It's understandable that a practice would drop a litigious patient

Regarding "Lawsuit leads clinic to drop patient, family" (Column, Dec. 10, 2007): I am concerned that it is not acceptable that physicians/groups protect themselves. For example, a patient can check for previous lawsuits against a physician and make a choice based on that information.

When physicians launched a Web site that listed the names of people who filed lawsuits against their doctors (this was public information) the site was shut down under pressure. So while patients can have malpractice information available on doctors, doctors are not supposed to have similar information available to them.

There are consequences for doctors who are legally high risk. What about consequences for patients who are legally high risk?

As a resident, I received a notice of intent for a high-risk surgical patient who had died (after being refused by several other surgical centers). The parties settled before any lawsuit occurred. I still have to include details about this nonlawsuit for work-related papers. I and everyone in this case did excellent medicine, yet we all have to carry this scarlet letter with us for years to come. I do not ever want to see that family again, and I can understand physicians who do not wish to continue to care for patients who have sued them (mine never went to suit). If the patient decides to see a doctor's co-worker, the sued physician still may be involved in that care, so one can see why a group may discharge them.

It is within the patient's best interest to seek health care elsewhere than the doctor they are suing. The stress can affect the best doctor and may influence the care: overtreatment or undertreatment, shotgun tests and more, all in fear of avoiding another legal complication. Remember how you feel when a patient says those words: "Well, if you are not right, I can always sue you." Can you forget the threat the next time you see that patient, even if said in jest?

I do not have an answer for this dilemma. Should a doctor accept the higher risk of accepting a multilawsuit patient? Should that patient be turned away because of his or her past legal choices? Should a family member be denied access to a group based on events that may have had nothing to do with them? What if the patients cannot find care? Are we obligated to help, to provide care at our own rising risk? No answer in this controversy is fair or equal to all parties. I do not have an answer or solution, but I do understand that group's action and the reason for it.

Natascha Lautenschlaeger, MD, Salt Lake City

Note: This item originally appeared at http://www.ama-assn.org/amednews/2008/02/11/edlt0211.htm.