Wednesday, May 27, 2009

Doctor's Conversation

A conversation with a doctor, about a patient, turned to a discussion about his high rate of medical malpractice insurance. Although this doctor was not actually complaining, he was telling me (the advocate) and the patient’s family member about the exuberant amount he pays. The topic, brought up by the patient’s family member made me very uneasy and the doctor, seeming to sense my uneasiness, made light of subject answering honestly the questions put out by the curious family member. This physician gave no sign of any discomfort but instead, seemed relaxed as if we were discussing a recent ball game.

To get away from the subject, I did say that I felt this was not appropriate since we were there to discuss the patient, but what was appropriate is if he wouldn’t mind explaining the large medical malpractice lawsuit he had a few years ago. Shifting in his seat, the doctor still in his comforting voice said “oh that?” and went on to explain what had happened to the patient and why he was involved in the lawsuit. He never asked how I knew but being a family’s advocate compels me to do some homework on the doctor we will be seeing as a team. This doctor told us what the patient’s complaint was and then started telling us about other lawsuits he had endured. He told us his side of the experience and then what he said the patient’s actions were that made this lawsuit un (non) believable.

I listened to every word he was saying, and the incident could have been a life changing experience I have heard any number of times by patients. But now I was hearing another version from the other side. I had to wonder what that patient, who was involved in a lawsuit that no doubt lasted years, would have given to sit in that room, with that doctor and hear what he had to say. After all, it started to make sense how an injury, such as he described, can happen.

Instead of a conversation between the patient and physician, the physician, who obviously has a great bedside manner and plenty of experience, had to endure a lawsuit. And the patient, who may have really liked this doctor, was probably never given the courtesy of learning what happened from their beloved doctor himself. Instead, the patient feels like a victim and the physician feels like a scapegoat because the hospitals still won’t encourage the dialogue to happen freely following an adverse event.

It made me sad that this discussion, even years after patient safety has begun to be a household term, probably never took place. For a patient to see a lawyer, most often, he or she is not getting the answers they need but the hospital attorneys encourage the medical team not to talk to the patient thrusting the patient into a time consuming, emotionally draining and messy lawsuit. Very often, it could be avoided by having a conversation – like we were that day.

So, though that doctor was distraught over the lawsuit (s) he encountered, I have to wonder if he would be willing to break down that wall of silence and would have met with his patient. Probably not.

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