[karmajunkie]

The problem with that theory is that many doctors require patients to sign documents that prohibit online reviews, and many "bad reviews" from patients are somewhat frivolous. So reputation management is largely worthless in the medical field.

Additionally, in Texas for example, tort reform has done nothing to limit costs of healthcare (though it has made malpractice insurance much cheaper, which makes life nice for doctors and their insurers.)

[stuki]

And what kind of reputation, do you think an Amazon seller who makes potential customers sign "no review" contracts, will get?

There's nothing magical about the medical field, that makes approaches developed elsewhere somewhat irrelevant there. It's just another fee for service arrangement. Although many Doctors do like to fancy themselves as special snowflakes.

[jemfinch]

> There's nothing magical about the medical field, that makes approaches developed elsewhere somewhat irrelevant there.

There absolutely is something different about medicine: consumers' participation in the medical market is involuntary. We don't see doctors because we want to see doctors, we see doctors because if we don't, we will be maimed or killed by disease or dysfunction.

By the time people are seeking a doctor, they're often not in any position to evaluate the market--if a real market for medicine even exists where they live--and weigh the reputations or contractual demands of several doctors before choosing one. They're in pain, they're suffering, and they need a doctor now. That's very different than buying a watch on Amazon.

[stuki]

Outside of emergency rooms and acute care, people have quite a bit of choice as to when to see a doctor, and whom to see. It is conceptually little different than auto repair in that sense. Making the world artificially black and white only serves to obscure nuances. Some times you really could use some help right now, most of the time not. The efficient way to deal with the former, is to plan ahead and make arrangements. For the latter, YAGNY may well be the efficient approach.

Heck, even someone rendering services as conceptually involuntary as a will executor, can have a reputation fr being good or bad. Despite you not necessarily having much choice on the matter when the headline service is being rendered.

[arrrg]

And in many cases everything goes well. The system is not completely dysfunctional and I don’t think anyone was claiming that.

This is mostly about exceptional cases.

[SilasX]

You could say the same thing about many goods. For example, "I'm purchasing food, not because I really want it, but because I need it to exist. Therefore, no one should be able to use review systems to decide which food to buy. [or make a profit, or be run by private corporations, or whatever other remedy is merited because of the human need for food]."

[rictic]

That's some elegant rhetoric and ideology but it doesn't address the reality of the situation.

The evidence that I see says that this has been a practice for at least five years, and according to the Boston Globe[2] one reason for this is that doctors feel like the conversation is one-sided, as they are legally forbidden from saying much about their patients.

1] http://boingboing.net/2009/03/05/doctors-force-patien.html 2] http://www.bostonglobe.com/lifestyle/health-wellness/2013/03...