The Medical Justice blog responds- a doctor and client should be entitled to reciprocal privacy rights. Apparently a doctor can’t controvert a patient's anonymous comment on the internet without violating doctor-patient confidentiality. Medical ethics make it impossible to confront the accusing patient.
The ethical duty of attorney-client confidentiality seems similar, except that it features the doctrine of "preemptive self-defense" which allows for the limited sharing of client confidences to dispel accusations of attorney wrongdoing in the course of representing the client. ABA Model Rule 1.6(b)(5). See also Comment 10 to Rule 1.6. However, the exception probably doesn’t allow for public (internet) disclosures. Comment 14 to ABA Model Rule 1.6. Seems like you have to convince the client to take the accusation back first.
Can the doctrine of "preemptive self-defense" can be stretched this far?
This will never fly in court, especially since the web sites are generally not complying with requests to take down negative reviews. My wife is a doc (disclaimer here) and we've looked at reviews such as those in the Portland Monthly. What most people don't realize is that the "outstanding doctors" campaign for those ratings on Portland monthly. Those don't come in from anonymous readers. My wife is asked all the time to "rate" her own providers and to recommend them for the PM survey. She demurs as she feels it is unseemly. We have good medical care, but wouldn't check Angie's List or elsewhere to find out about "customer satisfaction". If you are nice to a patient (who can be a complete a**hole) you *might* get a good review, but there is no guarantee. My wife gets commendations galore from patients but they don't pay the rent, don't lead to more money. In fact, all they do is increase the workload with no increase in compensation. Some reward for good service and patient care.
Yeah...And some doctors treat their patients like a grifter's mark. Need a new boat? Just convince this clueless patron that they need this unneeded, or risky, surgical procedure. Promise anything, deliver crap.
Of course, after the crap is delivered and the patient realizes they've been lied to and robbed, the surgeon hides behind the waiver the patient signed on the understanding of the surgeon's unmet promises.
Keep in mind that in-hospital medical mistakes are still one of the top ten morbidity sources in the US. The doctors hide behind medical associations, close ranks against consumers, and basically act as though they are not responsible for their work. Then, at places like OHSU, they get even more cavalier when the state limits the liability to which they are exposed.
I think something like this is long overdue. The consumer has waaaay imperfect knowledge entering this market and the market is stacked against the patient.
Also, if OHSU is any indication, if you have a problem, don't go to the institution's "Patient Advocate". That's a dead loss. That is the point person for the institution's Risk Management Department, and they will deny any liability or wrongdoing on the part of the hospital, clinic or their physicians and surgeons. If you want to fight it, it will require an attorney.
And...As we all know, justice is the purview of the wealthy. Poor folks can't afford an attorney. Even middle class folks can't afford an attorney to sue doctors and/or hospitals who have panels of professionals on retainer to protect them from their own mistakes.
Oh...Also, if a doctor promises you any result from therapy or treatment, tell them that you will consider it if they write down their promise and sign it in front of another person who is not a member of their staff.
No reputable doctor will "promise" you anything. That's why you need to sign an "informed consent" indicating that you understand the risks of the procedure or therapy. While the majority of cases may produce the desired result, the reality is that human variability affects outcomes. Despite all best attempts, shit happens. My wife is a living testimony to the shit happens department. A $1.3 million set of surgeries at the best medical institution in the west still had unexpected, but listed, side effects. This nearly doubled the bill as the doctors tried to get her healthy enough to finish the surgery. Aspiration pneumonia is not fun and she was in critical condition for a week. Malpractice or bad surgery - hell no. Shit happens. Yes.
If you go to a doctor expecting a perfect result without considering the risks of whatever procedure you need, you're foolish.
Charamba, Douro 2008
Horse Heaven Hills, Cabernet 2010
Lorelle, Horse Heaven Hills Pinot Grigio 2011
Avignonesi, Montepulciano 2004
Lorelle, Willamette Valley Pinot Noir 2011
Villa Antinori, Toscana 2007
Mercedes Eguren, Cabernet Sauvignon 2009
Lorelle, Columbia Valley Cabernet 2011
Purple Moon, Merlot 2011
Purple Moon, Chardonnnay 2011
Abacela, Vintner's Blend No. 12
Opula Red Blend 2010
Liberte, Pinot Noir 2010
Chateau Ste. Michelle, Indian Wells Red Blend 2010
Woodbridge, Chardonnay 2011
King Estate, Pinot Noir 2011
Famille Perrin, Cotes du Rhone Villages 2010
Columbia Crest, Les Chevaux Red 2010
14 Hands, Hot to Trot White Blend
Familia Bianchi, Malbec 2009
Terrapin Cellars, Pinot Gris 2011
Columbia Crest, Walter Clore Private Reserve 2009
Campo Viejo, Rioja, Termpranillo 2010
Ravenswood, Cabernet Sauvignon 2009
Quinta das Amoras, Vinho Tinto 2010
Waterbrook, Reserve Merlot 2009
Lorelle, Horse Heaven Hills, Pinot Grigio 2011
Tarantas, Rose
Chateau Lajarre, Bordeaux 2009
La Vielle Ferme, Rose 2011
Benvolio, Pinot Grigio 2011
Nobilo Icon, Pinot Noir 2009
Lello, Douro Tinto 2009
Quinson Fils, Cotes de Provence Rose 2011
Anindor, Pinot Gris 2010
Buenas Ondas, Syrah Rose 2010
Les Fiefs d'Anglars, Malbec 2009
14 Hands, Pinot Gris 2011
Conundrum 2012
Condes de Albarei, Albariño 2011
Columbia Crest, Walter Clore Private Reserve 2007
Penelope Sanchez, Garnacha Syrah 2010
Canoe Ridge, Merlot 2007
Atalaya do Mar, Godello 2010
Vega Montan, Mencia
Benvolio, Pinot Grigio
Nobilo Icon, Pinot Noir, Marlborough 2009
Portuga, Rose 2011
Revelation, Chardonnay, Pays d'Oc 2010
Beaulieu, Cabernet, Rutherford 2005
Monte Alto, Tinto Reserva 2005
Chateau Ste. Michelle, Cabernet, Indian Wells 2009
Espiral, Vinho Rose
Vin-Koru, Pinot Gris 2011
14 Hands, Hot to Trot Red 2009
Rodney Strong, Cabernet, Sonoma 2009
Abacela, Vintner's Blend #11
Portuga, White 2010
La Bourgeoisie, Red 2009
Januik, Red 2009
Three Rivers, River's Red 2008
Kirkland, Alexander Valley Merlot 2008
Muga, Rioja Rose 2010
Quinta das Amoras, Vinho Tinto 2009
Mauro Molino, Barbera d'Alba 2009
Garda Chiaretto Rose
Columbia Crest, Two Vines Vineyard 10 White
Chateau Ste. Michelle, Pinot Gris, Columbia Valley 2009
L'Hortus, Rose de Saignee 2010
Maculan, Pino & Toi 2008
McKinley Springs, Bombing Range Red 2008
Trader Joe's Pinot Gris 2009
Montes Alpha, Cabernet 2007
Gran Sasso, Sangiovese, Terre di Chieti 2009
Garda, Classico Chiaretto Rose
Beaulieu, Cabernet, Rutherford 1999
Picos del Montgo, Tempranillo 2008
Chateau de Montmirail, Vacqueyras 2008
La Granja 360, Syrah 2009
Montgras, Carmenere Reserva 2009
Lange, Pinot Gris 2009
Columbia Crest, Horse Heaven Hills Cabernet 2008
Kirkland, Pinot Grigio 2010
Trader Joe's Coastal Syrah 2009
Columbia Crest, Horse Heaven Hills Merlot 2008
Trader Joe's Coastal Chardonnay 2009
Vieux Papes Red
Domaine de l'Aujardiere, Chardonnay 2009
Santa Rita, Cabernet, Medalla Real 2007
Penfold's, Koonunga Hill Shiraz Cabernet 2008
Guild, Red, Lot #02 2008
Dievole, Dievolino Sangiovese 2008
Laforet, Burgogne Chardonnay 2009
Columbia Winery, Merlot 2007
Bonterra, Cabernet 2008
Elk Cove, Pinot Gris 2009
Maquis Lien 2006
Scott Paul, Pinot Noir, Le Paulee 2007
The Occasional Book
Neil Young - Waging Heavy Peace
Mark Bego - Aretha Franklin, the Queen of Soul (2012 ed.)
Jenny Lawson - Let's Pretend This Never Happened
J.D. Salinger - Franny and Zooey
Charles Dickens - A Christmas Carol
Timothy Egan - The Big Burn
Deborah Eisenberg - Transactions in a Foreign Currency
Kurt Vonnegut Jr. - Slaughterhouse Five
Kathryn Lance - Pandora's Genes
Cheryl Strayed - Wild
Fyodor Dostoyevsky - The Brothers Karamazov
Jack London - The House of Pride, and Other Tales of Hawaii
Jack Walker - The Extraordinary Rendition of Vincent Dellamaria
Colum McCann - Let the Great World Spin
Niccolò Machiavelli - The Prince
Harper Lee - To Kill a Mockingbird
Emma McLaughlin & Nicola Kraus - The Nanny Diaries
Brian Selznick - The Invention of Hugo Cabret
Sharon Creech - Walk Two Moons
Keith Richards - Life
F. Sionil Jose - Dusk
Natalie Babbitt - Tuck Everlasting
Justin Halpern - S#*t My Dad Says
Mark Herrmann - The Curmudgeon's Guide to Practicing Law
Barry Glassner - The Gospel of Food
Phil Stanford - The Peyton-Allan Files
Jesse Katz - The Opposite Field
Evelyn Waugh - Brideshead Revisited
J.K. Rowling - Harry Potter and the Sorcerer's Stone
David Sedaris - Holidays on Ice
Donald Miller - A Million Miles in a Thousand Years
Mitch Albom - Have a Little Faith
C.S. Lewis - The Magician's Nephew
F. Scott Fitzgerald - The Great Gatsby
William Shakespeare - A Midsummer Night's Dream
Ivan Doig - Bucking the Sun
Penda Diakité - I Lost My Tooth in Africa
Grace Lin - The Year of the Rat
Oscar Hijuelos - Mr. Ives' Christmas
Madeline L'Engle - A Wrinkle in Time
Steven Hart - The Last Three Miles
David Sedaris - Me Talk Pretty One Day
Karen Armstrong - The Spiral Staircase
Charles Larson - The Portland Murders
Adrian Wojnarowski - The Miracle of St. Anthony
William H. Colby - Long Goodbye
Steven D. Stark - Meet the Beatles
Phil Stanford - Portland Confidential
Rick Moody - Garden State
Jonathan Schwartz - All in Good Time
David Sedaris - Dress Your Family in Corduroy and Denim
Anthony Holden - Big Deal
Robert J. Spitzer - The Spirit of Leadership
James McManus - Positively Fifth Street
Jeff Noon - Vurt
Road Work
Miles run year to date: 21
At this date last year: 52
Total run in 2012: 129
In 2011: 113
In 2010: 125
In 2009: 67
In 2008: 28
In 2007: 113
In 2006: 100
In 2005: 149
In 2004: 204
In 2003: 269
Comments (8)
Can the doctor that requires this nonsense!
Posted by b h | March 4, 2009 12:22 PM
Is that even enforceable?
Posted by Kai Jones | March 4, 2009 1:48 PM
The Medical Justice blog responds- a doctor and client should be entitled to reciprocal privacy rights. Apparently a doctor can’t controvert a patient's anonymous comment on the internet without violating doctor-patient confidentiality. Medical ethics make it impossible to confront the accusing patient.
The ethical duty of attorney-client confidentiality seems similar, except that it features the doctrine of "preemptive self-defense" which allows for the limited sharing of client confidences to dispel accusations of attorney wrongdoing in the course of representing the client. ABA Model Rule 1.6(b)(5). See also Comment 10 to Rule 1.6. However, the exception probably doesn’t allow for public (internet) disclosures. Comment 14 to ABA Model Rule 1.6. Seems like you have to convince the client to take the accusation back first.
Can the doctrine of "preemptive self-defense" can be stretched this far?
Okay back to studying for the MPRE.
Posted by study studentson | March 4, 2009 2:41 PM
This will never fly in court, especially since the web sites are generally not complying with requests to take down negative reviews. My wife is a doc (disclaimer here) and we've looked at reviews such as those in the Portland Monthly. What most people don't realize is that the "outstanding doctors" campaign for those ratings on Portland monthly. Those don't come in from anonymous readers. My wife is asked all the time to "rate" her own providers and to recommend them for the PM survey. She demurs as she feels it is unseemly. We have good medical care, but wouldn't check Angie's List or elsewhere to find out about "customer satisfaction". If you are nice to a patient (who can be a complete a**hole) you *might* get a good review, but there is no guarantee. My wife gets commendations galore from patients but they don't pay the rent, don't lead to more money. In fact, all they do is increase the workload with no increase in compensation. Some reward for good service and patient care.
Posted by mrfearless47 | March 4, 2009 3:04 PM
Some people seem to treat a doctor’s office as though it were an Oil Can Henrys franchise.
Posted by Daivd E Gilmore | March 4, 2009 4:05 PM
Yeah...And some doctors treat their patients like a grifter's mark. Need a new boat? Just convince this clueless patron that they need this unneeded, or risky, surgical procedure. Promise anything, deliver crap.
Of course, after the crap is delivered and the patient realizes they've been lied to and robbed, the surgeon hides behind the waiver the patient signed on the understanding of the surgeon's unmet promises.
Keep in mind that in-hospital medical mistakes are still one of the top ten morbidity sources in the US. The doctors hide behind medical associations, close ranks against consumers, and basically act as though they are not responsible for their work. Then, at places like OHSU, they get even more cavalier when the state limits the liability to which they are exposed.
I think something like this is long overdue. The consumer has waaaay imperfect knowledge entering this market and the market is stacked against the patient.
Also, if OHSU is any indication, if you have a problem, don't go to the institution's "Patient Advocate". That's a dead loss. That is the point person for the institution's Risk Management Department, and they will deny any liability or wrongdoing on the part of the hospital, clinic or their physicians and surgeons. If you want to fight it, it will require an attorney.
And...As we all know, justice is the purview of the wealthy. Poor folks can't afford an attorney. Even middle class folks can't afford an attorney to sue doctors and/or hospitals who have panels of professionals on retainer to protect them from their own mistakes.
Posted by godfry | March 4, 2009 8:29 PM
Oh...Also, if a doctor promises you any result from therapy or treatment, tell them that you will consider it if they write down their promise and sign it in front of another person who is not a member of their staff.
Always.
Posted by godfry | March 4, 2009 8:31 PM
No reputable doctor will "promise" you anything. That's why you need to sign an "informed consent" indicating that you understand the risks of the procedure or therapy. While the majority of cases may produce the desired result, the reality is that human variability affects outcomes. Despite all best attempts, shit happens. My wife is a living testimony to the shit happens department. A $1.3 million set of surgeries at the best medical institution in the west still had unexpected, but listed, side effects. This nearly doubled the bill as the doctors tried to get her healthy enough to finish the surgery. Aspiration pneumonia is not fun and she was in critical condition for a week. Malpractice or bad surgery - hell no. Shit happens. Yes.
If you go to a doctor expecting a perfect result without considering the risks of whatever procedure you need, you're foolish.
Posted by mrfearless47 | March 5, 2009 9:09 AM