Bad Doctors
I have come across some very bad doctors recently. I really saddens me. For real. Being a doctor is a public trust. It is a unique calling that demands a lot of the person who has chosen the profession. It is an extraordinarily stressful job at times. It demands a level of performance on a daily basis that is high and a persistence to keep up with the latest advances to help your patients.
So many doctors work hard to be their best. A few bad apples come through the gate and we need to know who they are and how they go bad.
Here are a few observations:
When a doctor goes bad it can be in the following general categories:
There isn't a fine line between whether a test or procedure is indicated or not. It is not always so black and white. Within each clinical problem are a range of solutions; in essence, a corridor, where some reasonable doctors will treat one way and others will treat differently.
Just because a doctor owns his own testing facility or surgicenter doesn't mean he is guilty of doing something just for money. I recall a Chris Rock punch line; "A man is only as faithful as his options". Does this also apply to doctors?
Can it be said "A doctor who owns his own testing or treatment facility is only as honest as his option or ability to get that test or procedure performed?" It is an interesting question.
While many people believe it may be human nature to give in to temptation, I would say this is not the case. Priests don't encourage you to sin to increase the traffic in the confessional booth. A good Pharmacist doesn't recommend a skin cream because it is more expensive.
Good doctors don't offer treatments or surgery unless they feel it is in your best interests. Only businessmen do that, not professionals. That is the difference between a profession and a business. A professional is someone that protects the integrity of the very nature of the profession over self-interest.
Businessmen answer first to the financial bottom line and then the interests of the industry they serve.
Not all doctors are good, though. A colleague of mine in the Midwest saw a patient recently that was seen by another surgeon who told her she need an arthroscopy to washout her knee for knee pain. She had a normal x-ray. There was no MRI done.
He saw her in the office and after less than 5 minutes told her she needed surgery. After examining her, my colleague felt she may have had either a cartilage tear or mild knee cap arthritis. After an MRI, it turned out to be the knee cap arthritis where the treatment was a short course of physical therapy and a home exercise program.
This concerned him so he did a little investigative reporting on this surgeon. It turns out that on any given week, this surgeon performs over 20 arthroscopies a week. Considering in this relatively small city the next busiest surgeon did 7-8 a week, this raised an eyebrow.
It turns out, that after a bit more digging it appeared that a majority of these cases were work-related injuries and were referred to that surgeon by a single law practice in the area that specializes in settlements for work-related injuries.
My friend actually went back to the case that he prescribed physical therapy on and it turns out that this was a work-related injury also. He asked me what he should do.
I actually was at a bit of a loss on this one. There is a corridor of appropriate treatment for knee pain but this stunk like an old piece of cheese in the back of the refrigerator. It would be very difficult to prove there was grossly inappropriate behavior by this doctor, though.
To help my friend I asked him a corollary question. "Why don't you call this lawyer to see if you can get cases like this so you can make more money?"
His response: "Ira, what? Are you crazy?"
"We already know that I am but answer my question anyway."
"I could never do that because the reason to treat a patient a certain way is based on my belief that it will make the patient better and not make the legal case better or put more money in my pocket."
"I knew why I liked you. So what you are saying that essentially you are a good ethical person and this other doctor is coming from a bad place, a place of low ethics."
"I guess so."
"So you have my answer," I said. "Continue to be you and set the example for others for proper behavior. You can't change the other doctor. He is a bad egg."
My point here is that bad doctors are not bad because of temptation or someone luring them into a situation. It is because they are bad people.
A good person would not believe that taking a knife to another person in a dark alley is a good thing. Only a bad person would do that. A good person would believe that reaching out a hand to a person who has fallen in a dark alley is a good thing. A good doctor would not take a knife to another person in a well-lit operating room if he did not believe he was reaching out with his hand to help the person. Any other intent is unacceptable. It is bad people that make bad doctors.
Most people are good. Most doctors are good. Find the good guys.
Dr. K
Related Topics: Surgery Lite: Understanding Endoscopic Surgery, Knee Replacement: Making the Decision
Technorati Tags: medical ethics
So many doctors work hard to be their best. A few bad apples come through the gate and we need to know who they are and how they go bad.
Here are a few observations:
When a doctor goes bad it can be in the following general categories:
- Due to personal greed he performs tests, surgery, or other care with the sole intent to make more money.
- Substance abuse on the job
- Sexual harassment of a patient
- Fraudulent billing
There isn't a fine line between whether a test or procedure is indicated or not. It is not always so black and white. Within each clinical problem are a range of solutions; in essence, a corridor, where some reasonable doctors will treat one way and others will treat differently.
Just because a doctor owns his own testing facility or surgicenter doesn't mean he is guilty of doing something just for money. I recall a Chris Rock punch line; "A man is only as faithful as his options". Does this also apply to doctors?
Can it be said "A doctor who owns his own testing or treatment facility is only as honest as his option or ability to get that test or procedure performed?" It is an interesting question.
While many people believe it may be human nature to give in to temptation, I would say this is not the case. Priests don't encourage you to sin to increase the traffic in the confessional booth. A good Pharmacist doesn't recommend a skin cream because it is more expensive.
Good doctors don't offer treatments or surgery unless they feel it is in your best interests. Only businessmen do that, not professionals. That is the difference between a profession and a business. A professional is someone that protects the integrity of the very nature of the profession over self-interest.
Businessmen answer first to the financial bottom line and then the interests of the industry they serve.
Not all doctors are good, though. A colleague of mine in the Midwest saw a patient recently that was seen by another surgeon who told her she need an arthroscopy to washout her knee for knee pain. She had a normal x-ray. There was no MRI done.
He saw her in the office and after less than 5 minutes told her she needed surgery. After examining her, my colleague felt she may have had either a cartilage tear or mild knee cap arthritis. After an MRI, it turned out to be the knee cap arthritis where the treatment was a short course of physical therapy and a home exercise program.
This concerned him so he did a little investigative reporting on this surgeon. It turns out that on any given week, this surgeon performs over 20 arthroscopies a week. Considering in this relatively small city the next busiest surgeon did 7-8 a week, this raised an eyebrow.
It turns out, that after a bit more digging it appeared that a majority of these cases were work-related injuries and were referred to that surgeon by a single law practice in the area that specializes in settlements for work-related injuries.
My friend actually went back to the case that he prescribed physical therapy on and it turns out that this was a work-related injury also. He asked me what he should do.
I actually was at a bit of a loss on this one. There is a corridor of appropriate treatment for knee pain but this stunk like an old piece of cheese in the back of the refrigerator. It would be very difficult to prove there was grossly inappropriate behavior by this doctor, though.
To help my friend I asked him a corollary question. "Why don't you call this lawyer to see if you can get cases like this so you can make more money?"
His response: "Ira, what? Are you crazy?"
"We already know that I am but answer my question anyway."
"I could never do that because the reason to treat a patient a certain way is based on my belief that it will make the patient better and not make the legal case better or put more money in my pocket."
"I knew why I liked you. So what you are saying that essentially you are a good ethical person and this other doctor is coming from a bad place, a place of low ethics."
"I guess so."
"So you have my answer," I said. "Continue to be you and set the example for others for proper behavior. You can't change the other doctor. He is a bad egg."
My point here is that bad doctors are not bad because of temptation or someone luring them into a situation. It is because they are bad people.
A good person would not believe that taking a knife to another person in a dark alley is a good thing. Only a bad person would do that. A good person would believe that reaching out a hand to a person who has fallen in a dark alley is a good thing. A good doctor would not take a knife to another person in a well-lit operating room if he did not believe he was reaching out with his hand to help the person. Any other intent is unacceptable. It is bad people that make bad doctors.
Most people are good. Most doctors are good. Find the good guys.
Dr. K
Related Topics: Surgery Lite: Understanding Endoscopic Surgery, Knee Replacement: Making the Decision
Technorati Tags: medical ethics
