Patient Safety - Reality Check

The Blacklisting Issue

A discussion mired in its primary stages

The community of patients isn’t aware that doctors call other doctors to tell them not to diagnose someone, or that even without such communication doctors will refuse to make an accurate diagnosis and patient history if they feel it could be used as evidence against someone else in healthcare, and for other reasons as well.

Stories about blacklisting often seem paranoid to the uninitiated because the patient community lacks the information necessary to interpret the stories. My own story about how I was blacklisted sounds paranoid to people even though I had witnesses and a paper trail. My primary care physician called the offices of other physicians to tell them not to treat me (I was sued twice for telling my story once). This was communicated to me by people in the office of one of those physicians and yet the story still is hard to believe to most people.

When finally there is a newsworthy story that can be made public without the victim being sued, if it is a simple and a verifiable case of blacklisting that shows how it is done, then after that discussions of blacklisting can become more mature and nuanced because they will have that reference. Then we can discuss things like how it can be that physicians can contribute to blacklisting without admitting to themselves that they are doing it. Right now if a nurse says, “I don’t believe anyone is keeping a list” it is assumed to be reliable information from an authority dismissing the possibility based on the wisdom of her experience rather than from a person with an agenda mischaracterizing an issue in order to discredit it. The blacklisting discussion will be in its infancy until people understand enough to know that oversimplifications like “keeping a list” are not the issue, even though there have been attempts to keep such a list.

The Wider Discussion

It is not just the issue of blacklisting, but the whole patient safety discussion in general that is in its infancy. I once had a discussion with the founder of the Semmelweis Society (an organization set up to protect doctors) in which he said that a physician would have no motivation to harm a patient. It would be difficult for a discussion to be more in its infancy than that. I mentioned cases in which physicians had intentionally had harmed patients because of greed or lust. He maintained his position.

That is being in denial. The medical community as a whole is in denial. The patient community gets its information about patient safety from the medical community for the most part and the medical community fights for its own interests and discusses them as though anything in their interests must also be in the interests of patients. They do not speak of things like blacklisting. They like blacklisting. Blacklisting protects them. They are not interested in the extent to which it harms patients and do not acknowledge that it does.

Most people never hear stories about blacklisting and how victims of adverse events in medicine are prevented from getting care, let alone evidence, as healthcare professionals protect each other. Since the community never hears about it, stories about sound paranoid when they are finally heard. Those telling stories about blacklisting are in a difficult position because there is no foundation on which to build. When there is a foundation, when people understand a specific example of it and can say, “Oh, you mean like the So-And-So case,” referring to a proven instance in which the medical community protected one of its own by rallying against a patient, then the discussion can mature. But right now, the discussion is in its infancy.

Stories about blacklisting sound paranoid to the uninitiated not because the stories necessarily are paranoid, but because the audience lacks the basis necessary to understand the stories. This is true about the patient safety discussion in general but is particularly apparent with the blacklisting issue. Patients trying to explain what is happening to them cannot find a sympathetic audience. Patients who contribute their accounts to websites like www.patientblacklisting.org are unable to tell their stories in a way that does not sound paranoid no matter how much evidence they may have. And unfortunately injured patients often are afraid to present the evidence because if doing so identifies and of the parties involved then the patients can be sued. Doctors can talk to each other about patients, but patients cannot talk to each other about doctors without getting sued - one of the chief reasons that the community of patients does not develop the vocabulary necessary to discuss and understand issues like blacklisting. So the discussion remains in its infancy.

Maybe the world is not ready for the term “blacklisting” yet. Would it be possible to lay the foundation for the term without using the term? Let me know if you have any thoughts. My contact information is at the bottom of almost every page.

They silence each other too