Does publicizing physicians' bad behavior help patients?

Ayla Ellison -

An anonymous essay published in the Annals of Internal Medicine last week has received mixed reviews, with some industry experts calling it inflammatory, while others believe it sheds light on an important issue that needs to be addressed.

In the essay, the author recounts instances when physicians behaved in an unprofessional manner that went undetected by patients.

The author details one disturbing incident a medical student shared with him while he was teaching a fourth-year elective course. The student, who the author calls David, described how an attending physician made lewd comments as he cleansed a woman's vaginal area prior to a hysterectomy.

The author also recounts a time during his third year of medical school when a physician made lewd comments and gestures directed at a woman on an operating table who was experiencing dangerous bleeding following vaginal birth.

In an editorial accompanying the essay, editors of the journal said the purpose of publishing the essay is to dissuade physicians from engaging in disturbing and unprofessional behavior. However, some physicians have criticized the journal for publishing the essay.

Sigal Klipstein, MD, chair of the American College of Obstetricians and Gynecologists' committee on ethics, told The New York Times she was concerned the piece would keep women from seeking medical care. She also asked what the point of publishing the article was since the patients in both of the occurrences were not physically injured by the unprofessional behavior and received sound medical care.

However, Nancy Berlinger, a scholar at The Hastings Center who writes about ethical challenges in healthcare, believes the essay publicizing the physicians' unprofessional behavior could benefit patients by helping junior physicians understand that this type of behavior should not be tolerated.

"This is the worst thing a role model can do: to suggest that wrong behavior is acceptable, to nudge junior people to be callous and to misuse power," Ms. Berlinger told The New York Times. She said that in both cases the senior physicians made the less experienced physicians "feel dirty at an early stage of their careers."

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