Several months ago I saw a new patient who was referred (peds surgical specialty) for a benign cyst. At the wrapping up stage of the encounter patient’s mother inquired about another mass patient had that was rapidly growing and had been previously diagnosed as a lipoma. On my exam, this mass was absolutely not consistent with lipoma. I advised them we could remove this mass but would like MRI for further eval preop. Not long after seeing me they end up visiting ED at another hospital for a complaint (trying to be vague here) that ultimately was due to mass effect of this tumor. Had excisional biopsy of the mass at said outside hospital and turned out it was an aggressive sarcoma, stage IV at diagnosis. Patients mother told me they’d seen several doctors at primary care and urgent care for this and advised no further workup was needed/given the runaround in a sense. The patient ended up coming back to see me now for a complication from chemo/radiation. This poor mother. She said she wanted to sue the other hospital, xyz. I obviously don’t know the whole story, just her account, but from my perspective I don’t blame her. There are several patients I can think of in addition to this patient that in my opinion got subpar care prior to seeing me. Sometimes no harm comes from it, sometimes there is harm. Sometimes patients are angry and tell me outright about pursuing litigation, or even ask my thoughts. In every case I focus on empathizing with the patient, tell them my thoughts on what possibly happened (framing as a simple miss that could happen to anyone) or how I may have approached the diagnosis/plan, and if they bring up litigation, tell them I can’t speak on that as I don’t have all the info and am not a malpractice attorney. I never place blame on previous providers. But in some cases it’s tough as I do feel patients were failed. I always leave these encounters feeling a bit unsettled and wondering if my response may have been lacking. Any good approaches or phrases you use in these cases? Any of you actually told a patient outright the standard of care wasn’t met in your opinion?   submitted by   /u/likelysunny [link]   [comments]