From Foster's Daily Democrat in New Hampshire:

The part of this case that fascinates me, is whether she has grounds for a complaint. From the same article:

I'm struggling to see what grounds he might be might be found negligent on.

Questions for Debate:
1) Do doctors have a responsibility to avoid offending patients when discussing their their health issues? Conversely, do patients have a right to not be offended in their consultations?

2) Does the patient have grounds for a grievance against the doctor? Why or why not?

1) Do doctors have a responsibility to avoid offending patients when discussing their their health issues? Conversely, do patients have a right to not be offended in their consultations?
No.

2) Does the patient have grounds for a grievance against the doctor? Why or why not?
No.

This is a no-brainer. This woman will get nowhere with her complaint. When she filed her complaint, it was news; when it is dismissed, it won't be news. And people will complain about how this country is going to bell in a bandhasket. The country is full of hubris. Hubris is our distinguishing national characteristic. Sure, everybody can see the hubris of this woman, but it shows up just about everywhere else in American society.

Questions for Debate:
1) Do doctors have a responsibility to avoid offending patients when discussing their their health issues? Conversely, do patients have a right to not be offended in their consultations?

When it comes to whether or not they should confront their patients with real health problems? Absolutely not. Obesity leads to a great many serious health problems. A doctor would be doing their patient a huge disservice by not confronting their patient with that reality. This strikes me as an excellency example of political correctness carried to detrimental extremes. I would pose the following, reworded question...Do patients have an obligation to not be offended when discussing their health issues with their doctor?

2) Does the patient have grounds for a grievance against the doctor? Why or why not?

Wouldn't it be a sad state if doctor's get sued for correctly, accurately, and for the good of the patient describing their health problems and the current and future effects that will have on them? I see nothing in this article which indicates the doctor did anything wrong at all...which probably means the woman will sue and win a large settlement.



I think this is because you are applying logic to the situation.

Unless there is considerable information missing from the article, I would think further that the medical board has some serious issues here, which could potentially lead to a counter suit. You have a doctor offerring a patient a completely correct diagnosis, along with its accompanying prognosis...all in an effort to get the patient to improve their life. And they decide the doctor should apologize for this? Essentially, the board is either medically incompetent, or far too concerned with politics over sound medical practice. Are they ignorant of the health effects of obesity, or scared to own up to it? Neither of those scenarios indicates the board is fulfillings its obligations, and for that they should apologize.

1) Do doctors have a responsibility to avoid offending patients when discussing their their health issues? Conversely, do patients have a right to not be offended in their consultations?

The simplest solution for this women would have been to stop seeing this doctor if she was offended by his attempt to get her attention about the risks to her health.

But, lets turn this around. If the doctor, seeking to avoid offending her, choose instead not to address her Obesity, and she later died of Obesity related illness would not her surviving family members have possible grounds for a malpractice suit?

IMHO Doctors have a responsibility to get their patients attention. This smells of political correctness to me. I wonder. If I choose to file a complaint against my Dentist years ago because he asked me: "Are you suicidal?", in an attempt to get my attention as to the health risks I am voluntarily taking on by smoking, would the State Attorney Generals Office have recommended that my Dentist "take a medical evaluation course and acknowledge he made a mistake." Somehow I doubt it.

No one has a right not to be offended. It have a right to not be offended we have to remove everyone else's right to free speech. She has a right to take her money and healthcare needs to another service provider if she feel this doctor is offensive to her, but that is about it.


2) Does the patient have grounds for a grievance against the doctor? Why or why not?

Based on what the article has to say in regards to the state law and the responsibilities of the board I would say no. I believe this is why the board choose to escalate the problem, because technically they had no authority to act on the complaint.

A friend of my, while talking about this made a suggestion. All doctors should be offended by this action. They should also be concerned because any one of them could be drawn into a similarly ridiculous investigation. My friend suggested that all doctors in the State band together and simply that 2 days off as a form of protest. Perhaps that would get people's attention and remind them that Doctors are also people with rights. Like the right to protest, the right to choose not to work, etc.



EXCELLENT POINT! Bravo Hobbes!

I'm not sure if it would change any minds here (I'm not sure it changes mine), but the doctor did a wee bit more than just tell a woman she was overweight and needed to drop the pounds.

Apparently, the doctor has a prepared lecture he delivers to overweight women that include some 'scare tactics':
Fat chicks don't get dudes. Ouch. Pretty harsh.

Without turning this into a gender debate, this exemplifies why I chose women as my primary care physicians. I have had male doctors and I simply can't communicate with them as I can another woman. Herein, lies one of the issues of this particular debate. Blunt, in-your-face, provocative communication is often more effective between males than between a male and female or two females.

Do doctors have a responsibility to avoid offending patients when discussing their their health issues? Conversely, do patients have a right to not be offended in their consultations? I could regurgitate the old 'no one has the right to get offended' but that's fluff. There is no way I can answer this generally. People's perceptions of events are often very different (just check out the eye-witness debate! ). While there is no underlying responsibility, there is always a possibility for perceived or actual offense. I therefore think it's best to handle events of potential offense on a by-complaint basis and leave the interpretation to a board of experts (as seems to currently be the case).

2) Does the patient have grounds for a grievance against the doctor? Why or why not?
In this instance, no. The doctor was certainly more harsh than he could have been, but I don't think he violated the standards Doc outlined in his opening post. A complaint such as the one this women has levied against the doctor has very serious consequences. The potential punishment (license loss at the least) indicates those that who created the standards and punishments meant for them to have a very high scrutiny threshold before they would deem a doctor "unprofessional" or "negligent". Simply, what this doctor did is not worth his losing his license for any period of time.

1.) No. Doctors are here to keep their patients healthy, not to hold their hands. Sure, they can be offend. But a good remedy would be for a patient not to see that particular doctor if they are not impressed with their calls-'em-as-I-see's-'em tact.

2.) Not really. The doctor crossed an undefined threshold. And because it is undefined there is no grounds (unless the patient got sneaky and chose to completely disregard Doctor/patient confidentiality and plead defamation of character) on which to pursue the subject.

1) Do doctors have a responsibility to avoid offending patients when discussing their their health issues? Conversely, do patients have a right to not be offended in their consultations?

2) Does the patient have grounds for a grievance against the doctor? Why or why not?

Doctors who care about their patients are more likely to give the "dutch uncle" lectures, and that is the kind of doctor I like. My brother was told to go home, and stop bothering the doctors at the VA, until he decided to quit smoking. It scared him into quitting the cigarettes when nothing else did. Still, it was good advice too late. He is the youngest in the family, but will likely be the first to die. I know more than a few others who ignore their doctors advice, maybe they need this kind of doctor to wake them up.
Patients do have a choice to not be offended Her choice is finding a doctor who will quietly take her money while she continues to shorten her lifespan.

Do doctors have a responsibility to avoid offending patients when discussing their their health issues? Conversely, do patients have a right to not be offended in their consultations?

No and no. Doctors can be absolute jerks if they want to be; so can patients.

It may be well for some doctors, and maybe this one, to remember that compliance with a medical regimen involves a patient's willingness to comply. Scare tactics alone may not work. If the doctor can convey that s/he CARES about the individual, the person may be more willing to listen. It works for me; I have long ago stopped seeing doctors whom I am convinced were seeing me only for the money.

Does the patient have grounds for a grievance against the doctor? Why or why not?

I don't believe that the patient has grounds for a grievance, considering that the doctor legitimately pointed out to her a health disorder that she has. It would be hard without hearing exactly what he had to say whether his speech rose to the level of being offensive.

So, most guys don't like fat chicks. So what? Most fat chicks don't like dumb jocks, either, but every now and then a love connection is made that defies stereotypical thinking.

1) Do doctors have a responsibility to avoid offending patients when discussing their their health issues? Conversely, do patients have a right to not be offended in their consultations?

2) Does the patient have grounds for a grievance against the doctor? Why or why not?

* * * * * * * * *

As Jaime pointed out, this doctor's tack with overweight women was to say they were more likely to outlive their husbands, and that it will be hard for a fat woman to find a second husband because men don't like fat women.

Well, I am a fat woman who's never been married, and I say the truth hurts but death is worse. That's what's bothering this woman -- being 'insulted' with the truth. She needs to get a grip. Part of a doctor's job is to keep a patient from deliberately harming her health, and by overeating and underexercising, this patient is harming her health.

I will never be slim, but I eat a healthy diet and walk three miles a day, three times a week. I am on several medications for the medical conditions my obesity is linked to, and although my doctor could probably be 'meaner' to me than she is, she knows I'm doing what I can. My male gynecologist is more direct about the risks of overweight, and between the two of them they got me off my forty-year-old butt and I'm grateful to them. LOL

BTW ... from the older women who are widowed that I know, I hear that the few men you meet when you're widowed and over about 55 aren't worth much, anyway. So I'll concede that there are worse things than being alone -- but one of them is being alone and fat and sick and getting old.

I think I'm alone in my position here...Which is always fun.

Do doctors have a responsibility to avoid offending patients when discussing their their health issues? Conversely, do patients have a right to not be offended in their consultations?

Obviously doctors cannot avoid offending everyone, and it is their job to give sound advice, but it is also their job to do so in a professional manner. According to the doctor, "I told a fat woman she was obese … I told her, 'You need to get on a program, join a group of like-minded people and peel off the weight that is going to kill you.'"

Sounds perfectly reasonable, but the quote Jaime provided wasn't the same. "Fat chicks don't find future husbands" is a rather unprofessional way to relay advice. I'd expect this advice from Richard Simmons at a fat farm, but not a physician. This woman isn't suing this doctor, she filed a complaint for what she considered to be unprofessional conduct. I've filed similar complaints in the past myself. I'll elaborate:

A friend of mine was having her first baby, and her labor started. She was at the "stork's nest", a hospital room at an army base in Korea where mothers have to wait for the last two weeks of their pregnancy to deliver. She ran into the room crying that active labor had started. The response from a male physician, "Are you sure you're really in labor, lady? I don't want to stick my finger in your vagina unless I have to." I'm sure from his perspective he was just helpfully making sure she was in active labor.

Another example. For this one I didn't actually file a complaint, but called the pharmacy to complain. It happened about 14 years ago when I went in to renew a birth control prescription because I was going on my honeymoon in a couple of months. I hadn't taken the pill for about 6 months prior to that because it didn't agree with me, but thought that I should for the honeymoon since...you know. At the prescription counter the pharmacist asked me if I had been taking the pill for the past 5 months. I told him no. He looked at me sternly, pointed his finger and said, "That's very dangerous young lady!" I asked him if that was a health concern or a pregnancy concern and he told me it was a pregnancy concern. There were about 5 elderly people standing in line behind me at the time, so it was a loud, very public admonition about my private sex life, of which he had no idea about in the first place. I'm sure from his perspective he was just doing his job and offering professional advice.

So, to continue, there are professional ways to give advice, and I do feel that the physician was likely out-of-bounds here. Physicians should always be respectful towards their patients. Also, let's realize we don't know the full story. Total disclosure of all specific complaints hasn't been released. It was bad enough that the New Hampshire Board of Medicine is concerned, and requested that he attend a medical education course, a proposal which he rejected. I think he could use some counseling on improving his bedside manner. He's doing this lady a favor for telling her she's unattractive? Okay, physicians with bad bedside manner are exponentially more likely to be sued for malpractice. The lady is doing this doctor a favor so that hopefully he'll improve his personality before someone sues him.

Edited to add:

I would be more inclined to believe the opposite. We don't know what was said in the complaint, but the Medical board does and thought an apology would be appropriate. Therefore, the medical board must be wrong? Yes, a doctor can give the proper diagnosis in such a manner as to be inflammatory and degrading towards the patient. Should a woman who goes to the doctor for an STD be told that men have fun with promiscuous women but marry good girls as an anti-promiscuity prognosis "in an effort to get the patient to improve her life"?

In this case, we don't even know the reason this woman went to the doctor's in the first place. For all we know, she might have gone in for an ear infection and received a crude reprimand on her appearance.

Maybe the fact that he has some 10,000 patients is part of the problem.
He has become callous from too many patients, and he's lost his bedside
manner.



That is a very crude and inappropriate response from someone who is supposed
to be a professional. Gee whiz. Jaime made mention if this in her
post, and I have to say, similarly, that I would NEVER choose a male to be
my OBGYN. The woman who delivered my children is not only an amazing
doctor, she is a mother who knows what labor pains and mentsrual cramps are
all about. How can a male doctor match up to that? Besides, I don't trust a man
who chooses gynecology as his specialty.




I agree, wholeheartedly. I'm not a huge fan of medical doctors to begin with,
and those who choose not to show compassion and consideration are unprofessional.

Do doctors have a responsibility to avoid offending patients when discussing
their their health issues? Conversely, do patients have a right to not be offended
in their consultations?

Doctors have a responsibility to be professional. That means using proper
doctor/patient etiquette. As far as patients go, sure they have a right to be
offended, and perhaps filing compaints when they are appropriate. In this
case, who knows, maybe it was.




In this case? I can't say, because I wasn't there. If others have made
complaints in the past it would lend credibility to this patient's complaint.
My advice would be to look for another doctor and be done with it.

1. I don't know if I would go so far as to say that physicians (and other health care professionals) have a (legal) responsibility to avoid offending patients (an impossible goal anyway), but it would seem a good idea to try to have a good bedside manner. There are ways to offer a strong opinion about a patient's heath without being (to use the physician's own words) "stark" and "blunt." I can't agree with this:



When is it appropriate for a health care provider to be unkind?

I also wouldn't say that anybody has the right not to be offended (again, that's just impossible), but everybody has the right to choose a new health care provider and file a formal complaint. The board which oversees the profession is there to judge if the complaint has any validity. In this case, they seem to think so. It's not like they're taking the physician's license away; it's just a message of "Hey, you came on a little too strong; lighten up." The physician isn't a bad guy, and I applaud him for writing a letter of apology to the patient.

2. It sounds like the patient had grounds for a grievance, but not a major one. This is one of those times when a slap on the wrist is appropriate.

I am confident they will affirm what the doctor was doing and not do anything, it says they tried to get him attend a medical education cource, which he refused.

But I am sure he will review his bedside manners.

Some of his obese patients are backing him up.

http://www.seacoastonline.com/news/..._23special2.htm

1. No. Doctors have the responsibility to give advice that is in the best interests of the patient. If they don't want to hear the reality, it's the patient's problem, not the doctor's. Do patients have a "right" not to be offended? No. As I said, if they are offended, it's their problem, not the doctor's who is doing their job. If she wants a second opinion, she should seek one. But, she may not receive the opinion that she seeks. In the words of Rodney Dangerfield, "You want a second opinion? Ok, you're ugly too!".

2. No. It's idiotic. But, I'm sure some trial lawyer will take the case on a contingency basis and try to sue the doctor for "pain and suffering".