3 Ways to Report a Doctor

After dealing with chronic pain due to spine issues, Dr. L, my pain medicine doctor, wanted me to see Dr. S, a surgeon, to see if I needed surgery.   Dr. L had been the bright light in my life after I took a fall from my horse and broke 4 vertebrae.  He listened, validated my symptoms and concerns, and wanted to know what I felt I needed. 

Dr. S was your typical surgeon with little to no interpersonal skills, rushing in, and jumping into his side of the conversation before I was able to get a word in.  He looked at my imaging for two minutes, told me there was nothing he could do for me.  So far, so good....

He then went into a tirade about how pain meds were evil, that I needed to stop them immediately, and just get on with my life.  Go ride your horse and stop worrying about your pain.  

With tears streaming down my face, I left the office feeling not only hopeless but ashamed that I needed pain meds. 

I wanted to report him and tell everybody how terrible he was.  

But, other than being a jerk, did this doctor mistreat me, or more importantly is this reportable?

Well, it depends...and remember when reporting a doctor you want to state what change or result you would like to see.

1.  Patient Advocate

If you are having an issue with a doctor, many hospitals and organizations have patient advocates on staff.  Their role is to help advocate and communicate with your doctors. 

Be aware that patient advocates are not only employees but are usually part of the Risk Assessment department which is the legal department in many hospitals.  So, although they can sometimes be helpful and a reasonable place to start, remember that they are not looking out for you so much as trying to help the doctors and hospitals avoid issues.

I have found them to be helpful when you are asking for something, like a change in doctor or nurse, that is clearly written in the Patient's RIghts and Responsibilities.  For example, your doctor in the ER doesn't believe in your rare disease but refuses to let you see another doctor - the patient advocate may be able to help get you transferred to an alternative doctor.

And since they are part of the risk management department, you can sometimes leverage their desire to avoid risk when it overlaps with your goals.  For instance, if you are being treated in such a way that increases your chance of dying, especially with diseases like mast cell activation disorder, adrenal insufficiency, or mitochondrial disease, you may be able to communicate that is it in their best interest to work with you to provide appropriate care. 

2.  Department Chair/Head Nurse/Manager/Boss

Doctors and nurses tend to be employees within a larger organization or practice.  Finding the right person and sharing with them your concern or complaint within the organization can be an effective way to make a change. 

If necessary, you can move up the levels of hierarchy within the organization going as far as the medical administrators.  This could look like starting with the head nurse, ER manager or department chair. 

Doctors, like many other professionals, tend to defend and standup for their colleagues so here are a few tips to keep in mind to make your report more likely to be acted upon. 

• Find the right person to share it with
• Calmly and rationally explain the facts 
• Share what change or result you would like to see 

3.  State Medical Board 

If you feel your doctor used unprofessional conduct or an incompetent practice you can report them to the State Medical Board.  Each state has its own set of rules and ways of things being done.  

From Docinfo.com - 

file a complaint against your doctor (for unprofessional conduct or incompetent practice), find your state medical board and follow the steps explained on the state medical board's website. State medical boards allow patients to file complaints either online, by email, phone or standard mail.

The most common complaint received by state medical boards is an allegation that a doctor has deviated from the accepted standard of medical care in a state. Some of the most common standard-of care complaints include:

• Prescribing the wrong medicine
• Inappropriately prescribing controlled substances
• Failure to diagnose a medical problem that is found later
• Willfully or negligently violating the confidentiality between physician and patient except as required by law
• Disruptive behavior and/or interaction with physicians, hospital personnel, patients, family members, or others that interferes with patient care
• Failure to provide appropriate post-operative care
• Failure to respond to a call from a hospital to help a patient in a traumatic situation

It is important to report inappropriate treatment but there are a couple of caveats when it comes to reporting rare disease care to a medical board. 

• Rare diseases do not have a level of standard of care that more common diseases do.  So, although we may view a treatment as a standard of care, from a medical system standpoint, it may not be so clear cut.  
• Rare diseases are challenging and even controversial to diagnose.  Again, they are rare with lots of unknowns and without a well-defined standard of care. So, although you may be rightfully upset that a doctor failed to diagnose your rare disease,  it may not warrant action from a medical board against that doctor. 

Back to my story...

After my appointment, I spoke to Dr. L about my appointment.  He was supportive but not surprised about it.   His take was that we got the information we needed - I didn't need surgery.  And he assured me that we were in it together and if pain meds were needed for me to function so be it. 

I did send a letter to the head of the surgery department.  I got a noncommital letter back thanking me for the feedback. I hope that it lead to a discussion with Dr. S about appropriate behavior with patients. 

Only later did I find out that Dr. S's daughter had died from an opoid overdose just weeks before my appointment.   Context explains a lot...but doesn't excuse the behavior.