He wouldn’t treat the ear infection and sent the child away.
Related posts:
- An abortion fails, mother sues doctors for costs to raise her child
- When should you keep your sick child away from school?
- When you’re wrong about child abuse
- Becoming a doctor and being a mother
- A mother sues because she has twins
- Medicaid and child abuse
- Is the bipolar child and ADHD a purely American phenomenon?
KevinMD.com on Facebook
{ 30 comments }
It was a *blatant* violation of the Oath, and shows how completely ludicrous and dangerous fundamentalism can be.
OMG! You must be kidding me! So he took the ultimate power into his own hands, just like ‘god’ and decided who is and who is not worthy!?
That p***** me of!
That’s insance.
I thought we were all created equal?
I don’t condone it, but it is a private business. She could find another doctor or just go to the ER like most people do.
So, he didn’t like the moms attire.
What has that to do with his patient?
Is not ‘hate the sin, love the sinner’ a tenant of the Christian religion?
…just go to the ER like most people do.
Are you saying that ER is a proper place to go for a ear infection? So by refusing to treat her the doctor contributed to overuse of the ER.
I thought it is supposed to be for emergencies…
To the patient, an ear infection is an emergency. I saw half a dozen of them last night.
Those who work in the Emergency Department never call it the “ER”. If I had a choice between seeing an adult with migraine headache (most common ED complaint) and a child with otitis, I would go with wanting to see the child.
I hope that good doctor knows that when he dies and goes to heaven, St Peter’s gonna tattoo the word ‘*ssh*le’ on his forhead before letting him in.
“Those who work in the Emergency Department never call it the “ER”.
I do. But I’m old school.
Calling the ER the ED is like calling a physician a “provider” or a theater a “performing arts center.”
To the patient, an ear infection is an emergency. I saw half a dozen of them last night.
You have a point. Bottom line is the doctor shouldn’t have sent the child to the ER, but should’ve seen him. If it is an emergency, his behavior is even more reprehensible. Instead of helping a child in need, he sends the child to the ER where the child in pain could’ve potentially waited for hours if the ER had been busy with more emergent cases. Very Christian behavior. Unless he believes children are responsible for the sins of parents…
It’s wrong to judge people based upon how they look anyway. But a physician who would refuse care to a child based upon how the mother looked is not really a physician in my book.
ER, ED. The whole hang up with what to call it is silly. I have been an ER doc for 10 years and I work in an ER. Some of my residency class I guess are a bit more important because they work at an academic center ED.
BTW the pediatrician is a nut job.
It offends me as a Christian (and I am sure that it offends Christ) that he did this in the name of Jesus.
It is his right to provide care to whomsoever he pleases on whatever mutually agreeable terms he and his patient can come to. Having a medical license has never and should not obligate a person to accept any one particular patient. Docmalk needs to look at the Hippocratic Oath again–it does not obligate one to accept all applicants as patients.
On certain practical (if not religious grounds) his basis for exclusion of patients based on appearance is not irrational. I recall a study that confirmed the lore that people with tatoos are much more likely to have personality disorders–including antisocial–the latter being the very sort of person that, while 5% of a practice, causes 80 % of the problems.
It is not a matter of social class but of character–which sometimes shows in appearance. If a person chooses a type of clothing or has a tatoo applied they do so in order to communicate something about themselves to others. It should not surprise them that some people will take the message seriously and exercise their perogative to not deal with them.
>>”It was a *blatant* violation of the Oath, and shows how completely ludicrous and dangerous fundamentalism can be.”
What oath? The Hippocratic oath, you mean? I don’t remember anything about having to serve the children of tattooed mothers in that oath. So blatant, uh, . . . no.
Are you implying that the oath requires you attend every person who comes to see you? It doesn’t say that either. It does prohibit abortions, though, and euthanasia and, oddly, urological procedures for the treatment of urolithiasis. And nowhere does it say that you have to treat anyone for anything.
And of course, the oath is a traditional testament, not a law.
So a bunch of people think it is OK to exclude treatment on the basis of a patient’s parent’s skin color (artificial or otherwise). But suppose this opinion wasn’t restricted to a single nutjob, but instead was a belief held and acted on by many doctors. What happens then? Where is this lady supposed to go to get treatment for her child?
Or suppose circumstances precluded consulting a different physician? What then?
The problem with the “it’s a private practice and therefore he can do as he likes” line is that medical care isn’t something that just anyone can, or is allowed to, provide. We license doctors, in the process giving them unique status in regards to dispensing certain types of care. In exchange for exclusivity society demands that reasonable access to medical care.
Now, of course people will say that this is a minority opinion held by one lone wierdo and that care can be had elsewhere. But should we really be depending on the circumstances to legitimize this behavior? As Shakespeare famously remarked, “Men are the sport of circumstances.”
So: It may be his right to do what he did, but if enough doctors exercise this or similar rights we’ll be in very big trouble indeed.
>>”So a bunch of people think it is OK to exclude treatment on the basis of a patient’s parent’s skin color (artificial or otherwise). But suppose this opinion wasn’t restricted to a single nutjob, but instead was a belief held and acted on by many doctors. What happens then? Where is this lady supposed to go to get treatment for her child?”
Where do you read this? The point was made that a private practice is just that, the private business of its owners. Where do you draw the conclusion that others here or elsewhere approve of his action? I don’t read that anywhere. Of course that isn’t saying the same thing as the fact that the doctor has the right to do as he did, which was true. Kind of like the ACLU saying that the Klan has a right to march in Skokie; you have to hold your nose while you say it.
>>”Or suppose circumstances precluded consulting a different physician? What then?”
A private office is not an emergency room. By virtue of choosing to go to an office rather than an emergency room, you are pretty much revealing that you consider the matter to be non-emergent. EMTALA does not require a doctor to see you in his private office. Neither do state laws.
>>”The problem with the “it’s a private practice and therefore he can do as he likes” line is that medical care isn’t something that just anyone can, or is allowed to, provide. We license doctors, in the process giving them unique status in regards to dispensing certain types of care. In exchange for exclusivity society demands that reasonable access to medical care.”
And doctors do not enjoy monopoly concessions. Being licensed means only that you have satisfied the appropriate educational and training requirements, have the appropriate good standing to practice and have paid the fees required to buy the license. The state is “giving” you nothing more, no more than the state gives a building contractor that it licenses any business as a builder. The doctor and the builder have to go out and drum up business for themselves. All the state says is that each are meeting their respective qualifications.
I get the impression that you think because the state restricts licenses to those who meet lawfully established standards that there is some form of reciprocity required of those who qualify. You’d be wrong; it isn’t like a municipal but privately-owned bus company or utility company that is granted exclusivity to a market. “Access” to care does not mean you get to choose who has to deliver it. Right now, all you are entitled to is what is required under EMTALA. The services in question are not in that class.
The standards the states apply to medical licensees are a protection to the public, an assurance of a minimum standard of education, training and knowledge. They are not done for the benefit of those practicing.
>>”Now, of course people will say that this is a minority opinion held by one lone wierdo and that care can be had elsewhere. But should we really be depending on the circumstances to legitimize this behavior? As Shakespeare famously remarked, “Men are the sport of circumstances.”"
The price we pay for freedom; and while the behavior might be offensive, it is lawful. And even though rigid, and unkind, it is also probably ethical.
>>”So: It may be his right to do what he did, but if enough doctors exercise this or similar rights we’ll be in very big trouble indeed.”
Chicken Little. This is an extreme case, and likely to always represent that. If the mother had been abusive or threatening, I could even agree that more doctors would have done the same thing, but the story doesn’t say that.
And even though rigid, and unkind, it is also probably ethical.
How is it ethical? He sent the child in pain away when all he could do was treat a child and tell her to find a different doctor for future. You say that because she went to the office and not the ER, it wasn’t an emergency. But other doctors here mentioned that they consider a child with ear infection an emergency. It may not be life and death, heart attack kind of emergency that requires a hospital admission, but it could still be “see the doctor the same day” type of emergency.
Now, you say she could’ve gone to another doctor – but a) she was sent to this doctor by her HMO, in order to go to another doctor she needs to call her HMO, get another name, schedule an appointment. We don’t know what time of day it was and how many doctors there are in the same area that are members of her HMO. She may not have been able to be seen the same day.
“And even though rigid, and unkind, it is also probably ethical.”
Bullshit.
Legality never has and never will determine what is appropriate ethical behavior. Most people are able to understand that laws have to be interpreted wisely, justly, and humanely. Whenever someone tells me they’re adhering to “the letter of the law,” I know what they really mean is: It’s not right, but I can get away with it.
Not something to be proud of.
It’s kind of easy to say “she could’ve just gone to another doctor”. It is not like you can just drive to any pediatrician’s office and walk in.
She had an appointment with this doctor. She wasted time driving to his office and probablly waiting for the appointment as well. Does her time matter? The child was probably miserable for the duration of the trip, is it ethical to make child be miserable again?
He has right to see whom he want, but why then doesn’t he warn people about it when they schedule appointments? By the time people get to his office, it is too late -it’s not like she can remove her tatoo. Why doesn’t he tell about it to the HMOs?
I stand corrected. However, this pediatrician’s behavior was unethical. It may have been legal, but his behaviors disgrace his supposed Christian values.
Judgement is for Christ ONLY. No one here can judge. St.Matthew 18:4-7.
>>”Bullshit.
Legality never has and never will determine what is appropriate ethical behavior. “
Don’t make yourself seem so stupid.
Nowhere did I equate the legality of this physician’s act with the standards of an ethical act. Those are separate concepts. Nonetheless, his action probably meets the minimum ethical standards of the AMA. That is not necessarily the higher standard to which many people, including many doctors, would judge sufficient for their personal practice, and I do not believe it is intended to be. Those standards do not require philanthropy, something that many contributors to these comments repeatedly fail to grasp. And they do permit the practitioner to exercise considerable latitude in deciding who he may treat. And just because the doctor is a pediatrician and the prospective patient is a child doesn’t change that position. Yes, it may offend. Yes, many find it a very perverse notion of Christian practice. Yes, the patient and her mother were inconvenienced. All that can be true. But as compelling as these ideas might seem to most people, the doctor was still within his rights to do what he did and in doing so still did not breach the standards of ethics of the AMA. The AMA does not prohibit obnoxious beliefs. And you should not expect them to be the last word on “common decency” and other hard to define notions of considerate, compassionate behavior. Other better agencies are suited to make those standards.
And no one said you have to like any of it.
I work in the ER and NOT the ED!
on our EMR system ED only has one meaning and it is usually cured with a little blue pill……
That is not necessarily the higher standard to which many people, including many doctors, would judge sufficient for their personal practice, and I do not believe it is intended to be
I don’t see expecting someone to keep an appointment is a higher standard. No matter what business you deal with, you expect a person you made an apointment with to keep it. If a business has special requirements, you should be notified at the time you make an appointment, but not after you wasted time and driven there. This is considered proper and ethical behavior regardless the business you are dealing with.
In this particular case, it was more than inconvenience for the mother. The child was in pain. Also, many doctors here mentioned that a child with otitis could very well be viewed as an emergency. Saying that the fact that woman brought the child to the doctor instead of ER proves that this was not an emergency is ridiculous – we, as lay people, don’t always know what is or isn’t an emergency. Neither did the doctor until he examined the child. Given that one doesn’t just “go to another doctor” and is automatically seen the same day (we don’t even know what time of the day it was) and given that the wait times in the ER could be very long (and that the woman may not know if she should go to the ER or if her problem can wait till the next day), it is quite possible that a child could’ve suffered real lasting harm.
Having an “appointment” is not a guaranteed right to service. If you show up drunk, or behaving badly, or dressed inappropriately, you can be refused service, re-scheduled, or be told to get care elsewhere.
The doc thinks tattooed parents are not the kinds of people he wants around his private practice. That is his right and his choice. Showing up displaying a tattoo can get you refused service, just like wearing inappropriate clothing or being drunk.
If the doctor doesn’t want to see patients with tattoos, fine.
But he has the obligation to tell patients up front, when they are making appointments, that he does not see that kind of patient. No hiding his preferences. Full and complete disclosure of his practice’s policies. And a notice posted in his waiting room about his preferences. As well as a policy notice on any website that he maintains for his practice, or any hospital website that lists him in their physician directory.
I wonder what he does when an established patient or their parent, previously sans tattoo, goes out and gets one. Does the doctor fire that patient? Would the state board of medical examiners view that as a valid reason to fire a patient?
Many are assuming their was an appointment. They may have come in as “walk-ins”. The story doesn’t say. It also doesn’t paint a picture of anything else that happened there that day. Maybe the physician or his staff made the judgement that she was likely to be the kind of patient who is entitled and demanding and is more trouble than the next 20.
If that was the case, they may have judged correctly. How are we hearing about this? Is our learning of this a result of the would be patient trying to embarass a person with whom she never actually did business. Most people without a conflict oreintation would just shake the dust of his office off his feet, go somewhere else, and complain to their friends.
Medical ethics are clear: except in an emergency, a physician is free to choose whom he shall serve.
This post is taking on a life of its own. You might have to call the doctor himself about some of your questions. I suppose he prefers patients and families who would not get tattooed in the first place. And if you hid your tattoo under clothing, than how would he know until it was too late? All speculation.
The larger point is not about tattoos but about his deciding who he is willing to see and not see. In a private practice setting, it is pretty much his choice. He doesn’t have to give any notice except to say he won’t be seeing the patient. He actually doesn’t even have to give a reason why. And the board of medicine has no say in the matter either, except to field a complaint if there is one; they can’t make him see patients he doesn’t want to see in his private practice (and what is the “state board of medical examiners” anyway? I never heard of them.) So no, just because you think he ought to tell potentially excludable patients up front does not mean he actually has to do that at all.
This issue has been addressed in the courts already, namely by the U.S. Court of Appeals, 5th Circuit, which has affirmed a doctor’s right to refuse to see a patient in a private setting.
Unknowledgable people believe they can’t be refused service for peculiar reasons or even for no given reason at all, but that simply isn’t the case and never has been. These stories are odd and probably rare, but they are not a deviation from allowed practices.
it is strange that people base there opinions on “stories” rather than facts. Would it change your responses if you knew that in fact this mother WAS told about the “cover your tattoos when in waiting room” policy before she made the apt as a potential new patient; was given the option to go to another office when she questioned the policy; when she agreed to do so, was offered a same day apt. but mother wanted a next day apt! Came to the office with uncovered tattoos and when reminded to cover up the father uttered profanities and became threatning to the office staff; staff decided Not to process as new patient then both stared flailing arms at staff. Meanwhile the child was giggling, bouncing on the sofa and showing no signs of being in “pain” at that time! As “professionals/doctors” I thought would know better than to trust what they read in the general media. Moral of this incidence: please get the facts before passing judgement. THis doctor probably sees many patients whose parents are tattooed but covered out of consideration to other families. I hope to see people being upset about parents that use their children as social pawns. Why didn’t the mother bring the chil the same day? why didn’t she seek another provider if she didnt want to cover up her tattoes for one hour/ why did she and dad use profanities when reminded to cver-up and become physically threatning?
Maybe the doc thought the mother was sue happy or that Obama was saying to him “don’t do it, this isn’t covered under my new plan!”
Comments on this entry are closed.