View Full Version : The incompetence of doctors and the consequences thereof
olimikrig Sun, 4th Sep '05, 6:50pm A couple of years ago I was treated for Hernia rupture. A quite standard procedure, which normally doesn't bring any troubles along with it.
Hernia causes that the peritoneum and the underlaying softer parts penetrates a weak point in the surrounding tissue. The abdominal consists of muscles, which lays tightly together and keeps the inner organs in place. Weak spots in the abdominal are by nature placed around the groin and belly. So called 'hernia ports' can occur when muscles weakens as a result of overstretching.
The hernia rupture happens because of a physical exertion or by a cough or sneeze where the musculature in the abdominal are pulled together and the pressure in the abdominal cavity increases.
If the abdominal is so weakened then the peritoneum and the underlaying softer parts, usually part of the small intestine, can be pressed out creating a bulge in the skin.
Hernia rupture ain't a severe problem unless your intestine gets stucked making the flushing of it not functioning properly. However you want to get it fixed as quick as possible.
The treatment is simple: The bulge is pushed back into its place, and the 'hernia port' is sowed together to make sure the intestine is kept in place. Usually you will only have a fine long scar to witness what had happened. Now we come to what it's all really about! The doctor who operated me managed to make severe damage on my abdominal, so after the healing process I found myself not only having the ugliest scar imaginable, but after a quick consulting with my own doctor, it was diagnosed that I had scar tissue in the lover regions of my abdominal. This causes my abdominal to be hardened. Therefore whenever I do stuff like a sit up it feels like be stabbed over and over again! The upper part of my groin and the lower parts of my abdominal are sore, and things like sexual excitement or working out can cause immense pain to suddenly travel through my entire belly region, and it feels like someone crushes my balls! Unfortunately I live in a country wherein I cannot sue the doctor who operated me, and it will be very difficult to even get him fired; even though he so severely messed up such a standard operation. If I was to be operated again I could expect to have to wait at least 2-3 years before they could find time to me. Moreover re-operating would most likely rather worsen the problem than fix it.
Now my biggest concern is wether I should go for it and take the chance on the operation table once again, or if I should accept my fate and learn to live with it. What would you do, and why?
Felinoid Sun, 4th Sep '05, 7:16pm The upper part of my groin and the lower parts of my abdominal are sore, and things like sexual excitement or working out can cause immense pain to suddenly travel through my entire belly region, and it feels like someone crushes my balls! Sounds like an eternal groin pull. Much suckage. Get the operation done in the US; they know how to fix those here (relative had one, so I speak from experience), and if they screw up this time you can at least sue.
olimikrig Sun, 4th Sep '05, 7:26pm Probably, but that would cost quite some $$. In Denmark I can get it done free, because we've got a strong health care covering every single citizen. Of course it's tempting.
Morgoroth Mon, 5th Sep '05, 12:03am There is also a negative side of being able to sue a doctor who does a bad job. I've read that many doctors are afraid to do risky operations that could very well ease up a condition because they are afraid of getting sued if something goes wrong, but yeah it kind of sucks that with socialized healthcare the responsibility lies with the patient. Now I'm not sure how exactly someone should be compensated for mistakes of a doctor but I'm of the opinion that the doctor should not take the blame. They are not perfect and sometimes do mistakes, you can't expect them to be supermen. I do however think that failed treatment should be compensated by someone, either by the private clinic or in the case of public healthcare by the government.
olimikrig Mon, 5th Sep '05, 12:30am You've just hit the very core of the problem. If I had been operated in a private clinic I could demand compensation. However having it done on the governments bill, I somewhat voided rights to compensation. Of course if I really wanted to I could take it to the courts, but that would be very expensive and time demanding; and probably wouldn't lead to anything.
I've read that many doctors are afraid to do risky operations that could very well ease up a condition because they are afraid of getting sued if something goes wrong Yes, but this was a standard operation with almost zero chances of failure (I know, there's always the chance of failure).
Most cases of something going wrong when talking about Hernia rupture operations, happens after the operation. One have to follow a strict set of rules set by the doctor, otherwise chances are that the hernia'll return. In my case however we're not talking about a return of the conditions, but about my lower abdominal having been mutilated with a scalp (Well, exaggeration increases the understanding ;) )
Yes I know he's no superman, yet I cannot help feel oh so helpless; which I don't like. Especially considering that there's an roughly 50-50% chance (afaik) of things turning out to the worse rather than the better if I chose to be operated again.
Wordplay Mon, 5th Sep '05, 2:08am Mistakes happen and you shouldn't be so harsh to the doctor. A few well selected words maybe, but if a later surgery corrects the matter, no worries. You'd better really get that surgery too, for "just" living with the pain isn't fun at all. It like with poor eye-sight or the wisdom teeth; before you know it, you are having every day difficulties and once it has been treated, you will notice a perceivable increase in your overall well-being. ;)
Colthrun Mon, 5th Sep '05, 5:18pm Mistakes happen and you shouldn't be so harsh to the doctor.Wirhe, this is very easy to say when you are not the affected part. Having to bear constant pain (not to mention an unseemly scar) because the doctor who treated you screwed up badly, is not something anyone should simply "not worry about".
It's like bringing the car to have the shocks fixed. They fix that, but in the meantime they also screw the brakes, and scrape the paint around the tyres. But because the two things can be fixed later...
Mistakes happen, but a certain quality standard should be demanded, specially when dealing with another person's health and quality of life. It's not a matter of "who takes the blame", but of "let's make sure this is corrected asap, and that never happens again". If a doctor damaged me or a loved one during an operation, I wouldn't want money from the state, or that person to be fired. There is already a shortage of doctors around here. But I would require that this person was retrained, and not allowed to practice until considered fully capable of performing at the required standards.
And an heartfelt apology would be nice too.
dmc Mon, 5th Sep '05, 7:02pm You've really got two issues here -- whether to "fix" the "problem" and what to do about the cause of the problem.
Turning to the latter question first, there is a question of whether the doctor was actually competent at all. If this operation is as simple as you make it out (I'm not doubting you, I just don't know -- I'm a lawyer not a doctor), then botching it this badly surely requires a review by whatever agency/board governs doctors in your country. If you can't sue because of the nature of the care and your laws, you should at least be able to commence some kind of inquiry.
As for what to do. Living in pain sucks. I know as I am doing it right now. I had shoulder surgery about two weeks ago and, while it's getting better daily, it still hurts and disrupts your life with unexpected side effects (less sleep leads to more grumpiness, lower ability to think critically, etc.).
I imagine that there is some way to investigate the relative experience of your doctor. If you have a good relationship with your internist, maybe he can recommend a doctor with a good track record fixing your current problem.
Generally, you get what you pay for, so free care carries the greatest likelihood of incompetence. (By the way, your free care is not actually free, its funded by your taxes. However, it probably costs less than other care, which is all that matters here.)
I don't know your financial situation and whether you can afford to pay for the "fix-it" operation, but, if you can, you probably should. It won't guaranty success, but it will get you a better doctor in all likelihood.
lasgalen Tue, 6th Sep '05, 1:37pm Ouch. Sorry to hear your surgery had such a bad outcome. Scarring can be very nasty. If you do have a redo, get a few opinions regarding the chances of the scarring recurring. Clearing away the scar tissue might cause enough irritation to the body that it reforms.
How long has it been since your op? Some of the pain related to scarring does ease over time.
olimikrig Tue, 6th Sep '05, 2:07pm 2-3 years. It would need to get my medical journal in order to know fer sure :p
afaik it shouldn't easy up, since there's a lot of scar tissue in the lower parts of my abdominal, so it's only painful when I somewhat uses that part of it. However, I surely hope the soreness in my groin will ease some.
Aldeth the Foppish Idiot Tue, 6th Sep '05, 6:55pm Wait a minute. I can understand the possibility that you may not be able to sue, but there is no legal recourse for you to take against a doctor that possibly performed incompetently? If this surgury has say, a 99% success rate, it seems reasonable that in the 1% of cases that something goes wrong, that the doctor's actions should be examined. There are two people in my family who had a hernia surgury similar to yours (my father being one of them) and they have never reported any problems like you describe following the surgury. Yes, they were sore for a couple of weeks after the surgury, but nothing that lasted for years.
NOG (No Other Gods) Thu, 8th Sep '05, 3:12pm As to the 'who should be held responsible' issue, there are two different extremes, neither of which is good. In a lot of second & third world countries, you see the 'everyone screws up, no one to blame' mentality. This leads to an abundance of incompitent and just careless doctors, if no one blames them for screwing up, no reason to be too careful. At the same time, in sue-crazy countries like the US, you see a lot of 'you messed up, pay me for my pain' kind of situations, even when there was nothing the doctor could have done. This leads to massive insurance, higher medical costs, and fewer doctors. The balance is that, if the doctors genuinely messed up, they should be punished, but if this was unforseable, the doctor can't be held any more accountable than the patient. In your case, I think the doctor who screwed up should pay for you to go somewhere and get it fixed, if that means overseas, so be it. I know this will probably never happen, but its worth dreaming.
olimikrig Thu, 8th Sep '05, 5:59pm @ Aldeth: Yes, if I really wanted to I guess that I could probably get the mans record examinated. One problem is though that our new government has implemented a whole new set of rules regarding hospital screw ups. In the old days the doctor would probably just be examinated, and if he had a long history of screwing up on the operating table (which I by fact know he didn't, as it was my own doctor who recommended this one as a good doctor) then whe would get fired. Due to the new rules, however, a database has been set up, and you can visit this database and fer yourself see the records of a particular doctors operations. The problem with this is, though that if you first screw up one time, you'll probably won't get too many assignments in the future. Even though as a innate mentality in a whole society the 'everyone screw up, so no one should be blamed' is a bad thing, everyone do screw up sometimes, and if this is indeed a good doctor, then imho it would be a shame to wreck his career?
I just, ah, well, I just don't know what to do.
*sigh*
Well, none had seem to be too willingly to answer what I consider the overall problem: Should I take the risk of maybe worsen things by getting back on the operation table?
@Wirhe: re-read some of the passages of my original post! There's a good chance that things'll worsen if I go for another operation.
Aldeth the Foppish Idiot Thu, 8th Sep '05, 6:28pm @olimikrig
I see your point. It is true that there are good doctors who only occassionally make mistakes. My brother recently became a doctor, and one of the things they told him in medical school is that in the U.S. the typical doctor is found liable for medical malpractice twice during their careers. Given that the typical medical career lasts between 30-40 years, one mess-up every couple of decades is a pretty good track record, unless of course, you happen to be the person in which the mess-up occurs.
I suppose my other question is whether or not Denmark's health care system is fully socialized i.e., whether or not you had to pay for the first operation out of your own pocket. If the first operation was paid for by the system, and the subsequent operation to fix it also will be, then I see why you may not be able to sue.
Finally onto the advice. I don't think you really have much of a choice - you have to go through with another operation, even if there is a risk of your condition worsening. The way I see it, you are already living in pain, and not enjoying life as much as you could potentially be. If the after affects of this operation were going to subside, that would have already happened in the 2 years since the operation. So your choice is live in pain for the rest of your life, or take a chance that you may have to live in more pain for the rest of your life with the possibility of living pain-free. For me it's a no-brainer - have the second operation.
dmc Thu, 8th Sep '05, 6:29pm I'm not a doctor and I don't play one on TV. There's no way that I can answer your overall question as it is your body, your pain, and your risk. I imagine that most others will be similarly unable to answer that question.
olimikrig Thu, 8th Sep '05, 7:54pm @ Aldeth: All health care issues in Denmark is financed by the Government. That is unless you choose to get it done on a private hospital.
@ dmc: True enough. Maybe I could re-define the question to: What would you do in a likewise situation.
I would never dream on basing my decision solely on what some guy/girl said on a message board. However I see it as this: any advice is useful to me, and will in the end help me make up my mind.
As to you T.V. doctor, etc. remark: my own doctor said that even he wouldn't recommend one thing or another, because the chances really wasn't in favor of either of the sites (e.g. worsen/ease)
dmc Fri, 9th Sep '05, 12:49am For me, I'm very active, play tons of sports, and have two kids (7 and 4) that I do things with such as sports, messing around, riding bikes, etc.
If the condition in any way impacted my ability to do any of the above, and if there was a reasonable chance of fixing it, I would definitely do it. (Please note my recent shoulder surgery -- it wasn't necessary, but the pain kept me from doing the things I like to do, hence I opted for surgery.)
There's your answer from my perspective.
Shell Tue, 27th Sep '05, 9:43pm I'd have the operation, there's no point being in pain when you don't have to be.
Incidentally, I just found out that my doctor hasn't put me on a waiting list for an operation that I thought I had been on for over 3 months :(
Hardly confidence inspiring I know
St. James Wed, 28th Sep '05, 11:12pm Can you possibly get to a different doctor? Can you examine their history and get references? I sympathize for not being able to go to a private doctor, but there should still be a way to make sure the next guy you go to is better. Or do you have to take whomever comes up on the government's schedule?
grillen Thu, 29th Sep '05, 1:08am I feel sorry for you man. I the best choice I see is that you should get consulted by more than one specialist and go under the knife again. My dad is a doctor and he tells me that most doctors are quacks.
olimikrig Thu, 29th Sep '05, 1:36am @ St. James
I am "able" to get a priv. doc. I just can't afford it.
The Magpie Thu, 29th Sep '05, 1:53am @ Oli: Truly, that sucks. Surgery is always a risk; get at least two opinions upon what to do next, but if the situation is that: if you do nothing it'll get worse; if you have surgery it will possibly/probably get worse, then it may be best to look at surgery again. Of course, the problems caused by the botched operation may be such that you'll need multiple instances of corrective surgery, but personally I'd rather that than constant pain. For me, as further surgery seems the only way to restore a relatively normal life, that's what I'd choose. I can understand your reticence to go under the knife again, though; surgery is a scary prospect anyway, and the thought of that earlier, botched operation in the back of your mind only worsens things.
Objectively, surgery is still probably the best course of action if it's severely impacting your lifestyle, though. But definitely talk to more than one doctor/consultant: you can rely on them to give an honest, professional opinion on what to do about your problem, with a great deal more knowledge on the medical side than us here. If you get two opinions that are the same, then you can be confident that you've found the correct course of action.
I hope that was of some use, and that things get better for you soon. :)
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