Poor physician behavior – is it malpractice?

A close friend of mine who is a physician has severe low back pain. She has multiple anatomical abnormalities in her back and her pain is disabling. Her treatment has consisted of injections of steroids and pain killers, but they have offered only temporary pain relief.

My friend's primary care physician referred her to a respected orthopedic surgeon to see if surgical intervention was warranted. The surgeon performed a rather cursory examination and, of course, ordered a set of imaging studies consisting primarily of x-rays. Since she is a physician, my friend was used to being in a privileged position when she seeks medical care. She ordinarily receives rapid access to test results and immediate callbacks from her doctors with recommendations for treatment.  Needless to say, all patients should expect this type of treatment, but, unfortunately, few actually do.

However, this medical encounter was different. When my friend had still not heard back from the orthopedic surgeon a week after seeing him, she contacted his office and asked to speak with him about the studies. The office told her that he was very busy and usually did not get back to patients for three weeks.

My friend thought this behavior was inexcusable. She was in severe pain and needed to know how to proceed. She even asked her primary care doctor to contact the orthopedic surgeon on her behalf.  He obliged, but the surgeon still didn't return her call.

This behavior is shameful. The orthopedic surgeon, despite his reputation as a skilled technician, is not a good physician. He lacks basic communication skills and displays no empathy for his patients. His lack of responsiveness is so extreme that it should be seen as a form of malpractice.

As a physician, I love the profession of medicine, but I must condemn this surgeon's conduct. Patients' complaints about physician behavior and lack of responsiveness are often legitimate, as they were in this case.

As we move toward new payment systems where the volume of work will not be the driving force for reimbursement, physicians will be rewarded based on how well they actually care for their patients. Communication is an essential part of patient care. Physicians such as this one may be in for a rude surprise when their paychecks start to reflect the real quality of what they do.

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