@Ehay2k @bendelarre Is it preferable to show up, see the waiver, say "Sorry, I don't sign these, guess I'm leaving now?"
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Discussion
@pluralistic
I have walked out of appointments when their paperwork said, explicitly, they expected payment in full from me at the time of service, though I was fully covered by insurance. "Are you going to bill my insurance?" "Of course." "Well, why does it say the exact opposite here?"
I've always said it would be great to slide a piece of paper with my expectations as a patient to the doctor and ask /them/ to sign it.
@ridetheory @pluralistic During the height of COVID, my dentist called and reminded me about my appointment.
Then they asked a bunch of screening questions including if I was vaccinated against COVID. I answered them all.
Then I asked them the same questions. She wouldn't answer because it was private information.
So, I declined my appointment opting to go later when things had calmed down.
@pluralistic Cory, sorry to hear you're still having back pain - IIRC swimming was your go-to to keep it in check, has that stopped being as effective?
I've had my own revelation in the last 5 years: Lifting heavy weights, specifically powerlifting, has helped me manage my own lifelong chronic posture-related back pain.
@tris Keeps it from getting worse as quickly, but it's still bad and worsening.
@pluralistic sorry to hear that. I read this advice back in the day, and think of it often: https://www.hanselman.com/blog/brain-bytes-back-buns-the-programmers-priorities
@pluralistic
To me, the second sentence is the weirdest. Why does he feel the need to mention that you have had back pain for decades already, and that he thinks he could have fixed it, in the same email where he says he won't?
To me, the second sentence is the weirdest. Why does he feel the need to mention that you have had back pain for decades already, and that he thinks he could have fixed it, in the same email where he says he won't?
That part makes it sound to me like he is saying: "if only you hadn't asked this difficult question, I could have cured your pain".
Like, not only is he refusing you, he also wants you to know that it's your fault, and how big your loss is.
@jesse @pluralistic 99.9999% of customers don't query these contracts of adhesion. It's shameful that you were refused service on the basis of being careful about your legal obligations. It's also understandable that the business just picks low hanging fruit.
@jesse @pluralistic generous read: could he be scared of litigation, or had a really bad experience in the past?
@pluralistic Wow, and eeks. Reminds me of one of my favorite quotes:
"One of the ways the system protects itself is to describe as deviant behavior describing the behavior of the system."
(from Patrick McKenzie / patio11; more context here)
@pluralistic "you made me read the contract I require you to sign and it made me so uncomfortable I dint want you as a client"
@pluralistic @pseudonym
I had a dentist here in SF East Bay cancelled my initial appointment because I asked questions about their onboarding paperwork and HIPAA policy
I had a dentist here in SF East Bay cancelled my initial appointment because I asked questions about their onboarding paperwork and HIPAA policy
Because I would be a problem
Telling...
@pluralistic "I the person who gets people to sign legal paperwork just to really talk to me, feels uncomfortable with the legal framework actually being mentioned." Sorry to hear about your pain, but it doesn't really sound like it "feeling good to you" you may have saved a trip.
@pluralistic
As general rule, if someone demands that you give up your rights as a show of trust, that person does not deserve your trust.
As general rule, if someone demands that you give up your rights as a show of trust, that person does not deserve your trust.
@pluralistic I've had 3 doctors in 2 months refer to being "(un)comfortable" wrt to a possible treatment. Seems like something cultural is going around.
@pluralistic To a European, this sounds extremely crazy. I hope you'll find your therapy soon!
@pluralistic let us know if you find someone who answers this differently. I’m serious, I’m not saying you won’t. I hope you do, just really want to know how it would go better. It’s a fascinating case study. Sorry you have to go through it, but thanks for sharing.
@pluralistic This reminds me that Epic (makers of MyChart in the US) are putting a binding arbitration and class action waiver in their new Epic ID when patients to sign to see their medical records: https://central.mychart.org/MyChart/app/welcome-wizard/terms-and-conditions
Epic holds somewhere around 80% of patient records in the US, https://prospect.org/health/2024-10-01-epic-dystopia/ and is also in Canada and the EU.
@rpm @pluralistic pretty soon picking my battles, given the amount of my time and energy available, will mean I have control over one spaghetti strand out of a dozen boxes of spaghetti. Maybe not the best analogy, but you get my picture of {{{ frustration }}} .
Or better yet:
🙄 😩 🫤 ☹️ 😩 😖 😵 😵
Or better yet:
🙄 😩 🫤 ☹️ 😩 😖 😵 😵
@pluralistic That text says in as many words "I am shady af and don't want to risk being found out".
You dodged one there.
You dodged one there.
@pluralistic by "spector" they meant "spectre"?
@pluralistic He did you a favor, you dodged that mess. 'Legal threat' lol
@pluralistic I'm guessing that your question, to him, sounded something like "So, what is the mechanism, should I decide to sue you?"
I know that wasn't your intention, but I can understand him being a bit freaked out.
@pluralistic ... and why did he spend 40 minutes reading HIS OWN contracts? Shouldn't he have read it already before signing it and starting to work?
"But having a spoken threat of legal action in my consciousness, is not conducive to a healthy therapy process."
So he's just doesn't seem to trust his own work, being afraid of being sued over malpractice?
Better look for a confident therapist who really trusts in his work.
@pluralistic Christ, what an asshole!
@pluralistic
“being asked about his paperwork "made him uncomfortable."” … but he then had to spend “40 minutes accessing and reading the specific terms of my healthcare providers insurance policy” meaning he didn’t actually know what was in it.
This response is a horribly patronizing one: it means that the mere suggestion that a patient might be an equal partner in care, with their own agency, ideas, motivations, and standing is threatening to him.
I understand that some of it is fed by the awful mess that is insurance and a medically litigious society, but also in there the old idea that medicine is a mysterious, arcane black box that patients are just supported to subject themselves to on the hand-waving say-so of the great doctor; this is an archaic practice that needs to be diligently scrubbed out of modern medical practice.
@pluralistic
Besides the whole arbitration question and out-of-proportion reaction -- does that response strike anyone else as a little ... crunchy? Something about the way they talk themselves up (and in a context where that's not called for) just gives me some (perhaps undeserved) associations to essential oils and crystals.
@pluralistic that's exactly what I did at my last mammogram appointment.
@pluralistic (The hospital--the one at which my husband works--gave me a signature pad to sign. I asked "what am I signing?" and they gave me a multipage document in tiny font (8 point or less?) basically stating that I was agreeing to anything they decided to do to me. I left.)
@pluralistic dodged a bullet there. What a truly OTT response to a simple y/n q
@pluralistic Time to get out of Trumpistan and back to Canada? Before ICE catches up with you, asking questions is grounds for deportation now, isn't it?
@pluralistic
So, he took the time to check before canceling, and then implied he cancelled *because he might get sued".
Does that suggest that he might *not* have canceled if he did have arbitration? 🙄
@pluralistic
So, he took the time to check before canceling, and then implied he cancelled *because he might get sued".
Does that suggest that he might *not* have canceled if he did have arbitration? 🙄
Also there is an aspect that you made the doc waste 40min of unpaid(?) work, that they don't like doing (or even hate).
From a typical person perspective it's normal to be angry at the question "Can I sue you?"
@pluralistic i know this this platform is something of an echo chamber and i will get flamed... But put yourself in the doctors shoes. Would you in those shoes treat you in your shoes?
The US has become such a ludicrously desperate thirsty and litigious society, beyond a single doctor's control. I fear you're using this incident to score a cheap point with your fans, of which I am one btw. But picking a fight with a doctor who exercised their right to refuse you service seems a bit Karen.
@pluralistic From your post, I'm taking that you live in the USA. I was so astonished to read this, not for the reason a person in the USA might be astonished, but because such a question would come up in the first place. I, like so many others outside of the USA, look at what's happening in the USA with the thought that the 'lunatics have taken over the asylum'. I'm in the UK and whilst there are medical things go wrong and the courts deal with them, I would never even consider looking at terms of engagement with medical practitioners because there is trust in individuals and treatment. Plus the State has regulations for behaviour. It isn't perfect but I really hope to never ever see it go the way it is in the USA. I feel so sorry for people in the USA, to have lost all trust in fellow humans, insitutions and the legal system is a truly terrible thing. The USA seems to want to drag the rest of the world into it's 'systems, I hope that never happens. #Mastodon#Fediverse
@pluralistic I'm sorry that happened to you and also a bit relieved that maybe this will help you avoid a situation where your medical provider doesn't trust you. Patients should always self-advocate for their rights. You didn't do anything wrong or offensive for most people. Makes me wonder if he's been found liable in the past.
@pluralistic
Any alleged ‘therapist’ who spends 5 paragraphs, 3 of them wordy, justifying a frightened decision not to treat, apparently because they can’t understand their own legal situation does not inspire confidence. 🙁
The guy comes across as a wanker, buffing his own credentials by denigrating yours. As others have said in this thread: you dodged a bullet there! (Imagine all the other bad advice he could have coughed up on you, in his patronising way… ) 🙀
Let’s hope he doesn’t sue you for sharing what happened. Thanks for a thought-provoking item; very much hope better treatment comes forward for you asap. ♥️
Any alleged ‘therapist’ who spends 5 paragraphs, 3 of them wordy, justifying a frightened decision not to treat, apparently because they can’t understand their own legal situation does not inspire confidence. 🙁
The guy comes across as a wanker, buffing his own credentials by denigrating yours. As others have said in this thread: you dodged a bullet there! (Imagine all the other bad advice he could have coughed up on you, in his patronising way… ) 🙀
Let’s hope he doesn’t sue you for sharing what happened. Thanks for a thought-provoking item; very much hope better treatment comes forward for you asap. ♥️
@pluralistic Wow, that simple question is perceived as a legal threat?
Maybe I'm blissfully ignorant here on the frosty side of the border, but their response seems more akin to you brandishing a weapon.
@pluralistic someone in healthcare with a self-centered god complex? Nooooooo 😒
@pluralistic at my last appointment, my doctor asked if it was okay to use AI to record and transcribe our conversation. On one hand, it saves the doctor time by not needing them to type in my answers. On the other hand, AI is not very trustworthy. I said okay but now wish I hadn't.
@pluralistic "a spoken threat", seriously? You're better off without this person.
@pluralistic write “I don’t understand this” by the clause and initial it. Let the MD explain the legalese to you if they catch it and then, if neither of you is an attorney, tell them that you still don’t understand. I had an MD tell me he got a malpractice insurance discount by getting patients to sign arbitration agreements.
@pluralistic There is a contempt of patients built into health care culture, in spite of their own constant efforts to paint themselves as heroes. Some providers manage to avoid this, but they are rare in my experience.
This denial of service is nonsense. While trying to make it sound like you are a threat to him, what he means is that you won't allow him to be a threat to you. It's glib gaslighting. To say you threatened him is outrageous.
You dodged a bullet.
@pluralistic doctors are wise to filter this way. They must manage their risks. There are literally federal workers trying to "catch" them doing something illegal.
Especially in pain medicine.
If you want treatment you need to not look like a threat. Unfortunately.
Good luck.
My wife is having major surgery Thursday. The system is so antagonistic that we are looking for illicit sources of pain meds to be sure she is cared for.
The lawyers are not on the patients side nor the doctors.
@pluralistic this is crazy…but strangely I just experienced something like this; my daughter knew her fifth grade teacher’s middle name because she read it…in her own paperwork where it appeared. And this was enough for him to tell the principal that he was not comfortable having her in his class…as if she’d crossed a boundary 🤷🏻♀️ sounds like smart people who make average ones uncomfortable with basic questions!
@pluralistic What could have happened is that, after being asked about a binding arbitration clause, the doctor tried to read his malpractice insurance policy and after spending 40 minutes going through all the gibberish (designed by a corporate entity to allow them to pay out as little as possible), he wasn't sure what would happen. The question is whether to blame the doctor or to blame the large corporation that is providing the doctor's insurance.
@pluralistic How could your question be interpreted as a 'threat'? How chicken shit is this therapist? If they canʼt deal with what is a normal question arising in running a business, then maybe they shouldnʼt?
@pluralistic "Spector" FFS? Does he mean Phil?
@pluralistic "the spector has spoken"
@pluralistic Or…WHY CAN’T WE HAVE UNIVERSAL HEALTHCARE IN THIS COUNTRY, FFS?!
@pluralistic that's just weird but the US is quite litigious. At just they didn't include, "I prayed I about it" in their reasoning.
@pluralistic I had a job offer retracted because I asked to see the document that the agreement I was asked to sign said i had read and agreed to.
@wcbdata @pluralistic sleaziest group of people I ever encountered was the Yahoo! integration team. I worked at a company acquired by Yahoo! They showed up and handed out documents we "had to sign by end of day". They lost their collective s2t when I said I was going to take it home and have my lawyer look at it.
Them: "You can't come back tomorrow unless you sign it."
Me: "That's fine by me."
Them: "You can't come back tomorrow unless you sign it."
Me: "That's fine by me."
Wish I still had filled copy of that doc. It was horrific.
@allpoints @pluralistic As I recall, the language from this potential employer was something like "getting legal documents reviewed shows that you aren't willing to commit to the <redacted> family." 😬
@pluralistic
America is now a nation of "How dare you ask these impertinent questions, peasant!"
@pluralistic
1. most docs have no idea what a "binding arbitration waiver" is. You triggered them to spend 40min trying to figure out WTF that is and how it applies to their practice.
2. a logical interpretation on their end is that you are litigious person (like starting a marriage with a prenup: cool, but it takes two)
3. a lot of pain providers get sued and in their private practice they'll be more risk averse
4. obv. comment: it's unwise to share your pain history on the internetz.
1. most docs have no idea what a "binding arbitration waiver" is. You triggered them to spend 40min trying to figure out WTF that is and how it applies to their practice.
2. a logical interpretation on their end is that you are litigious person (like starting a marriage with a prenup: cool, but it takes two)
3. a lot of pain providers get sued and in their private practice they'll be more risk averse
4. obv. comment: it's unwise to share your pain history on the internetz.
@pluralistic I guess we need to normalize asking this question everywhere? I recently bought a new vehicle and the dealership required that I sign one of these to purchase the vehicle. This was of course after having already spent much of our time (my spouse mostly) and their time shopping, test driving, doing all the other paperwork, etc. I ended up caving because it was either that or walk away and and try to find a different vehicle from another manufacture, which was just not going to happen
@pluralistic
This response is complete shit. I'm sorry.
This response is complete shit. I'm sorry.
I've taken to requesting paper copies of anything I'm going to sign, then striking anything I don't agree with, initialing the strike outs, then taking a photograph of the paperwork before handing it in.
You would *not* be surprised to see how many practices do not care that you've stricken sections of their agreements from the agreement. No one teaches the admins to refuse service on altered contracts. <shrug>
@pluralistic He doesn't seem to understand that a patient entrusts their body to them, their life and limb, literally. That's scary, it's why a lot of people avoid healthcare. How can someone practise therapy without being aware of that?
If a patient needs an answer to a legal question to be able to trust you, you give them the answer and try to assuage any concerns.
@pluralistic I guess expecting to have human concerns matter was a bridge too far for this doctor?
I hope you find someone good soon.
@pluralistic that sounded like a very "cover your ass" response from the therapist.
I don't think it should be legal to request someone sign away their rights.
And while I'm at it, fuck NDAs on settlements. I've even seen NDAs that include the NDA itself.
@pluralistic
Only being a little evil can save us now...
Are we allowed to punch Nazis yet? Is it part of commonlaw? 
@pluralistic Pretty much in line with all the replies to a post from @RickiTarr about Chronic Pain yesterday. Sadly, what you experienced is very frequent for DUMB things that should be answered. Asking a question of course, is highly suspicious.
@pluralistic I'm not even sure if "red flag" or "dodged bullet" is the best metaphor here. Might be a tie
@pluralistic
Wow….asking about paper work gets that reaction….unreal.
Wow….asking about paper work gets that reaction….unreal.
@pluralistic wtf. the whole policy is a specter of legal consequences, not you asking questions to clarify it!
@pluralistic the deep troll part of me is like "you should sue him", 🇺🇸 is so broken
@pluralistic Upon entering into a business arrangement with someone, you asked questions to clarify the terms of that arrangement... How dare you, sir? 😆
It sounds playing the "hero healer" has inflated his ego to the point that he's forgotten that he's also running a business.
@pluralistic maybe you shouldn’t have something in a legal contract that makes you feel uncomfortable if someone asks you about it? Grow up. All the ways we try to distance ourselves from responsibility through contracts and middlemen.
@pluralistic HE feels uncomfortable? Crikey Moses. It is rough to have to continue your hunt, but you need to have confidence that a therapist puts 'your' comfort, and possible improvement foremost.
@pluralistic So much for “Do no harm”.
@pluralistic "interesting take there doc - I looked you up and am doing my research, the very least you could do is show me the same courtesy"
@pluralistic "I can't work for people who expect fair treatment."
@pluralistic yeah i have the same reaction. I tried to get solar installed in 2020 and there was one vendor who had binding arbitration in their contract, and i said 'hey, small business owner to small business owner, can i redline this?' and THAT ALONE was enough for them to refuse to do business with me.
businesses are just used to getting their demands met, no matter how horrible they are, because they think the customers will just capitulate.
but we wont.
@pluralistic what was the context around asking that question?
If it was stand alone, I can see why they might take it as "someone's preparing to sue me before we even begin".
However, if you couched it with "I have an ethical obligation to object to this from any service provider", they may have taken it differently.
@FunkyBob It was "I have never sued anyone, or been sued by anyone, but I don't sign binding arbitration waivers, and so I want to make sure that I'm not wasting your time. Can you confirm that you don't make patients sign these?"
@pluralistic You're better off without this clown.
@pluralistic
I think the message is, is that they do not want patients, just clueless customers that have insurance that they can profit from.
@pluralistic Hmm, i wonder what the likelihood is for this being a medical system so broken that doctors can't doctor properly versus a personal issue.
@pluralistic
Kinda feel like you dodged a bullet. If they are afraid to be sued, then they may have good reason to be afraid. And if they are not willing to help you protect yourself in that endeavor, chances are they aren't that willing to protect you from your ailings when things get dicey. But you know all that.
@pluralistic
“I practice xxxxx in a country where my entire career can go to hell if I’m taken to court, even if I win a decade later.”
“Why would I risk taking a new patient that ask this? It’s a dog eat dog out there and no one has my back”
@wtrmt @pluralistic
Because if they were planning to sue you they wouldn't ask and thereby give the game away.
It is perfectly ok to not take a risk for any reason, including just a gut feeling, if it makes you feel that you are avoiding trouble.
If you know you're doing right by your patient and after discussion they accept your treatment plan, that's as good as you get. If that's not sufficient perhaps consider a less risky occupation.
As others have said, if Cory merely asking legitimate questions is problematic for this other fellow it's likely there's some legal history involved.
One merely wonders why Cory didn't post their name to warn off the rest of us.
@pluralistic Wow, fuck that so much. We all sign away legal rights, and I certainly have for healthcare, do they really expect us to treat all of it like a EULA?!
@pluralistic I wonder if they're perceiving it as a threat of legal action - assuming you want to know because you're "planning to sue" rather than just checking if there's something fishy with the paperwork. I'm not trying to make excuses for them - this behaviour is shitty in the extreme - but I wonder if they were thinking "surely the only reason you would want to know that is if you wanted to sue me"?
Here's hoping you find someone else who can help ASAP.
@cybervegan @pluralistic
Like cop shows that make people look guilty for "lawyering up," AKA exercising a basic Constitutional right.
Like cop shows that make people look guilty for "lawyering up," AKA exercising a basic Constitutional right.
@pluralistic Answering legal questions about his business makes him uncomfortable?
RUN.
@pluralistic What a curious asymmetry — he cannot offer an assurance that his practice won't screw patients with a binding arbitration waiver hidden in the small print, yet he talks of "mutual respect."
@pluralistic
"I'm uncomfortable being asked non-medical questions" wasn't an answer you could ever give when presented with paperwork. Seems like a power imbalance.
"I'm uncomfortable being asked non-medical questions" wasn't an answer you could ever give when presented with paperwork. Seems like a power imbalance.
@pluralistic Absolutely wild that confirming something that should be a basic right is considered a "threat".
@pluralistic translation "I do shit that might get me sued and _you_ might notice"
@pluralistic this is sadly not uncommon in my experience.
You basically can't get medical care in the US now without agreeing to binding arbitration.
It's bloody ridiculous, but then so is everything about the US healthcare system!
@bendelarre No, he doesn't have binding arbitration in his paperwork - he's angry that I ASKED if he did.
@pluralistic @bendelarre he's not angry! He's afraid!
@pluralistic @bendelarre this is the wildest part, because at least on paper you two are _in_ _agreement_ about binding arbitration
@pluralistic @bendelarre
Not taking sides here, just trying to make sure I understand both points of view.
Cory, you dislike Binding Arbitration agreements in no small part because they impair ones ability to seek proper justice, is that correct? I agree
From a doctor's perspective, perhaps asking about the existence of a binding arbitration agreement, even before they've been seen, may come off as someone who is looking to sue? That could make them very uncomfortable seeing that person?
@Ehay2k @bendelarre Is it preferable to show up, see the waiver, say "Sorry, I don't sign these, guess I'm leaving now?"
@pluralistic @bendelarre
Would this be an option?: Show up, get the consultation, and then after you have at least started the relationship, ask about arbitration? To me, this is more about timing - asking about litigation before you've even seen the Dr. may come off to them as "Can I more easily sue you?"
Are there any #doctors out there who can chime in? Do you feel that arbitration agreements protect Drs. from frivolous lawsuits? (I am not in favor either way, to be clear. )
@Ehay2k
Doesn’t one usually sign legal documents, including waivers before entering into a contract for services? Receiving the service in an initial session creates an implied contract. Surely the time to ask the terms is before the service begins?
Doesn’t one usually sign legal documents, including waivers before entering into a contract for services? Receiving the service in an initial session creates an implied contract. Surely the time to ask the terms is before the service begins?
@pluralistic oh my.
It's ridiculous that even from the practitioner side now the ramifications of the legal system are so daunting even they can't deal with it and they're providing a service not actively suffering!
@pluralistic @donaldball is it though?
I mean... I KINDA get the therapist's point. You signaled that one of the most important things to you is whether or not you could sue them. That wasn't what you MEANT, that wasn't what you cared about - but how could the person on the other side know that?
Maybe soften the question in the future - "for legal reasons I can't sign any contracts that include binding arbitration clauses - do you know if you have one?"
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