REPOSTED FROM: INDYSTAR.COM

Wary of critical Internet reviews on ratings services such as Indianapolis-based Angie's List, some doctors are fighting back by forcing patients to sign agreements that they won't criticize them online.

In some cases, if patients don't sign the document -- which critics say is effectively a gag order -- the physician could turn them away.

Some ratings services say the move is an attempt to stifle free speech. But the doctors say it's necessary to protect their reputations and practices.

"Consumers and patients are hungry for good information" about doctors, but Internet reviews provide just the opposite, contends Dr. Jeffrey Segal, a North Carolina neurosurgeon who has made a business of helping doctors monitor and prevent online criticism.

Some sites "are little more than tabloid journalism without much interest in constructively improving practices," and their sniping comments can unfairly ruin a doctor's reputation, he said.

Ratings services such as Angie's List and Zagat allow people who have used a business to comment on the service. Such companies have expanded beyond restaurants and plumbers to include medical care.

Angie Hicks, founder of Angie's List, said that although only a small number of doctors have started using the waivers, no one should be forced to sign one.

"No one should be giving up or be required to give up their freedom of speech before receiving medical care," she said during an interview with a Flint, Mich., TV station.

The company receives about 10,000 reports a month in health-care categories.

Hicks advises people to read before signing documents in a doctor's office.

"Our goal is to educate patients on this potential practice and hopefully prevent it from continuing," she said.

Segal said critical postings often say nothing about what should really matter to patients -- a doctor's medical skills -- and privacy laws and medical ethics prevent doctors from fighting back.

Here's a real, anonymous comment about a doctor from RateMDs.com:

"Very unhelpful, arrogant, did not listen and cut me off, seemed much too happy to have power (and abuse it!) over suffering people."

Segal's company, Medical Justice, advises doctors to have all patients sign the agreements. If a new patient refuses, the doctor might suggest finding another doctor. Segal said he knows of no cases in which longtime patients have been turned away for not signing the waivers.

Doctors are notified when a negative rating appears on a Web site, and, if the author's name is known, physicians can use the signed waivers to get the sites to remove offending opinions.

RateMd's postings are anonymous, and the site's operators say they do not know their users' identities. The operators also won't remove negative comments.

Angie's List's operators know the identities of users and warn them when they register that the site will share names with doctors if asked.

Since Segal's company began offering its service two years ago, nearly 2,000 doctors have signed up.

Segal said the waivers are aimed more at giving doctors ammunition against Web sites than against patients. Still, the company's suggested wording warns that breaching the agreement could result in legal action against patients.