My podiatrist is being sued for malpractice. Should I still go to him?
June 16, 2015 9:15 AM   Subscribe

Should I trust this podiatrist even though he's being sued for malpractice? Also, do you have any advice for somebody with Morton’s Neuroma?

I live in NYC. I have a condition known as Morton’s Neuroma. I’ve already had 1 shot of cortisone, which didn’t seem to do anything. I’ve had orthotics made, and they help somewhat. However, my neuroma is still there and I still feel it. I would like to get a minimally invasive procedure done called Radiofrequency Ablation. There’s a doctor here in NYC who seems to have a lot of experience with it. Let’s call him Dr. Joe. I’ve had a couple appointments with him, and I like him a lot.

Dr. Joe has 12 reviews on Yelp and 180 reviews on ZocDoc. All of them are 5 stars, except for one. The bad review was left by a former patient who is suing him for malpractice. She posted the bad review to both sites. She alleges that Dr. Joe botched surgeries on both of her feet, for a total of 3 surgeries. In her Yelp review, she said things like “Dr. Joe ruined my life!” She shouted in ALL CAPS. She alleged that Dr. Joe’s numerous good reviews were fraudulent and made by Dr. Joe himself. Dr. Joe responded on Yelp. He said that her surgeries turned out well. Here, he referred to the x-rays. He suggested that she had a neurosis called RSD or CRPS, where the patient feels real pain even though the cause is psychological. He mentioned that, after the surgery, she started seeing a different doctor, which robbed him of the chance to give her post-operation support. He suggested that she seek out a doctor who specializes in pain management.

I asked Dr. Joe about this former patient. He said basically the same things he said on Yelp -- that her surgery had turned out perfectly, but she had a neurosis that was causing her pain. When I asked him “So what’s going on with her, is she just some crazy lady?” (my own regrettable word choice) He said something like ”Yeah, she’s kind of a crazy lady. I probably shouldn’t have operated on her at all.” I didn’t like hearing him refer to a former patient as a “crazy lady”, but I blame myself for introducing that unfortunate phrase into the conversation. Other than that, he did seem sympathetic towards her, and he wished her the best even though she has a malpractice suit against him. She made her Yelp post in late 2012, so presumably the suit hasn’t been settled yet.

My initial reaction was that I shouldn’t go to this doctor. My fear is that if he messes up the procedure on me, I’ll have no one but myself to blame since I chose to see a doctor who had a malpractice suit against him. So I booked an appointment with another podiatrist in NYC who offers the procedure that i’m interested in. Let’s call her Dr. Shelly. As it turns out, Dr. Shelly studied under Dr. Joe. On top of that, when she offers this procedure, she actually uses his office, because he has the machine. In any case, Dr. Shelly has a very high opinion of Dr. Joe. She said that she would bring her own mother to get operated on by him. She said that if she needed a procedure done on herself, she'd have Dr. Joe do it. I asked her about the malpractice suit, and she said that most podiatrists have been sued at least once in their careers, and that it shouldn’t affect my opinion of Dr. Joe. She said that Dr. Joe is more experienced than she is with the procedure that I’m seeking.

So what should I do? I like Dr. Joe a lot, he seems really experienced. He answered all of my questions about the procedure. He was pleased that I had done so much research. When I asked him about the malpractice suit, he was very open and willing to talk about it. However, it just seems like a bad idea to see a doctor who has a malpractice suit against him.

So, my options as of now :
1) Go back to Dr. Joe, have him do the procedure
2) Have Dr. Shelly do the procedure, even though she’s less experienced
3) Look for another doctor to do this procedure. There are a few other podiatrists in the area whose websites advertise this procedure. However, it’s possible that Dr. Joe may be the most experienced in the area. He’s apparently been doing it for about a decade and has had a lot of success with it. (I should mention that, even though this procedure has been around for a long time, it’s only been used to treat Moorton’s Neuroma for a decade or so)

(if you wish to MeMail me, I can send you Dr. Joe’s profile on Yelp and ZocDoc. I just didn’t want to mention his name here)
posted by apostate street preacher to Health & Fitness (21 answers total)
I can't really comment on your specific questions, but it I would be concerned that Dr. Joe is sharing medical information on another patient. It sounds like he has done this both on the internet and in person.
posted by Shanda at 9:27 AM on June 16, 2015 [15 favorites]

Just like with a great restaurant, you should not let one negative review online color your perception of your Doctor.

That said, I have such a HUGE concern about a Doctor disclosing medical information about a patient on fucking YELP under any circumstances that it makes me skeptical of your entire story. It's not plausible to me that any American MD would make any disclosures about patients in that fashion, even in a forum with nominal Anonymity, given Federal law and AMA professional standards. If he did in fact make those posts online I would say that is a disqualifying factor and urge you to seek a more professional physician who understands the importance of discretion.
posted by BigLankyBastard at 9:28 AM on June 16, 2015 [12 favorites]

A malpractice suit does not mean any malpractice occurred.

That said, I agree about the concerns with sharing medical information.
posted by biscotti at 9:30 AM on June 16, 2015 [14 favorites]

Most doctors get sued for malpractice at some point or another, because not every patient can have a perfect outcome.

HOWEVER the big red flag here to me is a doctor who responds to bad reviews online and posts a patient's personal medical information. HIPAA violation, anyone? The other big red flag is that he calls RSD a psychological disorder. My aunt has RSD (or I guess CRPS as they call it now) and I promise you it is very definitely a physiological ailment.
posted by Andrhia at 9:30 AM on June 16, 2015 [9 favorites]

RSD is not a psychological disorder. Your own link says that clear as day. So if he's disclosing a patient's medical information on Yelp and saying that RSD is all in her head, then I would not see him again.
posted by amro at 9:39 AM on June 16, 2015 [1 favorite]

I expect Dr. Joe's response to the argument that he shouldn't be disclosing medical information through Yelp is something along the lines of "Disgruntled Patient was opening the door to the discussion about why the treatment was unsuccessful, opening the door to my defense that there was something else going on that rendered the treatment unsuccessful." It's up to you whether you find that response compelling.
posted by craven_morhead at 9:43 AM on June 16, 2015

Response by poster: With regard to the information sharing over Yelp :

I was concerned about that, too! I also thought it was a breach of doctor-patient confidentiality for Dr. Joe to share that information over Yelp. However, I asked a different doctor about it, and he said it was not a breach. He said that it's only a breach of confidentiality if the doctor initiates it. However, since the patient breached confidentiality first, it wasn't a breach for the doctor to respond.

I have no idea if this is true or not.
posted by apostate street preacher at 9:46 AM on June 16, 2015

Her name is on the suit which is public information. So disclosing he was actually her doctor is isn't a breach. But sharing diagnosis is. Sharing x rays is. He can say the patient in question had a perfect surgery in his opinion and other health factors may be factoring into her complaint that are unrelated to the surgury performed. Anything other than that is a beach in confidentiality. To me even the other health factors is questionable. I've seen social workers fired for much less.

People mirror others people language all the time dont worry about that.
posted by AlexiaSky at 10:03 AM on June 16, 2015 [1 favorite]

I asked a different doctor about it, and he said it was not a breach. He said that it's only a breach of confidentiality if the doctor initiates it. However, since the patient breached confidentiality first, it wasn't a breach for the doctor to respond.

I have no idea if this is true or not.

That is so completely untrue.

The patient herself has no duty of confidentiality about her own medical information, or her opinion of the doctor. So there was nothing for her to "breach." By talking about her own experience on Yelp, she in no way authorized the doctor to discuss her medical information with the world at large.
posted by merejane at 10:07 AM on June 16, 2015 [2 favorites]

Response by poster: Okay, so I just looked at Dr. Joe's response on Yelp again. He did not diagnose her with RSD. He said that her neurosis led to her pain, and that she should look up RSD. Also, it turns out he didn't mention the x-rays in his Yelp response. He must had mentioned them verbally when I asked him about the previous patient.

Again, I don't know if this should make a difference. Just wanting to clarify things.
posted by apostate street preacher at 10:11 AM on June 16, 2015

It's NYC! Surely there are other, less worrisome doctors doing this procedure?
posted by HotToddy at 10:23 AM on June 16, 2015 [1 favorite]

I'm a doctor. If I were Dr. Joe I would suggest you find someone else. Frankly, I'd prefer that anyone who entertains my care not be so ambivalent and guarded about trusting in my expertise. It would be best for both your sakes. The Yelp reviews and undecided lawsuits are near-useless data points. And yes, even if Dr. Joe is an expert at RFA, his approach to patient confidentiality is rather troubling in my opinion.
posted by drpynchon at 10:38 AM on June 16, 2015 [5 favorites]

The review sites are really frustrating for medical professionals since 1) diagnosis and treatment are not exact sciences, and the possibility of bad outcomes even with correctly-executed treatment is always there. 2) Sometimes what the patient thinks they want is not appropriate or evidence-based medicine, and 3) the physician can't really respond due to privacy issues. I find that those sites are sort of useful in giving a sense of what the practice and the doctor are like interpersonally, and that complaints about not getting test results or practices being poorly managed are sometimes accurate. But they are basically useless in terms of being able to judge a provider's actual medical competence.

That said, I find it sort of disturbing that Dr. Joe responded online and actually discussed the situation with you. It's not totally inappropriate since he hopefully didn't give you any identifying information about the patient, but it's still further across the line than I would feel comfortable going.

Just incidentally, RSD is not a neurosis or psychological in nature. It's a real disorder of the nervous system, which may be where your confusion is coming from.
posted by The Elusive Architeuthis at 10:42 AM on June 16, 2015 [7 favorites]

There's always somebody who's a complete crazy and thinks the world revolves around them. In hotels they argue with front desk and concierge and blame room service for being 5 minutes late with their OJ and water. If they're in restaurants they order things NOT on the menu, claimed the food was too hot or too cold, and stiff the servers on tip with threat of bad reviews on Yelp.

You should ignore the "outliers" and stay with the consensus.
posted by kschang at 11:16 AM on June 16, 2015 [2 favorites]

I was told I had Morton's Neuroma about fifteen years ago. It only bothered me when I walked a lot, or was otherwise on my feet a lot. The foot doctor wasn't much help, sold me some fancy orthotics that didn't do any good. What finally eliminated it completely was wearing wider shoes, for sneakers I even wear a men's wide and can walk many miles in them without pain. I'd never worn really high heels, but if you do, stop!
posted by mareli at 11:38 AM on June 16, 2015

My opinion is that you should find another doctor, as I nth all the reasons mentioned above.

Can you look at the former patient's other reviews on Yelp? Are they reasonable or does she denounce other people/ places in all caps as well? If she does, there's a chance she really is somewhat unhinged, and the negative review wouldn't ring true.

Even for the positive reviews, a careful look at the reviewers' other posts might give you an idea of how authentic the reviews are.
posted by Everydayville at 2:00 PM on June 16, 2015

Anyone can sue anyone any time, for any reason. The presence of an unconcluded suit reveals little about its substance.

I would look at her behavior and his and conclude that it's not his problem. I mean, look at the complaint for sure and see if it matches your own concerns - if the suit is over his eagerness to rush to surgery, maybe get a second opinion on the need for the surgery, for example. But one loud complainer can come from anything and happen to anyone.
posted by Lady Li at 2:49 PM on June 16, 2015

I work for a surgeon, and every part of your interaction sounds reasonable to me. Sometimes patient outcomes don't match up to patient expectations - this will be a reality with any doctor you go to. This doctor is also a business owner who is entitled to correct misinformation and defend himself against slander on a public forum. My doctor does the same thing when someone behaves egregiously or straight up lies on Yelp. I would absolutely dismiss this outlier and go with this doctor - you sound like you've thought it through carefully and logically and the opinion of a single stranger whose reliability is unknown shouldn't dissuade you. Also, HIPAA is complex and it isn't entirely clear to me it was violated in this instance.
posted by tatiana wishbone at 4:10 PM on June 16, 2015 [1 favorite]

I think you would struggle to find a doctor who doesn't have at least one patient this unhappy. Also this: She shouted in ALL CAPS. - I generally find ignoring anything written in all caps on the internet has served me very well in life. I feel like you're anxiety over surgery/treatment perhaps is leading to to overstate what this particular case might mean for you. Do you have anxiety around this medical issue/medical stuff in general?

Best of luck,
posted by smoke at 5:57 PM on June 16, 2015 [1 favorite]

I think you'd be surprised about how many doctors have at least malpractice claims on their record (this 2011 article suggests that a great majority of doctors aged 65 have been the subject of at least one claim) . I wouldn't disqualify someone for that reason alone.
posted by ThePinkSuperhero at 6:20 PM on June 16, 2015 [1 favorite]

Response by poster: Thank you all for the help. I know I don't have to tell you how hard it is dealing with our medical system here in America. It's just absurd that it's easier to find a good burrito than it is to find a good doctor. We're basically given no good way to evaluate the skill of these people who are doing really important things to our bodies!

In any case, I've been obsessing over this for months, and you all have given me some perspective on the matter, which has been very helpful.
posted by apostate street preacher at 6:32 AM on June 17, 2015

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