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

 

 

Stopping medical malpractice- how patients can help -conclusion

(previously posted under the title 6 reasons to sue your doctor-and how not to-conclusion) 

The final  reason to sue your doctor involves feelings ,which is more  difficult to quantify and illustrate than the behaviors I have discussed before. Attorney Richard Baker tells physicians, “Don’t be afraid to face them (family of a patient with a bad outcome.) It’s important to let them know you understand how they feel. Compassionate gestures count.”

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 and considered and  are comfortable with the final decision.

mission trip in Mexico; photo by Brian Edgerton
mission trip in Mexico; photo by Brian Edgerton

More important than liking your doctor is feeling comfortable with their personality and communication style, respecting their knowledge and skill, and trusting that they will behave ethically and do what is in the patient’s best interest. Patients contribute to the relationship by respecting the doctor’s time, observing boundaries on the doctor’s personal life, and being financially responsible.

When you are unhappy with some aspect of your care, doctors prefer that you address the issue directly and respectfully; no one likes feeling attacked personally. A complaint should be as specific as possible and include what you think is the solution. If you find yourself feeling disappointed, frustrated, or angry at your doctor more times than not, don’t let the situation drag on or escalate. It’s time to admit that the relationship is not compatible and move on.

Here are some ideas on how to find a new doctor.

Here is a summary of the 6 ways patients can help stop medical malpractice suits: 

  1. Cultivate communication

    Doctors need to do it better, and patients need to feel that their input is welcome and valued.

  2. Understand what’s happening

    Doctors need to explain information and patients should ask questions when they don’t fully understand

  3. Credentials

    Doctors need to stay current in their specialty certifications and licensure and patients need access to that information.

  4. Follow up-

    Doctors need to report all diagnostic results and patients need to receive them

  5. Report problems-

    Doctors need to know if anything irregular is happening and patient should report their observations without fear of retaliation

  6. Establish rapport

    Doctors and patients don’t need to be BFFs but should respect each other and show kindness and compassion. We all need it.

Stopping medical malpractice- how patients can help – Part 2

 

(previously posted under the title 6 reasons to sue your doctor-and how not to-part 2)

In the article, “YOU’VE BEEN SUED FOR MALPRACTICE-NOW WHAT?” (Medical Economics, March 10, 2015) attorney Richard Baker offers 6 common reasons for malpractice lawsuits, and what physicians can do to prevent them. In this series I look at them from the patient viewpoint- what you can do to avoid getting care that makes you want to sue .

4.INADEQUATE FOLLOW-UP OF DIAGNOSTIC TESTS AND SPECIALIST REFERRALS

Physicians must report results of lab tests, x-rays, and other diagnostic studies directly to patients, without exception.

Make sure your doctor’s office has your current  contact information-address, phone, and email.

Ask the office staff how results will be reported-by mail, phone, or through a patient portal.

Access your medical records using a secure patient online portal if available.

Don’t   assume that “everything must be normal” just because you haven’t heard or read otherwise.

Reports from specialists may be  handled differently, depending on whether your doctor refers you for a consultation or refers you for ongoing care. Find out what you should expect from both doctors’ offices.

laboratory-313864_1280

an MRI of the human brain
an MRI of the human brain

5. IRREGULAR POLICIES AND PROCEDURES

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.

One day I was seeing patients  when a pharmacist called saying she took a phoned in prescription for a narcotic pain medicine earlier that day and wanted to confirm .  But no one from my office had called her.  A  former employee had been using my name and my DEA (Drug Enforcement Agency) registration number to call narcotic prescriptions for herself and an accomplice to multiple pharmacies for several weeks.   I recently read an article in a major magazine about an x-ray tech who worked at multiple hospitals where he stole IV narcotic pain medication for himself, and infected multiple patients with  hepatitis C from his used syringes. He is now serving life in prison.

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.

Stopping medical malpractice- how patients can help – Part 3

(previously posted under the title 6 reasons to sue your doctor-and how not to-part 3)

In the article, “YOU’VE BEEN SUED FOR MALPRACTICE-NOW WHAT?” (Medical Economics, March 10, 2015) attorney Richard Baker offers  6 common reasons for malpractice lawsuits, and what physicians can do to prevent them. In this series I look at them from the patient viewpoint- what you can do avoid getting care that makes you want to sue .

3. FAILURE TO KEEP CURRENT WITH STANDARDS AND KNOWLEDGE 

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 make sure  that  the  physicians have the appropriate credentials.  Social media expert Kevin Pho, M.D. explains  how to check out a doctor’s credentials online-

Finding a doctor online and researching your physician on the Internet

Physicians can attend live lectures, watch or listen to lectures online and even view CME activities on a smart phone or other hand held device.
Physicians can attend live lectures, watch or listen to lectures online and even view CME activities on a smart phone or other hand held device.

Physicians must have a license for every state where they practice. Most physicians in the United States are board certified .which shows competency in their specialty. They take  a written and sometimes oral exam  and perform the requirements for MOC- maintenance of certification – medical study through lectures, reading, chart reviews and interactive online activities and repeat testing every few years.

Some physicians question the value of MOC. We agree with the idea in principle but believe the current requirements are irrelevant ,expensive, and time consuming without adding anything to knowledge, skill or improved patient care.  A few quit MOC completely and let their certification lapse, or join an alternate board which has less complicated requirements.  I will remain certified by the American Board of Family Medicine but the process needs to be relevant and valuable.

Learn more about certification in Family Medicine and if your family physician is board certified at the website of the American Board of Family Medicine 

Stopping medical malpractice- how patients can help – Part 1

6 ways  to help your doctor avoid a malpractice suit -Part 1

 

(previously posted under the title 6 reasons to sue your doctor-and how not to-part 1)

“Being sued for malpractice, especially for the first time, can be an unsettling and frustrating experience for a physician.”

(quote from  attorney Richard Baker ,March 2015 issue of Medical Economics)

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, an unsuccessful surgery,   an outcome that left permanent harm or at worst, death. Patients become  upset and often angry, and 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. But  it may reflect some behavior on the part of the doctor, another healthcare professional, or even the patient that could have been avoided.

an ornate courthouse
Keep your doctor in the office, not the courthouse.

 

 

In the article, “YOU’VE BEEN SUED FOR MALPRACTICE-NOW WHAT?” Mr. Baker offers 6 common reasons for malpractice lawsuits, and what physicians can do to prevent them. In this series I look at them from the patient viewpoint- what you can do to avoid getting care that makes you want to sue .

When doctors and patients work together,  patients will get care that is safe, satisfactory and successful. 

1. FAILURE TO COMMUNICATE 

Too often, physicians don’t listen to patient concerns or explain their diagnosis and treatment in terms they can understand.   But it is also important for patients to communicate fully with their doctors.

Doctors know that some issues are  uncomfortable  for patients to discuss, like smoking, alcohol use, eating and  sexual practices. But if you  withhold information  on sensitive subjects , you do yourself a disservice.

When a doctor treats you with incomplete or inaccurate information about your past and current medical history, the advice they offers may be   incomplete or inaccurate also.

As embarrassing or uncomfortable as it may be, be open and honest with your physician about anything that affects your health-  everything in your life, past and current. Your doctor won’t judge and needs all the information necessary to understand your health status.Medical Record

 

 

If you don’t understand your diagnosis or treatment, ASK QUESTIONS.

Take notes, or ask your doctor to write down your diagnosis and instructions, or to suggest books or websites where you can get more information. With EHRs, (electronic health records) the office staff can  print out information from your visit.

When available, use a patient portal to access your information online.

Here’s another post about effective communication with your doctor.

2. LACK OF TRULY INFORMED CONSENT 

Informed consent means  health care professionals must explain the benefits as well as the risks of any medical procedure so the patient fully understands it. When you  sign the consent form, you say “I give permission for this procedure and I fully understand what might happen.”  Ask questions before you sign and don’t sign until you are confident that you understand what will or may happen.

Here  are suggestions on questions you should ask before making a decision and giving consent for surgery.

What to Ask Your Surgeon Before an Operation

Please review another post on this blog about communication with your physician. 

“How to tell your doctor what’s wrong with you”.

Book Recommendation on this subject-

What Patients Say, What Doctors Hear 

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

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