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Decision 97HDC6528

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Complaint

In early June 1997 the consumer visited the provider, a General Practitioner, with a throat complaint. The consumer advised the provider that their throat, one ear and the glands down the side of that ear were sore.

The provider examined the consumer's ear but omitted to check their throat until reminded by the consumer. On examination the provider found the consumer's tonsil was badly infected at which point the provider took a swab.

During the examination the provider discussed the consumer's spouse's ongoing health problems with the consumer. When requested to stop talking about this the provider became more and more agitated until they were angrily talking through gritted teeth. At this point the consumer reached for their prescription and motioned to leave the room when the provider came around their desk and barred the consumer's exit stamping their feet, pumping their fists up and down and continuing to talk through gritted teeth.

When challenged on their behaviour, the provider commented that they occasionally needed to vent like this and suggested that they discuss the matter at a later date.

Further to this the provider mistakenly wrote out a prescription for the consumer in the name of the consumer's spouse as opposed to the consumer. The error was detected by the dispensing pharmacist.

Investigation

The complaint was received by the Health and Disability Commissioner in early June 1997 and an investigation undertaken. Information was obtained from:

• The Consumer
  
  
• The Provider
  
  
• The Part-time receptionist at the Provider's surgery
  
  
• The ACC Case Manager, local branch
  
  
• The local pharmacy

The consumer's medical notes for the consultation in question were obtained and reviewed.

Outcome of Investigation

The consumer visited the provider suffering from a sore throat and swollen glands. The provider was running significantly late this day as they had just returned to work after a long period of absence due to the provider's own health problems.

The consumer states that the provider carried out a physical examination but did not look in the consumer's mouth until further requested to do so. However the provider states that they had every intention of examining the consumer's throat and had merely turned away to locate a light source to aid in the examination when the consumer had again requested that the provider look at their throat.

The Commissioner has been advised by staff at the medical surgery that on arriving at the surgery this day the consumer appeared distressed. The staff felt this may have been as a result of difficulties the family had been having over the lodging of an ACC claim by the consumer's spouse. They came to this conclusion as the consumer's spouse had attempted to contact the provider both at home and at the surgery during the provider's absence to discuss this matter.

The provider states that at the beginning of the consultation they also felt a certain amount of anger from the consumer and thought this could be as a result of the recent problems associated with the spouse's ACC claim. As a result of this the provider started to discuss the matter thinking this may defuse the situation. The consultation became strained and the provider states that the consumer was saying that the practitioner's service to the consumer's family over the years had not been up to standard. The provider has stated that, through gritted teeth, they said "I don't have to put up with this" and had risen from their seat. The consumer then responded "is this how you usually vent yourself". The provider chose not to respond to this and sat down as they were not prepared to discuss the matter any further.

The consumer states that when the provider started talking about the recent problems with ACC they requested the provider stop discussing these matters as the consumer was unwell and did not wish to discuss them. At this point the consumer states the provider became agitated and it was the provider who stated that they occasionally needed to vent in this way.

At the conclusion of the consultation the provider wrote out a prescription for Compocillin in the name of the consumer's spouse instead of the consumer. The provider later thought they may have made a mistake and phoned the chemist that they thought the family normally used. Shortly after the provider was phoned by the local Pharmacy and the prescription was amended.

The Code of Health and Disability Services Consumers' Rights

RIGHT 1
Right to be Treated with Respect

1) Every consumer has the right to be treated with respect.

RIGHT 4
Right to Services of an Appropriate Standard

2) Every consumer has the right to have services provided that comply with legal, professional, ethical, and other relevant standards.

Opinion: Breach

It is my opinion there has been a breach of Right 1(1) and 4(2) of the Code of Health and Disability Services Consumers' Rights.

Right 1

The consumer was entitled to be treated with respect during the consultation with the provider. It is not appropriate for a health professional to speak to a patient through gritted teeth no matter how difficult the consultation. It is a Medical Practitioner's responsibility to remain calm and behave professionally with patients. It was also inappropriate of the provider to discuss the consumer's spouse's health matters with the consumer.

Right 4

The provider incorrectly wrote the prescription in the name of the spouse and this did not comply with appropriate standards of care. While the provider later thought they may have made a mistake and attempted to rectify this, if they had been focused on the consumer and not discussing the spouse, it is unlikely the error would have occurred.

Recommendations

The provider has apologised in writing to the consumer and has retired from practice.

Should the provider return to practice I recommend that they refrain from discussing confidential information pertaining to another patient with anyone other than that patient.

A copy of this report will be forwarded to the Medical Council of New Zealand.

 

 

For further information, contact: HDC Communications Section (09) 373 1060.

Or by email: your.rights@xtra.co.nz