Letters

From the June 1997 ACP Observer, copyright © 1997 by the American College of Physicians.

Patients being shortchanged?

After 42 years of practicing internal medicine, I decided to retire earlier this year. Since that time, I have received feedback from patients who have had to seek medical care from other doctors.

The main point that I want to make is that the patients are getting shortchanged in their medical care by doctors who profess to be internists. Whether the reason be poor training, inadequate compensation for their work, Medicare, Medicaid, managed care, laziness, or plain old incompetence, these physicians are not giving the patients the care they deserve.

I am not brilliant, but I tried to make up for my lack of astuteness by diligence and attention to detail. What I hear from my former patients is that they are getting nothing. Apparently, a real history and physical exam are precious commodities which are hard to find. I don't know if this is something new, as I never had the opportunity to assess my colleagues' practices in the past. What goes on in a doctor's private office is not subject to scrutiny.

This distresses me greatly for the patients' sake, and because I can foresee more and more changes in the practice of medicine in the future, none of which will be very satisfying to the profession. From what I have heard, I would not be surprised to see an increase in malpractice cases because of errors of omission. For this reason, I would be opposed to any tort reform. This is the patients' ultimate source of protection, a hindsight one and, at that, not very satisfying to anyone.

Paul Teplis, FACP
Marietta, Ga.

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