Injured patients who want to help and be heard,
click here.
Thomas Jefferson said that given the choice between
government without newspapers and newspapers without government, he would choose
newspapers.
In medicine we have government without newspapers. Patients
cannot find out what they need to know to make informed choices. No one in
medicine records or reports the information patients need to know the most. So
patients will have to do it.
Blacklisting Patients
This is an issue routinely mischaracterized by the medical community
in order to cover up something that happens to be good for them and injurious
for patients. They dismiss it as though blacklisting a patient, or a group of
patients, required creating a physical list and passing that around. It does not
require that.
It is not about maintaining a list. It can happen with no communication between
physicians at all, as long as they all are on the same page regarding certain
issues, like, for instance, iatrogenic injuries. As long as they, as a group,
are more interested in protecting each other than in protecting patients,
patients with iatrogenic injuries are a good window on how blacklisting works
and how damaging it is for patients.
But since the discussion of this issue
is in its infancy, they easily mischaracterize is and dismiss it as though it
required people wearing masks delivering hardcopy of an evil list in the dark of
night.
On The Same Page
Physicians assume a basic level of honesty from their peers.
And expectations influence perception.
They do not anticipate sins like rape from colleagues and the deliberate obfuscation of such.
So a patient arriving claiming to have been raped by some other healthcare
professional, mostly will be regarded as a crazy person who potentially could
ruin the career of an innocent colleague. This though being expressed to other
doctors turns the white wall of silence
into into a black one with nothing more than a phone call or a nuance in a
referral.
Doctors, like members of any normal group, watch out for each other. If a patient never pays bills, or repeatedly files lawsuits, or habitually becomes violent, or travels around trying to get illegal prescriptions, one would expect a doctor who knew about it to warn colleagues.* But that kind of
communication can result in blacklisting patients who need treatment.
A patient being blacklisted can go from doctor to
doctor to doctor without getting diagnosed or treated and never know why.
Blacklisting can result in permanent harm or even death and can be criminally
illegal. What are the odds of the police pursuing it? Near zero. How is a
patient who figures out that it is going on to persuade anyone of it?
Where will be the proof? Doctors create the record. And the records are created
to protect doctors, not patients (see defensive
documentation). The police don't even know where to start looking. And state medical boards are run by other doctors to whom this looks like business-as-usual. The very suggestion of having been
blacklisted will "strain credulity."
But look at this graph. It documents how it was done to me and how it
can be done to you
if you ever have a problem in medicine. Patients who
understand it have a better chance of surviving in spite of it.
Overtness
It is not always as subtle as described above. Sometimes it is one physician blatantly telling another physician to find nothing wrong with a patient, to give no tests that could uncover injuries, and no referrals that could help the patient because anything found could indict a fellow physician.
Why would a physician risk his license and intentionally ruin the life of a patient? Well, there's really no risk. Who is going to report it? And who would believe the report? And who would do anything about it if they did? But still, what could be so awful that covering it up would be worth ruining the life of
the patient? The statistics are elsewhere on this site about how many assaults, rapes and homicides are committed by healthcare workers each year against patients. Do you know why there are not a corresponding number of convictions for committing those crimes? One of the reasons is that no one in healthcare believes that their colleagues
do these things, so they don't believe they are covering up anything. They simply refuse to find or record the injuries and/or evidence of the crimes. No record of it is created in the first place. And the patient doesn't get diagnosed or treated.
All it takes to blacklist patients is a hint that the patient might be making a case against a colleague. We patients cannot stop their gossip, and we cannot communicate among ourselves to overcome it without getting sued. All we can do is be aware that it is a problem, recognize that this is an unconscious
routine for them, and fight for the right to speak, complain and seek help, protection and oversight.
Doctors are supposed to consider the seriousness of the malady,
not the virtuousness of the patient.
Medicine is not like other professions. The consequences for its customers are too great. Doctors are supposed to treat villains as well as heroes, even if treating them enables villains to commit more villainy. But
they don't. If you were to go to your primary care physician with wounds received when one of his colleagues raped you, your primary care physician would diagnose you as being crazy, and so would every other physician you went to. When you hear in the news about a patient who finally lashes
out in frustration, the medical community unites in diagnosing the patient as being paranoid and crazy, and journalists always accept that without question. After all, the pronouncement has been made by physicians. Why would anyone question it?
The
healthcare industry is a monopoly as much as the water company or
an electric utility company and has similar obligations. If power and water utilities refused service to someone, at least the victims would know that they had been cut off. Patients who are manipulated out of care
without their knowing it, or even when overtly declined it, are left in a more sinister darkness.
Physicians rationalize that patients always can go to another
physician. But they cannot. Physicians are a community. On important levels they
look out for each other. Despite their differences and the disputes common in
any community, a patient with an iatrogenic injury rarely can get a diagnosis of
that injury in the record, and likely cannot even get treatment for it. Despite
their differences and disputes, if it appears that one of them might become the
subject of a suit or grievance, they unite to defeat, if not destroy, the
patient. That is not an exaggeration. They will let an injured patient's
untreated injuries become ruinous rather than give care that, in addition to
saving the patient, might make possible the
patient's holding responsible the health care providers who injured the patient.
Referral from a physician to a radiologist:
"Re: John Smith. This 57-year-old builder is requesting a CAT scan on his lumbar
spine to be performed on a private, fee-paying basis. Mr. Smith is a malcontent
of the highest order and holds a very warped view of life . . . expresses
contempt for orthopedic surgeons, chiropractors, osteopaths, acupuncturists . .
. "
from "The World's Worsts" by Les Krantz & Sue Sveum
Someone injured badly enough by one and then denied treatment
for the injuries by the others rationally will learn to distrust the orthopedic
surgeons, chiropractors, osteopaths, acupuncturists and others who did that to
him.
This is from an email a patient wrote to me about her
experience:
"All it takes is for one doctor to decide he doesn't like
you, and the patient will find that he can't get treatment anywhere else."
A disabled veteran we know of received this in a email
from a VA employee:
"I'm sure nobody would admit to blacklisting: they will say that they
use flags to warn staff of "disruptive" behavior (these appear in VISTA
and CPRS). . . "
Objective
People believe that other people's perceptions
might be shaped by socioeconomic factors or political or religious commitments
or loyalties, but that their own perceptions are the objective truth.
Whose subjectivity is more likely to lead us to an
honest appraisal of how many lives are being lost and how those lives are being
lost in medicine - the people whose lives are being lost or the people who don't
want to be held accountable for losing those lives?
It is self-serving, ignorant, ridicule to view, one
patient at a time, the quality of the information that can be gathered from the
patient community. As a community, patients are the more reliable source. They
do not have a vested interest in hiding the truth. Their lives depend on finding
it.
* *
*
Links to cases we haven't finished reading ourselves.
By the way, do you know what the police say when you try to report blacklisting? They say to contact the state medical board. Do you know what the state medical board in Ohio says when you report it to them? They investigate it for two years and then decide that the physician has not violated any provisions of law that their agency is
charged with enforcing, because they are not the police and not authorized to
investigate crimes even though they accept those cases and delay them until they
are too old to pursue. You know what provision of law they are charged with at that point? The provision that requires them to send their investigation to the agency that is charged with enforcing that law. Which is the police.
Which is where you started. But now the case is older and the trail is colder
and the police still think it must be someone else's job. Burt
and Kashyap are two examples on this site of this
being the runaround that patients get.
*It should be noted that patients do not have this right. Patients get sued for defamation if they warn each other about medical professionals. Physicians are allowed to talk. Patients are not. This leaves patients ignorant and powerless and further shields medical professionals. When even their victims cannot report
it, medical professionals are further shielded from normal inhibitions against acting out when experiencing lust or jealousy or anger or any of the other emotions to which they succumb from time to time.
People in medicine have a habit of mischaracterizing issues like this, in this case by declaring that there is no list or blacklist. It is not that there is a written list of patients that doctors have decided to screw. It is their nearly complete faith
in themselves and each other coupled with their nearly complete lack of faith in patients. Blind, self-serving biases allow them to
characterize it as something different than what it is as they do it.
"A conspiracy, not a profession...Every doctor will allow
a colleague to decimate a whole countryside sooner than
violate the bond of professional etiquette by giving him away."
- George Bernard Shaw on medicine.
If you want to say something about any of my
sites, my phone number is on almost every page. So is my
email address. There even
are Feedback Forms where you can communicate
anonymously. I am listening. I will be sensitive to what you say.