Opinion

Blaming the disruptive doctor ignores the causes of physician frustration

LETTER — Posted Nov. 22, 2004

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Regarding "Staff less tolerant of rude doctors" (Article, Sept. 20): Your article failed to probe the underlying frustrations that provoke "disruptive" physician behavior. Apart from hospitals tolerating such abusive behavior, hospital deficiencies are directly responsible for provoking this type of conduct. Blaming disruptive doctors is only a smokescreen.

Growing public distrust of the integrity of our health care system is partially attributable to a perceived reduction in the quality of hospital care. This has generated numerous patient safety laws steadily emerging from state and federal legislatures. Lack of public confidence may be responsible for the high number of malpractice lawsuits, suggesting that the public feels that their ultimate redress lies within the court system.

Increasingly marginalized, physicians are unable to verbalize their dissatisfaction with their patient's care and often feel that their criticisms are largely ignored by hospitals. Perhaps most galling is that physicians continue to be held to the highest standards while hospital standards have deteriorated. In most cases, it is rare to find a nurse, let alone a knowledgeable nurse, who is capable of discussing a patient's condition. This leads to the most substantial deficiency in hospital care: the availability and quality of proficient nurses.

The main challenge to the profession is the reality that American medicine has been taken over by corporations driven by corporate concern for profits and market share. Administrators find it easier to deal with bricks, mortar and advertising campaigns than develop a true understanding of their fundamental objective: Heal the patient. Rarely do they venture beyond their offices. If one assumes that nurses and technicians are the hospital, then hospitals will have to begin by improving the quantity and quality of their personnel. Hospital priorities seem to have become perverted.

Ideally, physicians should stand as patients' advocates. Yet we physicians are hesitant to assume that role when we find ourselves increasingly repudiated for criticizing hospital care. If patient care is the essence of what we doctors do, what is our responsibility when hospital deficiencies jeopardize our patient's life? If hospitals are truly desirous of correcting physician behavior, they will have to begin by improving care. Our fundamental obligation is to the patient.

Arthur E. Palamara, MD, Hollywood, Fla.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2004/11/22/edlt1122.htm.

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn