[WORDPRESS HASHCASH] The comment’s actual post text did not contain your blog url (http://www.seefirstblog.com/2009/06/08/mutual-assured-destruction-not-the-answer-to-med-mal-crisis) and so is spam.

I had a wonderful business utterly destroyed by a malicious antagonist, not to mention relationships, my career, finances, and the livelihood of other people that depended on the success of my business. Thankfully I was able to turn adversity into opportunity in that the business I have subsequently launched specializes in mitigating and remedying the destruction caused by this 21st Century pandemic. In effect, any efforts made by my antagonist to smear me becomes “exhibit A” for why I do what I do. My antagonist was jailed in May 2009, if a prison sentence follows things should get a lot quieter.

Physicians and all professionals need to make sure they have a robust online presence. You need to take control of Google search results for your name and the name of your practice. The worst thing you can do is wait for it to happen, it will take many months possibly years to bury offending material. This is compounded by the fact that the ISPs such as Google and other blog hosts have federal immunity from liability. It is a long and costly battle to redeem your name once you have been smeared.

Keep in mind also what is referred to as “The Streisand Effect” this is where the victim of libel or some other online problems caused thousands of times more attention to be drawn to it by picking a fight with the offender. As such, it is much better to “bury” the negative search engine results than to fight them.

Feel free to check out the tips I have posted on my website.

Anonymous libel is tough because you don’t know who is defaming you.

There’s nothing that stops someone – even someone who signed a form saying they wouldn’t- from anonymously posting on website that “I saw Dr. X and he made a series of racist jokes during my exam.” If it never happened, it’s defamatory, but you have no idea who said it. The best you could do is tell the website hosting it that they need to take it down on the basis that they are defaming you, too. But this has nothing to do with what you have your patients sign.

The more complicated cases are where a patient (anonymously or not) posts something defamatory about you in a way that you can tell who they are. Can you respond?

The Medical Justice people tell you on their website that privacy laws say you can’t, so you need these agreements to to protect yourself. But it’s not true. If the patient voluntarily reveals their information publicly, you can respond, as long as what you say doesn’t reveal any new information.

To take a simple example, imagine a patient visits a doctor and then goes to a website and says “I saw Dr. X for surgery on my elbow, which I broke while rushing to a meeting. I noticed that he had a diploma on his wall from Harvard, but when I asked him if he went to Harvard he said he had not. Look out for Dr. X, he lies about his credentials and wants you to think he went to Harvard!”

You would be within your rights to say “Hi, I’m Dr. X. I remember meeting you and having the conversation about my credentials. As I told you at the time, that diploma is from the colleague with whom I practice, it isn’t mine. I am a proud graduate of Yale and would never want anyone to think I went to Harvard.”

While it may be unpleasant to have to deal with this kind of public commentary, in the internet era there is no avoiding it. No agreement is going to put that genie back in the bottle.

And so this is why I think these agreements are misguided. They can have little or no impact on the extent to which people will post lies on the internet, but create a whole new layer of formality and legality into what ought to be a personal relationship.

More broadly, Carol, I agree completely with your point that the bond between patient and doctor ought not be one sided. Legal agreements won’t get us there. We need more voices like yours making the point about the importance of the doctor and patient relationship. Keep the lawyers out of the exam room (well, unless they’re patients!).