Malpractice Lawsuit Fear Provokes Defensive Medicine Response

Simon M. Helfgott, MD

At first glance, the thin, cream-colored envelope looked no different from the usual pieces of mail that I periodically receive from attorneys’ offices. Most are straightforward letters requesting medical records that could support a patient’s disability claim. Some are seeking information regarding a client’s medical status prior to an accident. But the content of this particular letter was quite different. The writer, a litigator at a large firm that specializes in medical malpractice, was specifically requesting copies of any personal correspondence I might have had with a certain Dr. R., a local internist who, over the course of his lengthy career, had referred just a single patient to me.

Dorothy & David

I happened to meet her about three years earlier. Dorothy was a woman in her early 70s with myriad aches and pains. She was no different from many other patients I see. So why did I remember her so vividly?

What struck me about Dorothy and her husband David was their absolute rage toward Dr. R. At first, they seemed like a pleasant older couple, until midway through Dorothy’s first visit, when his name came up. Suddenly, they were transformed into a marital version of The Incredible Hulk. Seething with anger, they described how they had known Dr. R. since his earliest days in practice in their leafy New England town. A rising star, he was highly regarded for his astute diagnostic skills. Lately, though, he had lost his touch. During office visits, he no longer had time to chat, and he did not seem to take any of their complaints seriously. Phone calls were rarely returned. He was just a horrible doctor. Their invective left me speechless. Generally, when a patient complains about their doctor, they don’t turn red in the face with tears welling up in their eyes. I decided to see Dorothy just for this single visit. I feared becoming the target of her next tirade, should I ever fall out of favor with her.

Because most of Dorothy’s pain was due to osteoarthritis, I referred her to a physical therapist in her town. I suggested that it might be easier for her to temporarily follow up with Dr. R. rather than drive the 50 stressful minutes from her home to my office via the winding Jamaica Way, a parkway best suited for the horse and buggy that Frederick Law Olmsted designed it for.