Tuesday, June 19, 2012

The "M" Word

Malpractice. Nothing can ruin a perfectly good day as much as a patient throwing out the "M" word.

It was DrH third to last day of residency. A patient with a recurring GBM (bad brain tumor, terminal) had come into the clinic for his follow up. Wife chews doctor out because patient didn't get his Rx steroids when he should have. Doctor leaves room. Leaves clinic. Goes home.

That is the short version.

When I talk to him as he is on his way home, I get the full story. The story about how they have operated on this patient 3 times. The tumor keeps coming back. It will come back again.

I listened to how my DrH described how he went over the discharge orders with the patient who was completely lucid and alert. How he checked for understanding. How he went over the medications (including the steroids) that he was to take when he went home.

I listened to how my DrH  gave his patient the most comprehensive discharge he could, not just to cover his tail, but to make sure the patient knew what he needed to do because his doctor cares. And then, how that patients wife told him to "get his hands off her husband", and to never touch him again when he walked in the room to say Hi and wish him well.

I feel sorry for that poor woman. I know that she is scared. I know that she probably doesn't mean what she says. I know that she is angry.

Her husband is going to die.

I feel like our entire future is hanging in the balance. Not over this particular case (because there isn't one), but because any time a patient is unhappy with an outcome they can throw this word around as a threat. Some are empty, others not so much.

Right now as we are on the cusp of applying for real world jobs, future employers are going to want to know if the doctor they are hiring has been named, or is currently named in a malpractice suit. I don't want my husbands name ever to appear on a legal document as the defendant.

I wish things were different. I wish I could tell this woman that my DrH is a good man. I wish I could tell her that he wants nothing more than to cure brain tumors like the one her husband has so that it isn't a death sentence. That is what this fellowship is all about. I wish I could tell her that his entire family is making a sacrifice so that one day no one will lose a spouse this way.

I wish I could tell her that it isn't nice to use the "M" word just because you are upset. It isn't a word that should be thrown around lightly, and frankly I don't think a patient should ever utter the word in the presence of their doctor.

I wish I could take away some of the power the "M" word holds.


  1. Malpractice threateners are the worst people out there. They will blame the doctor for everything. But then they praise God when there is a good outcome. Um, hello, it is the same God in both circumstances.

  2. I've been wanting to write a post about the "M" word forever and a day!! I'm afraid if I do I'll be jinxing us. You know, like when you say out loud, "Your pager's been quiet today" and then all hell breaks loose!

  3. I would not worry about it. Sadly in this day and age patients throw that word around a lot. My DrH was in clinic and they were prepping a patient for the OR. Attending heard the patient say something about suing (attending was already on the fence about this patient) and called the entire surgery off. That is the nice thing about surgeons they can refuse surgery to patients. As a resident it's unfortunate to be named in a lawsuit but I assure you it's not the end of the world (our program director was named in a lawsuit in residency and he is a program director) especially if DrH and his attending are well liked. Often times the doctors who are successfully sued AGAINST are the doctors who are jerks. Their colleagues/nurses throw them under the bus during depositions and their patients are LIVID with them for their poor bedside manner. Not always the case...there are good people out there who end up on the wrong side of things. The whole system is screwed up if you ask me. And really, it's the clinic patients who LOVE to throw that word around yet they are also the folks who pay $0 for their care from start to finish. Sad. Best thing to do when a patient acts that way is to defer to upper levels even if it means attendings. Facing death and mortality is hard. People are not rational when facing their loved one's mortality. All one can hope for is that DrH and his staff did everything correctly and the case will get thrown out--- if it ever gets that far.


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