Last week brought some significant coverage to the organization that calls itself "Medical Justice".

They describe their mission as "Relentlessly Protecting Physicians From Frivolous Lawsuits". But what brought them notoriety is a new contract offered to their physican clients. In which physicians are supposed to ask patients not to rate them online. Here is the coverage:

• WSJ Health Blog: Interviews the founders of Medical Justice and RateMD.com, the largest doctor rating site
• Health Care Law Blog: Bob Coffield notes how the new technology often challenges the status quo and inspires legal response.
• Kevin MD: Seems to imply that this kind of legal response is a good thing. Most commenters strongly disagree.

What surprises me is that no one (even RateMDs!) has called out "Medical Justice" for what they are really selling. A SCAM equally harmful to both patients and physicians. Why such harsh words? Let's take a deeper look.

First of all, why do they get physician's ear?

The reputational challenges brought about by the freewheeling nature of the Internet is real. I wrote earlier that physician ratings are coming and even though they may be flawed sticking your head in the sand will not help. But for most physicians who do not understand how social media works, the idea that a piece of paper would protect them is certainly appealing.

So "Medical Justice" is all too happy to exploit their fears

Commenters on the linked posts identified many of the problems with such contracts, but let me summarize them here to show how much the whole idea stinks on the balance. Here you go in no particular order:

1. Doubtful enforceability: The legality of the paper is questionable and in case of a real dispute would scare only the meekest.
2. Cannot stop anonymous speech: Even if enforceable, the same ratings can be posted anonymously or sent in as anonymous tips.
3. Promotes rating sites: Most patients still do not know they can rate doctors online. Thanks to such contacts they will now.
4. Ratings from Non-Patients: If you are insulted by such contract offered to you, what do you do? Go online and rate the doc as untrustworthy.
5. Screams "No Confidence": The contract sends a message that doctor cares about the liability more than patient care.

I could go on and on but it is pretty clear that "Medical Justice" is selling a false premise as a remedy to genuine concern. What worries me is that many doctors are not familiar enough with how the speech on the Internet works and could fall into this trap. So I would like to warn the doctors:

Beware of reputation & liabilility management quackery!

Fine, you might say but what should physicians do to protect their reputations if asking their patients to sign contracts is out? Well, let's take a practical look at what can and cannot be done:

1. Learn to let go: This is 21st century and no one's reputation is in their hands anymore. Physicians are not an exception. Accepting this is the first step to actually doing something about it.
2. Focus on what you control: While there is no way to control what people say on the Internet, it is in your power to improve satisfaction of your patients and get their word of mouth going.
3. Respond to abusive speech: If the negative comments happen respond with your story. If the postings are baseless or abusive you would have easier time having them taken down or discredited.

Bottom line is, we all have to adopt to the brave new world of transparency and need to look into the future. The idea of non-rating contracts has it backwards and being stuck in the past would not help. Just look at the recording industry that thought lawyers could protect their failed business practices.

Increased transparency is challenging the business of healthcare as we know it. Taking shortcuts could be costly in the long run.