Spotlight 5: Specialists’ blessings

Undoubtedly good communication between any group of people will keep things smooth, more so if they work in the same field. Good communication happens all the time in medicine. Bad communication, despite its paucity, creates tense and turbid environments that have a big impact. The vast majority of doctors are good communicators with their colleagues. However we all sometimes come across some who are intentionally or unintentionally poor communicators. These doctors poison doctor-doctor relationships. Using a wrong word or sentence in a consult letter may trigger some irritation which may subsequently create an unwanted reaction such as stopping using the irritating doctor's service. If it happens that this doctor has a unique specialty or a short wait time then patient care has been impacted. Read: Spotlight 4: Pharmacist’s blessings Mr. A called our office and booked a virtual visit for ear pain with diminished hearing for the past three days. He was assessed by a health professional in our office who to the best of his knowledge believed that the patient had an ear infection and that he needed an antibiotic—which was prescribed—and that Mr. A should come to our clinic for an-office appointment in three days if there was no improvement. After three days, Mr. A came to see me in our clinic. His pain and hearing loss had worsened and I didn’t see a sign of infection so I asked the patient to stop the antibiotic and to do a hearing test. As well, I referred him to Dr. F, an ENT doctor who has a very short wait time (less than two weeks compared to other ENT doctors' wait times which are up to one year), for an urgent assessment. The audiology test confirmed sensorineural hearing loss which was forwarded to Dr. F. After two weeks I received a less than half page consult letter from Dr. F which stated: "This patient was seen in a virtual clinic and prescribed antibiotic by his doctor without a physical exam, the audiology test was positive for SN hearing loss, in the exam today there was no sign of infection, the antibiotic was given without any indication." (Italics for emphasis added by me.) I read the letter a few times without a reaction or response and mumbled to myself: "Is this a consult letter or an insult letter?" I felt that the letter was inappropriate, condescending and disturbing. I showed the letter to one of my colleagues. She looked at me and said with a smile: “Unbelievable. Did the doctor send this letter to you or to the college?” She hadn't seen the specialist's name at that point but she asked me if it was Dr. F. Then she added: “I and a few colleagues never send patients to this doctor. We stopped a few years ago.” I then understood why Dr. F's wait time is very short. This was not the only short and condescending letter I received from Dr. F—it was probably the third or fourth one but again I used her service for a very short time. For the record, she is medically a good doctor. Now, due to her attitude, I may not really use her service in the future unless the visit is extremely urgently needed and I have no other choice. I feel that patient care is negatively affected by the poor communication of this doctor with her colleagues. I am not sure how many doctors out there have this same attitude. I hope there are only a few—as having many doctors like Dr. F would highly impact patient care in a negative way. Dr. Jabir Jassam is a family physician who works at Health Treasure Medical Center in Ottawa. This item is called “Spotlight 5” because he’s going to write a small series of spotlights like this.

Spotlight 5: Specialists’ blessings

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