You may have seen Medical Justice in the news lately: NYT (2/17/09), FOX News (2/19/09). Although Medical Justice Founder and neurosurgeon Dr Jeff Segal has highlighted the issues from a physicians point of view, some have criticized our program as a “gag order.” This could not be farther from the truth.

Medical Justice: Our organization is focused on serious proposals for reforming the entire healthcare system, not just for physicians, but also payers, and patients. These proposals, as well as discussions of our core offering, have been published in a number of peer-reviewed journals and presented at scientific, legal, and policy conferences.

Current solution: Mutual privacy agreements are designed to address the emergence of now over 40 generally anonymous physician rating sites. “Mutual privacy” means that patients are granted additional privacy protections by the doctor above and beyond those mandated by law.

Problem 1: On rating sites, patients, or people posing as patients- such as disgruntled employees, ex-spouses, or competitors can damage a hard-earned reputation. And a doctor has no recourse. As an arcane nuance of cyberlaw, the web sites are immune from any accountability. (Section 230 of the Communication Decency Act). These sites have generally taken the position they will not monitor or police any content.

Problem 2: In the U.S., the antidote to offensive speech is generally more speech. However, physicians are foreclosed from posting a medical record to correct any factual inconsistencies. As it should be. Both patients and doctors place a higher premium on privacy.

Not a “gag”: Patients remain entirely free to communicate about their treatment with friends, family, other health professionals, hospitals, licensing boards, attorneys, civil court, and more. There are multiple venues for communicating and/or venting, and these venues are more effective in addressing issue accountability. It is true a few patients do value a need to vent anonymously online. But most patients feel otherwise.

Ongoing Goal: We are not, in principle, against physician ratings. Patients want good information. But, facts matter. Honest – and useful – ratings will require a sophisticated understanding of outcomes research, risk stratification, etc. In other words, it’s not a simple task. In 2009, we are still struggling to compare apples to apples, like mortality and infection rates for institutions, much less individual practitioners. As healthcare consumers, we look forward to the day that we have statistical, actionable information delivered with transparency. But, the current flock of anonymous consumer rating sites fail in that mission.

Future Solution: Outcome measurement of clinicians and institutions is a reachable goal. This is what Medical Justice is working on at present. We are exploring partnering with a ratings company (such as to get ratings done right. While we may disagree with DrScore on some issues, we find common ground on others; specifically that doctors are interested in constructive feedback, and if the information is made public, it be based on statistical analysis and not just anecdote. DrScore is the one site pushing a scientifically validated survey methodology.

Our mission is to promote a transformational healthcare system where patients can make informed decisions using the Internet as one means. Patients rely on the Internet information highway for this now – potentially to their detriment. This will change…