Serious business: reporting bad doctors, saving future patients

Most doctors do good. They do lots of good, all the time, every working day. They’re not perfect (nobody is) but they do far more good than most of us have a chance to.
Moreover, most specialists were drawn to their specialty because they thought it was the coolest and most intriguing use of their time and skills.

It’s helpful to realize that it doesn’t so much take brains to get through med school, as the ability to work really hard on your own behalf. Moderate intelligence is enough, if you can be a solid student. It’s just a lot of hard work, with a guaranteed career at the end of it. This might explain why so many docs are simply mediocre, and most of the time, that’s really all they have to be. The trick is knowing when that’s not enough.

No profession — in fact, no large human grouping — is exempt from the reality of the bell curve. And this means that, while a few physicians are truly outstanding, a few are truly vile; a  few are famous, and a few are totally invisible; most are somewhere in the middle.

Almost all docs are honestly doing their best, and when they give up (which sounds like, “It’s all in your head” if they’re chicken, or “there’s nothing more I can do” if they’re not) or screw up (which sounds like, “whoops… it’s not my fault” if they’re chicken, or “I’m truly sorry, I’m still only human” if they’re not) it’s because the science, their imagination, or their intelligence is not always up to the challenge.

And that’s fair. Our science is vast but still inadequate to match reality, and not everyone is a genius, not even all doctors. We have to be realistic.

A very few are exceptionally smart, exceptionally diligent, and exceptionally good at communicating effectively with patients. They are at one tip of the bell curve, where miracles happen and people beat the odds.

A very few are exceptionally egocentric, have an exceptionally good act, and are exceptionally good at communicating with administrators (which is a special skill.) They are at the other tip of the bell curve, where others’ losses and suffering increase exponentially while the doc’s career blossoms in the adulation of those who don’t need them for care.

A few docs are so insulated from consequences and so accustomed to power that they become something distinct: they do more actual harm than anyone outside Congress or the judiciary can manage, and since they can’t be voted out, they need to be stopped some other way.

It’s rare, but, sadly, it happens to those hardest-pressed to stand up to them — and their obvious allies.

Those of us with rare and complex diseases are bound to hear of them, because rare and complex diseases are prone to develop “cults of personality” around physicians and institutions that get a good article written about them because the subject itself is cool.

These vile docs are a tiny, tiny minority, but they do exist, and sooner or later, we have to deal with them ourselves or aid our friends who do.

In a litigious country, it’s important to know what the agendas are. So let’s be clear about one thing, before going further with this article.

  • Those of us with CRPS and related conditions are not vindictive, we are desperately in search of effective care.
  • We typically exhaust all reasonable means of resolution, long after any normal person would have given up in frustration and despair. 
  • So, by the time WE are ready to trash a doctor or an institution, they have earned it — in spades.

The merely careless, ignorant or foolish are damaging, but still not worth our very limited time and energy.

When you really have to stop a doctor, you’ll know.

While I do believe in evil, I don’t think anyone is past saving… but in order to redeem themselves, some people have to lose what they hold most dear. They have to hit bottom.

In rare cases like this, where the lives of others are fodder for the cannon of someone’s willful and soulless arrogance, I have no trouble with that. Let ‘em hit.

How does that happen?…

By them losing enough of what matters most to them, that they have to either change or fail. Bad doctors in rarefied positions have huge egos and huge paychecks, and in practical terms, that is what matters most to them.

Egos and paychecks are tied together by reputation.

If you’ve been a victim, you can help re-adjust their reputations to something more in line with reality. This could really aid their personal growth. (Nice way of putting it, eh? Still true.)

If you’ve discussed it online and you’ve kept your paperwork, you’ve done most of the work already. It just involves cleaning up what you wrote to your friends, adding a few links, and laying your hands on the documentation created and collected along the way. I’ll write more about that soon, but for now, you can start with what you can easily get.

So here are some ways to do the most good:

  • Report the physician/s to the licensing board in your state.
    You can’t do much about what happens after that, but it goes on record and makes that doctor’s/institution’s future screwups harder for them to do damage control on. And there WILL be future screwups.
  • Review the physician or organization online.
    These review sites get read by patients, doctors, and doctors’ staff, so patients are warned by your record of consistent stinkery and — bonus! — a really stinky review often gets back to the physician via other physicians, providing “reputation readjustment” among the very people they most value. It sounds cruel, but hitting them in the ego is second only to hitting them in the pocketbook in terms of the salutary effect you can have once constructive efforts have been exhausted.
     
  • Submit letters to the editor in that doctor’s or institution’s area.
    These are followed by the PR departments of hospitals, government agencies and universities (this means that university hospitals will have a double dose of PR departments.) Docs who make the institution look bad, cost money. Once they look like they’ll cost too much, they lose their jobs… And, at higher levels, find it very hard to get another one.

In the end, maybe it’s not about whether you can get what you needed in the first place. Sometimes, it’s about protecting others, your cohorts in need. There are a lot more of them than there are of either vile doctors or great ones, but at least let’s steer them away from the vile. You can save lives this way :)

Links

…With surprisingly little effort, now that you know where to find all the links you need to get started.

How to report damaging and dangerous doctors

AMA FAQ on reporting physicians:
http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/frequently-asked-questions.page
Don’t be intimidated by the prim, imperative language. You’ve probably done almost all of that already.

Contact info for physician licensing boards in all 50 states:
http://www.ama-assn.org/resources/doc/ethics/state-medical-boards.pdf
This is who has the authority to revoke a vile physician’s right to practice. A consistent record of vileness can’t be overlooked once it gets to this level.

How to review your providers online

This site is well known and widely used. Even though it’s generic, physicians themselves have told me they fear bad reviews here:
http://www.Yelp.com/

Doctor-specific review sites:

http://www.vitals.com/doctor/rate
Reputable. You need to register.

http://www.healthgrades.com/
Find the doctor, click “About This Provider”, look under “Patient Satisfaction,”  and click “Fill Out a Survey About [doctor's name]“.

http://www.ratemds.com/
Looks rudimentary, but it’s been picked up by several national news outlets. Also, it has the perfect URL for its mission, so it will grow.

http://www.healthcarereviews.com/HealthcareRating.php
Seems relatively new. Could be worth it, if it saves one more person.

http://www.change.org/
Ideal for institutional-level stinkiness. You can set up a petition and this org will do most of the legwork to get others with relevant interests to sign it. This then gets mailed to the institution with aaaaaall those names on it. Also, if it’s a good story and the news folks are awake, it can hit national TV. Now THAT’s pressure!

Letters to the editor
- Guidelines for writing letters to the editor: http://www.pnhp.org/action/how-to-write-an-op-ed-and-letter-to-the-editor
Most important advice: keep it focused, human, and snappy. Cite relevant recent news (on the institution, the doctor, the disease, health care, etc.) so it feels like part of the larger reality (which it is.)
- Links to major news outlets’ Letters pages, with submission guidelines: http://www.ccmc.org/node/16179
- Or search “letters to the editor [your state or city]” for more relevant links.
These not only come back to the hospital administrators, but are followed by politicos. It’s a good way to make a big stink, especially given a good paper trail and a link to your petition. If you’re lucky, it could trigger some investigative journalism.

You can also research investigative journalists in your area, and pitch your story as an idea for a project. This is more time-consuming than the other options, and not all of us have that time or can make those contacts.

Not the last word

Once a reputation has been trashed, it’s very hard to recover… And sometimes that’s the only way to keep these hateful, [expletives deleted], predatory, self-serving, [more expletives, really vile ones, also deleted] from hurting others.

It would be helpful if more doctors stepped up to the plate and helped corral their own. It’s this damaging minority of trolls who stain the image of all doctors.

Any physicians who know of means to do that, it would be tremendous if you’d let us know… If only to assure us that some effort is being made. Even after roughly a decade as a nurse and another as a patient, I know of no mechanism that still lets you police your own — so if it exists, it’s awfully coy. It’s too easy to feel abandoned by the profession when we wind up in the hands of someone like this, and see the colleagues near them just shut up and knuckle under. If there were a wider pool of colleagues they had to answer to, it would help us to know that.

If you’re in the awful  position of needing to use this info for yourself or a loved one, please comment and let us know how these methods work for you.

Best of luck. May all your future doctors be good, capable, and really know their jobs.

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2 Responses to Serious business: reporting bad doctors, saving future patients

  1. Lili says:

    Wonderful piece. As someone who has had a lifetime of difficult medical troubles, I have also unfortunately had a number of horrific experiences with medical proffessionals who were completely out of line. I wish I had had the gusto to report them, as I know would be the right thing to do. However, these events have all taken place when I was in mortal difficulty, and very much disempowered and overwhelmed… I am certain that these are among the reasons that bad doctors continue unquestioned… the ones they harm are so often in no shape to fight back… Thank you for this excellent reminder and resources.

  2. Pingback: More on medical relationships as a 2-way street | Life, CRPS & Everything

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