Question

REALITY CHECK: The Patient Merry-Go-Round

The following is a letter that a frustrated patient with complex medical issues wrote to her consulting physician.

When I went to your office, it was with great hopes that someone was finally going to piece together all of the bizarre symptoms I have been experiencing over the last several months and get to the cause of my pain.

I was quite frankly shocked by how I was treated as a patient—especially one experiencing a health crisis.

I was examined by a medical student. He wrote my history and current health problems on a small “yellow sticky pad.” You were not in the room when he examined me, and then I saw you for approximately 10 minutes.

You took the card of my New York doctor and said you were going to call him, and then call me regarding what you thought the next steps should be.

I called you on Friday because my local doctor said that you had not called, and I was told you were on vacation until yesterday. I had asked that you call me. You never did. I called you yesterday again, but you did not answer nor did you return my call.

On Monday, I received a letter from a medical student, I assume. Although I empathize with the demands on your time, I have never seen a handwritten letter, which I received, informing me of test results I provided to you prior to my appointment with you. You never mentioned the liver enzyme elevations or my February test from New York. Moreover, no mention was made regarding any plan to help me alleviate immediate problems.

Doctor, I am not a complainer or a person with a low pain tolerance. Since moving here, I’ve had fainting episodes, severe chest pain and pressure, leg and arm pain and stiffness, congestion on the left side when the pain kicks in, and by 3 o’clock I have to go home and lie down because I’m so weak and tired. I cannot continue to exist like this. It is not normal. If you’re too busy and don’t want to take me as a patient, you will not offend me. Frankly, I need attention now to get these things resolved. Testing my cholesterol in a month will not address the problem. I’ve been treated for that for 3 years.

Please call or write to me so I can get another doctor if I have to.

—Nina

The physician never responded.

Question:

1. Describe the legal and ethical issues that appear in the correspondence the patient continues on her merry-go-round, discuss what you would advise her to do?

Answer 1

Legal and ethical issues:

• The doctor didn't respond the to the patient call .
• Doctor said lies to the patient he has called before.
• He didn't provide the care for the patient.
• Doctor avoid unnecessarily towards the patient call.
• Doctor didn't respond.
• Doctor didn't follow the rules and responsibilities of a physician.

Advices:

• Advice her to go for before where she has showned previously.
• She can get consult with other specialists those who are Convenient to her.
• She can go for the collestral test for once again and she must go for specialist.
• She complaint that she is having chest pain so advice her to go to cardiologist.
• Advice her to go for ECG and ECO test.