Blacklisting patients

Blacklisting Patients :www.patient-safety.com. Download the document here. 
This is another issue routinely mischaracterized by the medical community.
It is not about maintaining a list. But since the discussion of this issue is in its infancy it easily is mischaracterized.

 

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. This allows the white wall of silence to be turned 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 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.”

Overtness
It is not always subtle. 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.
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