Respect

I have a family member with serious, complex and for the FM-phobic doctors, completely verifiable chronic illness. that member travels, albeit slowly, across the country for about half the year. That person has sampled probably fifty or more ERs. some have been fantastic (shout out to the Naples Community Hospital), but frankly this member would rather have sepsis at home than deal with an ER because of tnhe horrible treatment received, primarily in the area of pain management, which is very poorly understood by ER staff. i have personally been turned away twice by an ER doc when demonstrably septic (thanks to the competent PA on the third trip) who (which was later obvious in his notes) just decided I was an hysterical female wasting his time — yes he was in the middle of that speech when the PA interrupted with my WBC, through the floor potassium, etc. etc. Don’t tell me it was an isolated incident — family experience demonstrates that you can expect third world, third rate medicine in the ER. So the protestations that the ER had to be right in his or her snap judgement — not so trustworthy. I am and my family are white, decidedly upper-middle class, and well insured. I can only imagine how the less advantaged are treated.

I fail to see how a doctor can be permitted to practice when using a blog to denigrate his or her patients for profit and notoriety. I know of no blogs by any other profession (other than nursing) that has a blogosphere devoted to trashing its clientele. More shocking is that there is a long ethical history and more recent statutory requirements for medical professionals to keep confidences confidential. How is it “respect” of patients to treat them as the latest contestants on survivor with the doctor on the film crew — and even survivor has the participants agree to be the subject of such voyeurism — I hardly imagine that this blogger obtained the consent of the patients before advertising their ER experiences as entertainment.

That’s what I think of respect.

Blogs like ERPs, which disclose patient information and trash-talk patients, based on race, payment status, medical condition, etc. will end up threatening the ability of other medical professionals to maintain blogs, even appropriate ones. How, well suppose this:

Round 1: ERP gets sued, or ERP’s hospital gets sued. Plaintiff’s attorney finds out about ERP’s blog and can tie it to the hospital. My guess is that ERP has trash talked enough groups that plaintiffs attorney will find something unflattering to use at trial. Insurance company decides that the suit is not defensible and settles.

Round Two: Insurance companies figure out that docs with blogs are in general going to have a higher risk rate, and they don’t want to be having to read individual blogs to make rating decisions, so all docs with blogs get a malpractice insurance premium “enhancement” of 25% of 50% or whatever.

Round three: hospital administrators get nervous that what happens on hospital premises that is supposed to be confidential won’t “stay in vegas” and so they require as part of their contract that docs (and nurses) disclose any blog that they might have and that untoward blogs can result in the loss of privileges. Can we guess how conservative those administrators are going to be?

In other words, because there is real life liability associated with riffs like ERPs, and administrivia is not likely to be wanting to make fine distinctions, a couple lawsuits gone bad will have the potential to silence a large chunk of the blogging by the medical community, if real world standards on the content of those blogs (not facebook standards) are not honored.

It is highly likely that ERPs blog violates the law of whatever state ERP is in regarding patient privacy. I do not think that it is in the interest of the on-line medical community to encourage or condone these kinds of violations