Mom went to hospital with difficulty moving legs, was berated by doctor
October 17, 2013 12:58 PM   Subscribe

Hello everyone, my mom was taken to a hospital by ambulance a few mornings ago when she couldn't move her legs and get out of bed. This stems from a previous issue with nerve damage and spinal problems which she's had surgery for before. She met the same doctor from her previous surgery, whom she couldn't pay, and was berated and threatened by him.

After the previous surgery, she was fired from her job and promptly lost her insurance coverage, leaving her unable to pay the bills, excepting what the hospital's various charities helped with. This time around after many tests, she then met with the doctor who did the previous surgery. He berated her, telling her that he had a million dollar medical education to pay for and children to put through college. He said that he couldn't do "charity cases" like this and that even if she had Medicare or Medicaid he still didn't make much off of those surgeries, either. He actually said all of this in front of a nurse, who, according to my mom seemed to be appalled and writing everything down.

My mom said that he spoke about the surgery she would probably need in detail to her, and she said that the way he spoke to her about it and phrased things, such as what could go wrong, even made her feel threatened and afraid to let him do the surgery. He then told her to get insurance and come back when the surgery could be paid for.

Needless to say, my mom came home crying, and I am furious. I'm just trying to sort everything out now, and was wondering what to do next, I definitely feel my mom was wronged. I know the doctor has problems of his own, but a patient is no place to unload those problems, and was wondering whether he should be reported to some medical board or what should happen next.

I'm furious, but even so I don't think I'm overreacting to this situation, but I would like some unbiased input on this issue, so thanks in advance for any advice anyone can provide.
posted by FireballForever to Health & Fitness (14 answers total) 9 users marked this as a favorite
Have her write down everything she remembers him saying now, as a first step.
posted by showbiz_liz at 1:00 PM on October 17, 2013 [8 favorites]

At the very least, you should contact the hospital's ombudsman to report this really appalling behavior. See if you can also get the name of the nurse who witnessed all of this for possible corroboration.

Usually medical board complaints are related to the standard of care, but not necessarily bedside manner. But, check with your state's board to see the process and criteria.

Another option: write an unbiased, honest description of this for Yelp or other online service that grades doctors. At the very least, this guy might be shamed into doing better going forward.
posted by tafetta, darling! at 1:01 PM on October 17, 2013 [15 favorites]

You can't realistically do much. Leave him a bad review, file a complaint, and find a new doctor. You can't sue him for being mean.
posted by tylerkaraszewski at 1:03 PM on October 17, 2013

If you are asked what you need out of this situation, the important answer is surgery for your mom!
posted by Cranberry at 1:20 PM on October 17, 2013 [3 favorites]

Most definitely speak to the hospital ombudsman.

Although not your main question, you stated:
"After the previous surgery, she was fired from her job and promptly lost her insurance coverage, leaving her unable to pay the bills, excepting what the hospital's various charities helped with. "

Was she employed at the time the surgery took place, and still under the insurance policy? It is my understanding that, even if bills arrive at a later date, insurance will cover their normal costs up to the termination date of your employment. If you are referring to the portion that insurance did not cover or follow-up care, I apologize, but it might be worth looking into whether or not some costs should have been covered.
posted by mikeh at 1:26 PM on October 17, 2013 [12 favorites]

It sounds like he was stating, in an insensitive way, that he didn't want to do the surgery without any insurance.

This is not uncommon and I wouldn't take it personally. He is venting. He wants to paid for the surgeries he performs.

It can be difficult to find an orthopedic surgeon who will accept Medicaid. I am a nurse and have heard patient complaints about this. I have heard of patients having to travel long distances to find a willing orthopedic surgeon. If it were me, I would let it go, obtain insurance, and find somebody else.
posted by Fairchild at 1:27 PM on October 17, 2013 [1 favorite]

Wow. Yes, you should absolutely report this to the hospital, at a minimum. I don't think you're over-reacting at all, and were this a member of my family I would be taking steps to report this doctor to his state licencing board.

1) Right now, today, record your mother describing exactly what the doctor said to her, as much as she can remember. Don't prompt her at all, except to ask her to state clearly as much of what happened as she can recall. It will be important to have a record of exactly what she understood him to say.

2) Contact the hospital's ombudsman. File a formal complaint.

3) Find another doctor for your mother as quickly as you can.

To answer a question you didn't ask, btw: I notice you say that originally your mother had the surgery and THEN lost her job. Her insurance should have covered any services that took place while she was still covered by that insurance. (Of course, there may have been deductibles and percentage coverage and whatnot that she couldn't pay after her income vanished.) (On preview, what mikeh said.)
posted by anastasiav at 1:30 PM on October 17, 2013 [6 favorites]

If your mother is in S.C. like you are you can start the complaint process here. I don't know if it will do any good, but you can try. That sort of behavior is unacceptable. I grew up with a doctor father, and doctors might bitch about stuff like this in private, but you don't treat a patient like that.
posted by dortmunder at 1:33 PM on October 17, 2013

Call the hospital's Patient Advocate Office and tell them what you've just told us.

If, at the time she had the surgery, she was employed with health insurance, I'm not sure why they wouldn't have paid. Unless there's something I'm missing.

If it's an option in your area, go to another hospital next time. Our local hospital screwed up a routine outpatient procedure for my wife (which is how I found out about the Patient Advocate Office), and it's at the point where if I have a choice in the matter (i.e. not transported unconscious due to a car accident or something), I'm going to go somewhere else, even though it's farther.
posted by tckma at 1:34 PM on October 17, 2013

Another vote for speaking to the ombudsman/patient advocate or other appropriate administrator at the hospital. I get the surgeon's frustration at the state of our health care system, but that's not your mom's fault and not something she deserves to be berated for.

I'd also look to talk to a social worker at the hospital or elsewhere about next steps toward getting her the care that she needs. You don't go into the details of your mom losing her job (and nobody here can give you legal advice anyway), but it is worth looking into whether she was fired illegally because of her medical condition, was covered under the Family and Medical Leave Act, or whether her employer otherwise acted improperly.
posted by zachlipton at 1:39 PM on October 17, 2013

You can also complain to your state medical board and your state's Executive Office of Health and Human Services.
posted by kythuen at 1:44 PM on October 17, 2013 [3 favorites]

Response by poster: Have talked to my mom about this, she says that she has written everything down and has nearly a four page complaint, including comments about the surgery procedure description. I also told her to find the nurse who was in the room with her.

She has contacted the hospital and they have told her that she will be receiving a survey in the mail in a few days and that she should include all of her complaints with that. I have told her not to just leave it at that, because she should really be filing a complaint personally with the hospital, and not just mailing in a survey. I told her that she needs to find a patient advocate, she said that she has had experience with one before.

To those asking about her previous surgery, about 2 years ago June 1, she collapsed when her leg fell out from under her, leaving her only able to drag her leg and not lift it. Her job at a daycare entails a lot of standing so she went to the hospital and then was scheduled for surgery. She says she contacted the daycare and let them know what was happening with doctors excuses. All of her doctors visits were paid by Blue Cross, she had surgery August 7. In October, she received a letter stating that her insurance had lapsed because she had been terminated from her job and that her surgery was not going to be paid for. She was never notified by her job that she was terminated, and she called after receiving the letter from the insurance company and her job told her that she was terminated months prior.

She told me that she was told by the state labor board that she didn't have any legal recourse in the matter because daycare centers operate by a different set of standards than other companies that apparently allow them to get rid of employees differently than other companies.

To clarify, I don't want to sue this doctor (although I'd be lying if I said the thought didn't cross my mind in my anger), I'm not looking for a payday, I just think his behavior of lumping all of his issues and judgement on a patient is something that would, if not make a patient physically sicker, it would definitely be mentally detrimental. Thanks all.
posted by FireballForever at 4:10 PM on October 17, 2013 [2 favorites]

Not to be contrary but it sounds like two things happened:

- He told her he wouldn't take her as a charity case.
- He told her the risks of the surgery as he is required to do for informed consent.

Yes he was a dick about it, but he's not obligated to be charming or to provide free care. You can certainly complain to the ombudsman and the licensing board and yelp, but it's not going get your mom the surgery she needs.

I understand being furious about it, but I'm not seeing an end to these complaints that yields a better outcome for your mother.
posted by 26.2 at 11:12 PM on October 17, 2013 [1 favorite]

The potential complications of spinal surgery can definitely be scary. When your mom has healthcare coverage again (has she applied for her Obamacare yet?) she should look into getting a second opinion, for sure, into whether she actually would benefit from surgery.

I don't think that this physician's behavior was appropriate by any means per the description, and I think it's fine for you to go ahead with your plan to submit a complaint. However, I wonder if there might be elements to the story that aren't described here that might have weighed upon the situation. For example, your mom went in an ambulance to the hospital for an exacerbation of her chronic pain, which tends to be a very tough issue to deal with in the emergency department because of the involvement of controlled substances - in most cases, the preferred route for this is to get further pain medications only from a primary care physician or pain specialist. I'm not talking about your mom's case specifically, but I'm talking about this category of patients in general - it tends to be the one that most drug seekers fall into. I am absolutely not saying that your mom is a drug seeker, but just saying this because sometimes patients with legitimate issues are affected by the bias of being part of this same group.

In most cases, people with exacerbations of chronic pain only see an emergency physician, who tries to give them some degree of acute pain relief and then will send them out for follow up with the doctor who prescribes their pain medicines. In this case, though, your mom saw her spine surgeon. This may vary by location, but generally spine surgeons only get consulted in the emergency department if there is thought to be an emergent condition like spinal cord compression. The emergency physician may have thought this could be a possibility due to "difficulty moving her legs". In many private hospitals there are no residents to perform consults, so the surgeons themselves have to be called in from home or called out of clinic or the operating room to come see the patient in the emergency department for this evaluation. This can be frustrating to them if they are in the middle of a busy schedule, or asleep, or having dinner with their family or whatever, and suddenly they have to come to the emergency department to see a patient who turns out to not have an emergency condition. It's no excuse for bad behavior - the customer service standard is to always try to give the patient the impression that they are not inconveniencing you and that you are happy to come in and see them (and in fact if a specialist is consulted from the emergency department, they are required by law, EMTALA to come in and see the patient, at least in the USA, or pay a large fine).
Also, of course, this sort of thing is the spine surgeon's job, although he may not have gotten paid to see your mom as a consult.

Anyway, I'm just speculating here, but one thing you might want to do would be to have your mom request a copy of her ED chart. Reviewing the ED chart might give you further insight as to why the interaction went the way it did.
posted by treehorn+bunny at 12:30 AM on October 18, 2013 [1 favorite]

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