Why patients sue their doctors

Too often doctors and patients become adversaries rather than partners, and this blog series addresses that.

 

 

“6 reasons to sue your doctor and how not to”

was the original title of a series of posts I wrote soon after starting this blog. Later the posts were called

 “Stopping medical malpractice- how patients can help”

 

The main point of the series ,the relationship between patients and physicians, prompted me to start this blog. Too often doctors and patients become adversaries rather than partners, and this series addresses that.

You will find  links to all four articles in the series here, with a brief excerpt from each one. They have also been slightly revised and updated.

Part 1

In the March 2015 issue of Medical Economics, attorney Richard Baker wrote,  “Being sued for malpractice, especially for the first time, can be an unsettling and frustrating experience for a physician.”    And stressful and unsettling for a patient, or patient’s family .

A medical malpractice lawsuit follows an adverse medical outcome –

  • a missed or inaccurate diagnosis,
  • an ineffective or harmful treatment,
  • a surgery gone bad,
  • an outcome that left permanent harm or at worst, death.

Patients become  upset and often angry, and may assume that malpractice has occurred. They want to hold the doctor responsible , and want compensation for medical expenses, lost income, pain and suffering.

I don’t understand all the legal aspects of medical liability. But an unsatisfactory outcome may not mean poor care ;  illness or injury can be so severe  that any treatment is ineffective.  Or  there were multiple possible treatment options so the physician  made a judgement call that proved less than ideal.

But  it may reflect some behavior on the part of the doctor, another healthcare professional, or even the patient that could have been avoided.

continued here

Dr. Aletha treating a child

 

 

 

Part 2

No matter how careful hiring policies are , incompetent, unscrupulous and dishonest employees get into the healthcare system undetected. This is  bad for any industry, but in healthcare is  dangerous and even deadly.

If you notice something out of line in a medical office or hospital, or if the care is not as expected, don’t hesitate to report it to someone in authority. You can do this anonymously, although the more specific information you provide, the more likely the situation can be corrected .Even if nothing proves to be wrong, it will  give them helpful feedback about their service.

continued here

Dr. Aletha examining an infant

 

 

 

Part 3

You can’t control  your doctor’s training, CME (continuing medical education), and certifications. But you have a right and responsibility to confirm that the doctor is qualified to perform the services offered. Doctors’ offices have diplomas, licenses, awards displayed on the walls for a reason-they want you to look at them.  Hospitals and other health care facilities confirm  that  the  physicians who work there have the appropriate credentials.

continued here

 

Dr. Aletha with a health worker in Central America
Here I am with a health worker at a rural clinic in Central America. We held a medical outreach with a volunteer team.

 

 

 

Conclusion

The best way for physicians and patients to work through their feelings about a bad outcome is to start out with a mutually respectful, cooperative relationship.

Just like any other relationship, there may be times of disagreement; but these can and should be resolved with each satisfied that their viewpoint has been listened to , understood, and respected

continued here  

 

Dr. Aletha talking to a mother and her son

 

(Photos are from volunteer medical trips to Mexico, Panama, Ecuador and VietNam )

 

 

Dr. Danielle Ofri , author of several books about practicing medicine and patient relationships, considers effective doctor-patient communication crucial to successful medical outcomes. I reviewed her book here

What Patients Say, What Doctors Hear- a book review

What Patients Say, What Doctors Hear by Danielle Ofri, MD- a book

 

 

3 keys to effective communication with your doctor, part 2

In part 1, we considered the importance of establishing a connection between doctors and patients before trying to communicate. The goal is to establish effective patient engagement. (if you haven’t read part 1, I suggest reading it now, this post will make more sense if you do)

Now we’re going to look at some practical aspects of exchanging information with doctors- remember, exchange means give something and receive something  in return. 

Doctors want to give patients the information they need and most of the time believe they have done so. We are surprised when patients come back and say we didn’t explain their problem and its treatment, or they didn’t understand what we told them about it. I think this happens for 2 reasons.

  • We doctors tell patients what we think is important, but it may not be what you the patient or family considers most important.
  • After patients hear part of what we say, they get saturated and don’t hear the rest, especially when it is emotionally charged.

 

That’s why it is so important for patients and families to ask questions; don’t just rely on what the doctors volunteer. What is important to them may not be what is most important to you. And the more specific questions you ask, the more detailed the information you receive will be.

The one question you should always ask a doctor at each visit is

“What is the most important problem today, and what is the next step in treating it?”

The most important problem that the doctor finds may not be the one you were admitted for or came to the office for. Or if you came with multiple problems, the most important may not be the one that seemed most urgent to you.

For example, you may go to an emergency facility for an injury that caused a large gash on your leg, one that needs stitches. This is an urgent problem that needs to be treated. But the doctor finds that you have high blood pressure that you are unaware of. High blood pressure can lead to heart failure and stroke  if left untreated. So the doctor is going to instruct you to see your primary care doctor to have this problem addressed. In terms of your long term health, the high blood pressure is your most important problem today.

 

It is important to control blood pressure
High blood pressure can cause a heart attack.

 

You will get more helpful information from your doctor if your questions are as specific as you can ask; always inquire as to how tests and procedures this will affect your treatment and recovery. Here are some examples-

  • What did the xray show and what does mean for my problem?
  • What was blood test result and will it change my treatment?
  • How will this procedure change my condition?
  • What needs to happen before he can move out of ICU?

 

Write important things down. Questions that you want to ask. Information that the doctors need. Answers to the questions. Refer to it each time you speak with the doctors.

 

When you or a loved one is in the hospital, your main concern is going home. When the time comes to be discharged, it is just as important to ask questions and understand the plan as during the illness. Too many times I have had patients return to my office after a hospital stay  unable to give me any information about their illness and care . Important information to know include

  • What problems were treated during this admission and how did they change?
  • What will we need to do at home to continue the recovery?
  • When do we need to see a doctor and which doctor do we see?
  • What medications will I need to be on when I go home?

 

Understanding your doctor– medical jargon may not be the problem

Doctors are being encouraged and taught to use “plain language” when talking to patients, meaning limiting the use of medical jargon. I agree that a string of highly technical terms of any kind makes communication harder. But I’m not sure that simply using plain words solves the problem either. Whatever terms you use to exchange information must be understood by both persons. And that is not always the case.

Here’s an example.

If a doctor says that you or a relative has had a Myocardial infarction , do you know that that means a Heart attack? 

But, do you know exactly what heart attack means? Probably not.

 

What causes heart disease?
A heart attack means the heart muscle is injured from too little oxygen reaching it, usually due to blockage in the arteries.

 

 

So,  if the doctor says “heart attack” without adding any additional information, you should ask

  • “I understand a heart attack to mean ________. Is this correct?”
  • “I do not understand what a heart attack is. Please explain.”

 

You can master medical  terminology . How many new things have you learned in the past 5 years? Each of those had a vocabulary and instructions that you learned and now use regularly. Think of your first smartphone, tablet, digital camera or even a coffee maker . You make the effort to learn what is important to you . 

Make an attempt to learn about your and your family’s medical issues; even if you don’t understand it completely your doctor will appreciate that you are trying.

In addition to  doctors you have nurses, pharmacists, dieticians, physical therapists, social workers who can answer questions. Ask for referrals to community resources.

There are helpful resources on the Internet so anyone with a laptop, tablet, or smartphone has access to medical information anywhere anytime.

Sometimes it is helpful to find accurate definitions of medical terms. Consider using the

Plain Language Dictionary from the University of Michigan

The dictionary is also offered as a free app on iTunes for iPhone and iPad .

Another source from the CDC is Plain Language Thesaurus for Health Communications-available to download as a  Word document or PDF versions

 

 

Understanding Medical Words: A Tutorial from the National Library of Medicine will help you understand where medical terms come from and how to interpret terms that are new to you. There’s even a test at the end to see how much you learned. Comment and let me know how you do.

 

rhinoceros
It’s easy to remember that “rhino” refers to the nose, as in rhinosinusitis.

Also on this topic, my previous  post How to tell your doctor what’s wrong with you