Thursday, January 13, 2005

Medical Idiot of the Month Award: Taking doctor malpractice activism too far...

The Medical Idiot of the Month Award goes to Dr. Mark Mullholland of Washington. The Seattle Times reports that Dr. Mulholland refused to treat a patient who refused to sign a petition for an initiative that would limit awards in malpractice cases.

No matter how messed up the malpractice system is and no matter how passionately we advocate reforms, this is going too far. As doctors, we cannnot ethically use our position to pressure our patients to act in a way that supports our political positions. Refusing to treat a patient anymore because that patient adamantly refused to sign a petition we support and expressed a political viewpoint that we strongly disagree with is unethical and inexcusable. There are many legitimate reasons a doctor can refuse to treat a patient, but a political disagreement is not one of them. Dr. Mulholland's promise to provide emergency care for 30 days and offer to refer the patient to one of his partners or to another physician in the community does not absolve him. Dr. Mark Mulholland will deserve all the criticism that will no doubt come his way. On top of it all, he's given sue-happy trial lawyers a big fat, juicy target to attack.

Money quote:

Dr. Thomas Gallagher, a UW internist who has written extensively on the doctor-patient relationship, said a doctor should be free to educate a patient about an issue of importance to him or her. But "pressuring the patient" is off-limits, Gallagher said.

"When a doctor starts to lobby a patient aggressively in this way, it puts the patient in a very awkward position," he said. "They may worry, 'The doctor isn't going to take good care of me, because I don't agree with him on this issue.' "

Of course, it's often a fine line between "educating" and "pressuring" patients, but not in this case.

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