Heartfelt with Dr Melissa Walton-Shirley

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Should physicians "gag" their patients to avoid negative chat-room commentary?

Jan 19, 2010 08:22 EST



I read with interest a recent piece by JoNel Aleccia on MSNBC.com about a new physician movement against negative patient commentary on public websites. One physician has asked his patients to routinely sign a "gag order," while others have asked their patients to "sign over copyright to future comments." The one-sided barrage of negativity against physicians is an ever-growing problem in the dissatisfying world of American healthcare, and chat rooms have become the one place a patient can go for both "therapy" and revenge.

Although there is a growing concern about chat-room commentary in the lay public, no one has seemed particularly concerned about comments against healthcare providers until now. I've certainly been a "victim" on occasion, with my efforts to promote a smoke-free city and my stance against the local option for alcohol sales in our community. When it first occurred, some of my patients became concerned, telling me, "You had better check to see what those idiots are saying about you." Unfortunately, I followed their advice and was devastated to see myself described as a "dictator" and an "alcoholic" who had "abandoned her patients" and "refused to come to the ER." Since I'm an avid teetotaler, the "alcoholic" description was ridiculous. I have no idea where the "ER" comment came from, as I frequent it multiple times per week, and as for the dictator complaint, that's purely a matter of opinion, and, well, "to each his own."

Out of curiosity, I contacted the local newspaper that hosted the site. They informed me that one poster had as many as five different identities and often had long conversations with himself to make the impression that multiple posters shared the same opinion. Not long after my inquiry, along with a local politician's wife and a local law-enforcement officer who were also victims of scathing commentary, they took down the site. It didn't take long, however, for it to pop up again with a different host. I finally followed the best advice ever given to me. It was an edict from my husband to "not ever get on that stupid website again." I haven't since March 2008 and I'm a much happier person.

Although it was an incredibly difficult ordeal for a weekend, I survived it because I have a wonderful support system and relatively good self-esteem. However, I can now better understand how someone with neither of those advantages can be devastated by anonymous comments. A recent landmark trial left a perpetrator with a mere slap on the wrist after her commentary caused the suicide death of a young teenager. That incident alone should tell us it's time to rein in the chat-room circus and gossip-fest that is growing hourly, not only in America but all over the world.
The solution is fairly obvious for all potential victims of negative cyber chat. Let us never muzzle our freedom of speech, but let us mandate that those who speak freely identify themselves. Written slander is prosecutable. If you are guilty of lying about a situation, propagating ill will with that lie, or spreading misinformation, you should be forced to keep your mouth shut and your fingers off the keyboard. If you do have legitimate concerns, you should lodge them in a reputable way by having a face-to-face discussion or reporting those concerns to a medical board. If you don't like your physician, get your records and find someone you do like, and don't attempt to destroy the doctor-patient relationship for others who are comfortable and happy. Hey, perhaps if we can implement tort reform, all those displaced malpractice lawyers could pick up the slack with cyber-harassment cases. It's a perfect solution!

A local physician's teenage daughter told the absolute lowest thing I've ever heard from a chat room to me. Her father died of a brain tumor after a harrowing year compounded by the loss of their mother several years previously. The comment she read not long after the funeral from an anonymous poster was that "he deserved it." That's the mentality we are dealing with on the majority of these websites. They are havens for the maladjusted, weak individual who lacks the courage to have a personal conversation. Let's demand their true identity be posted right along with their commentary. Let's let integrity "gag" all of us who might be tempted to propagate hate and ill will in exchange for a few moments of "therapy" or cheap entertainment in cyberspace. Let's see how different "freedom of speech" looks to us then.








Your comments
Should physicians "gag" their patients to avoid negative chat-room commentary?
# 1 of 2
February 8, 2010 08:25 (EST)
Tom Horton

I certainly agree that comments posted on chatrooms and blog should reveal the true name of the poster, I also see the side that it would open someone up for punative retailiation by those with "deep pockets" that no individual can hope to match.  While I doubt individual doctors would sue to punish bloggers due to the intense and negative publicity, I forsee the formation of public action groups that would respond on the doctor's behalf, allowing the doctor the same anominity that we are decrying in the first place.

Second, the solutions suggested by Dr. Walton-Shirley, such as finding another doctor or appealing to medical boards reveal an ignorance of the true facts.  Most people, even with good insurance, have trouble finding a doctor let alone those on medicare or those that don't even have insurance.  Most of the doctors have limited their practice or have waiting times of months. 

Those of us that follow medical boards and their rulings have found that a doctor has to be guilty of many acts of malpractice before being censured by the local medical boards.  One local doctor has been guility of several instances of sexual inpropriety and is still practicing.

It would be nice if there were true solutions to to these problems, but until there are true reforms in medical oversight the best one can do is to make sure that future patients are aware of what really goes on at the doctors office.  Ignorance is not bliss when it comes to quality healthcare.

 

# 2 of 2
February 11, 2010 07:15 (EST)
Melissa

Tom,

As I was reading your post, I remembered rounding the grocery store aisle a few years ago only to hear a patron in the next aisle loudly proclaiming that "Dr. Shirley just about killed me on that treadmill.  I thought I was going to die and they would not let me off".  I couldn't believe it!  Nothing could have been further from the truth and it was more than the usual whining.  I quickly took my cart down his aisle . He seemed a bit bewildered to see me there.  I told him "it's really difficult to die with a normal blood pressure, heart rate and stress exam, and you never asked to get off the treadmill". Smiling, I left him standing there wondering just how bad his luck had to be to have me hear him whine like that.

Bottom line:  would love for HIPPA to work both ways.  If you have something bad to say about your physician and you can't back it up, better think twice.  

 Additionally, I've heard patients talk about other physicians on numerous occaisions and I just shake my head at the misperception of the situation.  I remembert an instance where the patient thought the physician had acted in a medically inappropriate manner because he developed a rashh with a pill. The patient had no known allergies, yet he blamed the doctor for his rash. He changed doctors.   It was incredibly ridiculous!!!!

Yes, physicians are human and I find that most of them are just folks trying to help their patients, earn a living and then try to get back home to their families at night.

We really aren't as complicated or mysterious as people make us out to be.

Melissa 

 

 

 


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About Dr Melissa Walton-Shirley
Dr Walton-Shirley performs invasive cardiology, nuclear cardiology, and stress echocardiography in a private practice in Glasgow, KY.

Her chief medical interests are CHF/hypertrophic obstructive cardiomyopathy and the promotion of primary PCI for acute MI. Recently she played a significant role in helping to launch an ambitious pilot study of primary PCI in Kentucky, the Kentucky Primary Angioplasty Pilot Project. She has also participated in the TIMI 19, Duke-HF, NRMI, and CRUSADE trials and is proud to have been an advocate of the first smoke-free initiative in Kentucky (2011). She champions a smoke-free America.

Dr Walton-Shirley received her undergraduate degree at the University of Kentucky and went to medical school and did her residency and fellowship at the University of Louisville. She is married with two daughters. Her interests include singing, writing poetry and songs, fitness, and, of course, theheart.org.