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How do I report a doctor for bad care?

  • I just had a HORRIBLE HORRIBLE experience with a doctor. This is the reason most people do NOT go to doctors. It kinda makes me not want to go to a doctor.Let me give you the whole story so you can assess the situation, get really mad, and provide me with constructive advice. If you don't feel like reading it all, scroll to the bottom and tell me what I should do if I am unsatisfied with the quality of care from a doctor. So within the last 6 months, I noticed a LOT of symptoms, including a DRAMATIC weight gain over 60 days ( I'm 30 years old, and started off weighing 140-145 lbs..it has NEVER gone over 150 lbs, but suddenly I gained about 30-35 lbs for a total of 175+). Without going into too many details about the symptoms, so that everyone on the 'net knows what I have. I looked into it (webmd, mayo clinic, wikipedia), and said "wow...these are the same symptoms another member of my family had before being diagnosed with condition X". Maybe I have it too. I looked into patterns of inheritance...yes, it is possible. So I found an Internal Medicine doctor through my insurance (BCBS-PPO), called them up, and scheduled an appointment. At the office, the medical assistants/nurses checked my weight and blood pressure, and told me to wait in the room. I'll be honest, I didn't know what the hell to do in the room. The last time I went for a physical was 10 years ago. As I waited there for 15-20 minutes, I wondered if I should take my clothes off, or not...or what? Maybe the nurse/assistant forgot to tell me where those robes that don't cover your butt are stored, etc. In the end, I decided to keep my clothes on because the other option would have been a LOT more embarrassing if I was mistaken. When it doubt, don't let it hang out. So the doctor came in, didn't introduce herself, and went to work. She listened to my heart and lungs, made me follow her finger with my eyes, and did some simple reflex tests. I started to talk to her at this point, told her about my DRAMATIC weight gain (w/o any change of diet/lifestyle), and she just IGNORED all my symptoms. She asked about my exercise habits, and I told her they haven't changed in 10 years. "Maybe you need to exercise more". The visit with the doctor took less than 5 minutes. "Maybe, but theres no way that would explain 30+ lbs in 60 days", I said. "You're probably not exercising correctly". She said. "Possibly, but that still cannot account for the weight gain in such a short period. It could also be condition X that another member of my family has". "No, men don't get that", she said. "Actually, its rare, but men DO get it", I came back with. "Yes, I know, I'm the doctor". Ummm ok...what the heck do I say to her? "So can you give me some blood tests, because I still think something is off". "Ok, but you really need to exercise differently", she said. "You're getting older". So I left the office, feeling like I'm dumb, fat, and old (I'm 30...I don't look old. I get ID'd all over the place). I went over to the lab and gave them my blood. I joined a gym, and started working out hardcore. 2 hours each day, with 30-45 min of cardio EVERYDAY. During those cardio sessions my HR averages 145, and it maxes out at 171. I really am working out. After 2 weeks...no change in weight. Highly unusual. Whenever I want to lose 5-10 lbs, I go to the gym, hit a treadmill regularly for 2-3 weeks, and I shed weight like crazy. This time, its not working. I also kept tabs on what I ate. I eat about 1800 calories a day, spaced out in about 5 meals. Thats how I've been eating. I also have a fairly healthy diet (vegetarian except for fish and eggs, no fast food). The next week, I called the doctor's office and asked them about the blood tests. They told me that they can't release it over the phone, but if a doc didn't call me, its "probably fine". Umm, ok. So I came in that same day to get a copy of my blood test, and doctor's report. The report had NOTHING about what I talked about except that I was overweight (Alright, I'm a fatty...sigh). Everything on the blood test looks good (within range)...except for ONE test. I looked that up, and BAM...there it is. It confirmed my suspicion of condition X. Still no call from the doctor, though. I went in for a second opinion to another doctor. As soon as he came in, I said "I'm here for a second opinion. I believe I have condition X, " "What makes you say that", said the new doctor. "Well I have symptoms, symptoms, symptoms, and 30+ lbs weight gain over 60 days". "Wow...thats over 20% of your weight in less than 2 months...bodybuilders would want to do that, except it looks like it wasn't muscle (thanks again, I'm such a fatty). Well the first thing we would need to do is some blood tests" said the doc. "I have some from 3 weeks ago right here". Within 30 seconds of looking through it, he goes 'WHOA, this is 4 times higher than average...you actually DO have condition x. Why did you not tell your doctor about these symptoms?" "I did...she neglected to give them any weight, and even didn't write them down on the report. She just told me I needed to exercise' "What did you say when she called you with the test results?", asked the doctor. "Umm, she never called me...I had to go get them myself." "Wow", said the doctor. He took another blood sample, and prescribed me some meds...and told me I will need to come in monthly to see if I'm getting the right dosage, and vary if I'm not. He also said I will probably be on these meds for the rest of my life. Great. The good news is, that this should correct the symptoms I have been having, and I should see my weight back to normal by summertime. In any case, had I NOT taken the initiative to get the blood test results from the first doc, and taken them to another doc for the second opinion, I wouldn't have found this out until something REALLY bad happened and a competent doctor would have done the test AND FOLLOWED up, or for another 10 years when decide to go to another doctor. So now, I'm going to write professional, yet critical letter to the doctor, CCing her medical group, and the insurance company. Is this what I'm supposed to do? Is anything going to happen? WHAT CAN I DO? I'm not suing for money, I just want to do something so this doesn't happen again with this doctor. It was this doctor's bedside manner, and attitude that made me think "Wow...I totally remember why I don't to the doctor every year". I also totally understand why some people say "I don't go to the doctor...I hate doctors". What I used to think was an ignorant attitude towards medicine, now seems legitimate if all the doctors were like my first doc. If I was treated that way, I'm sure others are treated that way; thats just neglect. I checked the insurance to see the doc's bill. The insurance paid $155(for the doc, not the blood tests), I also paid $20 copay for a total of $175. $175 for a 3 minute visit, and a diagnosis of "FATTY!" What can I do, who can I report this to? Is writing a letter to the doctor too small, is writing a letter to the AMA too big? Would sending it to the insurance company do anything? Where in Blue Cross/Blue Shield do I send it to? HELP!

  • Answer:

    A friend of mine who has dealt with a decade of cancer treatments suggested to me that the best way of addressing your concerns is to contact the insurance companies. The idea here is that the insurance companies are paying the doctors for their services to you. The insurance companies are, to an extent, employed by you to ensure that these services are done and done properly. If the doctor has failed to provide appropriate service then the insurance company may feel that they've been defrauded and investigate. Plus there's the potential that the first doctor's inattention may have cost the insurance company additional funds that could have been saved had your condition been detected earlier. This is a hassle and a worry to you, but to the insurance companies this is money. They tend to take money pretty seriously. Alternately, you might consider contacting any appropriate HR offices that could find the doctor's behavior a concern, for many of the same reasons as contacting your insurance companies.

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I've been both of these docs, I think, although you never really know for sure what your patients are thinking about you. It's certainly true that you did a lot of things right on your second visit. One crazy study I saw in med school purported to show that the average primary care doc started disregarding spontaneous, unsolicited comments by the patient 14 seconds into the exam. Stating the purpose of your visit in those 14 seconds really helps your doc zero in on what the purpose of the visit is. I know that I have patients who don't understand that I know how my visit is going to go in the first 3 minutes. I then spend 50 or 60 more minutes taking history, doing physical exam, reviewing records and scans, making decisions about further tests and treatments, and communicating the plan to the patient. One of the things that annoys me the most is when patients are still bringing up undiscussed symptoms, other conditions they would like treated, or other new information when I have completed my focused assessment and would like them to take the scrip I have for them and get out of my office so the next patient can come in. It goes like this: "(after 60 minutes of interview and exam) I think you have had an epileptic seizure. I would like you to have an EEG. Please start taking this medicine." and the patient says back to me, "Oh, I wanted to say, I had headaches since 1969, and they are still bothering me." The time to say that was 58 minutes ago, not now. It's also worth noting that it's always, always easier to be the second doc. The first doc is worrying about and ruling out things that have never crossed the patient's mind. The second doc gets to read a record of this process and instantly allay his concerns and worries. Sometimes the first doc has done so much that the second doc can actually get around to the business of addressing the real problem. I always tell my patients who badmouth the first doc, "Look, Dr. **** did all the heavy lifting for me already, she made my job much easier," but they rarely seem to understand that. It's hard to know what went on with your case, much harder because you were vague about what your condition really is. If you are interested in improving things for everyone, I would recommend a polite letter to the first doc stating your concerns and suggesting ways that they could be improved. If you are interested in punishing the first doc, bad word-of-mouth on websites and a letter to the state medical board are about as much as you can do. If it's a pattern of behavior eventually someone will get around to discipline - maybe. I can't imagine a letter to the insurance company getting more than a laugh as it's tossed into the circular file. Insurance companies only care about money.

ikkyu2

This is the reason most people do NOT go to doctors. On the contrary, most people do go to doctors.

JimN2TAW

Writing the insurance company won't accomplish shit unless the doc is employed by them. More likely is that the doc is contracted through the clinic with your insurance. But try anyways if you like. If it were me I'd write a letter to the doctor directly. I'd tell them how miserably they failed to perform up to even a minimal standard, then move on. And your letter will have infinitely more effect if you first find yourself a decent editor. I can't imagine anyone spending time reading it if it were half as long and rambling as what you posted above. Good luck.

docpops

You need to make a formal complaint with the applicable health regulatory body for your state or province. There will be a formal complaints process or other way to let the people who license that doctor know that you have had a problem. This is sadly common - there are whole forums devoted to people's concerns about doctors who blame weight/inactivity on every health problem first, telling patients "come back and see me when you've lost x pounds" leaving the patient to struggle at weight loss and ignore their potential ailments. Luckily for you, you were persistent, got a second opinion (and with health insurance, thank goodness) and you were properly diagnosed. Try to pay that forward by filing a formal complaint. Any other actions could be potentially slanderous and aren't going to bring any formal reprimand to the doctor.

SassHat

What good does it do the write the insurance company? You might as well dump the letter into a black hole. I would write to the doctor. If you are really pissed I would write and contest the bill on the grounds of malpractice. I had to do this once in the face of actual malpractice (of a magnitude much greater than you experienced) and the bills stopped. I am not suit happy so I just let it go. If you are really, really pissed, then report her to the medical licensing board in your state and to the hospital at which she admits. On these facts alone I wouldn't go there.

caddis

Thanks for the love, everybody. Just to clarify one quick point: I don't consider being overweight a "MORAL FAILING", but I do consider gaining over 20% of one's body weight in 60 days to be drastic and indicative of an underlying problem. Unless you're a newborn, those little fatties always have moral issues beneath their extreme weight gain. I will be following this post up (somewhere on mefi), so any of you that may be watching it can find out what happens. Thanks guys, I REALLY REALLY appreciate all the posts.

hal_c_on

I totally empathize. I just made the decision today to find a new doctor after my current one disappointed me for the nth-and-final time. I second everyone who said to write a letter to your state licensing board (even if they don't take action, they keep complaints on file and yours might make a difference in the future) AND to write to the doctor personally. Make your personal letter sound very self-assured and matter-of-fact (e.g. not "emotional). Your doctor needs to be confronted, even if it's just in writing. Plus, you'll feel better after getting your feelings out on paper. Best wishes to you!

amyms

caddis, it is not clear what happened, so I do not know what should be reported and what shouldn't in this case. A letter to the medical board expressing dissatisfaction does not necessarily reflect poorly on that doctor. There are all kinds of nutjobs out there and some of them write angry letters to the medical board even when they're taken care of properly. A physician who has the patience to take care of angry, abusive patients in an appropriate and compassionate way is meritorious. Contrariwise, valid complaints also come to the medical board. I pay the medical board thousands of dollars in various fees; I expect them to use this money to hire someone with judgment to read these letters and evaluate them and take appropriate action. In fact they more or less do this, although every doctor knows that it is much harder than it ought to be to take action against a doc who's not up to the standard of care.

ikkyu2

I recently switched doctors for a similar reason. Your story also makes me think of my mom, who had post menopausal vaginal bleeding for almost 5 months before her gynecologist finally scheduled a hysterectomy which turned up cancer. I think she had seen the gynecologist once a month during that time. Although it doesn't strain credulity that the doctor's behavior while in the appointment was reasonable as she was trying to assess the likelihood of you having this disease, the fact that the doctor never followed up on the test results is simply unacceptable. Definitely write a letter, although it's unlikely that anything will come of it.

miss tea

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