Patient sues doctors for defamation, medical malpractice

On June 23, 2015 the Washington Post ran a story titled Anesthesiologist trashes sedated patient — and it ends up costing her. While preparing for a colonoscopy, a patient hit "record" on his smartphone to make sure he heard the instructions his doctor would give him after the procedure.

When he played back the recording he was shocked to find that while he lay unconscious, the surgical team had mocked him, told an assistant to lie to him, and then put a false diagnosis on his chart. The patient sued the doctors and their practices for defamation and medical malpractice, and a jury ordered them to pay him half a million dollars.

This story is horrifying. One might even call it a patient's "worst nightmare." To treat a patient in such a manner while they are sedated and vulnerable is both callous and unprofessional. For the staff at the Arnold P. Gold Foundation Research Institute, this incident raises several questions:

1. Does authenticity matter?
Do clinicians have to truly care about their patients? Or do they just need to act as if they care -whether a patient is present/conscious or not? We would argue that both are necessary. The Arnold P. Gold Foundation seeks to ensure that compassion, respect and empathy are at the core of all healthcare interactions. The Chairman of our board, Dr. Jordan J. Cohen, calls humanism 'the passion that animates authentic professionalism'. We believe that clinicians must strive to truly care about their patients in order to serve their best interests. While it may not be possible to muster 100% empathy for all patients every single day, no healthcare provider should ever ridicule and demean their patients.

Michael Kahn suggests that our minimum standard should be "Etiquette-Based Medicine." In his words, "a doctor who has trouble feeling compassion for or even recognizing a patient's suffering should nevertheless behave in certain specified ways that will result in the patient's feeling well treated." Such etiquette-based behavior should extend to communications when the patient is out of earshot as well. There is evidence from neuropsychology that behaving kindly and respectfully actually helps you feel that way.

2. Beyond the impact on individual patients, how does unprofessional behavior affect the culture of healthcare?
The old adage "If a tree falls in a forest and no one is around to hear it, does it make a sound?" may be relevant here. If this patient had not recorded the conversation, he would not have been aware of the disparaging comments, but those comments still 'make a sound' in the clinical environment around him. There are serious ramifications on the culture of medicine, on teamwork, on trainees, and even on the safety of the patient.

Increasingly, medical educators are pointing to role modeling as a significant factor in professional identity development. When students' role models are cynical and derogatory, as was the case in this recent incident, these unprofessional social norms are passed down intergenerationally and perpetuate a culture of healthcare that harms patients and siphons meaning and joy from the work of being a healthcare professional.

We must advocate for safe spaces in which healthcare trainees and professionals can talk openly about challenges in clinical care; they must be provided with opportunities to openly share their own (sometimes negative or frustrating) experiences with patients, and develop strategies to cope and communicate constructively. They must have avenues to share stories from 'the trenches' and to role-play potential responses to unprofessional colleagues and supervisors. In addition to opportunities for reflection and renewal, safe reporting opportunities must also be made available. We do draw hope from the work of Thomas Inui and colleagues who have successfully changed the culture of an entire medical school. Their aim is to liberate "individuals and groups from automatically reproducing existing patterns and gives them the ability to explore and change." In the end, those of us in healthcare need to insist upon deliberate change in the culture of medicine to become more humanistic; our patients' lives depend on it.

3. How can we ensure that the professionalism of healthcare employees remains intact?
Though we hope that students and health care providers do learn to speak up in the moments when they witness unprofessional behavior, we also acknowledge that it is not easy to do so. We need policy and legal recognition that professionalism in healthcare is a factor that affects a patient's experience of care, patient's health outcomes, patient safety, and provider burnout. Fortunately, some prominent organizations are bringing the importance of professionalism in education and practice front and center:

--The ACGME Clinical Learning Environment Review (CLER) mandate addresses professionalism issues in the environments in which residents work and learn
--The LCME states that "A medical education program must ensure that its learning environment promotes the development of explicit and appropriate professional attributes in its medical students."
--The Joint Commission has a zero tolerance policy for disruptive physicians.

The Digital Age brings with it the ability to easily record interactions. While this particular recording was accidental, other patients may secretly record their physicians. This both stems from, and contributes to, a culture of mistrust between practitioners and patients. Healthcare professionals should not practice in fear that they might be secretly recorded, but with the intention to express the highest standards of compassion and professionalism, regardless of who is listening.

Source:

The Arnold P. Gold Foundation Research Institute

Comments

  1. simika hopkins simika hopkins United States says:

    I am in same situation with an horrible nightmare at the hospital except I feel as if I have no proof and no witnesses to back me up and I’m facing with a misdiagnoses that says I’m mentally ill making it even worst of what I’m trying to explain as if I’m crazy or not wanting to hear me out trying to gain custody of my 1 year old who has not been in my care ever since he was born in the hospital. I was released from hospital after having my baby but he had to stay due to him being premature and need of intensive care and I did too after I was released I was already overly medicine and just had C-Section. My mother who is  schizophrenic end up calling a psych ward which she says she called to go back to were i had baby to recover. When paramedics arrived at my home I thought they was for my mother but did not want to hear what I had to say they instantly put me down and stuck me with a shot after them pleading and praying for them not to do that, I was unconscious until I woke up in a yellow gown at the facility no access to phone asking multiple questions that were never answered the staff treated me like an animal I kept saying I need to go and be at hospital with my son and they did not listen but just kept on asking me we’re I seeing and hearing things it took days until I said I was going to sue that hospital after they said they would discharge me and kept asking me was I still going to sue I said no to get out . I went straight to see my son now the hospital saying I’m restricted from seeing him and that I made threats to hospital which I don’t recall because I never had an access to a phone wondering if my mother had done it. DCFS got involved I explained everything including giving out psych ward records to show why I have not been up to hospital to check on son I soon found out the psychiatrist diagnosed me with serious illness of schizophrenia and this is the far most overwhelming thing I ever have to deal with in my life I’m very confused on what to do and I want everyone to know my story because it shows how you can have lots of plans, goals and achievements you want in your future but somethings happened in life you have to overcome.

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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