Jim Conway, senior vice president at the Institute for Healthcare Improvement in Cambridge, Mass., said the state of Massachusetts has been conducting consumer research in the past six months about what people want to know in terms of healthcare. One of the top three things users want to know is what other people think of their hospitals and their doctors.
"The perspective of the consumer is unbelievably important," Conway said. "In helping people make decisions around where they're going to seek care."
But patients know that consumer rating sites, particularly anonymous, unmonitored ones, are not the be-all and end-all source for physician information.
"It's a good thing for patients to have access to but you've got to watch out," said Panetta, an attorney in Boston, Mass., who is also actively involved in diabetes patient advocacy. "The people that are more likely to use it are going to be people who have an axe to grind, and it may be because they're crazy."
Segal pointed out that defamers could also be competitors, former employees or ex-significant others. Nor is there a way to monitor undeserved praise.
But a waiver such as the one Medical Justice proposes doctors use may not be the solution.
"I don't see how that kind of contract could actually protect the physician in any other specific way than they would have without the contract," Panetta said.
As with other printed defamatory comments, Panetta said, the doctor could ask the host site to remove the comments and, if they did not, he or she could sue, which may not be effective.
"I think it doesn't work for any of the parties," Panetta said. "You can't contract away liability."
But the wrong kind of contract can set the tone for the important doctor-patient relationship.
"Great patient care is the result of a partnership and trust-relationship between the patient and the people taking care of the patient," Conway said. "I worry that the introduction of something like this could begin to break down trust."
Segal believes the waiver, if presented correctly, can address the trust issue head on while acknowledging the patient's need to voice opinions about his or her experience.
"We don't want to repackage the problem because we know the inevitability of useful Internet rating sites," Segal said. "Try and view the program as a way to move the process forward where patients and doctors share in the solution rather than engaging in adversarial relationships."
Preventing Internet users from using the Internet as they like is a tall order, doubly so when it comes to healthcare where seeking out others' opinions is ingrained.
Blogger deBronkart knows exactly what he would do if his doctor confronted him with a waiver asking him not to post comments about him online.
"I would decline," he said. "But I would look him right in the eye and say, 'You don't need to worry about me shafting you.'"