If a skilled MD is confrontational & obnoxious w\ patients should he be disciplined?

Per this issue
Is there (or should there be) any point in the practice of medicine where a doctor can be too honest/blunt and confrontational and/or obnoxious about health issues and patient behavior to the point it requires professional discipline by his or her peers?

I could see obnoxious and or excessively crude being an issue

Version A (OK) Failure to correct or deal with medical condition X could impact you socially and emotionally over the long term.

Version B (Not OK) You’re a fat cow and nobody is ever going to want to fuck you except for maybe a male cow.

Even then if you have a doctor or any other high level professional who gets you positive results in your best interests, who cares if he’s an asshole.

I’ve personally taken an internist I once saw aside and mentioned his bedside manner was atrocious. I was in for an outpatient procedure and he walked into the diagnostics room, didn’t say a word to me, started doing whatever it was he was doing, and when I asked questions he actually shhhushhed me. :eek: You got to be kidding me… Anyway there were several other things that really irked me and when all was said and done, I took him aside later that day and mentioned some things to him. He was non-to-pleased but at least I got my point across. This guy had God perplex or syndrom or whatever… and needed to be brought back down a little closer to earth…

I see this becoming a new Doperism. :slight_smile:

If what an MD does is not ultimately in the best interests of the patient then disciplin is necessary.
For the article in the OP it would seem to me that their should be discussion probably behind closed doors with the MD over the reason he acted as he did, and possibly some minor disciplin.

Sometimes people are in denial over their state of health, in such cases I imagine being blunt with them is the most effective action for a doctor. Some people probably need to be told, you are clinically obese, and if you don’t do something about it you will likely die because of it.

Sorry if this is turning into “Worst bedside manners you’ve seen,” but I can’t help myself:

When my father was in the hospital, the big specialist comes into the room, followed by about a half-dozen med students. He immediately tells my father that his cancer is inoperable, and that they’ll try chemo, but it doesn’t look real good, and do you have any questions?

I swear, he was in and out in 30 seconds.


It is never ok, even behind closed doors, for a health care professional to treat a patient disrespectfully. We are held to a higher standard.
If a patient is non-compliant, we should find the reason. Belittling and berating will only result in the patient avoiding subsequent visits.

I know many doctors who feel their time is worth more than the patient’s. Their arrogance often derails their plan.
Since they don’t think anyone else’s input is necessary, they give the patients orders, rather than involving them in their own care. Then when their plan fails, they blame the patient for being non-compliant.

I’m proud to say I’ve made more than one med student/intern/resident cry for acting this way.

If the doctor is so confrontational and obnoxious that patients are likely to not only not return to that doctor but be less likely to see a doctor in general, then the doctor absolutely should be disciplined. Due to issues with cost, insurance (or lack thereof), fear that the doctor will find something scary, lack of inclination, lack of convenient time*, lack of transportation or other factors there are enough people who only see a doctor in an emergency or when they need a prescription refilled without doctors actively scaring them away.

*My dad will not take off work for routine doctor’s visits. Not can not, WILL not. There are probably people who can not.

I used to know a rheumatologist who made the bedside manner of Hugh Laurie’s Dr. House look like the ministrations of Mother Teresa. He was a brilliant diagnostician, but he should have found an area of medicine in which his patients were either dead or unconscious. What a prick. The nurses hated him, the other doctors hated him, his patients hated him. It baffles me that he’s still in practice.

My aunt was highly offended when my uncle’s doctor accused her of trying to kill my uncle. She brought him his cigarettes…and a plastic bag to puff into… while he was at the hospital… in bed…after a heart attack. True, he was going to be let go the next day if the tests were okay. But really…

Thanks for responses!

Oh, this I gotta hear.

I don’t think a doctor can be too honest, but I think tact and discretion are in order. One can lay out the facts of the situation honestly without being a pig about it. Problem is, some people don’t want to hear the facts, so they’re likely to be offended no matter how the doctor says it.

I think a Doctor should be allowed to tell a patient she or he is clinically Obese. This sounds like a legitimate diagnosis.
If the Dr. says your fat & ugly, well severe discipline would be in order.

If he tells the patient your fat and you need to lose weight or you’re risking your health/life. He shouldn’t be disciplined but I am sure a call from the PC police could be forthcoming.

I quit seeing my doctor after he copped a 'tude with me, not only about my weight and diet, but about the sorry state of my social life at the time. (He actually shook his head and clucked about my lousy dating record.) In my mind, he was putting me into a pigeonhole: I was no longer a fully viable human being, just a freak case. Consequently, I didn’t want to go back for more of the same.

The next time I forced myself to — surprise! I had crazy-high blood glucose and was on the way to a diagnosis of Type 2 diabetes. Not the doctor’s fault, of course, but I sure didn’t feel as though he gave a damn. “If he can’t eat like any reasonable person would eat, it’s his business,” I imagined he’d have said.

I switched to a new doctor soon after. No 'tude, just good solid advice.

There are some things that are really best left to the marketplace. If you think your GP is just rude, get another one.

Just remember, 50% of all doctors graduated in the lower half of their classes. :wink:

If your doc was a total jerk with you, send a note to the head of the hospital where he/she works. Maybe nothing will happen, but the next time a complaint comes up, your note will have some weight, as a previous incident.

I don’t think we have enough information available about Crafter_man’s obese lady and her doctor to actually know whether the complaint is reasonable. He could have been highly offensive. He might have just have been straight-talking. She might have come to him 15 times before, complaining about heart palpitations, and refusing to attempt to lose weight, and finally he lost all patience.

Part of being a decent doctor is learning to relate to your patients as (mostly) intelligent human beings with their own feelings and opinions. It’s a skill to be able to express your concerns or explain whatever disease or condition the patient may have, without being an insensitive dolt.
Doctors are smart people and should know how to do this. There is no “the Doctor is God” anymore. Most nurses never did have the “I shall not be Questioned! Fear me, I have Knowledge!” superiority complex. Funny that.

What makes you think that’s the half that is insulting their patients? :wink:

I’ve known med students (and more vet med students) who I wouldn’t want for a doctor (or veterinarian) based on their attitude. The ones that stand out the most because of that are also very good students, grade wise.

Not to say the caring ones are at the bottom of the school, but being on the top half does not prevent assholery.

Thank you! Thank you! Thank you.
I tried to make that same point in the thread at post #5, and had people telling me that since what the doctor told her was true it couldn’t possibly be a real problem.