Making a complaint about a doctor?

Nurses Relations

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The nurses were great, but I had to go to the ER for an asthma exacerbation. I'd already done my two updrafts at home first and the few times I remember seeing the monitor my sats were at 93, HR was 120ish. I only went because I finally couldn't take it anymore and was utterly exhausted, breathing hurt, I wasn't breathing deeply at all if I could avoid it because it hurt so badly to do.

However, she said she heard no wheeze, and when she walked out the door, I heard her say "I don't think she has asthma at all" to another colleague.

I don't know what she thought I had, because I was sent home with no treatment, that essentially they did a screening exam and did not feel it was an emergency. My friend who took me was so worried she took me to another ER, where they certainly acted like it was an emergency and nearly admitted me, though I got to dodge the bullet there.

I'm not going to judge someone for poor medical judgment, but is there any excuse for letting a patient hear a judgment call like that unless it's to, say, confront a delusion a patient has for their own benefit? That's really what I'm upset about. People make mistakes, but that was extremely unprofessional.

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Specializes in Going to Peds!.

Call the facility and get the name of their patient advocate/patient representative. Address your letter to them. Be brief & factual.

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Specializes in Emergency & Trauma/Adult ICU.

Just so we're clear ... it was that you heard her assessment, that she didn't feel your dyspnea and fatigue were related to asthma, that has made you unhappy with your care?

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I admit that hearing her assessment is what I'm actually going to make the complaint about, since she did not explain a bit of it to me -- if you're going to make those type of comments in your patient's hearing, please take the time to explain what you meant to the patient. A medical judgment is not something I'm qualified to evaluate, though the other hospital was extremely upset at hearing I'd been discharged like that without any treatment at all, and no comments on the discharge work.

I personally think she erred in failing to communicate her ideas about what she thought the actual problem was, if it was not asthma, and very much specifically erred by allowing me to hear that assessment, because it made me think she thought I was a hypochondriac. I mean, really, what could I be trying to game from an asthma exac? I have plenty of albuterol, I imagine some use it as a drug of abuse but I went in because it wasn't *working*, not because I wanted more! ;)

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I'll also say I was not happy that she talked over me when I was able to barely get words through breathing, as she might have gotten enough information to make a better judgment had she been patient enough with me for me to try to tell her when I had my last two updraft treatments. I was also not happy that even though I offered to make a deposit if they really felt it was non-emergent if there was any treatment they could offer at all, that they sent me home with the discharge papers showing an EMTALA letter and no actual information at all about what she felt was the problem. I was under a doctor's care and had contacted them, but they couldn't see me earlier that day, and their instructions were that if my updraft machine didn't do the trick, to go to the ER.

I don't go to the ER frivolously. I only go when my mental status from the combination of bronchodilators and not enough air is bad enough I don't trust myself to drive. Maybe I'd overdone the albuterol, but they could have said that, too, if that's what they thought it was. It was the lack of communication, judgmental attitude, and un-professionalism that if I were to receive a Press-Gainey on this would make me fill it out very badly, but then that might affect the nurses.

It's more the doctor that was an unprintable word, the nurse actually said next time I ought to go to the larger ER 20 minutes away if I had time, because "They have great people there." I didn't, I went to the closest ER since I had just moved this weekend, and that's more intelligent, right? To go to the closest one when your breathing is bad?

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Specializes in ER.

It was poor judgement on her part to say that where you could hear, but aren't you glad you knew what was in her head? I wouldn't want to discourage someone from being frank with a patient, even if they're totally wrong. You walked out of there knowing she was dumb as dirt and you needed to see someone else.

I think she needs some remedial education about asthma, and that would be where I'd complain. (If you can't hear anything, that means there's NO air movement, very serious)

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Specializes in Going to Peds!.
It was poor judgement on her part to say that where you could hear, but aren't you glad you knew what was in her head? I wouldn't want to discourage someone from being frank with a patient, even if they're totally wrong. You walked out of there knowing she was dumb as dirt and you needed to see someone else.

I think she needs some remedial education about asthma, and that would be where I'd complain. (If you can't hear anything, that means there's NO air movement, very serious)

Exactly this. If you have a desaturated SOB patient who is gasping & can't complete a sentence, but you don't hear wheezing, it's because they're too tight to move much air. I've had some really bad asthma kids, the kind of asthma kids that die from asthma, and they usually aren't moving much air when they are admitted with an acute exacerbation. It's usually hospital day 2 or 3 that they open up enough to hear wheezing.

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Exactly this. If you have a desaturated SOB patient who is gasping & can't complete a sentence, but you don't hear wheezing, it's because they're too tight to move much air. I've had some really bad asthma kids, the kind of asthma kids that die from asthma, and they usually aren't moving much air when they are admitted with an acute exacerbation. It's usually hospital day 2 or 3 that they open up enough to hear wheezing.

This is what worried me more about the situation. I would be complaining that the doctor could use a class on asthma. The fact that she couldn't hear wheezing, and you showed signs of being in distress should have been a huge sign that your situation was very serious. I know she wasn't very kind with her assessment and it would have made me mad, but I wouldn't be reporting her on not being nice. I would be wondering why she doesn't understand that when someone quits wheezing that there are bigger problems ahead if appropriate action isn't taken. I'm glad that you didn't take her assessment as the truth and went to get help elsewhere.

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Specializes in Going to Peds!.

This is what worried me more about the situation. I would be complaining that the doctor could use a class on asthma. The fact that she couldn't hear wheezing, and you showed signs of being in distress should have been a huge sign that your situation was very serious. I know she wasn't very kind with her assessment and it would have made me mad, but I wouldn't be reporting her on not being nice. I would be wondering why she doesn't understand that when someone quits wheezing that there are bigger problems ahead if appropriate action isn't taken. I'm glad that you didn't take her assessment as the truth and went to get help elsewhere.

Me too. And albuterol ain't gonna help if the patient's airway is too tight to get much in. Big whopping doses of IV steroids.

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Specializes in LTC Rehab Med/Surg.

This is the second thread concerning ER visit/asthma complaints the OP has posted. Are you simply not communicating well with the ER staff?

I'm not suggesting that your visit wasn't an emergency. I'm just wondering what it is about your condition, that caused more than one ER to doubt its severity.

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Uh, you have me confused, and I had to look back at my posts, as I've never had an ER underestimate asthma prior to this. The last two times I broke down and went, I was admitted, and that's what I was the most terrified of.

If it'd just been that I'd ODed on albuterol trying to self-treat, they could have at least told me that, then that way I'd know. I remember one time that happened during an attack when I was a kid and Mom took me in because I was in more distress. They talked to her a bit and it never happened again. But IANAN, and IANAD, so that's why I'm not trying to make any judgments.

I tried to communicate with her, but I was speaking with as little effort ( so quietly) as I could manage to conserve air. She talked over me and refused to let me complete sentences. I admit it's possible it was on me, but I have NEVER had an ER underestimate asthma before, or ever heard someone say something like that in my hearing before.

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Specializes in Oncology; medical specialty website.
I'll also say I was not happy that she talked over me when I was able to barely get words through breathing, as she might have gotten enough information to make a better judgment had she been patient enough with me for me to try to tell her when I had my last two updraft treatments. I was also not happy that even though I offered to make a deposit if they really felt it was non-emergent if there was any treatment they could offer at all, that they sent me home with the discharge papers showing an EMTALA letter and no actual information at all about what she felt was the problem. I was under a doctor's care and had contacted them, but they couldn't see me earlier that day, and their instructions were that if my updraft machine didn't do the trick, to go to the ER.

I don't go to the ER frivolously. I only go when my mental status from the combination of bronchodilators and not enough air is bad enough I don't trust myself to drive. Maybe I'd overdone the albuterol, but they could have said that, too, if that's what they thought it was. It was the lack of communication, judgmental attitude, and un-professionalism that if I were to receive a Press-Gainey on this would make me fill it out very badly, but then that might affect the nurses.

It's more the doctor that was an unprintable word, the nurse actually said next time I ought to go to the larger ER 20 minutes away if I had time, because "They have great people there." I didn't, I went to the closest ER since I had just moved this weekend, and that's more intelligent, right? To go to the closest one when your breathing is bad?

I guess I don't see what the problem was. You are assuming she's thinking all of those things. If you overheard that comment, why not ask if she could come back and clarify her remark?

I worked in the ED for several years, and while I don't mean to minimize your complaint, this was nothing compared to some of the doozies I heard doctors say to patients.

Asthma is sometimes diagnosed incorrectly. I've even heard a gastroenterologist say that some cases of asthma wound up being "silent GERD," and once the reflux was corrected, the asthma resolved.

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