Sunday, December 16, 2012
When doctors don't listen, patients suffer
About seven weeks ago, a relative had an MRI. She had been having some trouble hearing and, after an examination, her otolaryngologist ordered the MRI to rule out any growth that might be causing the loss. The family member waited for a report from her doctor.
A week passed. No report. Three weeks passed. Still no report. Finally, after four weeks, she called the otolaryngologist's office to ask if he planned to notify her about the results of the MRI.
She was reminded how busy the otolaryngologist was and that he would, of course, issue a report in due time. "I'm sure if there was anything wrong he would have contacted you right away," the otolaryngologist's assistant told my family member.
She still hasn't heard.
Then there's the reader in Lake Forest, Calif., who wrote to tell me that she had been called by her oncologist's office because they were curious why they received a report about a pelvic ultrasound. She told the oncologist's assistant that the oncologist had ordered the ultrasound to track ovarian cysts.
The assistant called back the same day to tell the reader she'd better come in. She pressed asking the assistant if there were any concerns, and was told she'd "better come in."
My reader drove 12 miles to her oncologist's office, learned that he was running late, waited patiently, and was finally told to disrobe so a physician's assistant (PA) could see her.
The PA came in with the ultrasound report and told my reader that her cysts are smaller than they had been and "everything looks fine."
"I asked her if this information couldn't have been imparted via telephone," my reader writes. "She agrees it could have. Now Medicare will be billed for what is essentially an unnecessary visit. I don't think this is fair."
She's right. It's not fair. It's both an unnecessary expense and both an inconvenience and was an unnecessary cause for alarm for my reader.
Both the failure to report on my family member's MRI and the failure to simply tell my reader by phone or through the mail that the results of her ultrasound were not of concern represent failures that have nothing to do with the shortcomings of Medicare or pending provisions of the Affordable Care Act in the U.S. Each represents a failure in treating patients efficiently and with respect.
In my reader's case, alarming her by telling her she'd "better come in" suggests the oncologist hadn't bothered to look at the report he had forgotten he ordered. In my family member's case, telling her that "I'm sure if there was anything wrong he would have contacted you right away" is simply a cover for the otolaryngologist who couldn't bother to keep up with his reports.
Each patient might have pressed further on the phone until an assistant took the time to find out the actual results of the respective test so they could give an informed response. But patients should not have to resort to badgering medical professionals to do their jobs. We all know doctors are busy. But the right thing is for them to do their jobs or empower their assistants to do their jobs and treat patients with the respect they deserve whether the news is good or bad.
Jeffrey L. Seglin, author of The Right Thing: Conscience, Profit and Personal Responsibility in Today's Business and The Good, the Bad, and Your Business: Choosing Right When Ethical Dilemmas Pull You Apart, is a lecturer in public policy and director of the communications program at Harvard's Kennedy School.
Follow him on Twitter: @jseglin
Do you have ethical questions that you need answered? Send them to firstname.lastname@example.org.
(c) 2012 JEFFREY L. SEGLIN. Distributed by Tribune MediaServices, Inc.
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