How do I report a doctor for bad care?
April 15, 2008 7:27 PM   Subscribe

I just had a HORRIBLE HORRIBLE experience with a doctor. This is the reason most people do NOT go to doctors. It kinda makes me not want to go to a doctor. Let me give you the whole story so you can assess the situation, get really mad, and provide me with constructive advice. If you don't feel like reading it all, scroll to the bottom and tell me what I should do if I am unsatisfied with the quality of care from a doctor.

So within the last 6 months, I noticed a LOT of symptoms, including a DRAMATIC weight gain over 60 days ( I'm 30 years old, and started off weighing 140-145 has NEVER gone over 150 lbs, but suddenly I gained about 30-35 lbs for a total of 175+).

Without going into too many details about the symptoms, so that everyone on the 'net knows what I have. I looked into it (webmd, mayo clinic, wikipedia), and said "wow...these are the same symptoms another member of my family had before being diagnosed with condition X". Maybe I have it too. I looked into patterns of inheritance...yes, it is possible.

So I found an Internal Medicine doctor through my insurance (BCBS-PPO), called them up, and scheduled an appointment. At the office, the medical assistants/nurses checked my weight and blood pressure, and told me to wait in the room.

I'll be honest, I didn't know what the hell to do in the room. The last time I went for a physical was 10 years ago. As I waited there for 15-20 minutes, I wondered if I should take my clothes off, or not...or what? Maybe the nurse/assistant forgot to tell me where those robes that don't cover your butt are stored, etc. In the end, I decided to keep my clothes on because the other option would have been a LOT more embarrassing if I was mistaken. When it doubt, don't let it hang out.

So the doctor came in, didn't introduce herself, and went to work. She listened to my heart and lungs, made me follow her finger with my eyes, and did some simple reflex tests. I started to talk to her at this point, told her about my DRAMATIC weight gain (w/o any change of diet/lifestyle), and she just IGNORED all my symptoms. She asked about my exercise habits, and I told her they haven't changed in 10 years. "Maybe you need to exercise more". The visit with the doctor took less than 5 minutes.

"Maybe, but theres no way that would explain 30+ lbs in 60 days", I said.

"You're probably not exercising correctly". She said.

"Possibly, but that still cannot account for the weight gain in such a short period. It could also be condition X that another member of my family has".

"No, men don't get that", she said.

"Actually, its rare, but men DO get it", I came back with.

"Yes, I know, I'm the doctor". Ummm ok...what the heck do I say to her?

"So can you give me some blood tests, because I still think something is off".

"Ok, but you really need to exercise differently", she said. "You're getting older".

So I left the office, feeling like I'm dumb, fat, and old (I'm 30...I don't look old. I get ID'd all over the place). I went over to the lab and gave them my blood.

I joined a gym, and started working out hardcore. 2 hours each day, with 30-45 min of cardio EVERYDAY. During those cardio sessions my HR averages 145, and it maxes out at 171. I really am working out. After 2 change in weight. Highly unusual. Whenever I want to lose 5-10 lbs, I go to the gym, hit a treadmill regularly for 2-3 weeks, and I shed weight like crazy. This time, its not working.

I also kept tabs on what I ate. I eat about 1800 calories a day, spaced out in about 5 meals. Thats how I've been eating. I also have a fairly healthy diet (vegetarian except for fish and eggs, no fast food).

The next week, I called the doctor's office and asked them about the blood tests. They told me that they can't release it over the phone, but if a doc didn't call me, its "probably fine". Umm, ok. So I came in that same day to get a copy of my blood test, and doctor's report. The report had NOTHING about what I talked about except that I was overweight (Alright, I'm a fatty...sigh). Everything on the blood test looks good (within range)...except for ONE test. I looked that up, and BAM...there it is. It confirmed my suspicion of condition X.

Still no call from the doctor, though.

I went in for a second opinion to another doctor. As soon as he came in, I said "I'm here for a second opinion. I believe I have condition X, "

"What makes you say that", said the new doctor.

"Well I have symptoms, symptoms, symptoms, and 30+ lbs weight gain over 60 days".

"Wow...thats over 20% of your weight in less than 2 months...bodybuilders would want to do that, except it looks like it wasn't muscle (thanks again, I'm such a fatty). Well the first thing we would need to do is some blood tests" said the doc.

"I have some from 3 weeks ago right here".

Within 30 seconds of looking through it, he goes 'WHOA, this is 4 times higher than actually DO have condition x. Why did you not tell your doctor about these symptoms?"

"I did...she neglected to give them any weight, and even didn't write them down on the report. She just told me I needed to exercise'

"What did you say when she called you with the test results?", asked the doctor.

"Umm, she never called me...I had to go get them myself."

"Wow", said the doctor.

He took another blood sample, and prescribed me some meds...and told me I will need to come in monthly to see if I'm getting the right dosage, and vary if I'm not. He also said I will probably be on these meds for the rest of my life. Great. The good news is, that this should correct the symptoms I have been having, and I should see my weight back to normal by summertime.

In any case, had I NOT taken the initiative to get the blood test results from the first doc, and taken them to another doc for the second opinion, I wouldn't have found this out until something REALLY bad happened and a competent doctor would have done the test AND FOLLOWED up, or for another 10 years when decide to go to another doctor.

So now, I'm going to write professional, yet critical letter to the doctor, CCing her medical group, and the insurance company. Is this what I'm supposed to do? Is anything going to happen?

WHAT CAN I DO? I'm not suing for money, I just want to do something so this doesn't happen again with this doctor. It was this doctor's bedside manner, and attitude that made me think "Wow...I totally remember why I don't to the doctor every year". I also totally understand why some people say "I don't go to the doctor...I hate doctors". What I used to think was an ignorant attitude towards medicine, now seems legitimate if all the doctors were like my first doc.

If I was treated that way, I'm sure others are treated that way; thats just neglect. I checked the insurance to see the doc's bill. The insurance paid $155(for the doc, not the blood tests), I also paid $20 copay for a total of $175. $175 for a 3 minute visit, and a diagnosis of "FATTY!"

What can I do, who can I report this to? Is writing a letter to the doctor too small, is writing a letter to the AMA too big? Would sending it to the insurance company do anything? Where in Blue Cross/Blue Shield do I send it to? HELP!
posted by hal_c_on to Health & Fitness (41 answers total) 12 users marked this as a favorite
there was a post about this before, suing without suing or some such - the consensus was to write letters. I'd write a letter to everyone I can think of.

Then again, I'm a knee jerky gal and want everyone to feel my pain.
posted by damnjezebel at 7:31 PM on April 15, 2008

i can't speak to the question of how to best complain about a bad doctor. so feel free to delete this, moderators, if it seems appropriate. but i just wanted you to know you're not alone. i don't know what you have and i don't want to out you, but i have an underactive thyroid and received similar treatment from the first doctor i went to. she gave me a referral to see a nutritionist and never called me back about my blood test. i had to get a copy of the results myself (which was obnoxiously, red-tape-ishly difficult to get! i mean, it's my blood!). and then saw a specialist w/a copy of my results in hand. and he put me on medication and let me know i wasn't crazy. again, you could have something way different, but it was my experience that thyroid conditions have an unfortunate tendency not to be taken seriously by primary care physicians. i don't know why. and i do know that it's WAY way WAY easier to be put on antidepressants (ridiculously easy!) compared to getting your damn synthroid. anyway, good luck w/your situation & i hope your douchebag doctor learns a lesson of some sort from this whole experience.
posted by apostrophe at 7:41 PM on April 15, 2008

Best answer: A friend of mine who has dealt with a decade of cancer treatments suggested to me that the best way of addressing your concerns is to contact the insurance companies. The idea here is that the insurance companies are paying the doctors for their services to you. The insurance companies are, to an extent, employed by you to ensure that these services are done and done properly. If the doctor has failed to provide appropriate service then the insurance company may feel that they've been defrauded and investigate. Plus there's the potential that the first doctor's inattention may have cost the insurance company additional funds that could have been saved had your condition been detected earlier. This is a hassle and a worry to you, but to the insurance companies this is money. They tend to take money pretty seriously.

Alternately, you might consider contacting any appropriate HR offices that could find the doctor's behavior a concern, for many of the same reasons as contacting your insurance companies.
posted by lekvar at 7:42 PM on April 15, 2008 [3 favorites]

Call the newspapers or your local news channel. they love this kinda thing, maybe they will even make an appointment with one of their hidden cameras. at the very least it might cost them some customers, ..... I mean patients.
posted by Mr_Chips at 7:44 PM on April 15, 2008

Best answer: Absolutely leave a review of the doctors on sites like ratemds. PLEASE do not let this go unnoticed! Consumer grades of doctors is really an important thing -- there's just no other method out there for people to find out about good and bad doctors (and I've read enough about state licensing boards to know that they're rarely worth their salt). Personally I have made it a point to try any doctor that has a favorable consumer review. Hey, even if it's just a shilled review, at least the doctor probably cares.
posted by crapmatic at 7:48 PM on April 15, 2008 [1 favorite]

Best answer: In a situation which is this ridiculous and extreme, I would write letters to every potentially relevant individual/entity. Possibilities:

1) the doctor themselves, just to give them some thought about maybe handling things different in the future
2) if the doctor is part of a large private practice and is not a partner of that practice, to the senior partners of the practice (a.k.a. some internal medicine/family practice groups may have 15 doctors, of which 3 or so are partners who own the business, and the others are basically employees) - if your doctor is part of a large practice call the receptionist and inquire about this
3) if the doctor holds academic titles at a university medical center, perhaps to the chair of their department
4) the relevant state's board of medicine (definitely do this, because the state board is the group with the power to actually do something to the doctor)
5) your insurance company
posted by david06 at 7:52 PM on April 15, 2008 [1 favorite]

Holy mackerel. What you went through is totally unacceptable. I am so totally not an expert on this, and I have my own knee-jerk tendencies, but I would definitely write the hospital and badger your insurance company until you get an appropriate audience. I would also talk to the doctor from whom you had received a second opinion and ask what he feels would be a good next step. You don't need to destroy this woman's career, but she does need a very serious wake-up call. It's fair to say that your experience was not an isolated one, and that, for all we know, she could be making many very serious errors due to her own ignorance and arrogance. The fact that you were essentially cheated out of money (and time) due to her incompetence pales in comparison to whatever could happen when she fails to address serious, pressing health concerns.

I will be following this question with great interest. The most I can contribute of substance would be my suggestion to write the hospital, write her, ask your second opinion doctor what he feels would be appropriate, and badger the living hell out of Empire until somebody yowls. Hopefully there can be some disciplinary action on the part of the hospital so that you don't have to set foot in a courtroom. Hospitals are not super-thrilled to have employees from whom they can expect a colorful variety of malpractice suits: I'm sure they would have procedures in place to address substandard doctors before they become larger problems. Same goes for insurance companies. Think about who would have a financial stake in the competence of your doctor, and tell them all about your unhappy experience.

On preview, I see the suggestion to contact your local paper. I think this is a very, very good idea, as long as you restrict your input to purely the facts and nothing else. I'm not sure if this one story would make the papers (or television), but it certainly couldn't hurt. For all you know, your story may be merely the tip of the iceberg.

Also, I hope you're feeling better.
posted by Sticherbeast at 7:52 PM on April 15, 2008

In my experience (of military medical care, so YMMV,) that's what passes for triage, or hypochondriac screening. Your first appointment will be totally blown off. If it's bad enough for you to bother coming back a second time, well, then there may be something to it. It pisses me off even though I know it's going to happen. That also explains why the 2nd doc believed you right off. That was your second visit.

Copy the letter to YOUR insurance company or whatever you have. She's not ripping you off as much as she is them, where money is concerned. They may be upset that she's charging them a doctor's rate to write the most obvious symptom on your chart and wash her hands of the whole thing. They may want to drop her as an authorized care provider, if they have multiple complaints.

Maybe she doesn't care about that. You should also copy the BBB in your location and the AMA. Again, one crank complaining probably won't do much. If, as you suspect, that's the way she is all the time, there should be lots of complaints, though. That's when they start getting interested.
posted by ctmf at 7:54 PM on April 15, 2008

I had a longer comment, but on preview -- what david06 said.
posted by R343L at 7:55 PM on April 15, 2008

My suggestion would be to write one good letter and send the same letter to all the above referenced entities. Along with the board that she is board certified with, the AMA and maybe the state licensing board.

Include in the letter a request for follow up- how will each entity address the situation?

But maybe before that, send a different letter to the doctor herself. What was she thinking, why didn't you get a call back, etc. The response you get might alleviate your concern. Or it will further solidify her seeming incompetence.
posted by gjc at 8:05 PM on April 15, 2008

Writing the insurance company won't accomplish shit unless the doc is employed by them. More likely is that the doc is contracted through the clinic with your insurance. But try anyways if you like. If it were me I'd write a letter to the doctor directly. I'd tell them how miserably they failed to perform up to even a minimal standard, then move on. And your letter will have infinitely more effect if you first find yourself a decent editor. I can't imagine anyone spending time reading it if it were half as long and rambling as what you posted above. Good luck.
posted by docpops at 8:21 PM on April 15, 2008 [1 favorite]

You have to figure out whether she is employed by a hospital or by a large medical group, or has her own individual practice. If the former, there are often patient advocates and quality control people, to whom a politely-worded and detailed letter can be addressed.

If the latter, then she essentially answers to no bosses. But any complaint regarding professional competence can always be addressed to the licensing authorities in your state. Depending on where you live, this step could be very effective in getting her attention. Even then, the episode will likely warrant only a reprimand. (You did have a good outcome, after all, due to your own diligence.)

I suspect that letters to the insurance company complaining about the quality of care will not get much attention. They probably get scores per week.
posted by megatherium at 8:24 PM on April 15, 2008

Make a formal complaint with the licensing body in your state (is that the board of medicine? we use different terms in Canada). They will then investigate the matter and decide on how far things have to go (probably not that far as you're OK). You could talk to the doctor directly but at this point it is too late, she's already disregarded her obligations to you.
posted by any portmanteau in a storm at 8:30 PM on April 15, 2008 [1 favorite]

What good does it do the write the insurance company? You might as well dump the letter into a black hole. I would write to the doctor. If you are really pissed I would write and contest the bill on the grounds of malpractice. I had to do this once in the face of actual malpractice (of a magnitude much greater than you experienced) and the bills stopped. I am not suit happy so I just let it go. If you are really, really pissed, then report her to the medical licensing board in your state and to the hospital at which she admits. On these facts alone I wouldn't go there.
posted by caddis at 8:31 PM on April 15, 2008 [1 favorite]

You need to make a formal complaint with the applicable health regulatory body for your state or province. There will be a formal complaints process or other way to let the people who license that doctor know that you have had a problem.

This is sadly common - there are whole forums devoted to people's concerns about doctors who blame weight/inactivity on every health problem first, telling patients "come back and see me when you've lost x pounds" leaving the patient to struggle at weight loss and ignore their potential ailments. Luckily for you, you were persistent, got a second opinion (and with health insurance, thank goodness) and you were properly diagnosed. Try to pay that forward by filing a formal complaint. Any other actions could be potentially slanderous and aren't going to bring any formal reprimand to the doctor.
posted by SassHat at 8:36 PM on April 15, 2008 [1 favorite]

i feel for you. it completely sucks to be treated that way, especially when it comes to your health. i'm glad you went with your instincts and pursued the matter. and yes, definitely write a letter—at the very least it will make you feel better about having done what you could.

as someone who goes to her doctor very regularly (and is on a first name basis from phone calls) i'm going to address your whole thing about this is why i don't go to the doctor: maybe stuff like that is why people should be going to the doctor to get checked up on a regular basis. just something to think about.
posted by violetk at 8:41 PM on April 15, 2008

Definitely write to both the doctor, whoever the director of her practice is, and the state licensing board. I don't know how complaints are handled by medical licensing authorities, but I know how they work in lawyerland, and if this was lawyerland, they'd at least have to open a file, contact her about the complaint, and do a brief investigation.

The other thing you might do, if you're exceptionally peeved, is to write to her malpractice carrier. I don't know how much attention your insurer will pay to your complaint (it may be a lot; it may be a little) but given that her carrier stands to lose a lot of money if her work isn't up to scratch, I bet that they'll pay significant attention.
posted by palmcorder_yajna at 8:57 PM on April 15, 2008

Pretty normal, when I had my gall stone, which is not very likely in men, the first 3 doctors just glanced at me and noticed I was over weight. Eventually I found a doctor who actually listened, a few test, surgery etc, and all is well again. 3.3cm stone. One of the doctors actually prescribed me valium when went into the ER during my worst episodes, for "stress". Amusing. Unless Valium works on gall stones somehow..

I wrote a long write up about it on the net, but it is probably not much reading for anyone else.
posted by lundman at 9:05 PM on April 15, 2008

Just wanted to chime in to say you're not alone. I and most of my friends experience this regularly. Most recently: Symptoms: sudden night sweats, anxiety, suddenly non-regular menstrual cycle? While you might think it's peri- or menopause it turns out the right solution is to take Ambien. wtf? Previous to that was the friend who had a grapefruit sized tumor in her chest. For 2 years she was blown off as "stressed." I can think of half a dozen of these off the top of my head.

And while I'm on a rant- is Ambien pushing their stuff really hard these days or what? Everyone I know seems to be on Ambien for things that aren't even all that sleep related. It's like it's the new Prozac or something.
posted by small_ruminant at 9:29 PM on April 15, 2008

When I went to the doctor with what I was certain was strep throat (I had ALL of the symptoms), she told me that there was almost no chance that I had strep throat, the symptoms were all wrong, it wasn't the time of year for strep (it was March - which IS strep season), but that she would give me a throat swab "to make me feel better." Yep. I had strep.
posted by The Light Fantastic at 9:32 PM on April 15, 2008

Fill a complain form with your state board of medical licensure and supervision.
All complains are reviewed.
posted by francesca too at 9:50 PM on April 15, 2008 [1 favorite]

I've been both of these docs, I think, although you never really know for sure what your patients are thinking about you.

It's certainly true that you did a lot of things right on your second visit. One crazy study I saw in med school purported to show that the average primary care doc started disregarding spontaneous, unsolicited comments by the patient 14 seconds into the exam. Stating the purpose of your visit in those 14 seconds really helps your doc zero in on what the purpose of the visit is. I know that I have patients who don't understand that I know how my visit is going to go in the first 3 minutes. I then spend 50 or 60 more minutes taking history, doing physical exam, reviewing records and scans, making decisions about further tests and treatments, and communicating the plan to the patient.

One of the things that annoys me the most is when patients are still bringing up undiscussed symptoms, other conditions they would like treated, or other new information when I have completed my focused assessment and would like them to take the scrip I have for them and get out of my office so the next patient can come in. It goes like this: "(after 60 minutes of interview and exam) I think you have had an epileptic seizure. I would like you to have an EEG. Please start taking this medicine." and the patient says back to me, "Oh, I wanted to say, I had headaches since 1969, and they are still bothering me." The time to say that was 58 minutes ago, not now.

It's also worth noting that it's always, always easier to be the second doc. The first doc is worrying about and ruling out things that have never crossed the patient's mind. The second doc gets to read a record of this process and instantly allay his concerns and worries. Sometimes the first doc has done so much that the second doc can actually get around to the business of addressing the real problem. I always tell my patients who badmouth the first doc, "Look, Dr. **** did all the heavy lifting for me already, she made my job much easier," but they rarely seem to understand that.

It's hard to know what went on with your case, much harder because you were vague about what your condition really is. If you are interested in improving things for everyone, I would recommend a polite letter to the first doc stating your concerns and suggesting ways that they could be improved. If you are interested in punishing the first doc, bad word-of-mouth on websites and a letter to the state medical board are about as much as you can do. If it's a pattern of behavior eventually someone will get around to discipline - maybe.

I can't imagine a letter to the insurance company getting more than a laugh as it's tossed into the circular file. Insurance companies only care about money.
posted by ikkyu2 at 10:13 PM on April 15, 2008 [10 favorites]

It's hard to know what went on with your case, much harder because you were vague about what your condition really is. If you are interested in improving things for everyone, I would recommend a polite letter to the first doc stating your concerns and suggesting ways that they could be improved. If you are interested in punishing the first doc, bad word-of-mouth on websites and a letter to the state medical board are about as much as you can do. If it's a pattern of behavior eventually someone will get around to discipline - maybe.

I can't imagine a letter to the insurance company getting more than a laugh as it's tossed into the circular file. Insurance companies only care about money.

I totally agree, with the exception of the letter to the medical board. As you have so eloquently stated, there are so many reasons why this was not incompetence, nor evil, even if it may not have risen to excellence. Reporting a doctor to the board is pretty serious stuff and I wouldn't do it myself unless I felt it was clear malpractice and not the type of malpractice that every professional commits, a mere and rare mistake, but rather a horrible error in judgment that seems to either arise from incompetence or indifference. Doctors, and other professionals, have it hard enough without people jumping the gun on reporting them to the state licensing boards and whatnot. This scenario is not good, but there are explanations for why it was not awful. If this had happened after a second visit, I would be all for reporting things all around.

It's kind of funny that ikkyu2 would seem more willing to condone reporting, although that is probably not true, it just might seem that way from his comment. I think it is hard to draw really negative conclusions from a single incident and reporting to state medical boards has serious consequences for a physician. I have once jumped all ugly on ikkyu2 for a single incident and I probably never really apologized for that. I know he knows what I am talking about. It was ver a bit of arrogance on his part (a fault to which I have no immunity) that I attacked his professional qualifications, but not on the merits. I still feel bad about that and ikkyu2, sorry, it was uncalled for. There are far more civil ways in which to disagree than impugning a professional reputation, especially of someone who from all other appearances seems more than qualified. I am pretty sure I would be happy to have you as my physician if the need arose.

Anyway, doctors thrive on their good reputation and it should be only a clear violation of their duties to a patient that triggers such a strong response as reporting them to the medical boards. It might very well be appropriate in this instance, but it is hard to tell from what we know. Given the very negative consequences to the doctor, I would always err on the side of caution.
posted by caddis at 11:11 PM on April 15, 2008

Misdiagnosis is fairly common. I'm not taking up for her mind you, I'm just saying that you are definitely not alone. I've worked with many doctors such as yours and I get really angry when they act like because they went to med school, they know everything. In fact, I once questioned a doctor's treatment plan and was actually told that I'm only a nurse and his decision was made because he was more educated than I am! Ugh!

In any case, one thing you need to understand is that a second opinion is standard. It is not common practice to ask for a refund because one doctor recommended treatment A while the other doctor recommended treatment B. That's the whole point behind second opinions. That said, you've not shared what the diagnosis is, and understandably so. The problem is that I can't really tell you how far off Dr. Jerk was in her opinion without knowing. I have a guess as to what it is, and if I'm right you should be able to ask for a refund. Either way, ask for one but don't be surprised if they resist.

Your idea on writing the doctor, her group and the insurance company is correct. Now the insurance company is key here. They're the ones responsible for any reimbursement Dr. Jerk gets. If they feel that a doctor makes errors, it is in their best interest to dump said doctor. This could really hurt Dr. Jerk in the end and the group she is with will not be happy over it.

You can write the board as some have suggested, but I seriously doubt they'll respond. They would likely write you a form letter that it is noted and under review, but the doctor will only get a hand slap, if that. Your life was not in immediate danger and that is what they're interested in. They have bigger fish to fry with botched surgeries and the like.

My advice for the future though is to not just pick a doctor out of the insurance book. Check around and ask your friends and neighbors who they use, then see if that doctor is in your book. If not, then check online for the doctors that are in there.

Good luck and I hope your health improves.
posted by magnoliasouth at 11:17 PM on April 15, 2008

I totally empathize. I just made the decision today to find a new doctor after my current one disappointed me for the nth-and-final time. I second everyone who said to write a letter to your state licensing board (even if they don't take action, they keep complaints on file and yours might make a difference in the future) AND to write to the doctor personally. Make your personal letter sound very self-assured and matter-of-fact (e.g. not "emotional). Your doctor needs to be confronted, even if it's just in writing. Plus, you'll feel better after getting your feelings out on paper. Best wishes to you!
posted by amyms at 11:20 PM on April 15, 2008

caddis, it is not clear what happened, so I do not know what should be reported and what shouldn't in this case.

A letter to the medical board expressing dissatisfaction does not necessarily reflect poorly on that doctor. There are all kinds of nutjobs out there and some of them write angry letters to the medical board even when they're taken care of properly. A physician who has the patience to take care of angry, abusive patients in an appropriate and compassionate way is meritorious. Contrariwise, valid complaints also come to the medical board. I pay the medical board thousands of dollars in various fees; I expect them to use this money to hire someone with judgment to read these letters and evaluate them and take appropriate action. In fact they more or less do this, although every doctor knows that it is much harder than it ought to be to take action against a doc who's not up to the standard of care.
posted by ikkyu2 at 12:16 AM on April 16, 2008

I recently switched doctors for a similar reason. Your story also makes me think of my mom, who had post menopausal vaginal bleeding for almost 5 months before her gynecologist finally scheduled a hysterectomy which turned up cancer. I think she had seen the gynecologist once a month during that time.

Although it doesn't strain credulity that the doctor's behavior while in the appointment was reasonable as she was trying to assess the likelihood of you having this disease, the fact that the doctor never followed up on the test results is simply unacceptable. Definitely write a letter, although it's unlikely that anything will come of it.
posted by miss tea at 4:25 AM on April 16, 2008

This is my opinion but I get the impression from what you wrote that she came in and saw you as overweight and that was it. I have had that happen to me before, I had a sinus infection and I went to my doctor at the time to get help when he just started going on about my weight and I finally had to ask him what that had to do with me having a sinus infection. That was the last time I went to him.
posted by govtdrone at 5:31 AM on April 16, 2008

I don't have much to add from the generally excellent advice above, but there's one other option I haven't seen mentioned. I think ikkyu2 is probably right that an insurance company isn't going to care much about the complaint from one person--after all, your average insurance company has hundreds of thousands of people enrolled, and losing one person doesn't make that much difference to them.

However, if you're getting your insurance through work, consider talking to your HR department about it. Depending on where you work and how good they are, they may just blow it off, but there's a definite chance that they'll care and follow up with the plan themselves, depending on how you phrase your complaint. I'd suggest sending an email or calling HR and raising your concerns about the quality of doctors in your insurance company's network, and maybe asking about whether other people have had complaints about the quality of care from the covered doctors. (The quality and quantity of doctors in an insurance company's network is definitely something that a company is paying for, so while your bad experience with a doc in and of itself might not concern HR much, the idea that they're paying $$$ to cover employees and getting a subpar product should concern them.)

I've actually taken a complaint about a bad experience I had with a doctor to HR (it involved first giving me the wrong results, then jerking me around for a month about the results of a biopsy), and I was pleasantly surprised to hear that the HR rep had a number of complaints from people in the company and was planning on talking to the plan about it. Losing one person = not a big deal to an insurance company. Losing an entire group plan of potentially hundreds of enrollees = more of a big deal. I don't know what ever became of it, but I felt pretty satisfied after talking to the HR rep; it made me feel like I had some 'big guns' on my side and wasn't totally powerless after being treated poorly. (YMMV, obviously--my company rocks hard, and I know not all companies do.)
posted by iminurmefi at 7:27 AM on April 16, 2008

This is the reason most people do NOT go to doctors.

On the contrary, most people do go to doctors.
posted by JimN2TAW at 7:55 AM on April 16, 2008 [1 favorite]

I get what the physicians and others here are saying about the role of the first vs. second doctor, the difficulty in dealing with patients, the seriousness of reporting someone to the medical board, and the difficulty in assessing the situation without more detailed information. It seems logical and easy to be on the patient (and peanut gallery) side of things and say “go to the papers!” “report to the medical board!” perhaps in part because of a lack of understanding of what is really involved in being a treating physician and because we empathize with being on the patient side of things. And I also do understand the tendency to blame the patient, which I sense that ikkyu2 is doing a bit (albeit in a more general sense—on preview robot is being a little more harsh with the OP). I’m a lawyer, and clients can be similarly stubborn and disorganized in their opinions of their situations, not understanding the law but refusing to believe they don’t have a case, leaving out relevant information, including irrelevant information, etc.

And I get that patients sometimes lie, often come in with incorrect preconceived ideas of their diagnoses (thank you, Interwebs), and are disorganized and annoying in their explanation of their symptoms, lifestyles, and exposures. In a perfect world, patients would come in with organized and truthful lists of every relevant symptom or circumstance, recognize and dispense with what is not relevant , not be intimidated, even if they are treated hurriedly or dismissively by the doctor, nurse, or other staff, put aside the emotional upheaval that scary and confusing symptoms often create, speak quickly and clearly in the first 15 seconds of their visit, and put full faith and trust that the doctor is competent.

A lot of these things are not the fault of the patient or the doctor, but of the larger structure of the system and methods of reimbursement. But being a ptient is scary. Being sick is scary. Patients forget things until the end because they feel stupid, nervous, upset, embarrassed, and intimidated. Patients don’t always know what’s relevant—sometimes the most troublesome or scary symptoms are irrelevant and the more subtle symptoms or exposures are more significant. Sitting naked or in a paper robe creates a huge power imbalance. Waiting in alone for an hour between having temperature taken and seeing the doctor creates and adds to the anger, frustration, loneliness, and fear patients already feel. Not all doctors invite patients to speak (as happened here). And not all doctors are competent.

There is nothing magical about an individual choosing a certain profession (and even reaching the appropriate benchmarks such as passing the boards or the bar or making it through residency) that guarantees that that individual possesses, learns, or perfects the optimal qualities for that profession. To a certain extent, one cannot succeed as a physician or lawyer without learning how to listen, assess, analyze, etc, but there is much variation in every field. But there are bad doctors, lawyers, accountants, yoga instructors, bartenders, presidents…

It’s hard for us to tell in this situation to what extent the first doctor was unreasonable or incompetent (on preview, as robot alludes to, maybe the situation would have resolved itself and not gotten more complicated, we don’t know), but there is no reason to continue to go to a provider that you distrust or even simply don’t like. To that end, the advice I would give to the OP is to register your unhappiness by never going to that doctor again and letting her know why, through a clear, professional, and rational letter. Perhaps you could speak to the second doctor or another physician familiar with the details and discuss whether incompetence actually occurred in this situation and then decide if more serious action is warranted.
posted by Pax at 8:01 AM on April 16, 2008

Response by poster: Thanks for the love, everybody. Just to clarify one quick point:

I don't consider being overweight a "MORAL FAILING", but I do consider gaining over 20% of one's body weight in 60 days to be drastic and indicative of an underlying problem. Unless you're a newborn, those little fatties always have moral issues beneath their extreme weight gain.

I will be following this post up (somewhere on mefi), so any of you that may be watching it can find out what happens.

Thanks guys, I REALLY REALLY appreciate all the posts.
posted by hal_c_on at 8:28 AM on April 16, 2008

Make sure you have someone else draft or at least review your letter.
posted by yerfatma at 8:29 AM on April 16, 2008

Yeah, this non-socialized medicine we get to have cause we live 'Merica sure is awesome. Please sue this doctor. I don't know exactly what condition you were diagnosed with—although I assume it wasn't extremely life-threatening; but what if it had been? Write the medical board in your city, etc. Do what you have to. This person doesn't need to be practicing. Good luck!
posted by littlerobothead at 8:34 AM on April 16, 2008

I just want to reiterate something- in your case, the doctor screwed up. There SHOULD be a record of that in as many places as possible. If it's a one time rarity, it will be obvious. But if it's not, there will be a paper trail and people will be able to see the pattern and take corrective action.

I sympathize that being a physician is hard, but that's the job. If this doctor can't hack it, she needs to be doing something else.

I look at it as a responsibility to society to make sure when we experience aberrant treatment (good or bad) to alert the relevant people. Feedback is the only way we learn and improve.
posted by gjc at 8:50 AM on April 16, 2008

frankly, i think your level of outrage is off for the situation. it's common (at least in my experience) for doctors not to call with test results and for one to have to follow up multiple times to get them.

it is also not uncommon for a doctor to be perfunctory and non-chatty during a visit--they have to see 157304983 patients a day and don't have a lot of time. i'm not saying this is right, but that's how it is in most offices.

also, apparently you have a condition that it is rare for males to get. you went to a generalist, but you expected her to know everything about rare condition X. i think that's unreasonable. she should have ordered blood tests, which she did, to further evaluate what's going on so she can either read up on rare condition X or send you to a specialist.

i completely agree that that much weight gain over a short period of time is bad, and should definitely be addressed, and that the doc should have been a bit taken aback. on the other hand, how does she know you're not lying? i mean, welcome to the world of fat discrimination by doctors. happens every day (concentrating on the weight instead of the real issue).

and i know that many doctors want to punch patients in the face when they come in with a list of possible diagnoses based on internet research. i mean, tachycardia is a symptom of a jillion things, cyanosis is a symptom of a bunch of're not a clinician so how do you KNOW that you made the right dx based on some 72dpi photos and a paragraph on mayo?

anyway. my point is that your experience is not unique. you are outraged by what you believe was a "bad doctor." the insurance company isn't going to care. the ama? they have bigger things to deal with. her medical group? they might care, but maybe not. and she may or may not care either. one letter certainly won't get them to fire her or her to change her ways.

she didn't amputate the wrong arm, she didn't leave gauze in your chest cavity, she didn't even misdiagnose you and prescribe a drug that made your actual condition worse. she didn't discriminate against you. write a blog post about how pissed you are, maybe give her a bad review on yelp and let it go.
posted by misanthropicsarah at 8:53 AM on April 16, 2008

Whoa, OP, are you me? This happened to me with my doctor and hypothyroidism. My doctor's response was "try Weight Watchers." I was super-insulted. I, too, eat 5 times a day, work out 2-3 hours a day and was dumbfounded by my weight gain (I've been approx. the same weight within a 5-pound up/down for 7 years). My response was to ask that he recommend a specialist.

My reaction was to tell everyone I could, including friends who share this doctor, and go directly to the specialist with my test results. To be fair, GP's don't always know everything; that's why you ask for a specialist (whether it's a podiatrist, endocrinologist or whatever, that's why you go to them). After awhile, though, I calmed down, because my doctor is fairly new and doesn't know my complete medical history. Neither could this doctor with you, right? After all, you stated yourself you never go to the doctor for checkups; this doctor has no history with you, and therefore doesn't know what your normal blood work, weight range, and health are like. Mine has only seen me 3 times now, so I cut him some slack... after all, what woman wouldn't freak out about weight gain? He had no idea that I've worked out daily for 8 years, or what I eat.

I would write a letter to the doctor explaining your feelings, and telling her that you are leaving her as a doctor and why. Contact your insurance company and ask them to send you a list of doctors in your area and try them out, if that's possible.

That is, if you feel like your reaction is justified. Otherwise, I would do what other posters above have said; vent in blog form somewhere and post a review of this doctor online to let other sufferers of Condition X know that she's not a good doctor for treating that condition.
posted by Unicorn on the cob at 10:18 AM on April 16, 2008 [1 favorite]

As an healthcare communicatinos strategist, I must urge you to defintely write to the doctor, her hospital affiliation, the medical board of your state and to the insurance company, in detail, letting all of them know you've alerted the others. If you get insurance through your employer, let them know too. Make sure you do your research so that the letters get to the appropriate offices -- call first and find how where you send your 'feedback' about doctors and services.

Don't dismiss the insurance companies as black holes! They are on the knife edge about healthcare right now and are embracing ratings systems for doctors big time so they can weed out those who have poor ratings, issue unnecessary tests, don't offer generic drugs, etc etc. Also, DOCTOR'S RATES ARE NEGOTIATED WITH INSURANCE COMPANIES before you even walk in the door. They need to know this 'doctor' was inefficient, causing you to seek a second opinion, racheting up needless costs.
posted by thinkpiece at 10:35 AM on April 16, 2008 [1 favorite]

I grew up with doctors. Here's my take on this, for what it's worth:

(1) (Mis)diagnosis - The key is "Horses vs Zebras." Common vs Uncommon. If the symptoms are for a cold, it probably is a cold, rather than the bubonic plague. In primary care, if it looks like a horse, it's almost always a horse, not a zebra. This is basic medical training.

The doctor starts thinking: Weight gain. Guy hitting his 30's. (It's on your chart.) Metabolism's slowing. Sedentary during the wintertime. Watching football and drinking beer. Most likely, he's getting fat because he's getting fat. And trying to blame it on something else. (No offense, I'm just explaining what's going through her mind, because to her thinking, it's the most likely scenario.)

(3) Not talking to the patient - bad.

(2) Not listening to the patient - also bad. Perhaps the doctor didn't know that men get condition X, or it really is extremely rare. (Note: If you'd started off talking about your family history of condition X, it might have started the doctor down a different path. There are ways to talk to doctors who don't listen. This is what you did with the 2d doctor.)

(4) However: If it's rare, then it's a "zebra." Just how rare is it? If it's really, really rare, I'd be thinking "fatty" too. (And I'd be wrong.) And if it is condition X, is your health at immediate risk? If not, then prescribe exercise; if it fails, then check for condition X (AND a host of other potential ailments). Diagnosis can have a progressive nature. ("Differential Diagnosis") Was the initial diagnosis bad? I wouldn't pass judgment on it without knowing more about condition X.

(5) Lack of follow up (since there was an actual test): Bad, but all too common.

(6) The medical community can be small. Word gets around about who knows their stuff, and who doesn't; who talks to patients well, and who doesn't and should have been a surgeon.
posted by coffeefilter at 11:27 AM on April 16, 2008

The state Medical Board will have a complaint process. Use it. Describe your experience in as unemotional way as possible.
On January 15, I saw Dr. Jane Doe. I reported x, y, z symptoms, and specifically told her of my concerns about a, b family history. Dr. Doe did not appear to listen carefully or with interest. Dr Doe recommended d. Dr. Doe did not ask this, did not check that. At my insistence, f, g tests were ordered.

On January 20, I called Dr. Doe's office to get the results of the tests, and was assured that the results were normal, but the office did not release details by phone. On January 21, I visited the office and obtained the test results, as well as the record of my visit. Etc.

After describing the events, describe the effect on you, explaining that Dr. Doe's treatment made you feel ashamed and guilty, then getting a different diagnosis from another physician made you angry that Dr. Doe dismissed your obviously valid health concerns. And that you are very concerned that other patients might have incorrect diagnoses and treatment due to Dr. Doe's poor listening skills. Etc.

Then you define the action you want, which should be that someone look into Dr. Doe's work, and perhaps Dr. Doe could get some additional training in listening.

Dr. Doe isn't going to lose her license because of your letter. Worst case, the board files it to see if there are other complaints about Dr. Doe. Best case, Dr. Doe gets a letter noting that a patient had a credible complaint about treatment. Copy your insurance company if you like, maybe they keep files and look into complaints; maybe not. Their primary function is financial. You might consider copying Dr. Doe on the complaint; maybe she'd like to be a better doctor. You have suffered no lasting harm (thankfully) so I'd be surprised if there was any investigation.

Do make the complaint. You never know what's going on. Dr. Doe could have had a bad day because her cat died, or she could be a drug abuser barely holding it together. If your complaint is the only one, not much will happen, but if your complaint is the 4th this month, they'll notice.

Good luck with getting treatment for Condition Q, and I'm glad you found a better doc.
posted by theora55 at 6:52 PM on April 17, 2008

And I also do understand the tendency to blame the patient, which I sense that ikkyu2 is doing a bit

Where did I assign blame? There are good, efficient ways for docs and patients to interact; there are also plenty of other ways. It's obviously not always clear to everyone involved what the best way is going to be. Trying to shed some light on those issues is far from trying to assign blame. In fact, I think it is dumb to try to assign blame when what the real goal ought to be is improving things for the future. If a tortious injury has been committed, sue. If the process could be improved, improve it. Patients have to shoulder some of that burden; so do docs.

Docs and patients, in fact, have a common task; they have to teach each other about each other.
posted by ikkyu2 at 10:03 AM on April 19, 2008

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