Written by Daniel Simmons with additional reporting by Paul Pogue and Mason King
Produced by Jeremy Stacy 

Voice-over:
Angie’s List member Dawn Christopher went to two doctors in Chattanooga, Tenn., to treat the same problem. She says the first essentially dismissed her concerns. The second correctly diagnosed her problem and prescribed treatment. Christopher strongly believes others should know about her experiences, which is why she’s a member of Angie’s List.

Dawn Christopher:
“I would like to go some place and say that she didn’t spend enough time with me and didn’t know what she was doing, so if you have this type of thing wrong with you, you may want to go [someplace else].”

Voice-over:
But some health-care providers say that online ratings are easily abused and can harm good professionals, too. Arizona chiropractor Brian Billings doesn’t believe in restricting patients’ right to comment. But he feels the current ratings sites need work.

Brian S. Billings:
“I feel there’s almost more harm than good available in the online review system ... As a consumer their expectations are often something other than what we really do.”

Voice-over:
Some doctors are fighting back with so-called patient “gag orders.” They’re one-page contracts – just a part of the stack of paperwork patients sign before care begins. And they forbid patients from commenting online about the doctors.  And if they do comment online? Doctors may sue for damages.

Dr. Larry Schlesinger:
“Jeff has very cleverly thought of a way to allow the doctor to protect his reputation.”

Voice-over:
That’s Hawaii plastic surgeon Dr. Larry Schlesinger, one of an estimated 1,000 doctors nationally who use the contracts. “Jeff” is neurosurgeon Dr. Jeffrey Segal. Segal started a North Carolina company, Medical Justice, in 2001, and remains its chief executive officer. The company created the gag-order contracts in 2007 and makes them available to its members.
 
The contracts have prompted a blast of criticism. Lawyers call them legally dubious. Patient advocates call them offensive. When responding to a poll, only 3 percent of Angie’s List members say they support the contracts.

Even some health-care professionals, whom the contracts are supposed to help, find them off-base. Indianapolis area dentist Dr. David Kristoff says he’d think twice about going to any health care provider who uses the contract.

Dr. David Kristoff:
“The fact that they are putting a gag order on me about the outcome of what is going to happen from this procedure, that kind of makes me a little suspicious.”

Voice-over:
Member Fred Dias of Burlingame, Calif. is a retired dentist. He thinks the contracts strip patients of basic rights.

Fred Dias:
“I believe in freedom of speech, you know. That’s ridiculous that you can’t say this and you can’t say that, I think sometimes it gets a little much. I think that if a patient gets good treatment, they should be allowed to say so, and if they get lousy treatment they should be able to say so.”

Voice-over:
In an AngiesList.com poll, just 15 percent of health-care professionals say they support the contracts. Three-quarters say they wouldn’t consider using them in their practice. However, many expressed strong reservations about online ratings sites, especially ones that allow anonymous postings. Dr. Nick Slenkovich, a plastic surgeon in the Denver area who uses the contracts, explains.

Dr. Nick Slenkovich:
“I am not aware of any site that does anything near the level of diligence that Angie’s List does, in terms of verifying people that are posting, scrutinizing the reports and then offering them to the people who are being reported upon.”

Voice-over:
Patient privacy laws restrict health-care providers’ responses to online ratings, and some say that causes a one-sided picture online. Billings again.

Brian S. Billings:
“There is always the opportunity for somebody to go and post false reviews or be spiteful or vengeful. My concern is that the physician doesn’t get to post the [rebuttal] that the patient didn’t follow through with care, or that he arrived 30 minutes late and was a real jerk to my staff. We’re held to a different standard there.”

Voice-over:
And while most doctors say the contracts aren’t perfect, either, some use them anyway. Dr. Larry Schlesinger again.

Dr. Larry Schlesinger:
“This may not be a perfect solution, but at least it’s a solution. It deals with things when you are supposed to – a priori. Every time I present it to a patient, I say, ‘You wouldn’t put up a nasty blog about me, would you?’ And they say, ‘No, I’d never do that.’ And I say, ‘OK sign here.’ That’s the end of it.”

Voice-over:
Meanwhile, national news reports about patient “gag orders” in January and February had an unexpected effect: more people posted online comments about health-care providers. On Angieslist.com, monthly health care reports jumped 50 percent between January and March. If patients are scared, they’re not showing it.

To learn more about patient “gag-orders,” read Angie’s List Magazine’s special report, “Medical Muzzle,” at magazine.angieslist.com.