'Anesthesiologist trashes sedated patient — and it ends up costing her'

[sunealoneal]

Say what? Are you saying that everytime this patient "looked" at his penis, he'd be haunted by the sarcastic words of the physician about the rash he acquired doing whatever and the words would cause him mental anguish and he'd have to go it alone in his despair because our mental health care system is subpar and insensitive to men's penis rash embarrassment.

Okay. Forgive me if I hear X-File sound track when I read that type of "chain of logic" perspective.

I don't think it's so unbelievable that comments mocking a visually apparent medical condition, especially one that would be intensely personal for most men, would stick with the patient. Especially since from the patient's perspective, those comments came out of nowhere. I'd actually be skeptical if I heard that he was not reminded of those comments often.

Re: mental health, I think wholly discounting the impact those comments could have had on him is a symptom of a dysfunctional mental healthcare system.

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[YF786]

Absolutely he deserved $500,000 and that anesthesiologist should have her license suspended if not revoked. I am astounded at these doctors' immaturity and lack of compassion. If you want to blow off steam, do it in the break room or your office. Not with the patient. But even then, the statements they made were so mean-spirited and vitriolic. It is downright sociopathic and shows a lack of compassion that is frightening given their profession. Total overkill for a fear of needles, which millions of people have. I've never heard anything like this in the hospital. Not to mention they falsified notes in his chart and lied to him about giving him post-procedure instructions.

How anyone can defend these docs is beyond me. Justice well served.

Such health care workers should not even exit in the first place. I agree with you 100% on getting the license revoked.

 

[charmiedermie]

I don't agree with the Gas doc at all. I actually think she had this coming. However, I don't think it's appropriate to award the PT this much. I also don't know what else went down between PT and provider but I can't imagine this PT was in any way, a pleasant person. It all comes down to who's got more to lose. Obviously, it's the physician in this case.

On the other hand, people are saying physicians act like this all the time. That's not a valid point, as its evident they can't act like asshats anymore. Not in today's world. We need training on how to handle difficult PTs, and how to handle problems in general. Ever notice how passive aggressive med students are?

You need to read the complaint. This wasn't a difficult patient. It was a scared patient, and they do teach you how to approach both in medical school. All her comments on the tape weren't that he was a difficult patient, but more that she thought he was being a complete pansy:

 

[ACSurgeon]

You need to read the complaint. This wasn't a difficult patient. It was a scared patient, and they do teach you how to approach both in medical school. All her comments on the tape weren't that he was a difficult patient, but more that she thought he was being a complete pansy:

Or her comments weren't really anything personal against this patient, just her trying to be funny.

 

[CardiacLion]

how many patients have you met so far? 2?
keep that holier than thou attitude in pre-allo
the main reasons for what makes medicine tough are 1) dumb rules 2) annoying patients

also, it was behind a closed door. the guy was obviously fishing for a payout

lmaoo this was cute. It's not a holier than thou attitude, it's just being a compassionate human, and yeah let's keep taking checks at each other's experience level to validate/justify a perpetual jadedness in the field - that will get us all somewhere I'm sure.

I agree medicine is complicated and made difficult by those two things, but just because it's so, doesn't mean your patients don't have a right to some form of respect and genuine attentiveness towards their well being.

I may not have seen as many patients as you oh great @Psai, but I've been on the other side many a time that I can empathize with what it feels like when your physician, the one you trust the most with your health concerns, turns your back on you and ridicules/belittles you in front of other colleagues.

 

[Psai]

wonder why it took so long to get a result when it was filed in 2013

 

[ImportedKamariya]

Her comments weren't just rude. And you can be disciplined by the licensing committee for unprofessionalism.

if i am at home and talk about the guy's car who i fixed last week at my shop, about how he has a potbelly and acne and smells very bad, am i now being unprofessional? the guy was not supposed to hear this conversation at the operating room. it was meant for the people working there only. just like how i gossip about my clients when i come home or even at the mechanic shop. if you eavesdrop into a conversation (you obviously were not invited to) and hear something you don't like, will you sue me? how does that make sense? people like you would LOVE to live in an orwellian world. you want big brother everywhere. disgusting.

 

[sliceofbread136]

if i am at home and talk about the guy's car who i fixed last week at my shop, about how he has a potbelly and acne and smells very bad, am i now being unprofessional? the guy was not supposed to hear this conversation at the operating room. it was meant for the people working there only. just like how i gossip about my clients when i come home or even at the mechanic shop. if you eavesdrop into a conversation (you obviously were not invited to) and hear something you don't like, will you sue me? how does that make sense? people like you would LOVE to live in an orwellian world. you want big brother everywhere. disgusting.

Oh come on...

At home after work does not equal in the OR with a vulnerable and incapacitated patient.

Mechanic does not equal physician.

Your analogy isn't an apt one

 

[charmiedermie]

Or her comments weren't really anything personal against this patient, just her trying to be funny.

Did you even read it?

As the colonoscopy neared completion, Defendant I, Defendant S, and an unknown medical assistant of GMA mocked Plaintiff for attending Mary Washington College instead of MIT, suggested that it was unsurprising that Plaintiff attended a college that at one time was a "woman's college", a "girl's school", and wondered if Plaintiff was gay. Defendant I stated, "Are you implying that he's gay? Because I know gay men that have more manliness than" the Plaintiff. "And I'm sure I know gay men in the military who just haven't let it be known that they're gay who are manly."

"And really, after five minutes of talking to you in pre-op I wanted to punch you in the face and man you up a little bit."

Yup, real knee slappers.

if i am at home and talk about the guy's car who i fixed last week at my shop, about how he has a potbelly and acne and smells very bad, am i now being unprofessional? the guy was not supposed to hear this conversation at the operating room. it was meant for the people working there only. just like how i gossip about my clients when i come home or even at the mechanic shop. if you eavesdrop into a conversation (you obviously were not invited to) and hear something you don't like, will you sue me? how does that make sense? people like you would LOVE to live in an orwellian world. you want big brother everywhere. disgusting.

Who is talking about what you do at home? Did this incident in this case happen at home or in the workplace? You will get tons of nauseating professionalism lectures on this type of thing more than you will ever want, trust me, and your licensing board cites professionalism type things all the time against physicians to take away their license. I'm not telling you my opinion that licensing boards cite you and your license for professionalism type stuff. It's what actually happens.

 

[Doudline]

The docs talked of firing a gun up the patient's rectum and punching him in the face; closely examined his genitals for funsies, with the goal of humiliating the patient; told everyone in the room that he had tuberculosis, syphilis; falsified his medical records; deceived the patient into thinking he had received post-op instructions from the one of the plaintiffs when he had not; called him "gay", a "whimp", a "******", etc.

And some of you are defending the plaintiffs?

Holy ****

And you can't see how it would cause psychological suffering for the patient? Or distrust of the medical establishment?
Jesus.

 

[jl lin]

The docs talked of firing a gun up the patient's rectum and punching him in the face; closely examined his genitals for funsies, with the goal of humiliating the patient; told everyone in the room that he had tuberculosis, syphilis; falsified his medical records; deceived the patient into thinking he had received post-op instructions from the one of the plaintiffs when he had not; called him "gay", a "whimp", a "******", etc.

And some of you are defending the plaintiffs?

Holy ****

And you can't see how it would cause psychological suffering for the patient? Or distrust of the medical establishment?
Jesus.

I am seriously and painfully astounded at the rationalizations here.

Also, again, if you are doing and saying the right things, you will not have a problem. The paranoia is w/ those that assume they would.
Remember, the patient and his/her family are the VULNERABLE ones here.

If you fix my car and talk smack about me while I'm away and you are fixing it, and if you do a good job, yet I hear about your smack talk against me, I may just address you and say, "YOU did a great job fixing my car. I sincerely appreciate that you did. I don't, however, understand why you felt the need to talk smack about me. Maybe you were having a bad day or whatever; but this kind of thing is bad for your business. And it is a shame, since you are such a talented mechanic."

Now, compare this to physicians and those involved in direct delivery of care to humans. Some pre-physicians and physicians don't want to buy that being a physician is a calling; but you see, it is. It goes far and away above simply performing a particular service. And there is the problem with some in HC today. It's all about services and fees, while the calling and the sense of humanitarian commitment isn't there. And I am telling you that this is a HUGELY problematic way for the medical profession to go.

You want to talk about advanced practice nursing overstep or other mid-level overstep? Holistic approach and human ethics and caring is thick in many and hopefully most nursing programs worth anything at all. Why? B/c it is a profession based on holistic, human need. It realizes that patients want and need to know that you actually give a damn about them--both in terms of the medical services you provide and about them holistically speaking. You can try to separate these two things; but it doesn't work. Hell, it doesn't work even in veterinary medicine. I could you a number of real life examples that illuminate this point.

What does it mean to be caring and humane? What does it mean to be someone that has a high level of expectation in terms of providing for people's health needs and such with respect, honest to goodness compassion, and genuine dignity. Yea. This is a calling, b/c as you do treat people with compassion, respect, and dignity, it shouldn't be based on merely whether or not you particularly like the said personality of said patient. And it should not simply be about whether or not you can fix a particular part of the person's body/condition. That person isn't a car. He or she is a multiply complex being--JUST AS YOU ARE.

Say what you want about nursing; but at my university program and even my initial ADN program, we had a ton of ethics courses or ethics throughly weaved in to the courses, which were thought-provoking and eve stirring. Of course some nursing students just get through them to get them done. But others of us really try to stretch and grow from our education.

I don't know how much of the tendency to be compassionate is nature or nurture/education. But what I do know is even beyond all the various ethical issues and dilemmas presented, there is one simple rule that has spoken to me deeply from my childhood. It is this:

"Do unto others, as you would have them do unto you." How would you as the patient want to be treated? IF you or your loved one was on that table, how would you want things to be conducted?

And sadly b/c some people don't have enough internal stuff to fully appreciate this; messages are sent from juries or judges For example, some stinging damages and such noted in this original, nightmarish story. Heck, those consequences are not going to kill the defendant. I hope they do help her to get some needed help and insight before she actually does end up losing her license. As long as you have a license, you can get some kind of work.

Stand back and thing about this just for a second. It is a good thing that people have a high level expectation of humanity-driven care from the medical profession. Who you really want it to be any other way????? People need to have a high level of respect and trust of those that so intimately and powerfully affect their lives.

To much is given, much is expected. Physicians everywhere should be glad they didn't give this woman a merely slap on the wrist. That would undermine the very profession in which you have chosen (and have worked so hard) to serve. Value what being a physician actually means.

Also, remember one day YOU OR YOUR LOVED ONE will be on the other end of receiving some very serious care. I pray you don't have to wait until that point to get some insight about what being a genuinely caring, respectful, and effective physician means--and yes, genuine caring goes hand in hand w/ effectiveness--even if you want to think otherwise. See if you care, you make it your business to know your business and incorporate that with the required compassion and dignity and respect. Try separating these from each other and all you have is something much worse that a robot--as the anesthesiologist clearly was in this example--unless the robot had been programmed to behave like a totally careless ass.

 

[Doctor Bob]

and yeah let's keep taking checks at each other's experience level to validate/justify a perpetual jadedness in the field - that will get us all somewhere I'm sure.

There are some topics of conversation, where levels of experience do matter. Not that it invalidates your ability to opine on a subject, but that it gives the rest of us a frame of reference, and an idea of how grounded in relevant experience it will be.
I would argue that most pre-meds, med students, and interns would find the idea of talking s*** about a patient behind their back abhorrent... but you're all also in the midst of writing lots of "why medicine is so noble" essays, and convincing people that you want to be a doctor to be an altruistic person. And that's ok.
Many upper level residents and attendings don't find the idea of talking crap about a patient all that unusual. We do it all the time. Now in this case it seems to be a bit beyond the pale, but I'm speaking in generalities. Am I going to ridicule the patient who comes into the ED demanding percocet for their sunburn (which is already in the peeling stage)? Absolutely. I'm probably even going to do it a little bit to their face, although it will be couched in professional mien.

Knowing who/where the opinion is coming from helps me, online as in real-life. If a pre-med or MS1 snarks at me for being unprofessional to a patient, I'm going to say thanks for your opinion, pat them on the head, give them a cookie, and send them outside to play. If a resident or attending says it, I'm much more likely to pause and re-examine my stance on things. Because that group knows better, from experience, where the acceptable/unacceptable line is and when it's been crossed.

At home after work does not equal in the OR with a vulnerable and incapacitated patient.
Mechanic does not equal physician.

Er.... a vulnerable and incapacitated patient? That's generally a qualifier brought up in regards to the things we do to patients, not things we say around them. It has no bearing here.
And we are talking about things that were said. Physicians come from a cross-sectional slice of society; so you will have all kinds of people being doctors. We want all doctors to do good, but they don't have to necessarily be good (other than they should be good at what they do). You can think ill of your patient so long as it doesn't affect the care you provide. If it does have an adverse affect... well, then that's a problem.

mocked Plaintiff for attending Mary Washington College instead of MIT, suggested that it was unsurprising that Plaintiff attended a college that at one time was a "woman's college", a "girl's school", and wondered if Plaintiff was gay. Defendant I stated, "Are you implying that he's gay? Because I know gay men that have more manliness than" the Plaintiff. "And I'm sure I know gay men in the military who just haven't let it be known that they're gay who are manly."

Aww, I went to Mary Washington.

 

[Doctor Bob]

Now, compare this to physicians and those involved in direct delivery of care to humans. Some pre-physicians and physicians don't want to buy that being a physician is a calling; but you see, it is. It goes far and away above simply performing a particular service. And there is the problem with some in HC today. It's all about services and fees and the calling and the sense of humanitarian commitment isn't there. And I am telling you that this is a HUGELY problematic way for the medical profession to go.

You are entitled to this opinion.

I fundamentally disagree with it.

So it goes.

 

[NontradCA]

You are entitled to this opinion.

I fundamentally disagree with it.

So it goes.

This is not a manner of opinion for said Anesthesiologist. Career= over. And your posts highlights all the reasons people hate doctors in this country: arrogance.

 

[runnergal]

wow - this happened to me before, comments made by lead OR nurse when she thought I was under. I just wrote about it in my survey that was mailed to me afterwards. I didn't know unprofessional and derogatory comments held substance enough to bring it up in court. Lesson learned.

 

[deleted171991]

This is not a manner of opinion for said Anesthesiologist. Career= over. And your posts highlights all the reasons people hate doctors in this country: arrogance.

And your post highlights one of the reasons senior residents and attendings hate medical students in this country: arrogance.

If I were a medical student, I would be very doubtful if I really want to contradict more experienced people, if I am not missing something in the big picture. I mean what are the chances that all these much more senior people are wrong, and I am right?

 

[WingedOx]

What a helpful coincidence that an unpopular SCOTUS Obamacare decision comes on the heels of this well-publicized unprofessional physician incident.

 

[Hyde]

I made an observation about coincidental events. Your response reflects poorly on you not on me.

 

[Member 1337]

Holistic approach and human ethics and caring is thick in many and hopefully most nursing programs worth anything at all.

Say what you want about nursing; but at my university program and even my initial ADN program, we had a ton of ethics courses or ethics throughly weaved in to the courses, which were thought-provoking and eve stirring. Of course some nursing students just get through them to get them done. But others of us really try to stretch and grow from our education.

But what I do know is even beyond all the various ethical issues and dilemmas presented, there is one simple rule...

It bugs me that most ethics courses given to healthcare workers are practically useless, and after wading through this wall of text it looks like instead of being taught how to systematically assess ethical conflicts using various models, you essentially had a love fest of courses on how to best not hurt peoples feelings.

Sometimes the most ethical thing to do is to not be nice. Sometimes the most ethical thing to do is to be comfortable with being offended at someone elses words, opinions, drawings, or religious views and not vindictively harm them physically or financially in revenge.

I am not defending either party in this case - I'm just pointing out that there are multiple conflicts being analyzed in this thread. You are ignoring the analysis while going on and on with platitudes and homilies about being nice, inappropriately implying that you're offering an educated ethical analysis of the situation.

Your posts are actually hurting the analysis and making people dumber.

 

[runnergal]

If a resident or attending says it, I'm much more likely to pause and re-examine my stance on things. Because that group knows better, from experience, where the acceptable/unacceptable line is and when it's been crossed.

Can you tell me more?

In your experience, does this group (resident/attending) speak up? Or most times, just shake it off, with a "not-my-business" attitude? Dr. Shah, the GI in this room nor any other staff in the room, spoke up in this case. I am curious.

In reference to this case, could you provide some examples of acceptable/unacceptable that this anesthesiologist could have been quoted saying and you believe would have been inappropriate?

 

[Doctor Bob]

This is not a manner of opinion for said Anesthesiologist. Career= over. And your posts highlights all the reasons people hate doctors in this country: arrogance.

The opinion of jl lin's that I was disagreeing with was the notion that being a physician is a calling.

Arrogance? My stance is why should physicians be held to any higher standard than the patients we take care of? Why should we be held to a higher standard than any other profession? We are just people. People err, people say mean things. It happens.

You will note... as I hope you are taking the time to read the entirety of my posts (and if not, so be it.. they are absolute gems and you're missing out), that I am not arguing that this specific anesthesiologist is blameless. I speak in generalities rather than specifics. I'm not going to opine on this specific case; I wasn't in that room and while I can read the transcript and listen to the tape, it's still just an opinion and would be infused with my own biases. Plus my opinion on a specific case (which has already reached a legal conclusion) is irrelevant.

So... arrogance? I would argue that you've reached an erroneous conclusion about me. But you are entitled to believe whatever you want.

 

[runnergal]

Yeah it is interesting. I am trying to think of another profession in which someone saying something mean or unprofessional to their "client" would get them sued for $500K.
......Whether or not the patient's award was justified or unjustified. None of us truly know.

 

[NontradCA]

The opinion of jl lin's that I was disagreeing with was the notion that being a physician is a calling.

Arrogance? My stance is why should physicians be held to any higher standard than the patients we take care of? Why should we be held to a higher standard than any other profession? We are just people. People err, people say mean things. It happens.

You will note... as I hope you are taking the time to read the entirety of my posts (and if not, so be it.. they are absolute gems and you're missing out), that I am not arguing that this specific anesthesiologist is blameless. I speak in generalities rather than specifics. I'm not going to opine on this specific case; I wasn't in that room and while I can read the transcript and listen to the tape, it's still just an opinion and would be infused with my own biases. Plus my opinion on a specific case (which has already reached a legal conclusion) is irrelevant.

So... arrogance? I would argue that you've reached an erroneous conclusion about me. But you are entitled to believe whatever you want.

I'm not even sure why I have to explain this. Simply, you're held to a higher standard because that's the way of the world. In a practical sense, you're getting paid a lot of money, and you're smarter than the average patient. I mean, you kind of said it yourself. You're awesome and you have all this experience. Act like it?

 

[Doctor Bob]

Can you tell me more?

In your experience, does this group (resident/attending) speak up? Or most times, just shake it off, with a "not-my-business" attitude? Dr. Shah, the GI in this room nor any other staff in the room, spoke up in this case. I am curious.

Residents are far more reluctant to speak up to attendings, I'll admit that. Especially to tell them they are doing something wrong.
Attendings very freely call out other attendings, especially when they all have a collegial relationship. The location of the appropriate/inappropriate line can get very blurry when you're all engaging in s***slinging.

In reference to this case, could you provide some examples of acceptable/unacceptable that this anesthesiologist could have been quoted saying and you believe would have been inappropriate?

No. I'm doing my best to avoid commenting on this specific case.

 

[WingedOx]

Arrogance? My stance is why should physicians be held to any higher standard than the patients we take care of? Why should we be held to a higher standard than any other profession? We are just people. People err, people say mean things. It happens.

Sure, but if an auto mechanic at a dealership gets caught by a customer saying something so stupid about the guy who has his car in for service, he's going to have a rough time holding on to his job.

 

[NontradCA]

And your post highlights one of the reasons senior residents and attendings hate medical students in this country: arrogance.

If I were a medical student, I would be very doubtful if I really want to contradict more experienced people, if I am not missing something in the big picture. I mean what are the chances that all these much more senior people are wrong, and I am right?

I'm not arguing with you as to how to administer anesthesia. I'm arguing that there's no reason to handle stress in the way this anesthesiologist did, and it was wrong.

 

[jw3600]

Sure, but if an auto mechanic at a dealership gets caught by a customer saying something so stupid about the guy who has his car in for service, he's going to have a rough time holding on to his job.

Yeah no ****. That's not what happened here. That person was sued and the plaintiff was awarded half a million dollars. The anesthesiologist losing her job is a result that I think most people on here would have felt was a reasonable action. Not that they necessarily would have to be fired, but I don't think its unreasonable. It's the $$$ that annoys me.

 

[WingedOx]

Yeah no ****. That's not what happened here. That person was sued and the plaintiff was awarded half a million dollars. The anesthesiologist losing her job is a result that I think most people on here would have felt was a reasonable action. Not that they necessarily would have to be fired, but I don't think its unreasonable. It's the $$$ that annoys me.

sucks, but that's what malpractice insurance is for. It's her company that's most likely paying out, not her. I really can't tell if people are pissed that the MD had to "pay" of if they're pissed the patient got $$$.

Sorry, but the responses opposed to the outcome here run the gamut from "Gasser is wrong but shouldn't have had an award" to "this is just how we vent! I saw my attending do it last week!" I can barely tell who is arguing what anymore.

 

[runnergal]

It appears that the blurry line is all about perception. I drink a fifth, and you drink a fifth, our perception will both be different. We need to respect everyone's perception.

He felt "some type of way" which in itself should be valid, jury validated his feeling and or the anesthesiologist's lack thereof, he was awarded money for compensation.

Respect it. And then learn to talk the trash at home with your spouse or significant other listening, not at your place of employment.

 

[jw3600]

sucks, but that's what malpractice insurance is for.

This wasn't malpractice. This thread is strange. I have no problems with differing opinions but we can't even seem to set the correct logical framework.

 

[deleted171991]

I'm not arguing with you as to how to administer anesthesia. I'm arguing that there's no reason to handle stress in the way this anesthesiologist did, and it was wrong.

Of course it was wrong (probably not as wrong as all the exaggerated public political correctness is making it out to be, but wrong enough to be tough to defend). But you haven't walked in a physician's shoes yet (and you are probably much younger and less experienced, too, than Doctor Bob, an academic attending). Don't throw that "arrogance" stone just yet; sooner than you'd think, you might become its target, too.

 

[Doctor Bob]

I'm not even sure why I have to explain this.

Because I don't think we're talking about the same thing and I'm not understanding where the disconnect lies. Clarification is always a good thing.

Simply, you're held to a higher standard because that's the way of the world.

Pssh; that's the world's problem, not mine. If the world wants to see me as better/more important than I really am, then fine. I'd complain if it was the opposite way (the world thinking I was worse/less important than I was).

In a practical sense, you're getting paid a lot of money, and you're smarter than the average patient.

Well... I'm in the military, so I'm not getting paid all that much. But that's neither here nor there.
And I'm smarter than the average patient in the realm of medicine. But I know very little about construction, food preparation, car maintenance, etc, etc.

I mean, you kind of said it yourself. You're awesome and you have all this experience.

That's the nicest thing anyone has said to me all day.

Act like it?

Ahhhh.... there's the disconnect.
So I'm not saying doctors shouldn't act like good people; that's more and more essential in this increasingly customer-service based field. I'm saying doctor's don't have to be good people. We can be callous jerks on the inside, we can be cynical asshats on the inside, we can be racist misogynistic misandriastic whatever else so long as it doesn't affect our work.

I rail against the increasing customer-service bent on medicine. Head on over to the EM forum and read all about the stupid s*** that goes on.
I can provide very good care to people while telling them they are being a dumbs***. What I say has (should have) no impact on the care I deliver. If it does, then it's a problem.

 

[jw3600]

I can barely tell who is arguing what anymore.

Totally. I personally am not pleased with a further continuation of our litigious society setting precedents for massive amounts of money settlements for what essentially is being butt hurt.

That is by far and away my biggest concern. It's legal precedent to sue for being offended. Simple as that. Everything else was smoke and mirrors.

 

[ucladoc2b]

I'm not arguing with you as to how to administer anesthesia. I'm arguing that there's no reason to handle stress in the way this anesthesiologist did, and it was wrong.

Yes, I think we agree that the mockery was over the top on a professional level.

That being said, you will have a fair share of unpleasant, frusterating patients in your career. It's ok to dislike them. And it's also ok to make a few jokes. This type of banter goes on in pretty much every workplace (healthcare or otherwise). Doctors are people, as much as we like to think otherwise.

I do have some problems with this lawsuit mostly on first amendment grounds. Essentially, making the provider fincially liable for opinions and jokes is worrisome (especially when the damage done to the plaintiff is questionable. I cannot imagine how his reputation was truly damaged during what is essentially a private conversation with a limited audience). I am also a bit worried about how the court interpreted the one party consent for the use of a recording device during a private conversation (especially since the plaintiff wasn't participating in it. It would almost be like listening through a wall or a clandestine bug when that person is not in the room).

I do have some questions about why exactly she had to mark hemorrhoids in the chart. This question would go back to why the patient was having the colonoscopy in the first place (screening vs. other medically indicated reason). Listening to the tape, it almost sounds like she needed some sort of diagnosis to complete pre op paperwork (or something along those lines...essentially the reason for the test).

 

[jl lin]

It bugs me that most ethics courses given to healthcare workers are practically useless, and after wading through this wall of text it looks like instead of being taught how to systematically assess ethical conflicts using various models, you essentially had a love fest of courses on how to best not hurt peoples feelings.

Sometimes the most ethical thing to do is to not be nice. Sometimes the most ethical thing to do is to be comfortable with being offended at someone elses words, opinions, drawings, or religious views and not vindictively harm them physically or financially in revenge.

I am not defending either party in this case - I'm just pointing out that there are multiple conflicts being analyzed in this thread. You are ignoring the analysis while going on and on with platitudes and homilies about being nice, inappropriately implying that you're offering an educated ethical analysis of the situation.

Your posts are actually hurting the analysis and making people dumber.

I am not deliberately trying to be unkind, but I find some of your statements (above) completely w/o sense and beyond unreasonable and unintelligent. What is with this either/or mentality? Talk about making people dumber? Seriously, no offense but "Pot to kettle."

Doing one right thing does NOT negate the need to do another right thing.

Reframe the entire situation in the positive. This is what I have done by being grateful that those in medicine and healthcare be held to the highest possible standards.

Just b/c you have heard something perhaps a number of times, doesn't mean it is any less true. If anything it may mean that you are that much more responsible for applying it.

IOWs, "Treat others as you would also like to be treated." That is to be taken in the positive, and as such, there is NO LAW against such a thing--ONLY FOR IT.

I found everyone of the ethics courses helpful and important. We do in fact direct our actions based on how we understand, perceive, feel things: hence, as person thinks, so is how he will behave.

"A man's (person's) mind may be likened to a garden, which may be intelligently cultivated or allowed to run wild; but whether cultivated or neglected, it must, and will, bring forth. If no useful seeds are put into it, then an abundance of useless weed seeds will fall therein, and will continue to produce their kind.” ― James Allen, As a Man Thinketh

In short, how we think, in one way or another, will affect what we do and how we live.

 

[sliceofbread136]

Er.... a vulnerable and incapacitated patient? That's generally a qualifier brought up in regards to the things we do to patients, not things we say around them. It has no bearing here.
And we are talking about things that were said. Physicians come from a cross-sectional slice of society; so you will have all kinds of people being doctors. We want all doctors to do good, but they don't have to necessarily be good (other than they should be good at what they do). You can think ill of your patient so long as it doesn't affect the care you provide. If it does have an adverse affect... well, then that's a problem.

I disagree. The patient agreed to make himself completely vulnerable to the physician with the understanding and trust that the physician would respect them and treat them with dignity. The physician took advantage of that vulnerability to demean and disrespect the patient. Being "part of a cross section of society" is no excuse for such unprofessional behaviour when you are an environment of such power.

 

[deleted171991]

It appears that the blurry line is all about perception. I drink a fifth, and you drink a fifth, our perception will both be different. We need to respect everyone's perception.

He felt "some type of way" which in itself should be valid, jury validated his feeling and or the anesthesiologist's lack thereof, he was awarded money for compensation.

Respect it. And then learn to talk the trash at home with your spouse or significant other listening, not at your place of employment.

Except we shouldn't pay $500k in damages for perceptions and hurt feelings. What's next?

 

[ACSurgeon]

I'm not arguing with you as to how to administer anesthesia. I'm arguing that there's no reason to handle stress in the way this anesthesiologist did, and it was wrong.

I don't think anyone here is saying that her behavior was good or appropriate.

 

[jl lin]

This is not a manner of opinion for said Anesthesiologist. Career= over. And your posts highlights all the reasons people hate doctors in this country: arrogance.

I disagree. The patient agreed to make himself completely vulnerable to the physician with the understanding and trust that the physician would respect them and treat them with dignity. The physician took advantage of that vulnerability to demean and disrespect the patient. Being "part of a cross section of society" is no excuse for such unprofessional behaviour when you are an environment of such power.

Absolutely correct.

 

[jl lin]

I don't think anyone here is saying that her behavior was good or appropriate.

A lot of dancing around w/ rationalizations--and to that end, missing the bigger, most important points!

 

[jl lin]

Oh for God's sake:

http://www.healthsourceglobal.com/docs/Patient Bill of Rights_merged.pdf



Respect and non-discrimination

You have a right to considerate, respectful care from your doctors, health plan representatives, and other health care providers that does not discriminate against you.

 

[NontradCA]

Because I don't think we're talking about the same thing and I'm not understanding where the disconnect lies. Clarification is always a good thing.


Pssh; that's the world's problem, not mine. If the world wants to see me as better/more important than I really am, then fine. I'd complain if it was the opposite way (the world thinking I was worse/less important than I was).


Well... I'm in the military, so I'm not getting paid all that much. But that's neither here nor there.
And I'm smarter than the average patient in the realm of medicine. But I know very little about construction, food preparation, car maintenance, etc, etc.


That's the nicest thing anyone has said to me all day.


Ahhhh.... there's the disconnect.
So I'm not saying doctors shouldn't act like good people; that's more and more essential in this increasingly customer-service based field. I'm saying doctor's don't have to be good people. We can be callous jerks on the inside, we can be cynical asshats on the inside, we can be racist misogynistic misandriastic whatever else so long as it doesn't affect our work.

I rail against the increasing customer-service bent on medicine. Head on over to the EM forum and read all about the stupid s*** that goes on.
I can provide very good care to people while telling them they are being a dumbs***. What I say has (should have) no impact on the care I deliver. If it does, then it's a problem.

I agree with you on all of this. I thought you were saying it's ok to act like an ass to patients. I didn't real lins post to know the context.

 

[Doctor Bob]

I disagree. The patient agreed to make himself completely vulnerable to the physician with the understanding and trust that the physician would respect them and treat them with dignity. The physician took advantage of that vulnerability to demean and disrespect the patient. Being "part of a cross section of society" is no excuse for such unprofessional behaviour when you are an environment of such power.

Purely hypothetical here...
Would the patient be entitled to damages, had the physician said the same things in the environment of a doctor's office?
The doctor and the nurse, standing outside the door to the patient's room, while the patient is sitting in a chair waiting to be seen?

Purely hypothetical #2
Would the patient be entitled to damages, had the physician said the same things while on a conference call, with the patient sitting in the comfort of their own home?

 

[runnergal]

Except we shouldn't pay $500k in damages for perceptions and hurt feelings. What's next?

Some people say $50K is enough to compensate him, some say it's too much. Some say he should have gotten more money, some say $500K was more than enough. Again, that blurry perception you guys keep talking about.

 

[NontradCA]

We need to talk about real issues instead of this. Gay people are getting married folks.

 

[jl lin]

Some people say $50K is enough to compensate him, some say it's too much. Some say he should have gotten more money, some say $500K was more than enough. Again, that blurry perception you guys keep talking about.

The statements and actions toward the patient were grievous enough to warrant these kinds of damages. This treatment was a violation of patient rights and ethical treatment--and again HURTS w/ GP and their feelings about trusting physicians and healthcare providers.
There really is No (zip, zero) justification, and the damages should stand.

They should be a warning to those that need to be reminded about how to rightfully deal with patients and families. Personally I have no time and tolerance for this sort of thing, and the hospital had enough sense to let her go for obvious reason--and b/c I can guarantee her words and actions violated the organization's own mission, value statements, ethical statements, standards, and patient bill of rights.

 

[jl lin]

We need to talk about real issues instead of this. Gay people are getting married folks.

How is this NOT a very REAL issue for medicine and healthcare?

 

[deleted171991]

A lot of dancing around w/ rationalizations--and to that end, missing the bigger, most important points!

It doesn't seem that anybody's missing anything here, except the people who refuse to look at the big picture.

The big picture is that, as a society, we shouldn't be as concerned about what this doctor did (simply because she's the exception, not the rule) as about where the jury has gone with it. It was an incredible knee-jerk reaction that will only drive up the cost of medical care in Virginia, and possibly elsewhere.

When one cannot reasonably predict what a jury will do in most malpractice cases, premiums and defensive medicine skyrocket, and so do healthcare costs. This was one of those cases, and that's way more alarming.

Also, they basically limited a doctor's freedom of speech by ruling that inappropriate speech is malpractice. That's just huge. Look at oppressive countries and societies, where one is afraid to say anything politically incorrect (by authoritarian standards). It won't feel much different, when the alternative to controlling one's mouth is $50K per occurrence.

 

[deleted171991]

How is this NOT a very REAL issue for medicine and healthcare?

Why would it be? Have you ever treated a patient differently because of his/her sexual orientation? Have you ever denied a patient the right to be with his/her lover or friend, at his/her bedside, just because they were missing a document?

More people will get employer-sponsored private health insurance. Great!

What am I missing?

 

[jl lin]

It doesn't seem that anybody's missing anything here, except the people who refuse to look at the big picture.

The big picture is that, as a society, we shouldn't be as concerned about what this doctor did (simply because she's the exception, not the rule) as about where the jury has gone with it. It was an incredible knee-jerk reaction that will only drive up the cost of medical care in Virginia, and possibly elsewhere.

When one cannot reasonably predict what a jury will do in most malpractice cases, premiums and defensive medicine skyrocket, and so do healthcare costs. This was one of those cases, and that's way more alarming.

Also, they basically limited a doctor's freedom of speech by ruling that inappropriate speech is malpractice. That's just huge. I grew up in a society where one was afraid to say anything politically incorrect (by authoritarian standards), and I can tell you it's oppressive and stressful.

OK, I think a number of us have been pretty clear. I perceive you indeed are missing the bigger point/picture; and no one here will be able to change your perspective on this--at least not any time soon. But experience can be a great teacher.