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More on Blacklisting Patients

Here is a typical example, received in an email, of how patients experience it.

"I went to a clinic I had never been to before and the doctor looked at his computer and then asked me if I was bringing a lawsuit. Where did he get the info because I had never met him before and this was the first thing he said to me. My health provider admitted that my health card had been red flagged after I began to find question some things." - Blitz Mitzi, Canada.

It can happen to health care professionals in the USA too.

"I am a Research Biologist, an Occupational Therapist and a Certified Hand Therapist.  I was injured during surgeries. . .  I was told by a physician's assistant . . . that I was obviously injured and that no doctor in San Diego would ever admit this.  I didn't believe this statement at the time, however, time has proved it 100% accurate.

"I have accumulated enough documentation to demonstrate how tests were performed inaccurately, data interpreted inaccurately and how my medical problems have not been entered into the medical record. . .  I also found out that there are no agencies or groups willing to investigate this matter."

This is the typical experience of injured patients. Injured patients have no friends in medicine, even when they are health care professionals themselves. Try to find one health care professional who knows that.

Most, but not all, blacklisting occurs without a list.

Doctors, like members of any normal group, watch out for each other. If a patient never pays bills, or repeatedly files lawsuits, or habitually becomes violent, or travels around trying to get illegal prescriptions, one would expect a doctor who knew about it to warn colleagues.* But that kind of communication also results in the blacklisting of innocent patients who need treatment. Especially if the injuries are iatrogenic.

It does not require a tip from another physician for a patient to go from doctor to doctor to doctor without getting diagnosed or treated. Such a patient usually will never know why it is happening, but can it be called anything other than blacklisting when the community has a shared understanding that results in the members of that community collectively denying care to one patient?

Blacklisting can result in permanent harm or even death and can be criminally illegal. What are the odds of the police pursuing it? Near zero. How is a patient who figures out that it is going on to persuade anyone of it? Where will be the proof? Doctors create the record. And the records are created to protect doctors, not patients (see defensive documentation). The police don't even know where to start looking. And state medical boards are run by other doctors who are on the same page as the doctors doing the blacklisting. The very suggestion of having been blacklisted "strains credulity" to their way of thinking. They have that much faith in each other and that little faith in patients.

They also have that much faith in themselves. It is normal for them to deny the existence of obvious injuries needing treatment, branding them as psychosomatic, and choosing to believe instead in that which serves their own interests no matter how fanciful that might be. They really do believe the self-serving diagnoses they create in order to protect themselves and their colleagues when they brand injured patients as crazy or having "Conversion Disorder" or as trying to cash in with a lawsuit or get revenge with a grievance or any of the other pejorative nonsense they choose to believe about the patients they injure, patients who only are asking for help.

The story the data tells us is often the one we'd like to hear, and we usually make sure that it has a happy ending. - Nate Silver in The Signal and the Noise

Look at this graph. It documents how it was done to me and how it can be done to you if you ever have a problem in medicine. Patients who understand it have a better chance of surviving in spite of it.

Overtness

It is not always as subtle as described above. Sometimes it is one physician blatantly telling another physician to find nothing wrong with a patient, to give no tests that could uncover injuries, and no referrals that could help the patient because anything found could indict a fellow physician.

Why would a physician risk his license and intentionally ruin the life of a patient? Well, there's really no risk. Who is going to report it? And who would believe the report? And who would do anything about it if they did? There is no one on the side of patients when things go wrong. But still, what could be so awful that covering it up would be worth ruining the life of the patient? The statistics are elsewhere on this site about how many assaults, rapes and homicides are committed by health care workers each year against patients. Do you know why there are not a corresponding number of convictions for committing those crimes? One of the reasons is that no one in health care believes that their colleagues do these things, so they don't believe they are covering up anything. They simply refuse to find or record the injuries and/or evidence of the crimes. The same for errors. Their belief in their own innocence and entitlement overwhelms accurate observation and self-awareness. They don't think they are covering up anything. At most they think they only are helping to prevent misunderstandings that might result from creating diagnoses that might create misimpressions among people outside of their group. No records of the injuries, or the claims of the patient, are created. The injured patient doesn't get diagnosed or treated.

All it takes for a patient to become blacklisted is the potential for a case to be made against a colleague. Doctors gossip about it among themselves in ways that can result in further injuries for the already injured patients. There is nothing patients can do to stop doctors from doing this, but doctors can stop patients from warning other patients about the doctors who do this. Defamation suits and threats thereof routinely are made to injured patients to silence them.

Physical Lists

Since discussion of this issue is in its infancy, it easily is dismissed by caregivers speaking of it as though it required delivering hardcopy of a list in the dark of night.

However, sometimes it is. Like http://www.doctorsknow.us/about.php. Billing themselves as risk management for the 21st Century, they keep a database of plaintiffs. In other words, if someone in medicine injures you, whether intentionally or not, and you sue them for it, they put you on a list in order to prevent other caregivers from treating you in the future.

You cannot see the list. You have to be a member. That's sort of like delivering a physical list in the dark of night, isn't it?

Patients cannot do the same thing to warn each other about incompetent or even untrustworthy doctors. Just filing a complaint can result in the most insidious retaliation.

Doctors are supposed to consider the seriousness of the malady, not the virtuousness of the patient.

Medicine is not like other professions. The consequences for its customers are too great. Doctors are supposed to treat villains as well as heroes, even if treating them enables villains to commit more villainy. But they don't. If you were to go to your primary care physician with wounds received when one of his colleagues raped you, your primary care physician would diagnose you as being crazy, and so would every other physician you went to. When you hear in the news about a patient who finally lashes out in frustration, the medical community unites in diagnosing the patient as being paranoid and crazy, and journalists always accept that without question. After all, the pronouncement has been made by physicians. Why would anyone question it?

The health care industry is a monopoly as much as the water company or an electric utility company and has similar obligations. If power and water utilities refused service to someone, at least the victims would know that they had been cut off. But when patients are manipulated out of care, often they don't understand what is happening, even when it is overtly declined it, and they are left in a more sinister darkness.

Physicians rationalize that patients always can go to another physician. But they cannot. Physicians are a community. On important levels they look out for each other. Despite their differences and the disputes common in any community, a patient with an iatrogenic injury rarely can get a diagnosis of that injury in the record, and likely cannot even get treatment for it.

Ruin rather than Care

Despite their differences and disputes, if it appears that someone in medicine could become the subject of a suit or grievance, they unite to defeat, if not destroy, the patient. That is not an exaggeration. They will let an injured patient's untreated injuries become ruinous rather than give care that, in addition to saving the patient, might make possible the patient's holding responsible the health care providers who caused the injuries.

Referral from a physician to a radiologist:

"Re: John Smith. This 57-year-old builder is requesting a CAT scan on his lumbar spine to be performed on a private, fee-paying basis. Mr. Smith is a malcontent of the highest order and holds a very warped view of life . . . expresses contempt for orthopedic surgeons, chiropractors, osteopaths, acupuncturists . . . "
from "The World's Worsts" by Les Krantz & Sue Sveum

Someone injured badly enough by one and then denied treatment for the injuries by the others rationally will learn to distrust the orthopedic surgeons, chiropractors, osteopaths, acupuncturists and others who did that to him and become malcontent. Patients need to hide discontent to have any chance of getting care.

It just takes one

This is from an email another patient wrote to me about her experience:

"All it takes is for one doctor to decide he doesn't like you, and the patient will find that he can't get treatment anywhere else."

A disabled veteran we know of received this in a email from a VA employee:

"I'm sure nobody would admit to blacklisting: they will say that they use flags to warn staff of "disruptive" behavior (these appear in VISTA and CPRS). . . "

In medicine they believe that they are objective and above self-interest beyond what even a federal judge would imagine him or herself to be. In other professions, they understand how personal interests can interfere with objectivity. In medicine they cannot be persuaded that they don't.

Objective

In general, people feel that the perceptions of other people might be shaped by loyalty or socioeconomic factors or political or religious affinities, but believe that their own are not. Our own we humans tend to assume are the objective truth. Medicine is not alone in this, but they are over the top in it. And they are making life altering decisions for other people.

Whose subjectivity is more likely to lead us to an honest appraisal of how many lives are lost, and how those lives are lost, in medicine - the people whose lives are being lost or the people who don't want to be held accountable for losing those lives? It has been demonstrated that patients are a more accurate source of information about adverse events in medicine than anyone in medicine is.

It is self-serving, ignorant, ridicule to evaluate the quality of the information available from patients by recounting what a confused patients says to a doctor. Patients might not know terminology and best practices, but sometimes they know what happened and they don't try to cover it up. This has been studied with organization and oversight. Patients do not have a vested interest in hiding the truth. Their lives depend on finding it. When given the opportunity, they are the most accurate source of information in medicine (see Medical Reporting) because they do not benefit from distorting or erasing it.

No one in medicine wants that information. And yet they manage to believe the opposite about themselves.

First Priority

If nothing else is learned from this page, it should be learned that the well being of patients is not the first priority of health care workers. Their own well being comes first and they are willing to cause physical injuries to patients to secure it.

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Examples:

http://paynehertz.blogspot.com/2007/09/vas-health-records-software-allows.html

http://www.vawatchdog.org/07/nf07/nfSEP07/nf091107-1.htm

http://tossurgerynightmare.com/blacklisted.html

Another patient, Cynthia Sullivan, sent this message on facebook:
"My ex husband died and his autopsy became missing. When I went to NC they dont have electronic records but they asked to sign a release. Then BAM! They refuse to give me my electronic records as well as HIPPA. This is so sick I cant believe it almost. . . I actually had one md call and say '
if you dont turn me in Ill help you.' Can you imagine that."

What's hard to imagine is one MD trying to help. We rarely hear of that.

Reporting Blacklisting

By the way, do you know what the police say when you try to report blacklisting? They say to contact the state medical board. Do you know what the state medical board in Ohio says when you report it to them? They investigate it for two years and then decide that the physician has not violated any provisions of law that their agency is charged with enforcing, because they are not the police and so they not authorized to investigate crimes even though they accept those cases and delay them until they are too old for anyone to investigate. Do you know what provision of law they are charged with at that point? The provision that requires them to turn their investigation over to the agency that is charged with enforcing that law. Which is the police. Which is where you started. But now the case is too old and the trail is too cold and the police still think it must be someone else's job. Burt and Kashyap are two examples of this being the runaround that patients get.

People are poor judges of themselves and their own behavior. In his book Thinking, Fast and Slow  (links to Amazon) Daniel Kahneman says that strangers on the street often are better judges of us than we are of ourselves. Why in medical school do they teach future health care professionals that it will be the opposite for them?

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A conspiracy against patients with or without a physical list.

If you show up in a physician's office with an injury that was incurred in medicine, you are not going to leave with an accurate diagnosis. You are on a list that is kept mentally, culturally, of the kinds of patients who are to be denied accurate diagnosis and treatment and branded in ways that can interfere with their getting medical care for the rest of their lives.

The health care professional (HCP) doesn't see it that way. The HCP doesn't believe you. To the HCP, you are the problem. An innocent colleague must be protected from your frivolous complaint.

As long as they, as a group, are more interested in protecting each other than in protecting patients, patients with iatrogenic injuries are a good window on how blacklisting works and how damaging it is for patients.

 

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Footnote:
*It should be noted that patients do not have this right (see asterisk above). Patients get sued for defamation if they warn each other about medical professionals. Physicians are allowed to talk. Patients are not. This leaves patients ignorant and powerless and further shields medical professionals. When even their victims cannot report it, medical professionals are further shielded from normal inhibitions against acting out when experiencing lust or jealousy or anger or any of the other emotions to which they succumb from time to time.

It's nothing new (for instance, see Benjamin Rush on this site).

See also Electronic Medial Records on this site.

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Grievances about authorities often are dismissed by claiming that the complainer is mentally ill, delusional, paranoid. The White House said that Martha Mitchell was when she claimed that there was a conspiracy in the White House. She was married to the attorney general of the United States. In person she saw the Watergate burglaries from planning to cover-up.

In that same way injured patients are in a position to know what no one in medicine wants anyone else to know.

No one believed what Martha Mitchell reported. In the years since Brendan Maher, a Harvard psychologist, has made her name the label for the problem, the Martha Mitchell effect, describing the circumstance in which someone is branded as delusional by people who do not want the information to be right.

Note collected later

A nurse wrote to a patient: "Most doctors won't step in when another doctor has done something since they have no way of knowing exactly what the first doctor had in mind (they'd need your record for that information). If they do and they mess up what the first doctor did, then they are liable and they're in a heap of trouble with the licensing board."

I'd like some second opinions on that.