Ethical vs. Unethical

[CFRBryan347768]

Do you thinks its fair for a doctor to demand/threaten you into coming into the office? Heres the situation...
Ring Ring

Jaimie:Hello
Dr.:You need to come in now!
Jaimie:Who is this?
Dr: Its' Dr.*****
Jaimie:I'm seeing another Dr. now
Dr: Says somethign i cant make out(Jaimie starts to cry)
Me:Who the Bleeeeeeeepppppp is this?
Dr:jaimies Dr. She has to come in right away or I am calling the Department of health.
Me:Why she is seeing another Dr. who seems to be PROVIDING THE RIGHT MEDS and taking better care of her than YOU
Dr:She still needs to come in
Me:Why?
Dr.:Because i will call the Dept. of health on her and her family ::click::

What the Dr. had said that i didnt hear was,"Your TB might me inactive but if you dont see ME its going to kill your baby."

Now she can threaten all she wants but the way the doctor went about this is very unethical or am i wrong? And care was transfered to a specialist so is this doctor after her money? Needless to say this doctor lost 3 patients because of this but yeah now im just venting hahah.

 

[VentMedic]

Who is Jaime?

What is the medical care?

Not enough info.

But, is this someone close to you that you are discussing their medical information?

It appears that "me" initiated the verbal confrontation first without knowing what was said that made Jaime cry. That probably came across to the doctor as avoidance or non-compliance.

Yes, the words TB and Department of Health do go together. The DOH must know about each case and the followup. If that physician initiated care, he/she is responsible for seeing that care is followed through either by himself or a Specialist and that the Specialist continues with the DOH paperwork. If it is a HMO type of situation where that patient is still listed with the initial doctor as a primary, there may still be some responsibilty there. These matters are not taken lightly and some of the medications used to treat TB can be very toxic to a baby. There are several legal steps as mandated by both Federal and State laws that can be taken against a person that has/had the dx of TB to ensure public safety and the safety of an unborn child.

 

[CFRBryan347768]

Care was transfered to a specialist and another doctor(who jaimie has yet to see yet) so the original doctor is initially out ofthe picture. This doctor called out of no where thats why im so confused

 

[VentMedic]

Care was transfered to a specialist and another doctor(who jaimie has yet to see yet) so the original doctor is initially out ofthe picture. This doctor called out of no where thats why im so confused

The DOH will impose stiff penalties on all physicians involved if the proper followup and transfer of care neglected to keep the DOH informed. This is especially true if there is a baby involved.

 

[CFRBryan347768]

Oh.....well shes supposed to be a professional so I still think she went about it the wrong way. but Thanks for the info!

 

[VentMedic]

Oh.....well shes supposed to be a professional so I still think she went about it the wrong way. but Thanks for the info!

Would you prefer an Officer of the Court to deliver the message instead?

Do you think your attitude in the phone conversation may have played some role?

 

[CFRBryan347768]

Would you prefer an Officer of the Court to deliver the message instead?

Do you think your attitude in the phone conversation may have played some role?

Absolutely, but all my attitude did was make her yell louder.

 

[aussieemt1980]

Was you partner transferred to the specialist for the management of her condition?

If that is the case, I would assume that the TB has already been notified to the department of health. In australia, TB means that you go into isolation with respiratory infection controls.

Doctors can be funny like that sometimes, especially if something comes up. Is the baby born or unborn? I dont think I have heard of a case of TB crossing the placental barrier.

But I do agree that medications can affect the development in uterus. A simple "I would like to make an appointment with you" would probably have sufficed, and in Australia, Doctors are not allowed to discuss any medical condition except with the patient, unless the patient has allowed their next of kin to be involved in the discussion at that point. The next of kin cannot contact the doctor a week later and ask further questions. They will get the "Medical in Confidence" speech.

My partner is pregnant, and the Doctors will actually talk to her and not refer to me unless I ask something. Although, I did have to take her into hospital the other morning, and I went in work uniform, and found a new experience - professional courtesy.That and for some reason, the referring hospital must have told them that an ambo was bringing her in, so we walked straight through the ED to the required ward (the ED nurse commented that she was waiting for us at the ambulance entry for the stretcher vehicle to arrive).

 

[BossyCow]

Care was transfered to a specialist and another doctor(who jaimie has yet to see yet)

That sounds to me like she is currently without care. I can see why the original doctor is concerned.

 

[BruceD]

...

Doctors can be funny like that sometimes, especially if something comes up. Is the baby born or unborn? I dont think I have heard of a case of TB crossing the placental barrier.

Just thought I would let you know that TB is a danger to the fetus, pregnancy does all sorts of weird things to your immune system. They do withhold certain tb drugs though, those that are especially dangerous to the developing fetus.

My apologies to those overseas, I only took the time to look up our (US) information.
http://www.cdc.gov/TB/pubs/tbfactsheets/pregnancy.htm
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5211a1.htm

Take care
-B

 

[aussieemt1980]

I stand corrected. I have only just started learning about the major stuff at uni where I am studying to be a nurse. In my job, we dont come across TB too much, just have to be immunised for just in case.

 

[Ops Paramedic]

I t sounds to me like the first Dr suspeted a condition that he/she needed to report t the DOH, and not maybe report you as per say. But there is correct way to do that.
To be honest, i can't remember if TB is a notifable condition or not, for us, i don't think so. We have hospitals dedicated for TB patients, otherwise they just walk into emergency department off the street anyway!

Hoping Jaime gets well soon.

 

[VentMedic]

Please review the links in BruceD's post.

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5211a1.htm

Responsibility for Successful Treatment

The overall goals for treatment of tuberculosis are 1) to cure the individual patient, and 2) to minimize the transmission of Mycobacterium tuberculosis to other persons. Thus, successful treatment of tuberculosis has benefits both for the individual patient and the community in which the patient resides. For this reason the prescribing physician, be he/she in the public or private sector, is carrying out a public health function with responsibility not only for prescribing an appropriate regimen but also for successful completion of therapy. Prescribing physician responsibility for treatment completion is a fundamental principle in tuberculosis control. However, given a clear understanding of roles and responsibilities, oversight of treatment may be shared between a public health program and a private physician.

The doctor is met with someone butting in, not identifying himself (also) and using profanity.

Me:Who the Bleeeeeeeepppppp is this?
Dr:jaimies Dr. She has to come in right away or I am calling the Department of health.

If a doctor said something I was doing could kill my baby, I would LISTEN! The pharmacy may have notified that doctor about a med error that could be very harmful. There are also other possibilities like wrong lab results. I would not curse at someone who has an interest in my baby's health either for ethical or legal reasons. Someone with even a little medical knowledge should be willing to listen to what the doctor has to say before passing judgment that could jeopardize the baby's health.

Care was transfered to a specialist and another doctor(who jaimie has yet to see yet) so the original doctor is initially out of the picture. This doctor called out of no where thats why im so confused

Care has not been transferred completely if the other doctor has not been seen by the patient. The original doctor still has a responsibility until that happens and possibly until the end of treatment depending on insurance situation and state laws.

Unfortunately, there are people out there who are non-compliant and don't follow the doctor's advice. You will be running into them often in EMS and you may even react with emotions (anger, disgust etc) at these people just like this doctor did especially when there is a baby involved.

If you had interfered in the treatment of TB or any other medical reason in my area as well as possibly jeopardizing the welfare of a child (born or unborn), our doctors would not have hesitated getting a court order.


To the original poster:
If you continue your training further in the medical profession, expect voices to be raised occasionally. Striving to be the bigger professional in attitude will get you further then slamming profanities at whoever for whatever reason.

Florida still has a secure hospital called A.G. Holley to isolate TB patients that are risks to the public.
http://www.doh.state.fl.us/AGHolley/index.html

Many hospitals can make provisions to quarantine a patient who is at risk of infecting others with a resistant strain of TB.

Yes, we do have people that walk into the hospital ED with TB. But, once they are diagnosed they are treated and possibly isolated depending on the strain and resistance.

Doesn't anybody remember that "little" incident with the guy on the international flight?

 

[JPINFV]

Secondary TB=not fun. There's a reason why the term "cavitation" sounds bad, as is why that guy should be burned at the stake (regardless of if he weighs the same as a duck or not).

 

[Ridryder911]

Care was transfered to a specialist and another doctor(who jaimie has yet to see yet) so the original doctor is initially out ofthe picture. This doctor called out of no where thats why im so confused

There is the problem, she still has not carried out discharge orders. Obviously, they lack concern by not following up as of yet. As Vent described, it is a serious issue with DHS or Child welfare as well as possible neglect can be assumed if not done and performed in a timely manner.

You may consider unethical, while the physician may consider neglectful and dangerous to the themselves and others. Remember TB is one of the few a diseases that one can still forced upon for treatment, due to possible risks to others...

Be glad child welfare and Department of Health is not ringing the door bell....

R/r 911