Medical Justice League of America

A new company is helping doctors write “gag order” forms for patients who might want to post about them on one of those health information sites. It turns out they’re also doing some other interesting, if provocative, things.

This entry in the Wall Street Journal’s Health Blog was intriguing:

Next time you go to the doctor, look for a new form buried in the stack of insurance and health-history paperwork you’re asked to complete. You might find a contract that would require you ask your doctor for permission to grade him or her online.

A new company called “Medical Justice” is selling services to doctors.  Among their offerings is a form that doctors can insist patients sign before providing treatment. The form forbids the patient from rating or reviewing the physician on any website or online forum.

“The whole notion of your reputation on the line and not having control makes physicians feel vulnerable,” Medical Justice CEO Jeffrey Segal told the Health Blog. “The goal is to regain control of the flow of information.”

We’re not proponents of anecdotal information to make medical decisions, whether it’s in the choice of physician or in determining a course of treatment. There is a lot of unsubstantiated information on the web, and it’s a health problem. And we’re sympathetic to beleaguered doctors.

Still, Dr. Segal’s solution sounds harsh, defensive, and insecure. All of us need to accept the fact that the Internet is here to stay, and that brute-force attempts to resist it aren’t as likely to be effective as more accommodating approaches. Handing yet another form to an anxious patient, with the implication that treatment will be withheld if its not signed, sounds heavy-handed.

The strident tone is borne out by a visit to Medical Justice’s website, where the slogan is “Relentlessly Protecting Physicians From Frivolous Lawsuits.” The subheading reads “Deterrence, Early Intervention, and Countersuit Protection.”

The website reads like a attempt to intimidate would-be litigants. Medical Justice promises to help organize and pay for counterclaims against people who sue physicians –  and to pursue suits against expert witnesses who testify for claimants, provide free expert witnesses for the defense, and “warn perpetrators with a strategic Early Intervention Program” intended to discourage the filing of claims.

“Medical Justice has been the driving force in getting numerous cases dropped,” the website boasts, “and has deterred many plaintiffs from filing frivolous suits.”

There is no question that frivolous lawsuits are a genuine problem, and that med mal premiums represent a crisis for many physicians. Physicians deserve to be protected from specious claims.

But the dominant tone at the Medical Justice site is rage – and therein lies the danger. The website comes perilously close to suggesting that the organization will discourage lawsuits through browbeating and intimidation, rather than a reasonable mustering of the facts.

The plan, and the concept itself, deserves further scrutiny. For example, the website claims under “Deterrence” that “In Florida, physicians are sued at a rate of 15% per year. (FPIC 2004 Q1 statistics, Crittenden). Matched by specialty, the overall suit rate for Medical Justice Plan Members practicing in Florida is less than 2%.” It continues:

A recent actuarial study of the Medical Justice track record by SG Risk, Inc. (Lyndhurst, New Jersey), concluded that the medical malpractice claim count against our plan members in Florida is statistically lower than those without protection (95% confidence level). Put a different way, Medical Justice plan members in Florida are sued much less frequently than their unprotected cohort.

Notice that it doesn’t say the study concluded that claim rates were reduced from 15% to less than 2%, or that the study concluded plan members are “sued much less frequently” – only that the plan’s members are sued at a “statistically lower” rate. Obvious question #1: Is that self-selection, because plan members are more cautious people in general? We can’t know.

A better risk management approach to medical malpractice is clearly warranted. And Dr. Segal et al. may have some interesting ideas. But their rhetoric borders on disturbing. and might even be used against their members at some point.

Conclusion: Real problem, genuine need, strident approach, questionable tactics – but worthy of more investigation and fine-tuning, either by this organization or another, more judicious one.

(WSJ link courtesy iHealthbeat)