Bad Doctors

A doctor in our area was recently indicted for allegedly running a “pill mill”. According to local news reports, patients were recruited to come in and ask for narcotics and the doctor received massive cash payments to write the prescriptions. After the guy was nabbed, his patients (the real ones and the others) spread out in the community looking for new doctors to take care of them (or to write them more narcotic prescriptions).

Another doctor in our area specializes in so-called “holistic” medicine. He runs expensive tests that aren’t covered by insurance. Many of these tests are either of questionable significance and utility, or are run in labs widely known for their “variable” quality. He puts his patients on unconventional mixes of medications and supplements, many of which he apparently sells. He and many doctors like him send their patients to “real” doctors to take care of the rest of the patient’s healthcare.

In the first case, the cops caught up with the guy. The fallout for patients will last for a while as the scramble to find new primary care physicians (there’s a shortage, you know), or have to suddenly deal with a narcotic problem after their source dries up.

In the second case, the doctor will continue to collect cash from patient to whom is is very kind, and who get the answers they want from a kind man.

The second doctor isn’t doing anything illegal. He’s practicing bad medicine, outside of the standard of care, but as far as I can tell, he’s not breaking any laws. And his patients love him. He listens, spends time, and tells them what they want to hear. I looked into ways to get this guy investigated, to have some sort of third party look over his practices, but I couldn’t find one. Complaints against healthcare professionals have to be lodged by patients or their agent. As far as I can tell, in this state there is no way for anyone other than a patient to complain about bad doctors.

This makes some sense. If someone opens a practice across the street from me and my patients start fleeing there, who says I wouldn’t call in a complaint just to hurt my competition? (I wouldn’t obviously, and there’s no incentive even if I were a bad guy. There are plenty of patients for all of us.)

But while doctors clearly breaking the law can get caught and prosecuted, doctors practicing obviously bad medicine are pretty safe. Their patients often love them and wouldn’t think of lodging a complaint. Even if every other doctor in the community knows another doctor is bad news, there’s nothing they can really do.

I may not be completely right. Maybe there’s a way to complain to the medical board in this state. Maybe not. I couldn’t find one, and I’ve never heard of it happening.

Doctors get disciplined if patients complain, maybe get busted for breaking the law, maybe get sued if a patient is unsatisfied, but they don’t get investigated for being quacks.

I don’t have a solution to propose that wouldn’t create layers of bureaucracy and put good doctors at risk of false allegations. But there must be some way to deal with quacks. Their work harms patients and makes my job difficult as I try to tease apart what they’ve done to my patients.

5 Comments

  1. Tired out

     /  January 23, 2013

    Is Doc #2 treating Lyme disease? Probably.

  2. Did you try calling the medical board? I’m in California and had a patient consult me who had seen a dentist in the southern part of the state (I’m in Northern California). We called his office to see what he had done for her and instead of treatment notes, he sent us a copy of her ledger. He did over $35,000 worth of extremely poor dentistry and quack treatments in around 10 days time. I was so enraged that I called our dental board. I told them that as a specialist, I saw a lot of treatment from a lot of different dentists and that this wasn’t simply a case of a bad day at the office – it was, in my opinion, systematic patient abuse. They told me that the board was aware of this guy, but they didn’t seem to be doing much about it. They wanted me to encourage the patient to sue for malpractice, but she couldn’t find an attorney to take the case on contingency. Meanwhile, the word in the dental community was that the dentist in question was netting over $1,000,000 a year (which is pretty hard to do if you’re practicing ethical dentistry and have a 70% overhead rate). And that was over 10 years ago.

  3. Anonymous Patient

     /  January 24, 2013

    “Doctors get disciplined if patients complain,”

    No they don’t, not always, not even for just complaints. The quacks to which you likely refer have political connections. They have support from elected officials in the states where they practice. They have journalists willing to publish false and misleading information in order to rally support and protection. They willingly violate nearly every facet of journalistic integrity and ethics, without a bit of remorse. Their actions are reprehensible, yet they are embraced as being bold and strong and fighting for their cause.

    It is indeed a distorted and sick side of human nature when patients, elected officials, and journalists willingly cross the boundaries of all reason and blindly embrace the exploitation of others.

  4. whitecoat rant

     /  January 25, 2013

    the medical board is a toothless watch dog. As physicians we are told we need to meet high standards and if we don’t we’ll get sued. The reality is that the med board is pretty ineffective. I had a very bad experience as a patient recently involving a back condition that had severely worsened and i could not weight bear any more. i called my treating orthopedic surgeon who at that time said he was going to italy for 6 weeks and that we’d deal with this when he got back. He would not tell me who if anyone was covering and blew me off. It turned out I was right. I had a space occupying lesion he did not diagnose that needed emergent surgery. I decided to eventually report this to the state board of california for abandonment In the state of california –nothing was done. This was not considered patient abandonment. Even though we know what is appropriate standard of care, the board and their consultants have a very different approach to standards and care that is very different than the high standards taught in medical school. I don’t think they do much but shuffle papers around.

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