Letters: The bad medicine of silence

I read with great interest your Aug. 2 article “The M.D.: Silence on Bad Doctors.” While you were addressing the doctors’ ethical dilemma on reporting incompetent colleagues, an equally pressing ethical dilemma involves the patients damaged by these unreported incompetent colleagues.

How can physicians live with their Hippocratic Oath-bound conscience? Their failure to report will only lead to more patient-victims every year — in numbers that are probably substantial. If the Journal of the American Medical Assn. survey at Massachusetts General Hospital is representative, and the estimate of 600,000 U.S. physicians is used, then 17%, or 102,000 physicians, “have direct, personal knowledge of an impaired or incompetent colleague.”

If only 1 in 3 of these 102,000 report on a bad colleague, then there are still about 67,320 bad physicians out there providing incompetent services. These 67,000+ incompetent physicians can create very substantial numbers of damaged patients. As most states have legal requirements to report, and all physicians have an ethical responsibility to report, aren’t the non-reporters also damaging patients by their inaction?

I speak from experience. A board-certified neurosurgeon, with no complaints, suits or blemishes on his record (I checked him out thoroughly before my surgery), botched the removal of my meningioma, leaving me with gross cerebral spinal fluid rhinorrhea. The documented and verified errors he made led to five corrective surgeries. I can’t even imagine what the other physicians and nurses in the operating room were thinking during my first surgery or why they did not report his obvious malpractice.

I have since found out that he was sued and fired from two major hospitals and settled out of court to eliminate any taint on his record. How, ethically, can this information be kept from potential patients? How can it be kept from insurance companies that have to cover (as in my case) millions of dollars of additional surgeries simply because of incompetence?

Barbara J. Sihilling

Irvine