A Doctor Apologizes but the Damage is Done

Written by: Lynne E. Porter M.D., FACP 

Mrs. Singleterry was referred to Dr. Samuels, an excellent, young gastroenterologist, for loss of appetite and weight loss.

Mrs. Singleterry’s appointment went well. Based on his evaluation, Dr. Samuels believed she had a gastric tumor. Tests confirmed that and revealed evidence of metastases and anemia. Dr. Samuels referred Mrs. Singleterry to his surgical colleague, Dr. Martin, who recommended surgery.

Mrs. Singleterry refused surgery wanting time for prayer and homeopathy. Dr. Samuels was very upset. He wanted only the best for her and could not understand her decision. At their next appointment, they had words. He cared about her and wanted her to have the best shot possible. Delay was not her best choice. Mrs. Singleterry did not agree. Dr. Samuels was very forceful in his condemnation of her choices. Mrs. Singleterry left angry and upset.

Mrs. Singleterry transferred her care to Dr. Martin.

Two months later, Dr. Samuels saw her in the hospital and apologized. He had realized how disrespectful he had been. He was paternalistic in his approach wanting her to say, “Whatever you think best, Doctor.” Mrs. Singleterry turned away.

A few months later, surgery revealed an advanced tumor. She died not long after. Dr. Samuels was devastated. He had learned a very hard lesson about respecting a patient’s choices. He had not helped her when she needed him most.

How does a doctor reconcile his disagreement with a patient’s decisions when they will make the patient’s clinical situation much worse?