My gyn blew off my concerns. She was wrong. What now?
May 29, 2013 6:44 AM   Subscribe

My former gynecologist laughed off my suggestion in 2011 that I might have endometriosis because of the severe pain I was starting to develop during my periods. I had a colon resection in 2013 and the surgeon had to remove an extra 6 inches out due to endometriosis adhesions. What do I do now?

This was me. I'm feeling much better now! But I can't get my former gyn's reaction to my menstrual pain out of my head. At first she diagnosed me with PID. After a few rounds with antibiotics and no relief, I went in for yet another appointment and asked about endometriosis. She said that because I didn't develop the pain until I was over 40 that it couldn't be endometriosis, that I would have had the pain since my teens. But yet, I told her, I was still having pain. And she said the thing that made me find a new doctor: "Well, what do you want me to do about it?"

My new gyn took me seriously, but endometriosis is the type of disease that's apparently not verifiable without actually looking inside of the abdomen. That happened during my colon resection, and there it was.

I have pondered what I want from Former Gyn. I don't want a lawsuit or money or anything like that. I want her to realize that she's fallible and to take her patients more seriously in the future. But how? Do I call? Write a letter? Yelp review? Who do I write to?
posted by anonymous to Health & Fitness (19 answers total) 6 users marked this as a favorite
Yelp review. Dwelling on stuff like this doesn't help your health. Good for you for getting a second opinion and taking care of yourself.
posted by discopolo at 6:49 AM on May 29, 2013 [3 favorites]

That's horrible. I'm sorry.

From what I've read, I think a lot of malpractice lawsuits start like this: patients feel hurt and unheard and though they've been put unnecessarily at risk. All they really want, in the beginning, is for the doctor to look them in the eye, admit that they were wrong, and offer some assurance that the same awful thing won't happen again to someone else. It is an eminently reasonable - and even altruistic - desire.

Unfortunately, doctors carrying a huge load of malpractice insurance and facing the risk of a lawsuit cannot usually take the risk of admitting they were wrong. Even getting them in the room once a mistake has been made can be difficult, never mind making any substantial commitments to change. They're not individuals at this point - they're participants in a very broken system. Of course, if the patient then decides to sue, the legal machinery sweeps in and takes over, years pass, and the whole thing takes on an ugly and often counterproductive life of its own.

All of this is just to say that you are in a very understandable and difficult position. The truth is that you are probably not going to get the kind of satisfaction you want and which, frankly, you deserve. You're more likely to get a straightforward apology from the guy who screwed up fixing your car. That's not your doctor's fault - although the fact that there are still things your doctor could have done to make you feel heard is the reason that the likelihood of doctors being sued (or not) is more far correlated to their bedside manner than to their actual skill.

I think you have two options. If you decide this is really important to you,you could meet with a lawyer and discuss - not a lawsuit - but some form of non-binding arbitration, in the hopes of getting exactly what you want: the doctor admitting her mistake, looking you in the eye, and admitting she shouldn't have laughed you off. This will be long and exhausting and dull, and whether she's doing this sincerely or in the hopes of avoiding another lawsuit, you'll never know - but at least you'll have been heard, and you may feel in the end as though you've accomplished something.

Alternatively, you can write out a long letter, explaining exactly how you feel and how the doctor's behavior concerns you and why you wish it had gone differently. Then, you can either put it in your desk or send it to her, knowing that, while the letter may make the doctor take future patients' concerns more seriously, the truth is that you yourself are unlikely to ever receive a truly satisfying response from her. After that, you'll just have to try your best to move on.

(I do not think that Yelp is a responsible way of evaluating medical professionals.)
posted by pretentious illiterate at 7:06 AM on May 29, 2013 [14 favorites]

IANAD, IANYD, but I had pelvic pain for years and it wasn't until I had laparoscopic surgery that my doc was able to see the extent of the damage from adhesions and she was like, "Oh, yuck; that explains everything."

Like you learned, endometriosis is the type of disease that's apparently not verifiable without actually looking inside of the abdomen.

Sounds like your doc lacked interpersonal skills, so good for you for leaving her and getting another doctor.

I think the best you could do is a Yelp review or any website that rates doctors. You could also request that all your pathology and surgery reports be sent to your former doctor and tell their office manager the situation so at the least, it's in your record and someone there knows.

(I want to add this aside: pelvic pain is really the worst and if you're ever seeing a doctor who doesn't take it seriously, then find a doctor who specializes in gynecological pain...they do exist and you don't have to suffer.)
posted by kinetic at 7:06 AM on May 29, 2013

If you didn't tell her why you were leaving when you got a new doctor, now might be the time, though honestly, her impatient response to you does not show her to be a person who's willing to listen or recognize her own fallibility.
posted by lemniskate at 7:06 AM on May 29, 2013

My sister once had a doctor that would look up her symptoms on WebMD, on his phone right in front of her. She was so turned off by this unprofessional behavior that she later called up the doctor's office and calmly explained why she was upset and that should would be seeing another doctor as a result.

She hasn't seen that particular doctor since, but she at least let the guy know what he was doing wrong. This gives that person a chance to correct their behavior for the next patient, and possibly save another patient the same anxiety that she did. But then again, some people are too hard-headed to change or admit their mistakes, and telling them of their errors won't do anything.

You probably can't get the doctor fired or anything, but there is a chance that you can help some other 40-year old patient with undiagnosed endometriosis that is a patient of that same doctor.
posted by nikkorizz at 7:07 AM on May 29, 2013 [1 favorite]

I think you did the absolute correct thing by changing doctors, but if you feel the need, drop the old gyn a note that says something like, "Just wanted to drop you a note as a follow-up to our last appointment so you can update your records, after a recent resection for other reasons, it turns out that I did have endometriosis contrary to your diagnosis." This is truthful and it gets your point across. I doubt you will ever get a response, but you will have some comfort knowing they know they missed that diagnosis by ignoring their patient.
posted by JohnnyGunn at 7:09 AM on May 29, 2013 [3 favorites]

The statistics on endometriosis are significant enough to warrant her more thorough examination before it was ruled out, especially with your repeat visits. At the very least, the gyn should have ordered a pelvic ultrasound or an MRI. 'What do you want me to do about it' is unacceptable rudeness, and is dismissive. Unfortunately, it is also what a lot of pelvic pain sufferers endure from their medical points of call on the way to clear diagnosis.

I would write a letter to your gyn in the most dispassionate, objective manner possible. I would outline your experience and report what was discovered by your new gyn and during the bowel resection. Tell her that you write to add to her understanding about this illness presenting later in life than she had allowed in your appointment time with her.
posted by honey-barbara at 7:11 AM on May 29, 2013 [2 favorites]

My old gyn missed endometriosis among other things. Make that many gyns over the years since I starts getting my period 30 odd years ago.

The first thing my new gyn did was offer a hysterectomy and 6 weeks later, I had one. (this was after an ultrasound showed many issues) Mostly, she totally believed me, which was such a relief.

At first, I was ready to scan and send photos from my surgery to my old doctors. Then, I realized that I needed to move on. Doctors are humans, and they can also come with a little dose of cockiness. I needed my life, knowing that my anger over the past wasn't going to help anyone.

Hope this helps.
posted by mamabear at 7:12 AM on May 29, 2013 [2 favorites]

Write her facility's office manager. Your concerns may be considered for HR decisions should others we lodged. If the facility is a teaching hospital you should write her immediate medical supervisor. They'll tell you who this is if you call, but avoid getting into details over the phone. A well-placed letter can have much more impact.

You may also write your state's medical licensing board but I've heard these agencies are pretty toothless unless multiple complaints are made against the same doctor. Unfortunately you're unlikely to hear an acknowledgment of any error from the doctor or anyone associated with her facility. Reviews at YELP, GOOGLE, and will help alert others.
posted by R2WeTwo at 7:13 AM on May 29, 2013 [7 favorites]

Contact the licensing division in your state or municipality. You can also contact the board of whatever body licensed her to practice to file a complaint. You may find that yours is the complaint that tips them into an investigation or something.
posted by mibo at 7:14 AM on May 29, 2013 [2 favorites]

I had three different doctors misdiagnose ovarian cysts over the course of two years (including one who told me that pelvic pain was, like, a divine punishment - I did formally complain about him - and one who told me I had to see my college's psych people before she would see me again, because she was so confident that it was all in my head, and not, you know, a dozen golf ball-sized cysts).

I filed a complaint about the one really egregiously awful doctor with my health care system. As far as I know, nothing happened; he's still practicing. The other stuff I just wear as a chip on my shoulder. If Yelp had been a thing at the time, I TOTALLY would have Yelp-reviewed the hell out of those people. I lived in horrible, near-constant pain for TWO YEARS because some doctor felt so sure that I was making it up.

Look, misdiagnosis is one thing; the problem with my docs (and yours, it seems) is dismissiveness. I actually don't think it's acceptable for doctors to blow off your symptoms just because it's not convenient for them to diagnose you with something complicated. Women get the shaft with health care all the time, and good on you for reviewing this person, if you choose to do so. As a person who now selects doctors very, very carefully, I would be glad to know about your experience.
posted by goodbyewaffles at 7:19 AM on May 29, 2013 [7 favorites]

Not sure if this is the kind of thing you are looking at, but if you want to take a more "official" route, you can contact your state medical association/society and just let them know the issue you had with this physician and also contact your state medical licensing board (the group that actually licenses and deals with malpractice reports) to report the physician. If your physician was board certified, you may also want to try contacting the OB/GYN specialty licensing board.

It's possible that you are not the only one being harmed, and a paper trail of complaints from other patients may help someone else.
posted by forkisbetter at 8:32 AM on May 29, 2013 [1 favorite]

I am the wrong gender, but I think you should write a negative yelp review on behalf of all of my lady friends out there in the world.
posted by oceanjesse at 8:35 AM on May 29, 2013

I left my dermatologist because I wasn't wild about her but then she suggested doing nine skin biopsies, which is a lot, and when I asked her about something else, she snapped, "I don't know, I can't replace all of your skin." I don't think that I Yelp-reviewed her but I totally check Yelp reviews out for doctors. I started seeing a new dermatologist who has to date, only done a few excisions, and I actually like him, like if I saw him at a bar, I might offer to buy him a drink. He was reviewed highly on Yelp. So definitely Yelp review.
posted by kat518 at 8:43 AM on May 29, 2013

I'd send a letter directly to the doctor and copy the state medical board. Also, leave a Yelp review. Discuss the incorrect diagnosis as well as the dismissive attitude.

I know you want validation from her, but I doubt you'll get it. It's sad, but it's true.

I'm sorry you went through this.
posted by Ruthless Bunny at 8:44 AM on May 29, 2013 [1 favorite]

Did you get referred to either of these two doctors through a health plan (Kaiser, Blue Cross, etc.)? If yes, perhaps you could contact your health plan and explain this whole thing, in writing, to them. Surely they'd want to know if they have a doctor on their list who is that unprofessional.
posted by easily confused at 8:48 AM on May 29, 2013 [3 favorites]

You should absolutely follow the advice about reporting the concerns about the doctor's poor professionalism.

However, I would be careful about declaring her to be wrong. Those adhesions could have been there for a long time, and only started causing pain recently because of the worsening condition of your colon.
posted by gjc at 9:06 AM on May 29, 2013

I want her to realize that she's fallible and to take her patients more seriously in the future.

This is perfectly valid. I'd suggest you think about how often you see this happen in any context—not just medicine, but across your life's experience. Do you find people undergo this change frequently, or rarely? When it does happen, what common circumstances or themes can you identify that led/helped it to happen?

Personally, I think a Yelp review is unlikely to accomplish your stated goal. You didn't say, "I want to warn people away from this doctor," or, "I need some forum to vent my experience." You're asking how to effect a positive change in the doctor herself. For a variety of reasons, and not least because Yelp is notorious for both fake reviews and high-maintenance customers inflating minor complaints, I think Yelp is not a very good choice for your goal. A sincere, personal letter to the doctor would be much more likely to get her receptive attention, I would think. (Not that I'm necessarily suggesting you do that.)

I'm sorry for your troubles and happy you're doing much better now. Good luck.
posted by cribcage at 9:18 AM on May 29, 2013 [4 favorites]

I am a lawyer, married to one doctor and friends with many others. My legal experience includes working in the legal department of a large medical institution. My personal experience includes many conversations with doctors about quality care, patient feedback, and improving one's profession. Here's my take:

1. Doctors don't respond much to reviews on Yelp. They don't know the facts behind the reviews, and so just don't take them seriously. If you want to change her behavior, this won't work.

2. In many states, doctors' apologies are protected from admissibility in malpractice lawsuits, so depending on where she is practicing, she may be entirely able to apologize without fear of a lawsuit. This is relatively new, and has developed in response to the problems outlined by pretentious illiterate. If you're looking for an apology, knowing how the law will treat that apology is a good first step for you.

3. In most practices, customer services is highly valued. This is largely enforced by the practice head, who may or may not be a physician. If you want to change the doctor's behavior, start here. As has been said repeatedly in this thread, putting the story in writing will go much farther than making a phone call, and bringing a carefully written letter to an in-person meeting will go the farthest.

Be aware, though, that raising medical concerns to a non-medical person can have some consequences to the privacy protections for your medical records. You can, to a great extent, limit this by stating explicitly in your letter what information in your records the administrator is free to share, and also stating explicitly that no other aspect of your medical records can be shared. Sharing is likely to involve only administrators within that practice, so we're not talking about your records going online or anything. I'm just warning you that once an administrator is involved, it's not only doctors seeing your records.

4. Most doctors genuinely want to help their patients: to correctly diagnose them, to effectively treat them, to treat them with respect. All doctors are human and make medical and personal errors, and very few can be effectively judged by single statements they make. My point is that comments like, "her impatient response to you does not show her to be a person who's willing to listen or recognize her own fallibility" are really overblown. I guarantee that this doctor -- like all doctors -- is well aware that she is fallible (all those years of pimping in med school and residency pound this into their heads). This isn't to say that she doesn't warrant reminders of this, or that she wouldn't significantly benefit from specific examples where she erred. She definitely would benefit from exactly that in your case, and you really would benefit her patients by providing her with this feedback.

The best way to get her to hear this is probably the same way she sees most medical issues: evidence. You can provide the evidence of the correct diagnosis, and also your own statement about how being treated dismissively affected you as a patient. That's evidence of the human side, and she'll likely take it seriously. So the letter that you give to the practice administrator should also go to her.

She won't lose her job because of this. She will most likely add this to her mental vision of how to be a good doctor, and it will likely affect her behavior most of the time. She will almost certainly make errors in the future, but hopefully she will make fewer. Hopefully her practice administrator will help her to be a better doctor, both as a clinician and a person.
posted by Capri at 11:35 AM on May 29, 2013 [11 favorites]

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