Sunday, September 07, 2008

Another Thing to Ponder


Thanks for the lively discussion in the post below. If you missed it, Click Here.

So Gerbil tells us she never refers patients to therapists she doesn't know personally.

This got me thinking: How much responsibility does a referring doctor bear for the treatment of his patient by another doctor, one he's referred the patient to?

Okay, so in this wide world of psychiatry, when a patient asks me for a referral (gay/straight/Republican/dog-owner, whatever), I often give names of psychiatrists I know personally whom I trust. In this realm, I'm pro-Gerbil. If someone wants a referral for someone in their insurance network, I tell them to call the insurance company: I have no idea who is in what networks. And sometimes I can even give people the name of a good primary care doctor (one I know and think highly of). If they go, and if the doc does wrong by them, how much am I held responsible for this? Most readers seem to feel it's not cool to "out" a gay doc, but am I obligated to tell a patient that someone I'm referring him to has been the subject of a malpractice suit? Or 5 malpractice suits? Or that decades ago he's been sanctioned by a professional board or banned from a hospital? Or that I happen to know he's cheated on his wife? If I don't just happen to know it (via the grapevine or whatever), am I obligated to research the past of another physician before I give out a name? Am I more obligated to do the Googling than the patient is?

So you say Why Would I Refer anyone to someone with an unseemly background? And actually, I wouldn't if I knew the doctor had these issues and if there were other choices. But what if one lives in a small town and the patient needs a specialist, and there is only one such specialist (...oh, say a retinal surgeon or a hand specialist... or a cosmetic surgeon who specializes in...name your body part) and that specialist is known to be competent despite his unsavory past.

I know, I know...therapists are different.

Chime in: