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I saw a poll about this on Angie's List the last time I logged in. You sign so much paperwork when you go to an office at times I worry about someone trying to sneak crap like this in on me.
For the most part I am healthy and I haven't had any issues with my healthcare, but to not be able to speak out and give my experiences with a certain caretaker/doctor would piss me off.
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Sigh. The first amendment only covers GOVERNMENT regulation of speech. Anyone else, employers, business partners, etc are free to limit speech as a contractual obligation.
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@cheviot: Sadly, yes, non-disclosure agreements are legally binding depending on who they are with. Although, I don't think they should be. In my opinion, the mere presence of a non-disclosure agreement for this type of contract indicates unclean hands. What other purpose could it serve than to prevent people from true but negative things? Doctors, and everybody else, already have protection from libel and slander given by the US government. Another contract only gives them license to deliver inferior or incomplete service.
@exconsumer9: Well, in the technical and commercial arenas non-disclosure agreements serve a legitimate purpose. For example, if I want to buy your company I typically will not make an offer unless I get to see your books, but in many cases those numbers contain commercial secrets, so I'm required to sign an NDA before I can see your books.
@exconsumer9: \"Doctors, and everybody else, already have protection from libel and slander given by the US government.\" Free protection, or does it cost them money and time as well as risk the Streisand effect?
This has an easy solution:
1) Enroll in such services anonymously, or use a common name (John Smith of 123 Fake Street). Let the doctor try to trace that!
2) Leave out opinion and 'how the Doctor made me feel unloved' comments. Stick to facts: Doctor did 'X', which I later found out was the incorrect procedure. He should have done 'Y' instead, and this caused me to have negative consequences. (This works doubly well, since it's helpful to others reading the review. Also, libel claims are dismissed if the statement is truth.)
3) Refuse to do business with any doctor who wishes you to remain silent about your treatment. Just because HIPAA doesn't allow the Doctor to talk about your health doesn't mean that you can't talk about his/her level of care.
@TheRedSeven: Actually, opinions have absolute protection under the 1st Amendment in defamation cases, so it would be wise to use only opinion.
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-871030-100x100.png\")
@TheRedSeven: And do you really want people to go to the doctor using a FAKE NAME? That's ... not right and could cause problems in the future.
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@nakedscience: He's talking about using the fake name to register for the review service, not using it at the doctor's office.
@TheRedSeven: \"Leave out opinion and 'how the Doctor made me feel unloved' comments\" This can be relevant to the care given, though. Doctors need at least some bedside manner. If I go in to get my yearly gyno exam and my gyno is an ass -- getting too personal, judging me for having sex and not being married, judging me for being on birth control, judging me if I ask about abortions, whatever -- then you damn well better believe I'm going to report it.
And re, 3): Great in theory, but not everyone has the option to change doctors.
@nakedscience: Actually, opinions that are clearly expresed as such cannot be considered libelous (or slanderous if transmitted verbally). But if you state a purported sequence of facts and your only defense is that the statements are true (the truth defense) then the burden of proof is on you to show that your allegations about the sequence of events are true. (IANAL, and these statements are based on my lay understanding of US law).
On the other hand, if your objective is to stay OUT of court, don't go to one of these doctors that forces you to sign the NDA in the first place. Which admittedly can be a problem in rural areas with fewer practitioners.
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Wouldn't it be more beneficial for both the Dr and patient to have an \"after visit\" survey before leaving the office? Or the Dr creates their own private website where anonymous complaints or comments can be left for him/her to read? If I had complaints, I'd rather they be brought to MY attention then the internet.
And as much as some patients can be a real pain in the ass... some Doctors are unwilling to believe that their etiquette or practices need improvement. One word: Denial.
Health care is just like any other business- you don't like the reviews? (Who does?) Then maybe you should look at the business model as a whole. As for patients who will never be satisfied, well... there's no changing them. Unless they blatantly lie, there's no recourse as well.
Every time I see my doctor (who is employed by my healthcare system, not a private doctor), I get an after-visit survey. I loves her. :)
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\"You've got shyster in my malpractice magnet.\"
\"No, you've got malpractice magnet in my shyster.\"
[both taste the other's cup]
In unison: \"It's delicious!\"
Or just don't sign the form. Just because someone hands me a stack of papers to sign doesn't mean I sign them.
@jamesdenver: I provide the bare minimum information a doctors office needs to provide medical services. Name, contact information, insurance information and medical history.
I quit giving them social security numbers and any other information including employers. I decided they don't have a use for my SSN and it is a ID theft risk. The rest of the things on those forms are largely not really needed.
So far nobody has called me out on not giving that info or refused treatment.
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@jamesdenver: Likewise, they can refuse to provide you with service if you don't agree to their terms.
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@supercereal: That's fine, I'm not going to sign an unconstitutional document just because it's signed to me. Take my ass to court.
As a general comment, something really needs to be done about medical malpractice lawsuits in the US. The cost for malpractice insurance is so high for doctors that people aren't doing the low-paying specialties like primary care or pediatrics because they don't like being paid 90k a year, paying 20k malpractice insurance, and having to pay off their loans at the same time after over 10 years of school.
@ilves: I don't think it's malpractice *suits* that have increased - it's more the fault of rapacious and/or reckless insurance companies.
I would not be surprised if the cause of the malpractice insurance bind is spelled A-I-G.
@ViperBorg - Facebook is the new AOL.: Ga, just because it's handed to me.
Sigh...
Apparently, only the Gods are allowed to have an edit button.
@Repique: And first amendment rights don't mean you can go around saying anything you want about anyone else, either. Slander and all that good stuff. You can always go to another doctor if you don't want to waive your rights.
Plus, \"closed mouth\" contracts are pretty much everywhere -- from a juror forbidden to reveal details of the case he's on, or a lady who settled with a huge company and isn't allowed to talk about the details, or a company that restricts employees from revealing trade secrets.
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yes, but in those cases, you aren't necessarily going to DIE because you didn't sign a NDA. \"Hmmm I can always find another job if I don't agree with the NDA from this company\" or \"hmm I won't get my 50k if I talk, but I deem my rights more important\".
Not \"Hmm every doctor has an agreement, so I can either get cancer treatment and give up my speech, or not and die\"
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If this does become a popular thing with doctors I can see them next requiring a signed document saying you wont sue them if they screw up. I guess that would lead to lower prices at the Dr. because they won't have to carry malpractice insurance..
or not
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My doctor is wonderful. That said, if I had a problem with him or with one of his staff, I would first go to either him or the office manager (or whoever is in charge there). If I didn't get any resolution, then I'd escalate.
If they tried to make me sign something like that, I'd flat out refuse and start looking for another doctor. Assuming I could find one that didn't do that and it wasn't something my healthcare network did across the board.
As nasty as this is I have a hard time blaming the doctors. With these review sites anyone can sign up and make any kind of claim and it's nigh on impossible to have even the most spurious ones removed.
Add to that things like the alleged shakedown by Yelp sales people and I'd be doing all I could to protect myself too.
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@JeffMc: \"nigh on impossible to have even the most spurious ones removed.\"
Traditional libel and slander lawsuits can take care of it. Unless what they're saying happens to be true.
I hate these ratings sites as well, but this is a totally inappropriate way to handle it.
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There is a problem in that if you make a complaint about a doctor, how can he respond without being sued for violating doctor/patient privledge?
Does talking about one aspect of your treatment with a doctor allow him to rebutt the accusations if it includes potentially embarassing details?
How do you think people would react if this exchange played out on RateMDs.com?
Joe Schmoe - Dr. Schmendrick didn't treat my butt pimple effectively.
Dr. Schmendrick - It was because you had un-diagnosed HIV
Now that being said, I am all for rating doctors just like any other profession. I just think it isn't as simple as rating a plumber.
@sleze69: Exactly. Why do you think there isn't a \"rate your patients\" website? The system is inherently unbalanced in many ways, sometimes towards patients, and sometimes against them. If you have a problem with a doctor, talk to them. If that doesn't work, go to the local licensing agency.
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If I went to a doctor that required signing a form like that I'd question the their confidence in and ability to provide quality medical care. I'd definitely find a new doctor.
As much as I enjoy Yelp and other such sites, I only really use them for restaurants and such.
Angie's List for contractors.
But Doctors? I don't know if I'd trust a bunch of anonymous people on the internet to give me reliable advice on medical treatment.
But I still think Doctors have no right to make anybody sign a waiver such as this.
First, I'm thinkin' this guy is engaging in the unauthorized practice of law, which North Carolina is surprisingly willing to prosecute. (Went to law school down there, they went after the craziest stuff as unauthorized practice.) Providing legal documents to others without a law degree is uncool. And since I doubt he thinks any moron should be able to hang out a shingle and practice medicine without a license, I'm interested that he's willing to do that with the law.
Second, this is PHENOMENALLY BAD PRACTICE if not actively unethical (and, if not, it should be). One of the reasons malpractice and doctor/patient relationships are such a big issue in this country are the ways that hospitals, insurers, and even doctors' groups have protected \"bad apples\" and kept them in practice. That leads patients not to have a lot of trust in their doctors or in the system that's meant to protect them. Any doctor who participates in a system that is meant to shut down complaints is participating in protecting bad doctors who shouldn't be in practice -- and I would refuse to go to such a doctor on the grounds that he's probably one of them if I have to sign a gag order.
Again in North Carolina, there was a doctor who had sexually abused more than 30 women WHO WERE WILLING TO COME FORWARD in North Carolina over a period of years who was REPEATEDLY shielded by his hospital and insurer and other doctors and the state med board when the women used proper channels to complain. (And this was the second state he'd done this in; the first state had agreed that if he left the state, they wouldn't say why and his first insurer had agreed if he went with someone else, they'd give him a recommendation.)
This doctor is providing protection for assholes like his sexually-abusive cohort there. That's been going on long enough.
@Eyebrows McGee: I don't think providing forms without substantive legal advice with them is unauthorized practice of law - the Nolo Press v. Texas is the seminal case in this instance.
But doctors who make patients sign these releases are total douchenozzles, and patients should be informed that these doctors *will* leave you waiting for hours, be sent into multiple exam rooms to wait some more, and finally be seen by a doctor for 5 minutes, be given a prescription pimped by a pharma rep, and billed three figures for the visit.
@varro: It goes by state, and when I was in law school, NC was very aggressive about going after people for things like this.
(Also, if I practice medicine and have high medical malpractice insurance rates ANYWAY, I think I'm probably going to hire a lawyer for any and all legal form related issues if only so *I* have someone to sue for malpractice if I get in trouble for the form. So either way your doctor's dumb.)
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I admit to recently using Yelp *as part of* my process of finding a doctor. What I was looking for from Yelp reviews were indications of bed side manner, does the doctor listen, does he/she make you feel comfortable and take your thoughts and opinions into consideration, etc. All things in which you really need the opinion of a former/current patient to get. I got a list of doctors together whose reviews I liked, and then I moved on to the AMA website, the website of the doctor's board certified specialty, the doctor's own website, and whatever Google had to offer to see 1. that they were board certified in the specialty I was looking for, 2. to view their education and employment background, and 3. to view their disciplinary and legal history.
I think word of mouth is hugely important and the doctors who fear this and try to repress this by having their patients sign these forms do so because they are most probably lacking in some way. Even the best doctors will get some bad reviews, there is no avoiding it, but if they are good, the positive reviews will overwhelm the bad and give the consumer/patient a good picture of the type of physician they are.
If this goes to court, any lawyer worth his salt would argue that the public right to know about how a doctor operates is greater then the doctor's right to keep such information private. Because of a Doctor's public work, and the risks of that work, for people's health and possible life threatening conditions, it is different then people knowing that XYZ metal fab shop makes shotty bed frames. If the doctors weren't in such a delicate field, then a Judge would be less likely to throw these gags out.
Medicine is a business.
There's no \"care\" left in health care.
that's the problem with insurance companies... doctor's have to over-extend themselves like crazy to be able to make any money
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Imagine if every business did this (made you sign a form saying you couldn't talk about them or their products and services online, ever).
@johnva: I think if it weren't for the logistical hurdles (combing review sites, tracking down reviewers) quite a few businesses would be interested - especially those that rely on reputation and word-of-mouth for customers.
That said, medical practice is not entirely a business. Obviously, money changes hands and in a lot of ways the practioner is providing a service to the customer. But medical ethics are completely different than business ethics, and (with some very limited exceptions) you have to put your patient's well-being first. Well beyond what companies are expected to do for their customers.
I think the fact that this doctor is considering these waivers highlights how much medical practice has become just another service industry, which is a shame.
@Saboth: \"Not 'Hmm every doctor has an agreement, so I can either get cancer treatment and give up my speech, or not and die.'\"
I'm not sure it's so black-and-white. Do you really think it's illegal to say \"I will not do business with you until you agree not to post malicious statements about me online?\" Especially when the punishment is \"the comments are removed from being posted.\" It's not exactly the same thing as being locked away and muzzled, especially given the wild and wooly nature of the internet.
I don't know if this is automatically evil (although it's certainly not a First Amendment issue), given that the internet is a relatively new phenomenon that is bending the rules of permissible speech and libel/slander all over the place before law and/or morality has a chance to catch up. Don't get me wrong, I'm not saying it's obviously the best thing since sliced bread either, just that it's a complicated issue.
So why don't they try to suppress bad reviews by, y'know, giving quality care? If I were given such a form to sign, I would probably we wary of the Doctor handing it to me.
I'd assume they weren't just being proactive. Perhaps more likely they have a history of trouble with their patients.
hah... you assume primary care docs have TIME to give quality care. Insurance re-imbursments are so ridiculously low that doctors have to see patients every 15 minutes to stay afloat.
There are a number of things I want to know about a doctor before even considering trusting them. Do they have extreme religious views that impact how they treat patients. Where I live that is a very common problem. I want to know if that doctor is condescending to women or does not take their complaints seriously. Some are like that and it can really hurt your treatment. Hopping from doctor to doctor can get you labeled a doctor shopper so knowing what your dealing with ahead of time can save some problems. I also want to know if they are hostile towards their patients. A few are but get protected by the system.
That said I take ANYTHING I read online with a big grain of salt. But if your seeing multiple sites and multiple reviews citing similar problems it might be a problem.
I swear to god this country is going to have a massive lack of qualified doctors in ten to twenty years. Being a doctor isn't nearly as great as it used to be. Unless you're one of the few that makes it into the well paying specialties like dermatology or orthodontics you're really not making that much money (like 90k for primary care doctors in NY). Plus, imagine getting paid 90k after 10+ years of school, having to pay back loans, while malpractice insurance costs you 10-20 thousand each year because everyone and their mother can sue a doctor for the stupidest reasons. There is inherent danger in EVERY procedure, sometimes bad things just happen, it's not necessarily negligence on the doctor's part because your result wasn't perfect. OB/GYNs are dropping the OB from their names because patients are suing them if their kids turn up with down syndrome, plus they can make twice as much money as only a GYN with less patients. There is going to be a severe lack of primary care/pediatricians/OB's soon unless the government does something to limit a) the amount of frivolous malpractice suits and b) the cost of malpractice insurance...
@ilves: They'll probably disappear noiselessly. Nurse practitioners or just nurses will take over at clinics. That's all that's really needed.
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I fully disagree - what people say about MDs they see directly can influence the MD's business. Therefore, if the MD is a quack sue him, but do not post up drivel that in most cases is probably just miscommunication turning into spiteful revenge and anger. I've had pts I've treated like family, but they have personality disorder (cluster B, look it up) and afterwards said some horrible untrue things about me. Luckily my attending was with me at the time and verified my side of the story, and the pt was 'fired' from our clinic. this goes both ways - all you people out there in America wanting 'free healthcare' for 'everyone' no matter who's paying for it will wake up in 10-20 years and realize our healthcare system has turned into shit.
If you want a damn good MD, you had better be prepared to pay for him/her. Funny how ladies have no problem forking over 1000s/dollars to get new boobs, but every asshole complains to me about the hospital bill after I save their fvcking life. Ridiculous. You'd rather pay 50g for a vehicle then pay your MD bill. Shameful. Americans - a bunch a 'self entitled' 'external locus of control' depressed anxiety ridden sex perv latch-key children whose parents ought to be jailed for child abuse for doing such an awful job raising 'em. (and yes, I fell into that category for years as well, until I traveled the world and realized finally what's what.) ignorance is a choice - go out and educate yourselves. got a bad mortgage - it's YOUR fault, NOT mine dammit. but still nObama makes me pay for it. DAMMIT ALL!!
@banmojo: Your patients were right tell others about you. I wouldn't want you as a doctor. You seem to think you're entitled to practice, but if customers knew what you were selling in advance, you would never get work as a physician.
@banmojo: Our health care system has turned into shit because it caters to the people who want new boobs, braces, and other procedures paid out-of-pocket, and shuns Canadian-style universal health care.
We also have quacktuaries at insurance companies practicing medicine instead of doctors.
@varro: no, who cares if people want new boobs out of pocket? It doesnt cater to that at all.
Its turned to shit because every 24 week pre-mie kid needs to be in the NICU for 3 weeks to grow up with a terrible quality of life and leave taxpaters holding the bag. Because 80 and 90 year olds want to have hip replacements etc under insurance. Because people just watch TV and eat crap food until they are 400lbs instead of workout, then bitch and moan when they get diabetes or heart problems. Its also messed up because of insurance companies who dont pay enough or less than cost, and dead beat pts, so docs turn to volume and procedure rather than actual care. And there is so much legal and documenting crap its RIDICULOUS. Ask a doctor how much time is spent writing notes vs patients. Its 50/50, if not worse.
Its also whack because people have no understanding of science and think an MRI or a surgery etc is \"too expensive\". Do they understand they just went through a multimillion dollar machine? Or that someone just opened them up and now they can live? No joke, most but the POOREST of patients have a nice cellphone, jewlery etc. I didnt believe it till I started working in the hospital. I am not calling every pt a deadbeat, but wait till you see a mom show up, not even know how long shes been pregnant, test positive for cocaine (as in, used in the last few days), no dad, no records, give birth, the kid sits in the NICU for a hey, we cant pay for it sorry.
I realize people need healthcare, but some people dont understand that a) they need to pay for it and be a part of it and b) there may be someone else that could use the time, money, and care more than they do, especially when they are looking at a short term vs long term. Theres a lot of good people out there, but theres a lot of people that frankly are just wasting time and resources at the hospital or the clinic. If people want healthcare for all, well tragedy of the commons, you're gonna get the worst care. Which is fine if you have a basic ear infection, but not when your life is at stake.
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I suggest signing it -- with a sloppy \"Not Agreeing.\" As long as they see something in the signature space, they'll think they've got you. Whoopsy!
Moreover, while anyone can sue you for anything if they have the money to hire a lawyer, if you stick to truth and opinion, and clearly define opinion as opinion, you're within the bounds of free speech. (I say this, not as a lawyer, but as a journalist who's been to a lot of seminars at journo conferences where they talk about what is and isn't okay.)
How about a review that says, 'Dr XXX wouldn't treat me unless I signed a waiver promising to never review him online, so I left.'
there are bad doctors out there, but there are some that are just ok. And there are some cases where patients are just very unfortunate, and blame the doctor.
please keep in mind that doctors cant respond or reply to any of these reviews or they could have a possible HIPAA violation on their hands...which is a very very bad things. So its unfair that while they get reviews, they cant address any of the reasons.
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Gosh I can't imagine this is legal...oh wait! It's okay to bury Stark Law disclosures in consent forms...
There are good doctors, and there are bad doctors. As a registered nurse with 33 years experience, including trauma, ICU, CCU, medical surgical units, cardiac surgery, I feel qualified to determine if I have a good doctor or a bad doctor.To determine same, a patient needs a copy of their medical records, and evaluation of same by a medical professional.
Everybody to one extent or another is exposed to being sued or having negative things being said about them so get over it .
Ok ,I don't post something online buy I blab about my bad experience in line at the supermarket,gas station,McDonalds,the gym etc which is even more effective than the internet since the area where I talk out loud in public is the area where the doctor is .I bet you more people will over hear my conversation about a particular doctor than will read it .
Then you can't tell me that doctors don't already have a list of black balled patients for what ever .Had one doctor refused to treat me unless I gave my last doctor/dentist .What does it matter who's work your giving a second opinion on .Your supposed to give unbiased opinion then worry about who .If you think of your patients-your very reason for YOUR medical career as the enemy get the F out NOW -I don't want you .
Then most doctors/dentist have already been having their patients sign away their rights on things like agreeing to pay what ever they want even though the conditions of accepting your insurance says you don't have to pay another dime in many cases .
To top it off you're already signing s crap load of consent forms snd waivers .Combine the CYA stuff with the prices the medical industry charges it's no wonder people want to sue on the drop of dime .
If you don't trust me I don't trust you .
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Simple solution . . . . DON'T sign and get a new doctor who's willing to be responsible for his actions.
Or, bring along your own form to have the DOCTOR sign, agreeing that you can blog about him doing a good job . . . . or NOT.
Open up and say \"ah\", so I can shove this agreement down your throat?
That's not gonna fly.
Any agreement signed by a prospective patient for medical care in the waiting room of a doctor's office would be a classic \"adhesion contract\". The \"gag order\" terms would offer nothing of value to the patient, but only favor the doctor, so the agreement would be unconscionable. Given the setting in which the agreement was forced upon the (often ill!) patient as a precondition to getting medical attention, the procedurally unconscionable way in which the agreement was \"offered\" and \"accepted\" would also render the agreement moot.
There is no reason for any consumer to fear these non-bargained-for bogus contracts that offer nothing in exchange for massive concessions in basic rights of the consumer. This is the stuff of small claims court, and judges are far more than willing to provide the rough-and-ready justice that declares such \"agreements\" to be nothing more than attempts to defraud.
Agreements must be offered, considered, and accepted by both parties, and the excuse \"that's our policy\" is no more an excuse for this sort of agreement than it would be for the actions of the Mafia when extortion protection money from store owners. \"That's our policy\" is not an argument, it is an admission of guilt and an admission of a deliberate pattern of criminal behavior worthy of a allegation of violation of the RICO statutes.
Yeah, RICO. Haven't heard that one in a long time, have ya? The Republicans have been in control of the Justice Department for so long, everyone has forgotten the difference between a legitimate business and an ongoing criminal conspiracy.
If you think about it, this blog would not really be as entertaining if not for the institutionalization of fraud, conspiracy, theft, and racketeering in the form of entire companies who have \"policies\" that are openly hostile to those foolish enough to be customers.
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Do they have classes in \"customer service\" (or whatever you call it in the medical field - patient relations, bedside manner, whatever) in medical schools? It just seems like too many doctors forget that their patients are *people* and when they're reminded of that on a review site they get mad.
Medicine is in part a service industry, so, yeah, they should be answerable to the people they treat. And, because your medical treatment is very personal (and there's a perceived power difference), it's hard to tell your doctor to his/her face if there's a problem (and mentioned above, hospitals and practices often don't try to fix REAL problems). Do comment sites like Yelp have a way for the subjects of posts to respond to customer complaints or contextualize the situation? I teach college students and every annual evaluation allows us to respond to student evaluation comments - we id trends and ways to improve, but my employer also knows that students write dumb comments and we're allowed to put the really stupid stuff (she's a bad teacher because she never canceled on a Friday) in perspective. Also, seeing how doctors respond to the comments could give a clearer idea of what kind of person s/he is - if the responses are really callous then you know - BINGO! Poster got it right!
Honestly, if a doctor tried to hand me a comment waiver to sign, I would assume that s/he is expecting a bad review and I would bolt out of there immediately.
@ burnedout - we have lots of bedside manner training, both in the basic sciences years (when you have simulated patients) and the clinical years, when you are rotating through hospitals. Most recently, we learned how to do motivational interviewing, where we help the patient figure out their goals, identify which one they feel comfortable completing first, and help develop a strategy for them to accomplish it.
Furthermore, we have courses in bioethics, community and preventative medicine, clinical skills, etc. So we're not exactly untrained in how to respect meatbags (tossed in there for irony).
What may be annoying to your doctor is that when people review him online, he can't respond to the reviews that are false, or the reviews by unpleasant, obsessive patients who expect to be treated like kings and queens when their insurance company will reimburse your doc about a third of what he bills you for (one of the major reasons why health care costs have been increasing over the years is because doctors have increased their rates in order to get the necessary amount of money from insurance that they're owed).
And you know what else doesn't help deliver great care? When patients LIE TO YOUR FACE when you're trying to figure out what's wrong with them.
The person who helps me with media scans & replies to comments about myself or my practice. It takes time, money and energy to build a successful practice. I'm not going to ignore criticism. The manner in which I respond to criticism on gripe sites may even inspire you to make an appointment.
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Sounds illegal to me. \"Hmm I deny you treatment based on the fact you wish to keep your first amendment rights - prohibits the United States Congress from making laws \"respecting an establishment of religion\" or that prohibit the free exercise of religion, laws that infringe the freedom of speech, infringe the freedom of the press, limit the right to peaceably assemble, or limit the right to petition the government for a redress of grievances.
Sounds like they are trying to limit freedom of speech and press to me.
@Saboth: IANAL, but if it were a medical emergency, you might be able to make a case about signing under duress.
@Repique:
yes, but if all medical practices went to this method, basically you would have to choose between your rights and medical coverage.
@Saboth: The *government* has to protect your first amendment rights; private individuals have no such obligation. Not that I agree with this in general, but just to clarify.
@Saboth: Erm. While I think these gag orders are shady, it's not an infringement on free speech.