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The Curious Case of Medical Justice

Mutual Agreement to Maintain Publicity

Segal Covets Unique Brand-Recognition

Dr. Jeffrey Segal is a neurosurgeon from Greensboro, North Carolina. He also practiced in Indiana where he had to answer two separate malpractice lawsuits (the plaintiffs were David Bedwell 1996, and Mark Bachelor 2001). In result Segal abandoned his career to sell malpractice insurance.

Segal has two names for his website – the original Medical Justice Services, Inc. plus a newer imprint, eMerit. From his site he pursues a mantra of Relentlessly Protecting Physicians via such tactics as intimidation of plaintiff witnesses, deceptive trade practices which flout FTC regulations, and manipulation of online critiques of doctors.

Segal boasts that Medical Justice Services, Inc. has unique brand recognition. But at the time when Segal with his Gag Waiver was just emerging in a storm of controversial news, we did an internet search with this criteria: we looked for websites or blogs where the phrase Medical Justice (literal, with no intervening words) formed the most prominent part of both the site-name and domain-name.

We found ten such sites. Eight advocated for patients, one belonged to U.S. Congress, while the tenth – Segal's – was the only arena for doctors. Repeating the search in 2019 shows that 60% of those Medical Justice sites have either folded or changed their name (see the table at the end of this page).

Tuum Est was Originally a Medical Justice Site

And the Ensuing Events …

The site you are visiting was founded in 2008 with name Medical Justice (Canada) on host Apple MobileMe. Our domain had a complex prefix followed by our Apple username, to give the base URL Before the invention of the iPhone, Apple had only 5% market share, which meant little competition for Apple usernames: we encountered no other use of the phrase Medical Justice within our ecosystem. As Segal had little presence in Canada, we were unaware of his site or his grail. Within two years that altered as Segal transformed himself into the public nemesis of RateMDs.

Report from Tuum Est webmaster Georgena Sil: When I registered with RateMDs I chose the screen name MedicalJustice; this seemed a logical choice as it matched my website name. My first post to the forum of RateMDs was in July 2010. And Lo, the responses!

MedicalJustice is from Canada. From what I can see, this poster doesn't really exist. wrote Wishandaprayer, adding a blue emoticon of a winking face. She quickly became a well-wisher after the RateMDs moderator (Katherine) posted on the forum: LOL. Actually this MJ is not related to our nemesis.

Aren't you a little biased? asked Gagal, whose post was abruptly withdrawn when I produced an excerpt from one of my webpages on Medicare Fraud.

Within hours, the RateMDs moderator (Katherine Coyner) emailed me privately to recommend I change my screen name because Forum readers were confused by posts from two Medical Justice sites which had opposite goals. To abolish the tumult I complied, and later changed my entire site name to Tuum Est (Canada).

Tuum Est Held a Private Opinion, Unspoken Until Now

Animosity, or Publicity Stunt?

When Segal astroturfed RateMDs, the co-owner of that rating site, John Swapceinski, traced the data for display on the RateMDs forum. John's final remark was couched in playful language:

I think Medical Justice has some splaining to do!

  • In 2011 Dr. Jeffrey Segal was caught astroturfing RateMDs. Later when confronted, Segal claimed he had been testing a prototype of his Review Builder Program. Segal now actually markets this as eMerit Patient Satisfaction Survey.
  • Facts: Segal planted 86 fake reviews on RateMDs. The reviews spanned half a year, named 38 different MDs, and were uniformly glowing (five stars in every category). The six IP addresses were all traced to Dr. Jeffrey Segal's company, Medical Justice Services, Inc.

The RateMDs co-owner John Swapceinski published the data on a RateMDs forum page titled Medical Justice Planting Glowing Reviews on RateMDs. In his post, John's final remark was couched in playful, almost comforting, language: I think Medical Justice has some splaining to do!

The locution sounded cozy. So we wondered … Was the animosity real?  Was it a publicity stunt?  Was it initially real, then capitalized on for publicity?   These questions gain traction in the face of other curious evidence. For example:

In the HTML code for the RateMDs Forum page, examine the hyperlinks. On the rare occasions when a reader was allowed to post a link back to their own website, RateMDs assigned nofollow to that link, without exception. That is normal. Now the oddity: On the same page, RateMDs staff discussed the Gag Waiver and, for educational purposes, posted links directly to the Segal Medical Justice site – but those links lacked the nofollow attribute, without exception. Impact: RateMDs helped increase the page rank of Segal's website. The evidence doesn't end there.

Rating Sites and their Nemesis Segal:  A Degree of Mutuality

Public Use of Doctor Rating Sites Jumped 50% in Three Months

In 2004, RateMDs first went online, co-founded by software engineers John Swapceinski and Joanne Wong. They had no media contacts, thus they arranged their own Press Release.

In 2007, Jeffrey Segal of Medical Justice created his Gag Contract. He too lacked media contacts, thus arranged his own Press Release. Within a month, the media picked up the story and kept it front and center until late 2011 when Segal rescinded the Gag Contract during an investigation by the Federal Trade Commission (FTC).

Impact on Segal – The Gag Contract was a loss leader. Segal endured, and even fomented, negative publicity. The drama lured curious MDs to his website; once there, the focus adroitly shifted to militant articles on health law and the pricey malpractice coverage which could make those physician-centered dreams come true. Segal's total membership roll for Physicians Shield jumped from 1,600 members in 2007, to 3,500 members in 2011. The Gag Contract, no storm, was a rainmaker: It more than doubled his membership (the increase was 118%).

Impact on Rating Sites – The Fourth Estate paid homage from 2007 to 2011. In the middle of that period, one measurement is on record to quantify the effect on rating sites. In 2009, the staff of Angie’s List wrote: Intensive news reports about Gag Orders had an unexpected effect: more people posted online comments about doctors and searched others' health care reviews. On, health reports filed monthly jumped 50 percent between January and March 2009.

How Popular was the Gag Waiver Among Physicians?

Used by 0.14% of MDs in the USA, Puerto Rico, and Canada

In 2002 Dr. Jeffrey Segal abandoned his neurology practice to sell malpractice insurance through his web company Medical Justice Services, Inc. His malpractice plan is called Physicians Shield. From 2007 to 2011 that plan had an optional supplement, priced separately, which went by the name Web Anti-Defamation Package (popularly called the Gag Contract).

In 2010, near the peak of the Gag Contract phenomenon, the New York Times interviewed Segal who said he had mustered a membership of 2,500 physicians for his malpractice plan. Of those, about half – or 1,250 physicians – signed up for the Web Anti-Defamation Package. By comparing those figures with census statistics, we can determine what proportion of physicians nationwide actually used the Gag Contract.

Census data for the relevant countries is listed in the table below. Bottom line: In 2010 there were a total of 941,782 physicians licensed to practice medicine in the locales where Segal operates (America, Puerto Rico, and Canada). From that pool, a scant 1,250 doctors used any version of the Mutual Agreement to Maintain Privacy. This amounts to 0.14% of the nation's physicians.

Gag Contract at its Peak: Used by just 0.14% of the Nation’s Physicians
Geographic Regions &
Segal Medical Justice
Number of Active
Physicians (2010)
Percent of
Data Source
United States 850,085   FSMB Census
Puerto Rico 11,108   PR Medical Board
Canada 80,589   CMPA Annual Report
Sum the 3 Countries 941,782 100.00 %   —
Segal total membership 2,500 0.28 % Segal Interview NYT
Segal members who
used the Gag Waiver
1,250 0.14 % Segal Interview NYT

Data available for 2014 and 2009; interpolated to 2010

Segal Membership During Full Period of Gag Waiver

The calculation above represents the peak of interest in the Gag Contract. The climb to that point is recorded in commentary from Segal during several newspaper interviews.

Synonyms:  Web Anti-Defamation Package;  Mutual Agreement to Maintain Privacy;  Agreement;
Online Review Contract;  Gag Contract;  Gag Waiver;  Privacy Waiver

2006 July 19

Segal Press Release

Currently, Medical Justice Services, Inc. represents more than 1,400 physician plan members in 47 states.

2007 August 22

Wall Street Journal

About a third of the 1,600 doctors who pay Medical Justice's annual fee have asked for the online-review contract since the company started offering it earlier this year.

2009 May 28

Angie’s List

Approximately 1,000 doctors nationwide reportedly use the Gag Contract

2010 January 13

NBC News

About 1,000 of Medical Justice's 2,300 members require patients to sign privacy waivers, making them part of a small but growing group of doctors trying to clamp down on scathing reviews.

2010 May 31

New York Times

Dr. Jeffrey Segal, chief executive of Medical Justice, said about half of the group's 2,500 members use the agreement.

2011 December 1

Eric Goldman Law Blog

Today we retired the form, said Dr. Jeffrey Segal. He is telling his 3,500 members to stop using the contract in the future.

Websites with ‘Medical Justice’ in Both the Name and the URL
Medical Justice Services, Inc. Jeffrey Jonathan Segal, MD:
‘Relentlessly Protecting Physicians’
Medical Justice Act (USA) USA Congress Bill H.R. 896 of 2011
Medical Justice (UK) Charity: Healthcare and Basic Rights for Refugees and Political Detainees
Office of Medical and Scientific Justice OMSJ: Integrity is Worth Defending
Illinois Medical Justice Fighting for Patient’s Rights:
Monteleone Law Firm, Rockford, Illinois
Medical Justice Petition (UK & Europe) Hypothyroidism Diagnostics and Treatment  
International Coalition for Medical Justice Human/Civil Rights in Science and Medicine  
Medical Justice Board Guiding Victims of Medical Mishaps  
Rural Medical Justice Australia Phone-In: Survey of Rural Healthcare  
Medical Justice (Canada) Legal Rights of the Physically Disabled
Site name changed to Tuum Est in 2012
Georgena S. Sil
Saskatoon, Canada
Physicist & Technical Writer
Alumnus: University of British Columbia
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