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Doctors To Patients: First, Do No Yelp Harm 581

theodp writes "When he walked into the dentist's office, Ars Technica's Timothy B. Lee was looking for cleaner teeth, but was shown the door after expressing outrage at being asked to first sign a 'mutual privacy agreement' calling for him to transfer ownership of any public commentary he might write in the future about his experience to the good doctor. Lee reports that similar censorious copyright agreements are popping up in doctors' offices across the country. 'Doctors and dentists are understandably worried about damage to their reputations from negative reviews,' writes Lee, but 'censoring patients is the wrong way for doctors to deal with online criticism.'"
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Doctors To Patients: First, Do No Yelp Harm

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  • Streisand Effect (Score:5, Insightful)

    by Hatta ( 162192 ) on Wednesday May 25, 2011 @01:25PM (#36241064) Journal

    Have these dentists never heard of the Streisand Effect? If anyone asked me to sign one of these I'd go right on Yelp and report it. Then everyone would know the professional in question has something to hide.

    • Re:Streisand Effect (Score:4, Interesting)

      by Mordok-DestroyerOfWo ( 1000167 ) on Wednesday May 25, 2011 @01:31PM (#36241130)
      I was under the impression that a contract cannot take away rights guaranteed by the constitution. Am I wrong?
      • by LunaticTippy ( 872397 ) on Wednesday May 25, 2011 @01:34PM (#36241186)
        Many contracts are not legally binding. Many legal contracts contain unenforceable clauses. Lots of them are done intentionally, not for legal reasons but to bully the signer.
        • Re:Streisand Effect (Score:5, Interesting)

          by guspasho ( 941623 ) on Wednesday May 25, 2011 @01:57PM (#36241512)

          You mean like the supposedly unconscionable forced arbitration clauses? The ones that the Supreme Court just ruled are valid?

          When everyone requires that you sign all your rights away as a matter of course, what rights do we have left? To to live in the woods somewhere and never interact with another human being.

          • by Amouth ( 879122 )

            To to live in the woods somewhere and never interact with another human being.

            If only i could do that - they don't let you do it in the national forests (public land) and if you have private land they come around looking for taxs

        • by coats ( 1068 ) on Wednesday May 25, 2011 @04:07PM (#36243218) Homepage

          Many contracts are not legally binding.

          IANAL, but...

          Two good examples: real estate transfers and copyright transfers, both of which require specific written language.

          The dentist's contract is inconsistent with the copyright law's requirements for copyright transfer (and hence is null and void, as a matter of law).

          It is extortion for the doctor or dentist to use his position of authority so to attempt to coerce the patient in a manner contrary to law.

      • Re:Streisand Effect (Score:4, Informative)

        by ElectricTurtle ( 1171201 ) on Wednesday May 25, 2011 @01:34PM (#36241190)
        Then no NDA would ever work. You can contractually waive certain rights within limits defined therein. It's not so much 'taking away' as 'voluntarily waiving'. Duress itself invalidates a contract. IANAL etc.
        • Excellent point. I wasn't trying to be snarky, just legitimately curious about the law.
        • NDAs are a little different, at least in my mind. An NDA only gags free speech in so much as it can cause direct harm to a company. If I develop some super secret process that allowed me to turn rainbows into gold, and in the process of me contracting you to help with a part of it, you blabbed to the world how it's done, that would cause me direct financial harm.

          It's my understanding that you cannot order someone under an NDA (at least, it's not enforceable) to not talk about things that either 1) would b

        • Duress? (Score:5, Interesting)

          by RingDev ( 879105 ) on Wednesday May 25, 2011 @02:38PM (#36242084) Homepage Journal

          I would be curious if the threat of withholding health services could be considered duress.


      • Re:Streisand Effect (Score:5, Informative)

        by mr1911 ( 1942298 ) on Wednesday May 25, 2011 @01:36PM (#36241224)
        The Constitution says the government cannot infringe on your right to free speech. You can certainly enter into a contract to limit your speech. That is exactly what Non Disclosure Agreements are.
        • But if the government enforces a contract that limits your right to free speech they are violating the constitution.
          • by mr1911 ( 1942298 )
            Not even close to being correct.

            The government is not doing anything to impact your right to free speech. You do that yourself by signing the contract.

            The government is not going to enforce this by sending soldiers to break your fingers if you type a bad review on The contract is a civil matter, and you will be sued in civil court. There is no government infringement of your rights anywhere in the vicinity of this concept.
      • by bws111 ( 1216812 ) on Wednesday May 25, 2011 @01:51PM (#36241430)

        A contract can not make you do something illegal. There is nothing illegal about saying 'I won't talk about you.'

        More importantly, the Constitution says only what the government may, may not, and must do. It says nothing about what individuals may, may not, or must do. You have no 'constitutional rights' when dealing with another non-governmental entity.

      • The Constitution guarantees that the government cannot abridge your freedom of speech, it says nothing about voluntarily giving it up in a private contract.

        • Re: (Score:2, Interesting)

          by _0xd0ad ( 1974778 )

          Then they're welcome to put it in their contract, as long as the contract can be enforced by them and not by the government.

        • Copyright arises entirely out of government dictate, and not from private contract. Private contracts about things that exist only by virtue of statute are suspect at best.

          You do know that copyright originated as a scheme of censorship, don't you? Being put to it's original purpose is not altogether surprising, but contrary to freedom.

    • Re:Streisand Effect (Score:4, Interesting)

      by elrous0 ( 869638 ) * on Wednesday May 25, 2011 @01:45PM (#36241342)

      More than the Streisand Effect there. Not only does this make you look awful to POTENTIAL customers, it makes you look even worse to EXISTING customers, who you're asking to sign the form. If you walked into a restaurant and were met at the door by an employee asking you to sign a waiver indemnifying them in case of food poisoning, would you stay and eat, or run like hell (and NEVER come back)?

  • by gestalt_n_pepper ( 991155 ) on Wednesday May 25, 2011 @01:30PM (#36241108)

    You should probably find another doctor or dentist.

    • by jandrese ( 485 )
      That's my thought too. Why would they need such a document unless their service is crap? If someone is maliciously writing bad reviews, chances are they don't even go to that doctor or dentist in the first place.
      • Because many customers/patients blame the vendor/doctor when the product or service is fine the the customer/patient is an idiot.

      • by h4rr4r ( 612664 )

        Just wait until the ER wants you to sign this while you are bleeding from a headwound or some other serious injury.

  • by LunaticTippy ( 872397 ) on Wednesday May 25, 2011 @01:30PM (#36241110)
    If I get bad enough service anywhere, I will post a review somewhere. Mostly products and restaurants, but I've done it for a doctor that gave me an appointment 3 months out and then was hours late.

    I almost never do this with my real name. It can be my pseudonymous yelp, google, etc. account. No doctor would be able to know that some nick is my real name. Unless they want to get a subpoena for every negative review (actually I can see some asshole doctors doing this) there is no way to enforce this policy.
    • Man, I hate when doctors don't blow off emergencies to be on time to appointments made three months ago.

      • by h4rr4r ( 612664 )

        A golf game is not an emergency.

        If you cannot make your appointments have your secretary call the people who will be impacted and reschedule. If you want to charge $40 for a missed visit, I should be able to charge my hourly short term contractor rate for time I wait beyond a reasonable 5-15 minutes.

      • I'd be more sympathetic if it wasn't a pattern. I spoke to other patients in the waiting area, and some of them were regulars. They lamented the wait, and said that it was always bad. First appointment slot of the day was often late because the office would schedule 10 of them.

        There are lots of doctors that don't habitually overbook their schedule. Smart ones actually leave gaps for urgent matters, or to recover their schedule after an unexpectedly long appointment.

        I don't care if they have loans or whatn
      • by spun ( 1352 )

        Man, I hate it when doctors charge ME a fifty dollar cancellation fee if I'm ten minutes late, but they feel free to schedule patients at ten minutes a pop when they KNOW it is going to take longer. It's not emergencies that make a doctor late, it is greed and a complete lack of respect for their patients' time.

    • But, if you're going to be posting a review it ought to be under your real name. It's the only way for their to be any accountability. This isn't like a restaurant where you can be pretty sure about what is and is not the fault of the restauranteur, with medicine it's tricky and doctors can end up being negatively rated for things which they have no control over.

      • There is no way I am putting my medical care on the interwebs under my real name.

        Besides, the doctors made their bed. They fought having meaningful rankings made public. They fought having outcomes measured. They don't deserve sympathy for people trying to review them despite their constant opposition.
    • by SethJohnson ( 112166 ) on Wednesday May 25, 2011 @01:58PM (#36241528) Homepage Journal

      I almost never do this with my real name. It can be my pseudonymous yelp, google, etc. account. No doctor would be able to know that some nick is my real name.

      See, that's what I was thinking. Then I re-read the description of the agreement. The patient is turning over all copyrights to future reviews to the doctor. If the doctor has one of these documents signed by EVERY patient, then he can petition the review site (Yelp) to remove negative reviews because he would claim to have copyright ownership of those reviews purportedly written by patients with anonymous names.

      People posting in this thread about signing away right to free speech, etc. have only skimmed the summary without understanding this is assigning copyright ownership of future reviews to the doctor. There is no surrender of free speech. It's saying the doctor owns the content the patient may produce as a result of the service. It's the same as a journalist working at a newspaper. The newspaper owns the copyright to all articles created by its staff. Sure, it's backassward and a powergrab on the part of whatever doctor is trying to use this to suppress negative ratings.

      Should it ever go to court, it would be unlikely to hold up, but I doub't an outfit like Yelp would resist a formal letter with some attached photocopies of some signed legal-sounding agreements. They'd probably yank the criticism from the site and then offer to sell some ads to the doctor in the same conversation.

      Don't forget, Yelp isn't selling anything to the users. Yelp's customer is the doctor.


      • Should it ever go to court, it would be unlikely to hold up, but I doub't an outfit like Yelp would resist a formal letter with some attached photocopies of some signed legal-sounding agreements. They'd probably yank the criticism from the site and then offer to sell some ads to the doctor in the same conversation. Don't forget, Yelp isn't selling anything to the users. Yelp's customer is the doctor.

        RTFA. Yelp says that they have never taken down a negative review at a doctor's request, and they don't intend to.

        Yelp told us that they "have never elected to remove a review in response this type of takedown request."

        Yelp shares Seltzer's assessment, telling Ars that "there are any number of reasons to believe the agreements don't hold water as a legal matter." Yelp spokeswoman Stephanie Ichinose signaled a readiness to fight these agreements, which she says "put the needs of doctors ahead of a patient

      • he would claim to have copyright ownership of those reviews

        I don't think you can copyright a review. I could easily write a program to generate every possible 100-word review (for instance), store them in a closet, and claim copyright over every single 100-word review in the world.
      • Astute point, Seth. The doctor isn't shutting up his patients, he's just making a copyright grab for whatever reviews they write.

        If I were a patient who had a bad experience with such a doctor, I'd write plenty of bad reviews. I'd write a couple thousand words of bad review every day, and post them to multiple sites all over the internet. I'd write a robot to re-post them every few days. Sure, the doctor owns them all and he can spend as much time as he wants chasing them down and having them removed.

      • First it is completely different from a newspaper/reporter relationship (not just backassward). In the first case the reporter is creating a "work for hire" which is a well established principle. In the Doctors/patient case the patient is paying the doctor so "work for hire" does not apply.

        There is also a huge loophole in the contract. A patient goes to a doctor and has an issue. The patient verbally tells a friend about the issue. The friend posts a review. There is no stipulation about verbal communicatio

  • This type of thing should be illegal. First thing wrong is it hampers someones right to free speech. Second, a man should be subject to his actions. If he does something wrong, the public (future patients) have a right to know about it.

    Granted, you have idiots and troublemakers who post unwarranted bad things, but they too should be subject to their actions.

    • by mr1911 ( 1942298 )

      This type of thing should be illegal.

      Why? it is a voluntary contact. Yes, it is stupid. That just means you need to find a new doctor.

      First thing wrong is it hampers someones right to free speech.

      No, it doesn't. Again, a voluntary contract. Your speech is only limited if you sign the contract - just like a Non Disclosure Agreement.

    • by sohmc ( 595388 )

      Just to clarify:

      The Constitution protects you from the government, not to a private entity. If you sign a contract, then you agree to it.

      The best way for a doctor or dentist to prevent bad exposure is to make clear that they want to fix anything if you have a bad experience. Always give the merchant a chance to turn things around. If they still fail, then they deserve the bad review.

    • Why would it be illegal? Just find a different doctor/dentist if you don't want to sign it. If enough people do that then they will think twice about requiring it.

      And many things hamper a persons right to free speech. Everything from NDAs to sexually harassing comments. And unless Congress is your doctor then the 1st Amendment doesn't play here.

  • by Anonymous Coward

    The office complained that the main reason to ask people to sign these was that non-patients were fraudulently posting lies and negative information on message boards. When Timothy asked how this NDA would even apply to non-patients, they shut up and couldn't answer him.

  • by eepok ( 545733 ) on Wednesday May 25, 2011 @01:38PM (#36241246) Homepage

    While I don't agree with such contracts, I really can understand why doctors would want to use them.

    Back in the day (5-10 years ago), most doctor reviews were tempered by face-to-face interaction. "Hey Bill, how's your dentist?" -- "He's alright. Just ask to get gassed and all dentists are good, am I right?"

    But come the internet with pseudonymity (or at least obscurity), people have deemed themselves connoisseurs of consumption-- veritable professional critics of the utterly mundane.

    Yelp houses an asinine number of these people who will judge an entire business (small, large, chain, etc.) on single experiences. Their words will be filled with praise or disdain. Hate or Love. They photograph EVERYTHING, photograph and compare perfect omelets, critique the crispness of lettuce in salads, comfort of chairs in waiting rooms, and even banter of workers.

    They scrutinize everything mundane because the quality of service and products are so similar, there's NOTHING TO TALK ABOUT otherwise. They polarize their opinions with "Avoid this place!!!" and "YOU MUST TRY THIS PLACE OUT!" and given the following on sites like Yelp, it actually affects business.

    And it's not as though histories of reviews can be wiped. I know of one small bike shop that was, understandably, railed for its elitist attitudes towards budget bikes. When new management came in (bike hippy instead of Lycra-rider), the Bike Shop itself changed, but it still had to fight 3 years of bad reviews on Yelp.

    I really don't blame doctors for attempting this route. There are better ways to go about it, though.

    • by h4rr4r ( 612664 )

      That bike shop should have changed its name. That is what one should always do if such a massive change is made.

      If I am going to a restaurant I want to know if they serve soggy lettuce. Doctors often charge if I am late but make me wait hours so the damn chairs better be comfortable, and hell yes if I am paying the workers can try to pretend to be working.

    • by spun ( 1352 ) <> on Wednesday May 25, 2011 @02:01PM (#36241584) Journal

      Don't you hate it when inferior people get all uppity and attempt to judge their betters? They should just mindlessly consume what they are told to and spare us their worthless, inferior opinions.

  • by Valacosa ( 863657 ) on Wednesday May 25, 2011 @01:39PM (#36241252)

    What are they thinking? The doctors aren't thinking outside the box enough. Really, instead of getting people to sign old-fashioned contracts, they should emulate the EULA. You know, by putting up a plaque in their office which says something like this:

    By entering this building, you agree to transfer to this establishment copyright on all creative works you own including but not limited to written works, drawings, photographs, spoken-word works, in perpetuity.


  • by jellomizer ( 103300 ) on Wednesday May 25, 2011 @01:43PM (#36241300)

    Part of the problem is when ever someone is unhappy it is now much too easy to rant about your disapproval. However positive messages are harder to come by. For many these angry rants are not about facts but emotions of the time, and often a misunderstanding of the service they will receive.
    A minor lapse in bedside manner, or just telling the patient something they didn't want to hear could effect their credentials.

  • From TFA: Dr. Ken Cirka

  • So, I run into the dentist's office with a horrendous toothache, tears in my eyes and pain in my expression - and get handed this to sign. Do the legal beagles out there think this is a fair contract signed in good faith?

    I'm betting that a case can be made that this at least some such signatures were obtained under duress and therefore not valid.

  • I do think that it is tough to give definitive bad reviews on diagnoses and outcomes of treatments due to the complexity of our bodies. However, I think it is completely fair to give reviews based on the experiences with the staff and office itself. If you wait an hour after your appointment was scheduled, if the nurse or doctor was rude, or if the office was not in a clean condition, I want to be able to read those reviews.
  • Used to be- "Hey doc/dentist, [whatever you did] didn't help. And you were kind of snarky about it." Ya know, human communication and all that fancy word talking?

    Now- "My tooth still hurts, so I'm going to post bad reviews instead of going back and asking it to be fixed. Or get it fixed, and still say bad stuff."
    Someone above said they never use their real name in bad reviews. And probably would be the first person to complain about (at least semi-) anonymous reviews about their service.

    There are bad do

  • I have an excellent family doctor now. I and others sing his praises online - with the caveat that because he is so popular, getting an appointment is impossible. Same goest for my current dentist. I love her to bits. I dread ever moving and having to find other doctors and dentists. Neither of them have any such sign or agreement - because they don't need it!
  • by Missing.Matter ( 1845576 ) on Wednesday May 25, 2011 @02:03PM (#36241612)

    I kind of understand where these Dentists are coming from. I used to work at a pool construction company that was heavily impacted by unwarranted negative reviews online.

    Pool owners are the worst; they're usually well off, used to getting their way, and generally don't understand how construction time tables work. They usually start thinking of a pool in March, or April, and want it done and open for Memorial Day or the 4th of July. They usually don't understand we have more than one customer who all also want their pool done on the same timeframe. Further, they don't understand we can't work in bad weather, which means time tables tend to slip in the rainy season.

    So inevitably, people get delayed and it's the end of the world for them because they won't have their pool open for their all important Memorial Day BBQ. So they fly online and rant and rave about how awful our business is, because they couldn't read their contract. And of course, if you type our name into Google, the first three results that come up are from or a similar site.

    What's worse is these stay online forever. We've made most all of our customers happy in the end, and they've told us they would take down or redact the negative reviews, but even they can't. So because they flew off the handle despite our goodwill efforts, we're the ones that have to suffer.

    So, while I feel like the Doctor's approach isn't the most tactful, I understand where he's coming form.

    • by Garwulf ( 708651 )

      I'm sorry, but I can't really side with the pool company here, and I'm a small business owner.

      In the initial negotiations, it is up to the contractor to set reasonable expectations and timeframes. If there's a good possibility that the pool won't be ready when the customer wants it, this must be made clear up-front.

      If you have told your customer that you can have the pool installed by July 4th and you do not deliver on that, it is your fault. If you have over-extended yourself by taking on too many contra

  • by Invicta{HOG} ( 38763 ) on Wednesday May 25, 2011 @02:14PM (#36241774)

    This is obviously stupid and censorship. But it does suck to have internet feedback as a doctor. When I search for my name on the internet, the first ten hits on google are a doctor ranking site and various copycats that mirror it. I have only one rating - my name shows up with one out of five stars and an angry tirade by a patient with psychiatric problems who became angry with one of our nurses before I even walked in the room. She accuses me of racism (and we are both white!), ignorance, etc. when I actually was quite accommodating to her quite angry demands. And due to health care laws in the US I cannot say anything in my defense.

    So, basically it sucks to have your name plastered all over google as a racist without having the ability to mount a defense. But censorship is not the way to go. I think the medical profession just has to grin and bear it. Or start astro-turfing...

  • by Above ( 100351 ) on Wednesday May 25, 2011 @02:30PM (#36241982)

    I love to talk with the managers/owners of restaurants, and have reviewed plenty on Yelp and Urbanspoon. Of course they are always very concerned about their bad reviews, and looking for ways to make the bad reviews go away. My advice to them is always the same. Leave those people alone, they are already unhappy. Rather, get your happy customers to leave good reviews and drown them out.

    I've encouraged several businesses to pay the $5 for a Yelp or Urbanspoon sticker to put on their door. To claim their owner pages, and use them to post specials and send updates to regulators. To drop a reward on their "duke" on Yelp. You know what? In 2-3 months they easily amass tens or hundreds of positive reviews. Now the situation is 150 good reviews to the one bad one they were worried about, and their reputation is just fine.

    The only reason these are such a big deal for most businesses is that people who feel they have been wronged are more likely to speak up. If you have only one review and it's bad, well, you look like a bad business. You will never satisfy 100% of your customers, so just get the 99% that you do to drown them out.

    Easy, cheap, and builds loyalty with your regulars. Plus, you now have great reviews, so when people visit the area or move there and have nothing to go on but the reviews you'll be one of the first they try.

    Use the technology, don't fight it.

  • by dbarron3 ( 1659841 ) on Wednesday May 25, 2011 @02:47PM (#36242208)
    I did RTFA. (yesterday, actually). A better subtitle might have been: "Scummy legal group duping doctors to request legally-unenforceable waivers from patients. Don't get caught in the loop." Doctors (or their business managers) need to be educated about why these waivers are unnecessary, unenforcable, and just bad business. Patients need to be informed and willing to fight back so this type of legal chicanery dies a quick death.
  • +5, fuck yelp. (Score:4, Insightful)

    by t0qer ( 230538 ) on Wednesday May 25, 2011 @05:15PM (#36244050) Homepage Journal

    Doctors should be worried, because yelp can be gamed, and they'll let the gaming happen if it's in their best interest... An anecdotal story.

    I've work in a karaoke bar the last 10 years. This is before American Idol made it go crazy popular. FF>> to a few years ago...

    There was a local karaoke company (this is multiple individuals, not one guy in a bar like me) who were tired of all the good press, yelp reviews, and awards our place has gotten over the years. They'd play favourites with karaoke singers to gain favour with them, then have them write negative reviews about our place (without even having set foot ONCE in there)

    Around the same time yelp starts calling, "We can sort those bad reviews to the bottom of the list for $400@mo" I'd be on the phone with these jackasses for hours, saying these reviews were bogus, and how dare you try and extort money from us...

    Few days later, bad review start floating to the top. The little "soundbites" (don't know what else to call them, the little highlighted bits of reviews at the top) started being nothing but negative.

    I got tired of it. Being the old school dickhead BOFH that I am, I started dropping dox weekly on our website of yelp employees one by one(upper level management mostly, was leading up to stoppleman). Sure, I'd get threats, but I'd just give them the same bullshit answer they gave me, "Hey, it's publicly available info man, just like you guys told me!"

    One day the owner's son (of where I work) came down to talk to me. He said, "Dude, I know these guys, they got a lawyer full time on staff, they just gotta drop this off on their desk and say "attack". Please, take down the docs.

    So I did. And magically these dickheads reviews got sorted, or deleted.

    Moral of the story is, yelp is fucking corrupt. If your competitor wants to slander you on yelp, you have 0 recourse without full legal action. Fuck you yelp, go suck a dick. (and yes I probably typed something similar before)

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