doctors suing patients

September 17, 2005 1:07 PM

Doctors suing patients Are you angry and upset because of what a doctor did or did not do during a medical procedure? Did you express your anger online? Now doctors are suing patients for expressing their anger online.
posted by halekon (31 comments total)

In the not-too-distant future, you will probably have to sign waivers the minute you set foot into a hospital or clinic, promising that you won't publish any information relating to the doctor's services you are about to receive.
posted by sour cream at 1:43 PM on September 17, 2005

sigh

Sour cream is probably right.
posted by grouse at 1:51 PM on September 17, 2005

"He sued for libel"

I really don't see a problem with this. We are all responsible for what we say (or post online). If we libel someone, we'll get sued. If we are truthful, probably nothing will happen (as was also mentioned in the article).. Physicians have the same rights any of us do if someone makes untruthful and harmful public statements. What is the problem with this?
posted by HuronBob at 2:04 PM on September 17, 2005

Alas, if this were only a good-guy/bad-guy problem.

It isn't. I hear stories all the time about how doctors order procedures that probably aren't necessary -- some of them invasive, like Caesarian sections -- just because they can't risk being sued. All these extra tests and procedures clog the system and send health care costs through the roof. In the end the ones who suffer most are the poor.

Doctors are by in large pretty smart folk, but there's less and less incentive for them to practice intelligent medicine. There simply has got to be a better way to deal with the inevitable errors. It seems like doctors are almost surpassing lawyers are the most loathed professionals. And this should not be. They're there to care for us.
posted by Hobbacocka at 2:14 PM on September 17, 2005

Not only that, Texas doctors are putting patient's names online who sue for malpractice. Your healthcare dollars at work.
posted by Rothko at 2:23 PM on September 17, 2005

We need "ratemydoctor.com".
posted by craniac at 2:39 PM on September 17, 2005

There simply has got to be a better way to deal with the inevitable errors. It seems like doctors are almost surpassing lawyers are the most loathed professionals. And this should not be. They're there to care for us.

I wonder sometimes part of the problem has to do with the expense of medical school and the culture of pressure within.

Most of the doctors I see seem very rushed. I don't know if this is out of habit, or out of a system that demands they keep visits to less than 15 min or they can't be profitable. Or something else entirely. But I have to wonder if it'd be easier to make expenses if there weren't huge debts involved, and if that would lead to a place where doctors work more slowly, deliberately, and attentively.

Or if there wouldn't be a market for that kind of care anyway. There are times when I'd pay extra for it.

I really don't see a problem with this. We are all responsible for what we say (or post online). If we libel someone, we'll get sued. If we are truthful, probably nothing will happen.

I agree with this.

But this:

In the not-too-distant future, you will probably have to sign waivers the minute you set foot into a hospital or clinic, promising that you won't publish any information relating to the doctor's services you are about to receive.

should never, ever happen.
posted by weston at 2:46 PM on September 17, 2005

Well, there's RateMDs.com...
posted by curtm at 2:46 PM on September 17, 2005

Well, apartmentratings.com is flourishing -- where's the trusty webmasters who were supposed to come up with a medicalratings.com? Don't tell me they're worried about being sued, cause you can always put the damn server in the Netherlands.
posted by rolypolyman at 2:59 PM on September 17, 2005

docornot.com
posted by Snyder at 3:03 PM on September 17, 2005

Most of the doctors I see seem very rushed. I don't know if this is out of habit, or out of a system that demands they keep visits to less than 15 min or they can't be profitable.

I think it's largely the profit thing. Or just needing to keep up. In 2003 new regulations were passed limiting medical student hours to 80 hours per week -- a big step forward, in one sense. But on the other hand this often means more work for doctors, who have to coordinate patient hand-offs between shifts. With resources stretched so tight you really can't fix one problem without creating another. And the really sad thing is that, with the old stoic culture dying, there's not much left to encourage doctors to go into the difficult, time-consuming specialties like surgery. The smart ones say screw it, and do derm. What could possible reverse this un-virtuous cycle?

Did anyone see Malcolm Gladwell's bit on "Moral Hazard" in the New Yorker, incidentally? There's a little voodoo in his argument, as usual, but it's interesting.
posted by Hobbacocka at 4:14 PM on September 17, 2005

but there's less and less incentive for them to practice intelligent medicine

But this is intellint medicine in the sense that doctors will be sued if one patient out of a hundred needed the test and it wasn't ordered. They are just covering their asses.

limiting medical student hours to 80 hours per week

It is the residents (finished medical school) that are limited to 80 hours a week (maybe the med students as well, but they aren't really doing all that much yet). Not that it has really worked. Residency programs don't have to count hours in which the resident is being taught, so lectures, journal discussions, and whateverelse is convenient are ignored. Many residents I know still work well over 100 hours per week.
posted by jmgorman at 4:35 PM on September 17, 2005

But this is intellint medicine in the sense that doctors will be sued if one patient out of a hundred needed the test and it wasn't ordered. They are just covering their asses.

Sorry, by 'intelligent' I meant relying on and encouraging the intelligence and initiative of doctors, rewarding the use of informed discretion to decide which people need tests and which don't. This is what they're trained for. If one person in a hundred needs a test, one person in a hundred gets it; the rest don't. One thing seems clear: the less initiative doctors are allowed the less efficient and the more bureaucratic the system becomes.

About the 80-hour week. You're right, a lot of hospitals are not in compliance, but I believe the switch represents a significant shift in the culture. It will be easier for the next generation of residents to say, Sorry, my time's up. This kind of change takes time.
posted by Hobbacocka at 4:44 PM on September 17, 2005

Part of the problem is that patients may think they are informed and were treated poorly, but actually received the correct care. My father was a doctor and so were most of his friends. At one party a woman started shouting at a doctor insisting that he had mistreated her husband in the ER, even though the broken leg healed perfectly well. Turned out she had the wrong doctor, the doctor she yelled at was in London at the time and had no connection with the case. This is just one of several incidents I've witnessed and I can see why doctors would be worried about online rants impacting on their reputations.
posted by miss-lapin at 5:33 PM on September 17, 2005 [1 favorite]

I am fine with patients posting their complaints online, aside from blatant libel which is already covered by law. By the same token, if doctors want to set up a database of patients who misuse healthcare, file frivolous lawsuits, or make ridiculous complaints that should also be allowed. It's part of living in a country where we have free speech and aren't forced to do business with people if we don't want to. I'd rather have a socialized healthcare system but under our current system allowing people to speak their minds is essential.
posted by fraxil at 6:01 PM on September 17, 2005

Most of the doctors I see seem very rushed. I don't know if this is out of habit, or out of a system that demands they keep visits to less than 15 min or they can't be profitable.

I think it's largely the profit thing. Or just needing to keep up.

but there's less and less incentive for them to practice intelligent medicine

Let us not forget the 800-lb gorilla in the healthcare room...the insurance companies. Much of how a doctor runs his/her practice these days is highly influenced by what insurance companies will, or will not, pay for. The level of care you recieve is often determined (or heavily influenced) before you step into the doctor's office, once the office people check your coverage.
posted by Thorzdad at 6:32 PM on September 17, 2005

For the last five years I've tracked the web activity of a woman I've never met, who has been writing everywhere she can , about her mother, who she believes was starved by her doctors. Her mother, who came to me less than a month before she died with this woman's sister (a former patient of mine), was fired by her previous doctor for non-compliance, was almost eighty, and at autopsy was described by the pathologist as having the worst atherosclerosis he had ever seen (he was nearing retirement). She continues to post her rantings in various formats and locales on the web, feeling that the doctors who cared for her for the last two years of her life, including me, and the nursing home, are guilty of wrongful death, neglect, starvation, etc. because we could not take a shell of a dying woman and turn her into the thriving "momma" that her daughters had once known.

At one point I did make a threat of legal action when she listed my clinic, me, and one of my peers on one of her many sites.

I have a large and growing practice, and the notion of one person saying anything negative about me online, as far as being a threat to my livelihood, is laughable. But if you understood the sort of personal devastation that a lawsuit carries, much less a wrongful death suit, and as well knew that the majority of truly horrific suits were the groundless creations of zealous and politcally motivated DA's, you would do nothing short of bludgeoning these liars' empty fucking skulls in for having the stones to make you and your family's life public fodder.
posted by docpops at 6:33 PM on September 17, 2005

Most of the doctors I see seem very rushed. I don't know if this is out of habit, or out of a system that demands they keep visits to less than 15 min or they can't be profitable.

...As a physician, this has been the most difficult part of the job for me. Many of my colleagues are also stressed but what can be done? Spending the time helps ensure nothing important is neglected and allows the patient (and MD) to feel good about the encounter. But as they say, "time is money" and there is less of it coming into my office lately.
Leaving the dais with my medschool diploma I thought it was "all downhill from here". WRONG. (Maybe my mistake for going into primary care!) Billing hassles, endless regulations, malpractice concerns - all a nightmare. Sometimes literally. It's all the difficulties of starting a business, with twice the paperwork and liabilities.
Oh, and reimbursements have been falling steadily.

How about your insurance payments? -Hmm?
I'm ready for single-payer universal healthcare!
posted by infomaniac at 7:01 PM on September 17, 2005

My google fu must be really on tonight, because Docpops, I think I found the person you described. And even if not, I'm sure its a similar tale. The worst part about it seems to be the family blames everyone but refuses to accept that maybe they played part of it, or maybe it was even *gasp* nature. They even seem to switch from blaming the doctors to blaming hmo's to blaming the state.

I think the biggest problem is that the lay person thinks they can be a doctor. I try to self diagnose all the time, and I'm always wrong. Well, 9 times out of 10. I'm sure the other is dumb luck. So I can appreciate why someone might think they were treated badly or incorrectly, but they really should try to seek a second opinion before declaring the doctor was wrong.

On the other hand, I was threatened with a libel suit once. It was completely a bullshit bluff, but I was freaked out for a few days because even though everything I wrote was true, I had no financial means to fight it in court and the person threatening knew that. I suspect often libel/slander cases against individuals are done more to intimidate than actually prove wrongful comments have been made. But how do you remedy that? I don't know.
posted by [insert clever name here] at 7:32 PM on September 17, 2005

Rushed doctors? Perhaps because fewer people are going into this decreasingly attractive field? Meanwhile, illnesses and medicalization are being out and out sold too us by the drug and diet industry. Lots of people going to fewer and fewer doctors working in a growlingly stressful field?

I'm too drunk too back this up, and I may just be speaking on hearsay. infomaniac, care to set me straight?
posted by es_de_bah at 7:33 PM on September 17, 2005

Yup. OK -Stop drinking to excess.
Bad for the liver.
;o)
posted by infomaniac at 7:47 PM on September 17, 2005

not so much excess; just enough to engage my wide, bountiful tracks of sloth. :)
posted by es_de_bah at 7:57 PM on September 17, 2005

Actually, I believe enrollment is up. So is the percent of women in med school. Due to child rearing and other factors they tend to spend less hours as Physicians. I recently read that some association of med schools is calling for a 15% increase in enrollment as a result.
There still remains a relative shortage of MDs going into primary care, where the volume is greater, hours are longer and pay is lower.
posted by infomaniac at 7:58 PM on September 17, 2005

I've had so many bad experiences with physicians that I have to wonder am I just unlucky or is this par for the course?

Some highlights:
The female gynecologist my mother sent me to when I was 15 and having my period every two weeks. My mother suggested that I ask about birth control pills. This physician yelled at me for making up a story and "wasting her time" and sent me away without bothering to do an exam.

The GP I was assigned by my HMO as my primary care giver who was brutal and nasty in all her dealings with me. The final straw was when my mother (an administrative nurse who was working as an Insurance liaison) upset over her actions-- some of which actually jeopardized my health-- wrote a letter of complaint to the HMO and received in return a copy the letter the doctor had sent. The letter meant to cover her ass was filled with lies.

The OB assigned to me by my HMO who started me on a pitossin drip and then left the hospital. When I was fully dilated and ready to deliver, he was nowhere to be found. The baby went into distress and without a physician around was stillborn. The OB lost his hospital rights and later his license.

As to the endocrinologist who thought nothing of making me wait for 2 hours or more-- a hearty Fuck You!
posted by Secret Life of Gravy at 9:28 AM on September 18, 2005

Most of the doctors I see seem very rushed. I don't know if this is out of habit, or out of a system that demands they keep visits to less than 15 min or they can't be profitable.

In his essay The Computer and The Hernia Factory Atul Gawande suggests that developments in medical technology would allow doctors to spend more time with the patient not less. He argued if machines were allowed to take over certain jobs previously part of the physicians realm (like assessing a patient to see if he/she is having a heart attack) this would free the physician to talk to the patient and therefore make the experience less traumatic. Unfortunately it seems that experience of most patients doesn't seem to support his theory.
posted by miss-lapin at 9:41 AM on September 18, 2005 [1 favorite]

I think I saw a site with ratings for doctors, in US. I'm curious if there are similar sites for other countries.
posted by kuchin at 11:05 AM on September 18, 2005

(A primary care doctor speaking)

We're taught over and over again in school and residency that medical mistakes happen, outcomes can be devastating even when all the right medical decisions are made, and patients can be unreasonable when dealing wtih life and death. This happens every day in my practice. But the reason why doctors get sued is if they are assholes, if the patient perceives that their doctor isn't sensitive to their experience. Sometimes I am so amazed by how true this is when dealing with my patients. If I have a good relationship with them, they think I walk on water regardless of how good a doctor I think I am. If I don't provide them with what they expect (this might be caring and compassion, but it also might be a prescription for OxyContin), they will rip my fucking heart out. It's a very difficult place to be.

The thing that every American needs to be concerned about, is that the entire health care system is conspiring against the basic principles of a caring, compassionate doctor-patient relationship. From insurance companies who make record profits but don't reimburse us adequately, so we need to see more and more patients in the same 12 hours day to pharmaceutical companies who want us to spend the entire visit discussing Levitra. Patients walk in the door, pissed off from the start about their $600 a month premium and their $30 co pay and we have a malpractice insurance system that makes it absolutely impossible for a doctor to admit when something went wrong.

Most doctors are genuinely more concerned about the welfare of our patients than our income and working hours. Given what I have had to give up, financially and emotionally, to get where I am, it really saddens me that this is the state of things. Honestly, physicians have been railing about the system for 20+ years but we hold less power than ever before, and my god, we are tired...

Sorry about the rant, it doesn't take much to set a busy primary care doctor off these days.
posted by Slarty Bartfast at 12:14 PM on September 18, 2005

Ditto what Slarty said (more elequently).
Thanks ....oops cell phone ringing - kid you not!
posted by infomaniac at 1:45 PM on September 18, 2005

The thing that every American needs to be concerned about, is that the entire health care system is conspiring against the basic principles of a caring, compassionate doctor-patient relationship.

I couldn't have said this better myself. The only thing in between these forces and my poor patients is my good heart. Sometimes they roll right over me and the patient gets *%(!ed over anyway.

Most doctors are genuinely more concerned about the welfare of our patients than our income and working hours. Given what I have had to give up, financially and emotionally, to get where I am, it really saddens me that this is the state of things.

Well said, and my sentiments precisely.

I praise the powers that be every day that I am working - for now - in an academic center where I am allowed the time I need to care for my patients the way they deserve. The 75% pay cut I'm taking for this 'privilege' is well worth it for my peace of mind, at least for now.
posted by ikkyu2 at 11:08 PM on September 18, 2005

Slarty Bartfast: But the reason why doctors get sued is if they are assholes, if the patient perceives that their doctor isn't sensitive to their experience.

Agreed, with commentary about my own horrible doctor experience... The arm specialist who headed the Large University Hospital Ortho Department (as well as the local VA's orthopedics department) was a grade-A stupid asshole from the get-go, and his neglect gave me a permanently disfigured, dysfunctional elbow. Some highlights, a la Secret Life of Gravy:

* He locked me up in a cast for 6+ weeks when he could've put me in an air cast with limited motion. A friend broke the same thing the same way -- we compared x-rays and you couldn't tell 'em apart. He got an air cast and his arm is fine today, but on mine, everything grew together.

* During the surgery to try to pull it all back apart, I woke up halfway through. NICE ONE, ANESTHESIOLOGIST. He then gave me so much juice, I didn't come out of it for hours, and when I did, they threw me out of the hospital because my -- and I quote -- "banshee-like screams" while still under were scaring the other patients.

* I took my physical therapist to an appointment with him -- she got to watch him abuse my arm (which wasn't healing right, and he knew it...so he took his frustration out on me physically). She was so shocked, she wanted to report him.

* Doctor Jerk accused me of being drug-seeking in front of witnesses. Told my physical therapist & she laughed. Why? Because he'd just gotten busted by the state medical board for self-prescribing Vicodin...yet he was allowed to keep practicing, and calling the kettle black.

* My arm now has a massive scar, and it will never straighten properly again. Subsequent plastic surgery/other consultations confirm both.

Now, if he'd been slightly nicer, I wouldn't have even wanted to sue him. I'm told the elbow is a tough joint to fix, so fine, I can accept that. But he was a total asshole: abusive, nasty and utterly undeserving of his position. His staff was inept (don't even get me started on the fun stuff they did, like fax my blood test results to my work fax number instead of my doctor -- I don't even know HOW they got my fax number), his bedside manner nonexistent, and his skills negligible. If I could've sued him, I would have. The lawyer in my accident case advised against it, just in case we did go to trial and needed his testimony.

Would I stand up in a crowded theatre and yell about his putzdom? Hell yes. If he tried to sue me? Good luck, asshole. All of the above is documented and could be proved in a courtroom.

I don't envy doctors -- I know the insurance companies are screwing with your businesses something fierce. But some of your colleagues are just plain idiots, and they deserve to be called out on it. If these kind of lawsuits restrict our ability to do so, it'll be really sad.
posted by bitter-girl.com at 11:16 AM on September 19, 2005

and then there is this chick: "woman offended by obesity advice"...
posted by TrinityB5 at 3:18 PM on September 19, 2005