On Being Malpatient

On Being Malpatient
by Gary M. Votour, MHCA

Medical malpractice is defined as a doctor’s failure to exercise the degree of care and skill that a physician or surgeon of the same medical specialty would use under similar circumstances. A while ago, an advocate and fellow blog author (Hari Khalsa, the owner of Healthcare Whisperer) used the term “malpatient” to describe me in an article entitled When Doctors Sue Patients? Malpatient?”.
At the time I was being sued for defamation by a neurosurgeon. Malpatience, as the author put it, is the opposite of malpractice. It is part of a growing trend where doctors are suing patients for the comments they make online about the quality of the care they or their loved ones receive.
The defamation claim had arisen because I wrote and published a letter online directed at the neurosurgeon, where I stated my opinion that I felt there was a lack of compassion in her care of my wife after her discharge from the hospital where the surgery was performed. I had gone through the appropriate channels at the hospital in an attempt to speak directly to the neurosurgeon, and despite the willingness of the hospital to allow me to speak, I was met by the neurosurgeon’s refusal to meet with me. I felt, and still feel, that I was well within my rights to exercise my right to free speech. At no point did I lay any blame on the surgeon for strokes that had happened to my wife during the surgeries, nor did I even suggest that anyone considering that surgeon as a health care provider should reconsider their choice or seek a different surgeon or hospital. You can read more about the lawsuit and its settlement at the site of the original open letter to that doctor here at “I Forgive Her“.
While I was earning my Masters Degree in Health Care Administration and now as a patient care advocate, I have learned a great deal about our health care system. I believe that one major problem is that when we are sick we give up our autonomy to doctors because we trust them to “do no harm”. We put our faith in a system that is based on our belief that doctors always have our best interests at heart. The reason I believe this is a significant issue is that although the vast majority of doctors do deserve this trust, some may not.
Health-Care-Bill-Capital-US-Flag-jpgYou would think our current system of government oversight of medical professionals and peer review procedures between doctors would be enough to weed out the doctors who do not deserve our trust, but it isn’t. For example, Medicare keeps accurate records of doctors’ errors and the impact they have on patient outcomes, but they do not release that information to the public. State medical review boards rarely take a doctor’s credentials away for making mistakes, and when they do doctors are often able to simply move to another state and start over again. Even unfavorable peer reviews kept within a hospital between doctors often  results in nothing more than horizontal employer changes, with doctors moving from one hospital to the next and leaving their mistakes behind them each time.  Many doctors will also admit that peer review is heavily influenced by the potential of vengeful payback, where a doctor chastised by their peers in the medical community will wait for a chance to unjustly damage the reputation of those doing the chastising.
Since the established system does not create enough accountability, what do we… the patients who pay for doctors mistakes, the ones who suffer from their lack of compassion, the ones who bear the often crippling burden of grief when we lose a loved one or watch them suffer… what do we have left to hold them accountable with? If we can not hold them accountable, how can we trust them?
We have our protected speech, in the form of our online comments. Most importantly of all… we have our forgiveness. As long as we speak truthfully, and with the intent to improve our health care system, we should never fear being sued for being “malpatient”. We do not choose to become patients, or in my case the widowed husband of a patient. We should be allowed to express our truthful opinion in a way that may be helpful to the care providers themselves and their future possible patients, because having said what we need to say we can move on to forgive those who we believe have done wrong to us.
Doctors can learn to either accept the blame they deserve, and ask for that forgiveness from us when they do not meet our expectations, or not. If they choose not to, they can find ways to offset the perceived damage done to their egos by our truthful voices by emphasizing other voices that praise them, or they can simply ignore us. The web is full of opinions… and we all know enough to recognize the voice of someone who is angry about a medical error or grieving the loss of a loved one. Just because that one voice appears in your Google search results does not make it defamatory. It does, however, raise the question of accountability… and a doctor who does not feel accountable likely does not deserve to be trusted.
In our current health care system, medical errors are often met with a “deny and defend” response. To earn our trust, this needs to shift to a response of  “admit and apologize” to be worthy of our trust. To regain losFree-Speecht trust, doctors can seek our forgiveness by promising to learn from their mistakes. If that surgeon had reached out to me, a grieving husband, and sincerely apologized to me for not allowing me to speak to her three years ago, or even tried to explain her reasons for being so un-compassionate following my wife’s surgery, I would have removed the blog then. Better yet, if she had simply allowed me to speak to her from my place of grief, the blog would never have been written. What doctors should not be allowed to do is sue us for speaking up, so long as we speak truthfully. What doctors should not be allowed to do is make us revisit our grief and loss just to defend their egos. We have a right to set our own expectations of our doctors, in order to better trust them to care for us. We have a right to speak when we feel they have not lived up to that trust. We have a right, and a responsibility, to hold them accountable.
If we set realistic expectations of our doctors, we can speak out when they do not meet them. If we feel wronged, we must speak out, with truthful voices, to hold them accountable so we can continue to trust them with our lives. When we do, they should not be able to wrongly threaten or harm us.
Because two wrongs do not make a right.

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