How to apologize after medical error, and when not to:
An FP in Washington State learned this the hard way when he failed to notice, until a follow-up visit, that a patient’s PSA was elevated. “I referred him to a urologist, who successfully treated him for prostate cancer,” says the FP, who requested anonymity. “The delay in diagnosis had no negative effect, but I told the patient because I felt he had a right to know. He responded by suing me. In retrospect, I still feel that I did the right thing. It would have been nice if the patient had done the right thing, too, but he didn’t.”
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Nooo, once again it was not. Your inability to read for any type of meaningful comprehension means you failed to appreciate the context in which the statement “the insurance can’t get sued” was made. For the third time, yes we are aware that insurance can be sued to recover the cost of a denied test. Yes we are aware that insurance companies are sued every day Conceded. Debate over. But that is not what anyone was really talking about. (In case you need it spelled out: HMOs CANNOT be sued for any malpractice claim or damages sustained as a result of their coverage decisions.) Clearly the statement was in response to the idea of damage (again, physical or emotional) incurred by the patient when an HMO refuses to auhtorize testing and treatment. If a doctor were perceied to be responsible for this kind of “damage”, they’d be sued for malpractice. But because insurance is “just a payer” (albeit a payer who gets to also make medical decisions) they CANNOT be sued. Read Anon 9:10- “people are going to get frustrated and they’re going to strike back.” The question is- can they “strike back” at the appropriate source (their insurance)? No, and this is exactly what that supreme court decision pertained to. And so the worry becomes that patients take their frustrations out on the doctor and their staff… I have had many patients bitch at me and my employees when their insurance denies a prescription or test. They definitely misplace their anger, but I am an accessible and immediate target, their HMO is not.
Do you get it YET? Or shall I explain a third time…
And BTW, you’ve yet to defend your ridiculous and sarcastic claim that any physician in here was “trying to practice law.” Arrogant indeed.
“Correct anon, the Supreme Court ruled that patients do not have the right to sue health insurers or HMOs in state courts.”
This was the statement. It is incorrect in that it is too broad. The ruling only applied to ERISA plans.
“The question is- can they “strike back” at the appropriate source (their insurance)?”
If by “strike back” you mean be rude to you, then yes they can. If by “strike back” you mean have a malpractice claim against, you, then the answer is no.
Perhaps it was a question of specificity that led us astray. But as you know from reading reports of medicine in the media, lack of specificity can cause some huge misunderstandings.
I sincerely don’t mean to offend anyone here, but for those of you who are medical professionals: Are there systems in place at your hospital/clinic that give patients an opportunity to work out questions and conflicts without resorting to other measures (which may well be extreme and inappropriate, as you have said)?
My own experience at a large local clinic was that concerns are directed to a Patient Relations office which reports to clinic Risk Management attorneys. They would simply not discuss the question I asked (involving my inability to get test results from a surgeon, who felt that telling me “it’s just benign” was sufficient…since the problem recurred, I felt a little more detail was appropriate and did not think I should have to pay $20 for a copy of my records just to get test results).
I had and have no intention of suing anybody. I’d have happily signed away any right to do so just to get a straight answer.
Anyway, it seemed to me that the clinic was a bit eager to slam the door in my face. If that’s not an exception to the rule, I’d hesistantly propose that maybe such attitudes contribute somewhat to the problems here.
Patients rarely seem to understand their rights concerning medical records very well. Records are the property of the physician, not the patient. Test results are the property of the physician who requests (orders) the test, not the patient whom the test is performed on. Now the law does allow patients the right to receive copies of their records, but both HIPAA and state laws provide for doctors to charge and collect a records copying and/or handling fee. A fee can’t be charged for records to be sent to a specialist that they’ve been referred to, but any other purpose (changing to a new doctor or moving, personal uses, etc.) can be charged for. The maximum amount chargeable varies from state to state, but in my state, you may charge $15.00 up front plus $0.35 per page for copying, plus any postage expenses.
Now, with all that said, I DO feel that your doctor obviously owes your more of an explanation than “its benign”. I don’t know what to tell if you he won’t though, other than to purchase a copy of the record yourself. BTW, did you contact them by phone asking that the doctor talk to you with more explanation or did you schedule an appointment to go over the results in person? Doctors often may resent being asked to give additional explanations by phone (for free) when they could be paid for the time at an office visit. Not saying its right or wrong, but that’s how it is. Good luck.
Thanks. No one explained that records are the physician’s property so I assumed (it being my tissue and my having paid both the surgeon and pathologist to get the testing done) that maybe I was entitled to more specific results. If not, OK, I’ll pay for the records. I did leave a message for the surgeon that I’d pay a consult fee to go over the results in more detail, but if he got it, he never responded. Anyway, thanks again for the perspective.
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