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Medical [Dental] Anti-Defamation Contracts and Doctor Accountability

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Was the ADA Complicit?

By D. Kellus Pruitt DDS

If you were to walk into my dental office with a toothache, and I told you that before I relieve your pain, you have to agree not to say bad things about me on the internet, how badly would the tooth have to be hurting to keep you from walking out the door?

The article, “Toothache lawsuit may stifle medical gag orders against online rants”, by JoNel Aleccia, was posted yesterday on MSN.com.


The Patient

“[Robert Lee, 42] who had a bad toothache has filed a class-action lawsuit against his New York dentist after she required him to sign a contract promising not to trash-talk her online — and then fined him thousands of dollars trying to enforce it.”

Aleccia adds: “[Dr. Stacy Makhnevich] was among hundreds of medical professionals nationwide in recent years who refused to care for patients unless they signed anti-defamation contracts. In the contracts, the doctors and dentists promised not to evade federal patient privacy protections in exchange for patients’ agreeing not to post public comments about them.”

The Dentist

Other than its obvious ineffectiveness for this particular Manhattan dentist, whose practice is on the 69 th. floor of the Chrysler Building, Lexington Avenue at East 42St., (212) 697-4400, what’s wrong with this business plan?

First of all, aside from the insult, if a dentist required you to sign a contract forfeiting your right to express your opinion about the quality of care even before being seen, how confident would it make you feel about the doctor’s abilities?

The HIPAA Question

Then there’s HIPAA. It’s sad that healthcare providers on the 69th.  floor of the Chrysler Building would take advantage of vulnerable Americans who don’t understand that their right to privacy isn’t something that can be withheld – even as part of a twisted “copyright” deal intended to enable a dentist to dodge accountability. It seems to me like the Office of Civil Rights as well as the Attorney General should be alerted. How is threatening a patient’s privacy in return for direly-needed treatment different than extortion?

The Gotcha!

Mr. Lee had forgotten the contract until months later when he allegedly discovered that Dr. Makhnevich had overcharged him by about $4,000, improperly filed the insurance and then refused to provide him with the documents he needed to file the claim himself. That’s when he started posting rants on sites like Yelp and DoctorBase, such as, “Avoid at all cost! Scamming their customers!” and “Honestly, how do you live with yourself? Just try being a decent human being.”

“Within days, Makhnevich demanded that the sites remove the comments and threatened to sue Lee. She also said he was infringing on her copyright provisions and started sending invoices for fines of $100 a day. By October, the total topped $4,600, he said.”

The Service

Since the dentist purchased the right to use Medical Justice Inc. anti-defamation contracts to prevent complaints from dis-satisfied customers from being discussed on the internet, I say she is due a refund. What’s more, if she’s given any trouble about it, she should get on the internet and complain – if she didn’t forfeit that right as part of the agreement.


So where did Dr. Stacy Makhnevich learn about Medical Justice Inc.’s ineffective, unethical and probably illegal anti-defamation contract service? Of all places, it may well have been in ADA Headquarters, 211 E. Chicago Ave., Chicago, (312) 440-2500

Dr. Jeffrey Segal [MD, JD], the neurosurgeon and founder of Medical Justice Services Inc. which sold providers like Dr. Makhnevich the right to use his company’s contracts, was a featured speaker at the American Dental Association’s [ADA] annual Benefits Conference last year.

The ADA leadership’s decision to invite Dr. Segal to advertise his product at a benefits conference (?) reveals the old timers’ underlying paranoia that makes them prefer silence from members as well as their own dental patients.


Since the ADA effectively put its stamp of approval on Medical Justice’s anti-defamation contracts, don’t you think the ADA News should at least post a warning about the liability to members who attended Dr. Segal’s presentation in ADA Headquarters? Let’s watch dentistry’s leaders ignore the abysmal results of yet another half-baked blunder caused by people too proud to listen.


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11 Responses

  1. Publisher’s Invitation

    The Medical Executive-Post invites Dr. Stacy Makhnevich and Dr. Jeffrey Segal to comment on the above MSN report and Op-Ed piece from Dr. Darrell K. Pruitt.

    Dr. David Edward Marcinko MBA
    [Founder and Publisher-in-Chief]


  2. Medical Justice Inc. and Yelp validate DR.Oogle

    Today we learned that Medical Justice System’s ADA-approved, anti-defamation contract with an aggressive Manhattan dentist actually attracted defamation, plus a lawsuit to boot! What a deal!

    But that’s not all, sports fans. This adventure also reveals that DR.Oogle is arguably the most reliable dentist ratings site on the internet.

    Let’s go back a year. Why do you think ADA staff writer Kelly Soderlund chose the title “Annual benefits conference adds new topics” for her September 20, 2010 ADA News article describing the ADA dental benefits meeting that featured Dr. Jeffery Segal’s Medical Justice Services/Dental Justice Inc.?


    Could it be she recognized that the vendor favored by one or more ADA officials was conspicuously out of place at a conference about dental benefits, and needed a preemptive, excuse-me segue as early as the article’s title?

    Soderlund writes “Jeffrey Segal, M.D., J.D., and founder and CEO of Medical Justice Services/Dental Justice, provided information on doctor rating sites, explaining how patients or people posing as patients can post comments about medical professionals on websites without them being able to defend themselves.”

    Dr. Segal’s prophetic warning that Yelp allows non-patients to post harmful reviews about dentists was spot on correct.

    Yesterday, his client, Manhattan dentist Stacy Makhnevich DDS, had 5 reviews on Yelp. Then came more news of how over the last few months, she successfully inflamed an already dissatisfied patient by enforcing Dr. Segal’s twisted copyright contract that the dental patient signed while in pain – charging the infuriated patient $100 a day for not deleting his opinion of her ethics on the internet.

    It turns out that Dr. Makhnevich had purchased very bad advice from Medical Justice. Along with a predictable class-action lawsuit, she quickly attracted the attention of people who already have a visceral dislike of dentists and don’t mind sharing it. And just like Dr. Segal warned, the mostly profane complaints were from people who have never been Dr. Makhnevich’s patients.

    Here’s the bonus discovery: In 24 hours, Dr. Makhnevich’s reviews on Yelp climbed from 5 to 300, while on ratings website DR.Oogle (doctoroogle.com) – which only accepts reviews from the dentists’ patients – Dr. Makhnevich had 10 reviews yesterday and still has only 10 reviews today.

    What should that tell consumers about the reliability of reviews on Yelp versus DR.Oogle?

    D. Kellus Pruitt DDS


  3. An excellent post

    I am one of those “who has a visceral dislike for dentists”. This developed about ten years after I came to the US – due to obvious and blatantly unethical practices by 4 out of 6 dentists. This is despite having friends and relatives who practice this profession (and no, I am not their patient).

    There are, as in any professional group, good and bad dentists. The difference between other professionals and dentists is that the latter’s professional association appears to tacitly approve if not encourage unethical or at least questionable conduct as you point out in this post. This shifts the balance between the good and the bad and it is good to see a vocal minority.

    Many of us, are reluctant to take a more active stance for several reasons. One is that it is just not worth our time – there are always other options. There is also a fear of sinking more money into a bad investment.

    Balaji Shyamkumar


  4. On the Publisher’s Invitation

    I too welcome responses from Dr. Segal and Dr. Makhnevich. However, since they both may already be involved in the dental patient’s class-action lawsuit, I think it’s unrealistic to expect either to comment. Nevertheless, I see no reason why ADA President Dr. William R. Calnon can’t explain why Dr. Segal was chosen to be a featured speaker in ADA Headquarters during last year’s annual Dental Benefits Conference.

    Dr. Calnon has only been President for a couple of months, and like virtually all ADA officials, he doesn’t encourage personal contact on the internet – not even a Facebook account. In the event that there is not a single ADA official following this thread to pass on the invitation to the President, I’ll post it where Dr. Calnon can’t miss it.

    I know very little about the Rochester, NY general dentist. It will be interesting to find out if he’s any more accountable to the dental community than the last half-dozen shy ADA Presidents.

    D. Kellus Pruitt DDS


  5. More on “Medical Injustice”

    An excellent essay, by Paul Alan Levy, on this volatile topic.


    Ann Miller RN MHA


  6. Feds Allow Use of Medicare Data to Rate Docs

    The government just said yestersday that Medicare will finally allow its extensive claims database to be used by employers, insurance companies and consumer groups to produce report cards on doctors – and improve current ratings of hospitals.

    By analyzing masses of billing records, experts can glean such critical information as how often a doctor has performed a particular procedure and get a general sense of problems such as preventable complications.


    So, there is no data privacy docs – get over it!



  7. No calls, please!

    A few minutes ago, while I was on the phone with a colleague, a reporter with the CBS affiliate in St. Louis called. He told Janis that he had been reading my stuff and wants to talk to me. Unfortunately, he had hung up by the time I got to his call. I had unintentionally left him on hold for too long while I looked for new batteries for my recorder.

    That’s why I prefer emails over phone calls.

    D. Kellus Pruitt DDS


  8. IMHO

    Doctors, and all medical professionals, will be better served if they communicate effectively with their patients, provide appropriate services and fees, and develop a trusting relationship with their patients.

    Adam & Eve


  9. Adam & Eve,

    The personal attention we all want requires more time than managed healthcare models afford providers. I’ve heard that some physicians actually carry timers to let them know when their patients’ allotted face-time is up.



  10. Survey: 80% of Doctors Monitor Their Online Reviews

    Vitals recently conducted a survey on physician interaction with online reviewers. Here are some key findings from the report:

    • Over 80% of doctors monitor their reviews and ratings online.
    • 1 in 3 doctors said they monitor reviews monthly, and 12% check them weekly.
    • 13% of doctors said they almost never monitor online feedback from patients.
    • One third of doctors have responded to online patient feedback.
    • 25% of U.S. adults consult online doctor-rating sites.
    • 200,000 patients leave a review or rating each month on Vitals, the largest collection of reviews.

    Source: Vitals, August 11, 2015


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