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What Can We Do About a Negligent Doctor?

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Specializes in Gastrointestinal Nursing. Has 29 years experience.

What can we do when doctor is negligent?

As a nurse, how can we protect our patients? As a patient, how can we know what we read in the reviews is true when there are websites that can be used to erase bad reviews.

What Can We Do About a Negligent Doctor?

Respect For Doctors

I’m afraid there may be more questions than answers regarding reporting physician malpractice. Things are certainly better than they were when I first started my nursing career in 1992 in relation to physician behavior. I remember doctors frequently being inappropriate, especially in a sexual manner.  Newer nurses have raised the bar with improved expectations, which has helped to change the physician/nurse dynamic. Programs have been developed that protect nurses and techs from being bullied. However, there remains the troubling issue of bringing concerns about physician practice to light. 

I have the greatest respect for doctors. The training and long hard years of school that they spent sacrificing to learn. Their hard work doesn’t end with graduation, but begins. Healthcare is a fulfilling career, one that becomes a way of life. But just like in any other profession, there are some that don’t hold themselves to higher standards. 

There are many stories available in several forms such as podcasts, that can spin the stories of patients who have suffered greatly at the hands of incompetent doctors. These stories are easier to bring to light because of the terrible tragedies that ensued, such as death or severe maiming. Most of the doctors in the latter stories are mentally ill and purposely hurt people or prescribe treatments that will kill them, not only costing their lives but money. 

Concerns

My heart lies with the stories concerning patients that do not get a complete exam. For example, during a colonoscopy, a doctor is required to go to the cecum, the very end of the colon.  They must go up to the ileocecal valve and go into it so they can examine the entire area. They should also attempt to go into the small bowel. This is not always possible, but it should be a priority if the patient is having diarrhea or any colitis symptoms. A larger percentage of cancer is found on the right side of the colon, which is why standards dictate that the cecal area be examined thoroughly.

Once the cecum is reached, the requirement is to examine the colon for six minutes on the way out. This is standard practice across the United States, it is the time needed to completely visualize the colon. When a person completes the wretched prep, pays a co-pay, and comes into the hospital or clinic to have a screening or diagnostic colonoscopy, they expect that the exam will be done properly. I have seen polyps left, masses that should have been taken out just minimally biopsied, and cecal times the same as the end times. That means, the doctor exited the colon within a minute or less of reaching the cecum. These are just a few examples, but they are some of the most worrisome. 

I speak to colonoscopies because that is what I know, but this concern applies to any treatment, surgery, exam, or office visit. If all of the data is not looked at, or all of the anatomy isn’t examined, then it can lead to a disastrous future for the patient. 

Reporting a Doctor

Reporting a physician is a difficult thing, both emotionally, and professionally. As I write this, my stomach feels sick.  Questions roll around in my head about the “what if’s”. But if we don’t say something as the patient advocate, then who will?  I have filled out incident reports each time that I’ve been a part of negligence or malpractice. Sometimes I am told that it’s my word against the doctors. When are doctors going to be held to the same standards as the rest of healthcare? They are not above lying, cheating, fraud, or malpractice. 

There is an ethics hotline that is available to anonymously report something or someone at our facility,  and there are the good old incident reports for reporting untoward events at my facility. But is that enough? How do we know that it goes beyond the risk manager, or the person reading the report or listening to the phone call? There is a way to report doctors through the State Medical Boards ( a simple Google search finds each state).  These government agencies file complaints according to the potential for harm. The issues that are considered high priority are: sexual misconduct, practicing medicine while under the influence, and providing substandard care (Docinfo, n.d.). 

The report is then studied and if they have the authority to look further into the complaint they then begin investigating. The doctor and parties involved are notified, expert witnesses give their opinion, and action is taken or not taken. It can go to a court trial and if the physician is found guilty, a public notice is given and disciplinary actions are taken. Reports aren’t taken very seriously on their own, it’s when there becomes a trend. I do understand that they need protection from false claims, but there must be a middle ground.

In part two of this article, I will look more in-depth at the reporting system and its effectiveness. 

Have you ever reported a physician for malpractice? What was the outcome?

Reference

Reporting a Doctor for Unprofessional Conduct. (n.d.). Docinfo. Retrieved from https://www.docinfo.org/report-a-doctor/

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9 Comment(s)

Daisy4RN

Specializes in Travel, Home Health, Med-Surg. Has 20 years experience.

Thanks for the article and info. When I was a brand new nurse of about 2 weeks I told the patient's MD that the patient was constipated, he told me to order whatever I wanted and walked off the unit. Say what?!

Document "MD aware" and testify against them in court 🤣🤣

Orca, ASN, RN

Specializes in Corrections, psychiatry, rehab, LTC. Has 26 years experience.

Interesting that you should mention colonoscopies. In my city there was a major outbreak of Hepatitis C connected to a local endoscopy center. At the root of the problem was the lead physician trying to squeeze every possible dime of profit out of the practice. They were reusing bite blocks and syringes, and drawing multiple doses of anesthesia out of single dose vials. The physician was eventually convicted of several felonies, and he died in our state prison system - but not before he tried to fake being too mentally ill to stand trial, after he had tried to ship a lot of his belongings back to his native country and flee the US before his arrest.

When the story first came to light, a local physician with a similar (but much smaller and less assembly-line-like) practice said that they were literally saving pennies on the syringes. He said that his office paid about ten cents each for the syringes in question, but that he was sure that the endoscopy center got a better price because of their volume. He also said that in his office an endoscopy took about half an hour, while the endoscopy center was finishing in 3-5 minutes. His comment was, "When you go that fast, you miss things."

Edited by Orca

morelostthanfound, BSN

Specializes in CVOR/General Surgery. Has 29 years experience.

I have spent most of my nursing career as an OR circulating/scrub nurse and have witnessed my share of residents that I felt were inadequately overseen by their attending surgeons.  Example, percutaneous pinning of a digit and the resident doesn't seem to have much of a clue as to the operation of the wire/pin driver???  Another example are general surgeons that are marginally competent (at best) and there routine surgeries take 3-4 times the expected time and heir laparoscopic surgeries have a high incidence of complications and converting to an open approach.

TheMoonisMyLantern, ADN, LPN, RN

Specializes in Mental health, substance abuse, geriatrics, PCU. Has 14 years experience.

7 hours ago, morelostthanfound said:

I have spent most of my nursing career as an OR circulating/scrub nurse and have witnessed my share of residents that I felt were inadequately overseen by their attending surgeons.  Example, percutaneous pinning of a digit and the resident doesn't seem to have much of a clue as to the operation of the wire/pin driver???  Another example are general surgeons that are marginally competent (at best) and there routine surgeries take 3-4 times the expected time and heir laparoscopic surgeries have a high incidence of complications and converting to an open approach.

I too have seen the teaching hospitals in my area giving residents in certain specialties a wide berth when it comes to supervision. I realize they have to learn to become independent practitioners but in July there really should be all hands on deck when it comes to monitoring the residents.

There was an oncologist at one facility I worked where I had a theory that he was a serial killer because he was so overly aggressive with treatment in patients where treatment was futile. He was not a fan of palliative care and the running joke was that he'd order chemo for you even when you were on your way to the morgue. His patients were always so sick from all the chemo he ordered, multiple complaints and concerns were raised over the years but nothing ever happened to him. 

I knew a vascular surgeon that had a reputation for being over eager to amputate limbs, he was always talking about how that was his favorite type of surgery, and no lie, amputation always seemed to be his recommendation when he was consulted. Maybe he was just really good at spotting when it needed to be done? 🙄

Brenda F. Johnson, MSN

Specializes in Gastrointestinal Nursing. Has 29 years experience.

On 3/4/2021 at 4:01 PM, Daisy4RN said:

Thanks for the article and info. When I was a brand new nurse of about 2 weeks I told the patient's MD that the patient was constipated, he told me to order whatever I wanted and walked off the unit. Say what?!

Wow, thank you for your input!

On 3/4/2021 at 5:54 PM, Orca said:

Interesting that you should mention colonoscopies. In my city there was a major outbreak of Hepatitis C connected to a local endoscopy center. At the root of the problem was the lead physician trying to squeeze every possible dime of profit out of the practice. They were reusing bite blocks and syringes, and drawing multiple doses of anesthesia out of single dose vials. The physician was eventually convicted of several felonies, and he died in our state prison system - but not before he tried to fake being too mentally ill to stand trial, after he had tried to ship a lot of his belongings back to his native country and flee the US before his arrest.

When the story first came to light, a local physician with a similar (but much smaller and less assembly-line-like) practice said that they were literally saving pennies on the syringes. He said that his office paid about ten cents each for the syringes in question, but that he was sure that the endoscopy center got a better price because of their volume. He also said that in his office an endoscopy took about half an hour, while the endoscopy center was finishing in 3-5 minutes. His comment was, "When you go that fast, you miss things."

Amazing isn't it, that they risk lives to save a dime, unbelievable!

Brenda F. Johnson, MSN

Specializes in Gastrointestinal Nursing. Has 29 years experience.

15 hours ago, TheMoonisMyLantern said:

I too have seen the teaching hospitals in my area giving residents in certain specialties a wide berth when it comes to supervision. I realize they have to learn to become independent practitioners but in July there really should be all hands on deck when it comes to monitoring the residents.

There was an oncologist at one facility I worked where I had a theory that he was a serial killer because he was so overly aggressive with treatment in patients where treatment was futile. He was not a fan of palliative care and the running joke was that he'd order chemo for you even when you were on your way to the morgue. His patients were always so sick from all the chemo he ordered, multiple complaints and concerns were raised over the years but nothing ever happened to him. 

I knew a vascular surgeon that had a reputation for being over eager to amputate limbs, he was always talking about how that was his favorite type of surgery, and no lie, amputation always seemed to be his recommendation when he was consulted. Maybe he was just really good at spotting when it needed to be done? 🙄

OMG! The part about giving chemo to pt's who don't need it, or will benefit from it sounds very much like the second episode of Dr Death, the podcast. It turns my stomach. Maybe psych evals should be part of residency???

On 3/5/2021 at 4:56 PM, Brenda F. Johnson said:

Wow, thank you for your input!

Amazing isn't it, that they risk lives to save a dime, unbelievable!

It's actually all too believable.  Human nature...

Hannahbanana, BSN, MSN

Specializes in Physiology, CM consulting, nsg ED, LNC. Has 51 years experience.

On 3/4/2021 at 4:01 PM, Daisy4RN said:

When I was a brand new nurse of about 2 weeks I told the patient's MD that the patient was constipated, he told me to order whatever I wanted and walked off the unit. Say what?!

FWIW, there are hospitals where nursing has standing protocols for constipation, skin care, urinary management, and other routine measures. Perhaps that MD was in that mind set.