What Happened to Honesty & Integrity?

A great deal of time and research was invested in developing a safe plan to resume seeing patients in our office. We prescreen everyone before scheduling an appointment. We screen again the night before the visit and, once again, at the front door. We ask extensively about their contacts and exposure. I expect the answers to be truthful. I have a professional responsibility to keep my patients safe and well cared for. I also have a responsibility to protect my staff and myself.

My first patient back had pushed his way into an expedited visit with a complaint of excessive weight loss. His request for one of the first visits after we reopened was supported by “telehealth” consults recently from two specialists – assigning the evaluation of this problem to me. Of course, they hadn’t bothered to weigh him.

When he arrived at the front door, we gave him a mask. He answered “no” to unmasked close encounters with others and to questions about behavior and visits which might raise his risk of catching COVID-19.

I treat all patients now as if they are contagious so I was masked, face shielded, wearing a gown and feeling safe. After a detailed history he told me he was flying on a commercial airline in two days to his northern home.

On Monday, his “back doctor“ was going to inject him for chronic low back pain. I asked him if his northern physician was aware that he was flying commercially and not maintaining a 14-day self- quarantine as advised. He said “no” and he had no intention of informing him. I told him that was wrong and that with diabetes, hypertension, heart disease and obesity I didn’t think flying on a crowded jet was a great idea.

His exam showed nothing of concern and when we weighed him his weight loss was minimal. He brought blood test results from his other physicians which we discussed. I wished him luck, suggested he quarantine after flying commercially and suggested he drive up instead. He chuckled, removed his facial covering and wished me a safe summer.

Two days later, as we closed up the office, my cell phone rang. The patient had flown up north and as he walked down the concourse he received a call from his friends who told him they were ill, were hospitalized and tested positive for COVID-19. He was calling to ask me what he should do.

He admitted that a few nights before his visit to my office this couple had been to his home for dinner. No masks were worn and no social distancing was practiced. I suggested he go home and self-quarantine for 14 days and seek medical attention if he felt ill.

The patient said he said he did not mention his encounter which occurred before his exam at my office because he wanted to be seen and did not wish to wait 14 days.  What happened to honesty and integrity?

One Response

  1. Well, I usually don’t like reading the whole blog, but when it comes to you. I can spend hours reading your blogs and enhancing my knowledge. Keep posting more.

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