. Obviously, this privacy concern does not affect the complaints about matters outside the professional relationship. In short, there was little for the Boston medical establishment to worry about. Although this is limited to one area of the country, it may suggest the professional concerns are unrealistic, i.e. they want to go back one-hundred years to the time when no one criticized their betters.

The legal battles are now growing more public on free speech issues. Some doctors and dentists have been insisting their patients sign agreements banning the publication of any comments about their treatment on electronic media. The intention is to gag everyone whether online or using one of the many different electronic messaging systems. No action is available against the ISPs or the sites that host the comments. They have legal protection and, for the most part, they ignore take-down notices issued by doctors and dentists. So attorneys have been threatening individuals with actions for defamation and breach of contract where they have signed confidentiality agreements.

To reassure you, it is very doubtful any of the confidentiality agreements you have been asked to sign are legally enforceable. Nevertheless, unless you have specialized legal advice when the threats arrive, it can be highly stressful. The intention, of course, is to deter as many people as possible from posting any reviews of doctors and dentists. In this, health insurance providers could play a useful role. Indeed, they could be directly involved in disputes if network doctors and dentists refuse treatment unless their patients sign non-disclosure agreements. The whole point of health insurance plans is to provide easy access to effective treatment. If doctors and dentists begin to lay down unreasonable conditions, this defeats the purpose of the insurance.


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