An essay in a prominent medical journal spotlighted an often-hidden problem in the medical profession: doctors belittling, sexualizing and dehumanizing patients.
The piece in the Annals of Internal Medicine describes several disturbing incidents that the author witnessed as an intern and resident.
In response, other physicians have been sharing stories of disturbing doctor behavior they’ve observed.
One of the most disturbing comes from a physician describing what she witnessed as a medical student in the ER, watching an intern perform a pelvic exam on a young girl with abdominal pain.
(Warning: this description is graphic).
“The resident was creepy at every stage of the exam. He was clearly relishing the process, slowly instructing the poor girl to position herself correctly on the table. He held her knees apart as she whimpered and cried. He pretended to have difficulty positioning the speculum, inserting and reinserting it an unconscionable number of times. All-in-all it probably took ten minutes for him to get a cervical sample (this usually takes under 60 seconds). He performed the bi-manual portion of the exam in a bizarre, sexualized manner.”
This doctor witnessed what is essentially a child rape.
A doctor’s actions can have a long-term affect on patient health.
Imagine what the long-term consequences are for that young patient.
She had a terrifying, painful, and abusive experience this at the hands of a doctor—the most trusted of medical professionals.
How can a patients with an experience this traumatic ever again trust a doctor?
A person with this experience is understandably likely to be fearful of future medical care.
No doctor can help a patient who doesn’t seek treatment.
A doctor’s conduct is important to good healthcare.
“Doctors must be respectful even if a patient is sedated…”
Nancy Berlinger, The Hastings Center
Hospital patients are ill, often scared, and unusually vulnerable.
They have to put their trust in the doctor and medical team. That’s hard to do, considering how much can go wrong.
- Medical errors are the 6th leading cause of death in the U.S.;
- 1 in 3 hospital patients experience an adverse event, such as being given a wrong medication;
- “Wrong site” surgeries occur about 40 times a week; and, to top it off,
- Hospital costs average about $3,949 per day.
With everything else that can possibly go wrong for a patient, more complaints are filed against physicians for a lack of professionalism than are filed for medical malpractice, according to medical licensing boards reports.
Healing the culture of the medical profession
The general callousness—congenially called “gallows humor” —of some physicians is not a new phenomenon. It’s just been hidden in the medical community.
The problem seems to be rooted in the culture of medicine. The doctor is at the top of the medical hierarchy: in most hospitals, there is little or no tolerance for questions or criticism by nurses, medical students, or staff … let alone by patients.
No system works without accountability. In this culture, only other physicians are in a position to question an individual doctor’s bad behavior.
Hospital administrations are complicit in the culture of silence in the medical community, often prioritizing doctors over patients.
The only fix for doctors behaving badly may be a combination of peer pressure and public accountability.
Holding Doctors Accountable in Court
A patient undergoing a colonoscopy recorded the procedure. He heard the anesthesiologist mocking him, making comments about his body, cracks about syphilis and tuberculosis, and stating to him:
“… I wanted to punch you in the face and man you up a little bit.”
A jury in Virginia awarded him $100,000 for defamation, $200,000 for medical malpractice—and $200,000 in punitive damages.
Many people found this doctor’s conduct shocking, but more people were surprised at the amount of the jury verdict. They shouldn’t be surprised.
Those punitive—“punishment”—damages indicate that the jurors empathized with the plaintiff, and wanted to send a message to the medical profession.
An anesthesiologist in Oregon sexually assaulted at least a dozen female patients. My law firm represented several of the sexual abuse victims.
The other doctors and nurses at the hospital were aware of his sexual abuse, or at least suspected him of incredibly inappropriate behavior. The hospital administration had received bad reports about him for years.
Patient complaints were ignored. Hospital investigations were tainted.
And no one did anything to stop this anesthesiologist from harming patients.
Those patients turned to the civil justice system. Jurors awarded millions of dollars to the victims.
The message to the hospital administration: you are responsible for patient safety, and you completely failed to protect patients.
The patient cases described here vary in severity, but they all fit a troubling pattern: doctors failing to see patients as individuals, worthy of respect and care.
Maybe the recent spotlight on doctor’s behavior will expedite a shift in the medical culture. It is encouraging that doctors are finding the space to have honest conversations.
If nothing else, doctors may be encouraged to treat their patients with due care and respect out of the fear of lawsuits like these.
It’s the same fear that has propelled many of the patient safety advances in the last few decades.
Let’s hope we don’t have to wait that long for patients to get the respect and care they deserve.