Re: Patient legal question
From: art fougner, md (evsono@pipeline.com)
Tue May 6 16:19:27 2003
God watches out for the fools - so i humbly suggest that you let Him
take care of her - send the bug letter, including the name and address
of 3 gyn oncologists whose judgement you trust for her to choose. again
Rogers Rule comes into play here.
art
At Tue, 6 May 2003, Richard Chudacoff, MD wrote:
>
>I think this is called Darwinism. Either she survives and a whole new race
>of people willing to make irresponsible decisions propagates, or she gets
>invasive cancer and another dim-witted GYN (not you but the GYN willing to
>follow outside of standard of care) adds to the legal law suit quagmire, and
>commits professional suicide.
>
>--
>Richard Chudacoff, MD, FACOG
>
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>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Lynn D.
>Montgomery, M.D.
>Sent: Monday, May 05, 2003 4:39 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Patient legal question
>
>Its a patient I actually posted on the list some time ago. She had a pap
>smear that was suggestive of invasion. A cone that demonstrated frank
>invasion and referral to regional gyn onc was arranged. Didn't keep the
>appointment. Went to Denver where somebody did another cone that this time
>showed clear margins and he told her she was cured. Discussed the case with
>gyn onc again cause I didn't agree with the treatment and they agreed with
>me. I sent a registered letter reiterating my opinion to her and
>encouraging an appointment to discuss things. Initially, she made the
>appointment, but called and cancelled and requested referral to a female
>gynecologist "who will just follow pap smears".
>Lynn
>
>Lynn D. Montgomery, M.D.
>Rocky Mountain Women's Health
>2835 Fort Missoula Rd., Suite 303
>Missoula, Montana, 59804
>406-549-0978
>fax 406-549-0987
>e-mail: apgar10@montanadsl.net
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>DoctorJoe@aol.com
>Sent: Monday, May 05, 2003 3:20 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Patient legal question
>
>In a message dated 5/5/03 15:41:33, apgar10@montanadsl.net writes:
>
>Hypothetically, if you had a patient with documented cervical cancer who
>won't return for treatment, but calls following receipt of certified letters
>asking for referral to a physician "who will just follow pap smears", how
>would you handle it:
>
>1. Respond nicely stating that you do not know of anybody who would "just
>follow pap smears in this case", but she is welcome to seek one out.
>
>2. Provide a firmer response essentially firing her, but stating that until
>she finds another physician within a reasonable period of time, you will
>provide emergency care.
>
>3. Just document the fact that she is noncompliant despite certified mail
>explanation and leave it at that.
>
>Tough one. How do you do a brain transplant . . . . Hmmmmmm.
>
>One question: Hypothetically, what's the actual diagnosis? By biopsy, by
>conization, what?
>
>I would certainly document EVERYTHING, including the return receipts on the
>registered letters.
>
>I might ask her if she has any gyn or even a good GP who could give a 2nd
>opinion (knowing that if YOU picked the 2nd opinion, you'd bias him!). Or
>maybe refer to the list of local ACOG members and let her pick.
>
>In any event, a strong letter documenting that there is NOBODY to your
>knowledge who will do this, and that it constitutes malpractice. Plead for a
>name to whom you can send the records and if you don't get a reply within
>x-days, you consider that she's left your practice and you're no longer
>responsible.
>
>Sound do-able?
>
>Joe P.
>
--
art fougner, md
ich bin ein New Yorker
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