Bridgette Allan
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Wellness coach

 


2018-02-27

Bad medicine - Is your doctor really as good as you think he is?

scared.jpgTowards the end of last year I had to undergo surgery to repair torn tendons in my ankle. Unfortunately I had left the injury unattended for 18 month before seeking help and this had exacerbated the problem. 

It was only when I could no longer sleep at night from the pain in my leg, that I sought out a doctor who could help me. No doubt you’re wondering why somebody who is IN the medical field left the injury for so long. The answer is simple. I do not trust the medical profession. 

It is not uncommon to see a patient who has been under the care of a specialist and has undergone a multitude of unnecessary procedures, unrelated to his/ her illness. Patients are sometimes admitted to hospital for exhaustive testing and referred to numerous other specialists for NO good reason. 

This article is in no way meant to lump all doctors into the same dirty bin, there are of course many highly skilled, compassionate and caring medical professionals but it’s long overdue that the public became more aware of the bad practices found in the profession and understand that they have a right and a voice to call out bad practice. 

Working in the field exposes one to the plethora of patient mismanagement, misdiagnosis, medical aid fraud and over-servicing of patients. Many doctors practice beyond their scope of practice - in other words perform procedures that they are not experienced or competent to perform and many doctors liberally prescribe treatments or refer patients on for further investigations that the patient does not need.

6a00e5540ff48a8834011572288773970b-800wi.jpegI recently came across someone who openly admitted that her doctor manipulated the diagnosis and ICD-10 codes so that her condition would fall under a PMB (prescribed minimum benefits - for those who don’t know a PMB condition is a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the medical aid benefit option they have selected.) She thought her doctor was so wonderful for doing this for her that she was recommending him to others. This, people, is fraud. The doctor doesn’t do this with the patients best interest at heart - but his own. If the patient had to pay cash for a procedure not covered by her medical aid, she would either not have had the procedure or gone to a state facility and the doctor would have lost that income. Manipulating the codes and lying about the diagnosis however, ensures that the medical aid pays up and the doctor gets his money. I will discuss this behaviour in a future post - it’s one of the most common judgments made against doctors at the disciplinary hearings.

A quick google search reveals how extensive this problem actually is. You might ask how doctors get away with it so easily? Well , the patient generally doesn’t know better. In many instances doctors are still revered and elevated to almost God like status by their trusting patients. All it takes is a pleasant and empathetic bedside manner, a sympathetic ear or the liberal handing out of sick notes, and the patient is hooked.

It is common to see people ask for recommendations for a “good” GP or specialist on social media community groups. People recommend doctors based on their experience with them as people and not based on the doctors knowledge or skill. How would a lay person know how skilled, up to date or knowledgeable their doctor is ? The truth is , they don’t. People consider a doctor “good” because he has serviced them in a way they deem suitable, whether that be his or her cheerful and friendly disposition, taking more time with the patient than the allocated 15 minute appointment or for prescribing a multitude of drugs for an ailment that was self limiting anyway (but the pt didn’t know that, they just feel cared for when the Dr gives them loads of meds)

Worryingly, doctors who have in some way contravened the rules are generally not suspended. They are fined - a mere slap on the wrist, and nobody is any the wiser because although the judgments against doctors are in the public domain, few know where to find the documents.
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These reprimanded doctors are not obscure nobodies, they are colleagues, doctors who are loved and respected by some of their patients, doctors to who we may have referred patients and this begs the question, how do we know we are safe in our doctor’s hands?

Sadly, there is no easy way to know but educating people on their rights as patients might go a long way to determining the good from the bad. 
People need to understand that they have a right to question, they have a right to a thorough explanation of EVERY procedure recommended for them - known as INFORMED consent, they have a right to an explanation of the billing systems and ICD-10 codes and they have a right to a second or even third opinion.

It is not always easy to determine whether or not your doctor is doing right by you UNLESS you request a full explanation of the diagnosis and treatment. Communication with your doctor is essential. There are many patients who feel that they have been slighted or treated incorrectly when they have not been and mostly this is simply because their doctor has not communicated with them effectively. 

Here are a few tips for finding a good doctor

1.Being a nice doctor does not necessarily mean a good doctor. Be sure to check the doctors credentials and affiliations. Bedside manner is not everything. Even caring doctors have bad days but steer clear of a consistently uncaring and indifferent doctor. 

2.Good doctors help get their patients better. We know that sometimes an illness may be hard to cure but generally repeated visits or hospital admissions for the same ailment are not a good sign. 

3.Getting every test under the sun might make you feel that your doctor is being proactive but more tests do not generally result in better outcomes. Sometimes tests are ordered because the Dr has financial ties or a stake in the business. Sometimes doctors run extensive tests because they are inexperienced or unsure of their own medical knowledge. If your doctor becomes offended when you question them or ask for a referral for a second opinion, see this as a red flag. 

4.Beware of doctors who give in to patient demands. Sometimes a doctor agrees to treatment or writes a prescription because he is pressured to by the patient and want to avoid a bad review. Patient demands should not trump doctor expertise. 

5.A good doctor respects your schedule. We know that emergencies happen and sometimes an unforeseen lengthy consultation pushes the schedule out but this should be the exception - not the norm. Beware the doctor who takes other patient phone calls or social calls in your time.

6.A good doctor will take time to LISTEN to you !

7.Transparency is important. Doctors are human so beware the doctor who never says ” I don’t know”. A doctor who is transparent about his/her limitations or mistakes is often more trustworthy that the arrogant know it all. Don’t overlook a continued pattern of sloppiness and poor communication.

8.It is estimated that 40% of patients are initially misdiagnosed. Many illnesses are self limiting and get better on their own irrespective of the diagnosis. A good doctor will explore other possibilities, encourage you to seek our more information or refer you to specialists. Medicine is not an exact science - beware of arrogance. 

9.Good doctors stay abreast of new developments and are willing to learn more about new techniques and open to new ideas. Beware the doctor that shrugs off new evidence. If a doctor refuses to try new and improved techniques because it takes them out of their comfort zone, it does not bode well for patient care. 

10.If your doctor uses scare tactics to get his way- beware. Doctors should not steamroller patients into accepting treatment. A treatment plan should be mutually agreed upon by patient and doctor once the patient has a full understanding of his condition and the proposed treatment plan. A good doctor will listen to patient concerns and address questions.  
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In my next few blogs I will be dicussing some of the most common misdemeanors in the medical profession. 
In the meantime here is the link to the HPCSA website where you will find information on the professional code of conduct and what you should expect from your medical practitioner. 
Conduct and Ethics

Admin - 07:27:05 | Add a comment


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