The Business Ethics Blog

Information asymmetry — big differences in knowledge about a product — is a big problem in the marketplace. Consumer empowerment basically boils down to finding various remedies to such asymmetries. Jim Sabin over at the Health Care Organizational Ethics Blog had this nice blog entry 2 days ago, on an attempt to empower patients by letting them post comments, online, about their experiences with particular physicians: Up with Zagat! Down with Patient Waivers!

I recently discussed the collaboration between Wellpoint and Zagat for rating physicians and concluded that the benefits of web-based rating systems outweigh the risks. Since writing that post I have come upon (a) a very informative report about physician-rating websites by Ruth Given and (b) a seven year old physician protection enterprise called “Medical Justice.”

Anonymous online rating systems can make your mouth go dry, if you’re the one being rated — regardless of whether you’re a business whose product is being rated, a professor whose teaching is being rated, or a physician whose bedside manner is being rated. For docs, that’s where Medical Justice steps in. According to that organization’s website, the solution is what they call (and what they charge to facilitate) a “mutual privacy contract” between physicians and patients. According to the organization’s website…

Mutual privacy agreements are designed to address the emergence of now over 40 generally anonymous physician rating sites. “Mutual privacy” means that patients are granted additional privacy protections by the doctor above and beyond those mandated by law.

In return, patients agree not to post to anonymous doctor-rating websites. Good idea? Sabin (himself a physician and educator) says “no.”

…the idea of asking new patients to sign a contract eschewing physician-rating sites and sweetening the deal with “additional privacy protections” is unseemly. Meaningful privacy protections are fundamental moral obligations – they’re not chits to use as enticements for patients to sign a contract. If a physician greeted me by asking me to sign such a contract I’d be out of the office in an instant and badmouthing the physician shortly thereafter.

Sabin is right. Contractual solutions might be apt for many kinds of straightforward commercial transactions. But the relationship between physician and patient is a special one, one that necessitates a level of trust that seems incompatible with crude contractual solutions.