Health care & Arbitration.
April 18, 2019 6:35 PM   Subscribe

For the first time ever, I am interacting with a medical provider who is asking me to sign an arbitration agreement before providing services. My brain and ethics says this is a big deal. Is this a big deal? Is it worth it?

I have so far successfully navigated though this world without signing away many rights. I am pretty uncomfortable with this, and this immediately puts me in an uncomfortable place of 'this place doesn't give a shit about my health, they give a shit about money' which is some pretty awful footing to start out (especially when this is a mental-health related provider, and i already feel pretty awful about a great number of things).

There are only two providers of this service in my area that are covered by my insurance, so I have options, but this one is much more convenient, and have (aside from this) been a bit more responsive (but not the most professional).

It should be stated that this behavior is not illegal in my jurisdiction, but in some states you're allowed to opt out of such an agreement with no repercussions, and I am not in one of those states.

Is this a big deal? Is not signing this the battle to fight?
posted by furnace.heart to Law & Government (14 answers total)
I would absolutely not sign it. And I would be suspicious of a medical practice thT asked me to. Unless they’re in a particularly high risk specialty, I would wonder what went wrong to make them go that direction.
posted by stoneweaver at 7:51 PM on April 18, 2019 [4 favorites]

I would be extremely skeptical.
posted by praemunire at 8:15 PM on April 18, 2019 [2 favorites]

I would refuse to sign this too.
posted by sevensnowflakes at 8:29 PM on April 18, 2019 [1 favorite]

Hard hard no. This is a huge red flag for a medical practice. Especially a mental-health care provider.
posted by Homo neanderthalensis at 10:00 PM on April 18, 2019

Don't sign this, find another provider.
posted by zdravo at 10:52 PM on April 18, 2019 [1 favorite]

I am on the other side of the opinion. I would sign it. I probably would not sign it if it was for medical/physical care, but mental health care yes.

I am having a hard time understanding what you would be in a legal dispute with a mental health provider. Sure, there are a few highly unlikely scenarios, but that is a small risk.

Arbitration will cost less, go faster and be a viable avenue to bring up a smaller issue that would be prohibitive in a court setting. To me, the things I would look for are who picks the arbitrator or the panel, what are their qualifications and who bears the cost if you lose. Do you owe the other side fees?

Also, what does your insurance policy company say about it?
posted by AugustWest at 10:56 PM on April 18, 2019 [1 favorite]

I’d sign it. It’s weirdly common in Florida for gyn practices to have noticed up about not carrying some kind of malpractice insurance... but it’s been a while since I went to a solo practitioner place.
posted by tilde at 2:01 AM on April 19, 2019

posted by james33 at 4:59 AM on April 19, 2019

Seconding the hard no. That agreement is in place because they messed up something *bad* in the past and took a legal hit on it, and now they're starting out every patient relationship with mistrust and antagonism. Run.
posted by mccxxiii at 5:10 AM on April 19, 2019

This seems pertinent as a few have brought it up; this is for TMS, so mental heath care but also an actual ‘let’s dig around in your brain’ kind of thing. Thanks for the answers so far. I’m going to avoid treatment here unless it’s my only option.
posted by furnace.heart at 6:42 AM on April 19, 2019

I'd probably sign it, but it might affect my interactions with them, knowing that they are not necessarily bound to the same level of responsibility as a provider who doesn't do that sort of thing.

It's not clear exactly what type of provider they are, so that might affect my decision. If it was, I dunno, a brain surgeon or something, then I'd probably be kinda concerned. A relationship counselor perhaps less so—not that relationship counseling isn't important, but you're typically in a better position to evaluate their advice/recommendations and act on them or not yourself, than when you're out cold and someone's digging around in your skull. So you could consider their recommendation, add in the "I can't sue them if this goes wrong" factor, and then decide what to do.

Or put differently, consider the difference between a pharmacist and a streetcorner drug dealer. There are drugs that you can get from either one of them—but you know when you buy from the dude on the corner that you don't have many options, or at least a very different set of options, if it turns out you got sold Tic Tacs, vs the pharmacist. Call it a "liability continuum". Arbitration agreements move you along the liability continuum away from a nothing-up-my-sleeve, I'm-not-afraid-of-the-rules, regulated and fully liable profession, and a little ways towards the other end. Not all the way, of course, but arbitration panels are notoriously friendly to the side mandating arbitration, which is to say not the patient/consumer. In response, I think you need to be a bit more caveat emptor in your interactions. But that doesn't mean you shouldn't sign, just that it needs to get weighed in to how far you trust them.

I think they're doing their profession a grave disservice with this sort of thing, because it creates a (valid!) reason for patients to distrust them, but I suppose that's between them and their professional licensing body.

EDIT: I left my post in preview for a long time and missed OP's latest followup. Since this is literally a digging-around-in-one's-brain situation, I'd tread carefully. Like maybe... backing away slowly.
posted by Kadin2048 at 12:51 PM on April 19, 2019

Having done TMS, it's non-invasive, but correct placement of the electromagnets is key to getting good results since they have to get it over the correct part of the brain to stimulate.

I'd be very wary of a company demanding this, especially since you'll have no way as an outsider to judge their competence in this area. You'll never know if the TMS didn't work for you or if the provider just screwed it up somehow.
posted by zug at 5:01 PM on April 19, 2019 [1 favorite]

I worked in a TMS practice a few years ago and do not recall having patients sign anything like what you are describing. I was the office manager and was responsible for maintenance of the patient records, payments, insurance appeals, etc., so would definitely have remembered if there was a form like that. Perhaps things have changed, but I don't think so.
posted by sundrop at 10:17 AM on April 20, 2019

Just an update, and to close this out; I found another TMS provider and when i described what the other place had tried to get me to sign, they were kind of upset.

I filed a complaint with the medical board overseeing their practice, as well as another state agency that oversees some other parts of their office operations. I've also followed up with my local & state representatives that this kind of behavior shouldn't be allowed (despite, after some research that in Oregon it is totally legal for a medical practitioner to ask you to waive your rights to all sorts of crazy shit before treatment begins), and asked them to take drafting legislation disallowing this kind of behavior.

Thanks for providing a much needed reality check everyone; even the answers not marked as best were valuable for setting context.
posted by furnace.heart at 9:36 AM on May 4, 2019 [3 favorites]

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