Docs Gone Wild

Update: Be sure to read A Davis’ comments on this post as well where he provides some more perspective and understanding on the magnitude of the issue.

And in a bit of a break from our usual EMR and EHR content, we have a couple of stories that caught my eye on Fierce Healthcare.

The first story is about a talk on provider disruptive behavior presented at the American College of Healthcare Executives (with the somewhat hilarious acronym ACHE) Annual Congress in Chicago. The kind of behavior that includes ponytail-flipping, pestering patients and colleagues for dates and not taking no for an answer, threatening to use AK47 etc. Rolling your eyes because you’ve never encountered these doctors from hell? Me too. To a person, the doctors I’ve encountered here in the US have been professional, courteous and polite.

But how common is this kind of stuff?

The Fierce article doesn’t say, but the not-so-subtly titled “Physicians behave badly online” provides some statistics on doctor behavior online.

The litany of complaints against doctors is as long online. The most common complaint is that doctors ask patients out on dates. According to the article, 48 participating state medical boards had at least one case of online misconduct, and the accusations leveled include:

Inappropriate online communication with patients (69 percent), such as sexual misconduct

Inappropriate medical practice (69 percent), such as prescribing medication without establishing a clinical relationship with the patient

Misrepresenting medical credentials online (60 percent)

The penalties for these online faux pas included reprimands, loss of licence, community service, fines etc.

Taken in totality, doctor behavior both on and off-line has some cause for concern. The same behavior in the real world translates to disruptive behavior online. I would also argue that it’s not just the same behaviors, but also the same set of doctors who misbehave. If you meet a jerk in the real world, chances are it’s the same person that might pursue you on a dating site.

The statistics as reported on Fierce Healthcare are a little fuzzy though. OK, so 69% of the 48 states had at least one reported online misconduct case, but how many doctors were involved? What percentage of doctors displayed inappropriate behavior? Were there repeat offenders, or multiple cases against the same misbehaving doctor? I don’t know. The JAMA abstract is woefully short on any meaningful details.

Does the online world just make this worse? Do we see more of this happening and since it’s so easy to connect with patients online? Does it also make the doctor more accountable for their actions since something done online can be more easily tracked and reported?

About the author

Priya Ramachandran

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

3 Comments

  • Just for the sake of the argument, let’s assume that in each state there were 10 physicians involved on misbehaving on-line. It’s a wild guess, but since our starting point is “at least one”, it may not be too far off the mark. That’s 500 physicians, total.

    The number of “providers” in America is over one million – but that includes physicians, chiropracters, advanced nurses and PAs, depending on exactly who’s doing the counting. For “doctors”, those with MD or DO degrees, the number is roughly 800,000.

    S the number of bad boys and girls out there amount to… wait for it … 0.0625% of all physicians.

    And that’s why the article didn’t mention numbers. If they included numbers, they would have been expected to include percentages. But 69% (of all medical boards who have sanctioned one or more physicians) is a helluva lot juicier a figure – and, importantly, more headline grabbing – than is 0.0625%.

    Once again, numerous articles have been spawned by an unthinking press responding to the desires and manipulation of a self-serving interest group. In this case, that group happens to make it’s living, in part, by discriminating against physicians.

    The problem with articles like this is that it is so damned difficult to stuff the S&%# back into the bull…

  • A Davis,
    You act like since it’s only 500 doctors, that it’s ok for this stuff to go. Reminds me of when hospitals sometimes say that they only had 10 people die due to hospital error.

    Maybe the above article could have done a better job in explaining better the magnitude of the problem and the issues, but 500 incidents is still an issue that should be addressed.

    The good difference between this site and others is that we have open comments where people like yourself can help to expand on the subject at hand and provide a well rounded look at the issue at hand from multiple perspectives. So, thanks for providing that. Although, let’s not go so far as to wipe this potential issue under the rug either.

    I also updated the post so that people would be sure to read your comment as well.

  • A Davis – while that’s a perfectly valid reason why you would not provide %, % figures do provide context. I would think that if only 0.000625% of doctors are rogues of some sort, I would actually be quite reassured.

    The other context I would like to have see is something beyond “at least one”. At least one, but how many total complaints did the boards receive? 10, 100, 1000?

    And finally my mad mad ire at JAMA/authors for (not) providing an abstract. The first 150 words of a paper do not an abstract make.

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