Imagine you are seriously ill and have found a clinic that promises what other doctors could not. Somewhere in the stack of intake forms is a “non-disclosure clause” saying you will not publicly criticize the clinic, its staff or its treatments. You sign it because you want care, not a legal fight.

Months later the treatment has failed, the bills have piled up, and you want to warn others. Then you remember what you signed. While the non-disclosure clause is almost certainly void, most patients will never know it.

Agreements like these have no place in medicine. Patients cannot inspect a surgeon’s technique or audit a clinic’s outcomes. Reviews, word of mouth and complaints to regulators are how warnings travel from one patient to the next. That matters most where the risk is highest: clinics marketing expensive, unproven treatments to people with cancer, chronic illness or few remaining options. When one patient is silenced, the next one walks in without the warning.

Congress recognized this a decade ago. The Consumer Review Fairness Act of 2016 voids form-contract clauses that bar honest reviews or penalize customers for posting them, and it covers medical practices.

But the law has a gap. Only the Federal Trade Commission and state attorneys general can enforce it; courts have held that individual consumers, patients included, cannot sue under it. The FTC polices the entire national economy and rarely pursues a single local clinic. So a provider can hand patients a gag clause at little risk, and the clause still works, because the patient who signed it believes it is binding. The intimidation does the job the contract legally cannot.

Arizona can close that gap with a state law built on three principles.

First, pass a law barring non-disclosure and non-disparagement agreements in all healthcare practices. The law must be broad and bar provisions attempting to treat medical treatments as “trade secrets” or confidential.

Second, the law should require reporting all such non-disclosure clauses to the professional board that oversees the profession. The law should specify consequences for this activity, including potential suspension or loss of license, and apply them equally across all professional boards.

Third, the law should create a private right of action with a set cost. Any patient asked to sign a gag clause, or threatened under one, should be able to sue and recover statutory damages plus attorney’s fees. A set dollar amount matters because silence is hard to put a price on, and fee-shifting lets an ordinary patient find a lawyer for a small case. Real penalties would turn these clauses from a tool into a liability.

Arizona’s Constitution already strikes this balance: every person may freely speak, write and publish, “being responsible for the abuse of that right.” Patients who publish false statements could still be sued for defamation. Providers face a real imbalance: privacy law bars them from answering reviews with patient details, but the remedy is defamation claims and takedowns of false content, not silencing patients. The law would target only one thing: using a contract to keep truthful accounts of medical care from reaching the public.

California already gives consumers a private right of action against non-disparagement clauses. Arizona should follow, and go further by writing these protections specifically for patients.

While lawmakers act, the Attorney General should study how widespread these clauses are across Arizona and enforce the federal and state laws already on the books. And Arizonans should know this: if a medical office asks you to promise never to criticize it, that promise is very likely unenforceable. You can decline to sign and report the request to the Arizona Attorney General’s Office.

We come to this from different stages of the same profession: one of us is a physician and attorney with 17 years in anesthesiology, and the rest of us are starting our medical careers in Phoenix. We’ve all learned that medicine runs on trust, and trust works only when patients feel free to tell the truth about their care. Arizona should make sure no one can buy their silence.

Brian Wilhelmi, MD, JD, is an anesthesiologist at Barrow Neurological Institute in Phoenix with 17 years of practice. Jad Mazboudi is a third-year medical student at Creighton University School of Medicine in Phoenix. Aaron Stevens is a second-year medical student at Creighton University School of Medicine in Phoenix. Ahmed Nabhan, MD, is a research fellow at St. Joseph’s Hospital and Medical Center in Phoenix. The views expressed are the authors’ own and do not represent their institutions.