Is This Shocking Behavior by Physicians Really Malpractice?

Neil Chesanow

Disclosures

July 02, 2015

These Doctors Behaved Badly, but Should They Have Been Sued?

Doctors, being human, sometimes say and do outrageous things, as a recent Medscape article pointed out. The question posed by the author, neurosurgeon Jeffrey Segal, MD, JD, is whether such doctors should be sued for malpractice when, despite their eyebrow-arching behavior, they didn't make a medical error or physically harm a patient.

To get readers thinking, Dr Segal presented three cases that did not fit the traditional concept of malpractice but would predictably make many physicians wince. In the first, doctors mercilessly mocked an anesthetized patient during a colonoscopy for their own amusement. The patient may have been unconscious, but his smartphone was on and so was its voice memo recorder, which captured every insult. The patient claimed to have been "verbally brutalized and defamed by the very doctors to whom he entrusted his life while under anesthesia."

In another case, a patient admitted to a clinic for gallbladder surgery had tattooed on his penis the words "Hot Rod," which the chief surgical resident found so hilarious that he snapped a photo of it with his smartphone and then circulated the photo to surgeon colleagues. A member of the surgical team alerted the media. "It was the most horrible thing I ever went through in my life," the patient told a reporter. "They were supposedly the best of the best. I have no complaints about the medical care I was given. But now I feel violated, betrayed, and disgusted."

Finally, Dr Segal related the case of a prankster dentist who offered his surgical assistant free dental care, but while she was sedated, he placed false teeth—replica wild boar tusks—in her mouth and snapped some photos for the delight of all present. The dentist didn't show his assistant the photos, but someone else did, figuring she would find them funny. Instead, she resigned and sued for battery, invasion of privacy, dental malpractice, and other assorted claims.

Most respondents were incensed at the physicians involved. "Sociopathic," "immoral," "cretinous," and "reprehensible" were just a few of the choice adjectives evoked.

"Medicine is a profession, and as such, physicians need to behave like professionals," an ophthalmologist commented. "The doctors involved should be punished for this type of behavior. Since there is no public flogging anymore and the process of censure through self-policing medical boards is too onerous and unpredictable, malpractice suits offer a vehicle for redress."

"The behavior as reported is unprofessional and needs to be sanctioned as detrimental to the practice of medicine," noted a psychiatrist. "Any licensed physician manifesting this sort of attitude toward patients should not be considered a physician suitable to treat a human being. Let's practice ethical medicine or leave the field entirely."

"Do your best and be kind to others. I tell my kids, 'If you follow these two rules, you will succeed in life,'" a radiologist observed. "In all three instances, the caregivers failed. Yahoos like these have polluted the practice of medicine."

"The behavior of the doctors in all those cases horrifies me," an anesthesiologist wrote. "So they were slapped with malpractice? That'll teach them to respect their patients. The resident who took a picture and put it on the Internet? Were I his program director, he would be advised to finish his training somewhere else."

"All of these examples did not just involve one unguarded comment but a stream of inappropriate behavior," a neurologist noted. "Not only should the doctors be sued, but their licensure should come under review. There is NO excuse for such behavior. How can you trust someone's survival to cretins who do not have the judgment to behave in a humane fashion toward their patient when their patient is unconscious and helpless?"

"A goof-up is occasionally understandable, if one is under great pressure," a cardiologist commented. "I interned at a big-city hospital, and unless one works there, one cannot understand the pressure, so a little ribald humor is understandable. However, the dentist, the resident picture, and the colonoscopy incidents are not understandable."

But some commenters expressed more understanding views of the doctors' behavior.

"As a medical student and resident, I've been present at many different procedures and never seen or heard anything remotely like this," one physician wrote. "Well, maybe once or twice," he confessed. "The physicians involved probably were on drugs or had mental health issues. Where's the empathy for the physicians, people?"

"Meanwhile, that bad old doctor removed a precancerous polyp, saving the patient's life," a preventive medicine specialist reflected on the colonoscopy incident. "What an ingrate. I don't need my doctor to be nice. I need him to be competent."

"In my experience, there is among residents and young docs that tendency to see the subject as a piece of meat," an anesthesiologist remarked. "It's a coping mechanism, and most grow out of it quickly. But bratty behavior remains in the gray zone, like personal jeers and attacks on patients while presumably unaware. Such docs speak more to their own pathology than the patients'."

"Patients are always complaining about how 'My doctor doesn't joke. He is too serious' or 'too quiet.' 'He didn't cry with me when he gave my 100-year-old grandma a terminal diagnosis,' which are purely human traits and behaviors," a general practitioner opined. "But when a doctor jokes or shows any type of emotion, 'He/she behaved inappropriately,' patients say, and they feel that somebody owes them some money. It is ridiculous. All suits are frivolous. The cases illustrated here are extreme, and these providers should have known better. But I have seen crazier cases in which no fault could be proven and still doctors got harsh punishment."

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