Sunday, November 24, 2013

The Second Opinion & Facebook

Every patient has a right for second or third opinion. Likewise, when approached by a patient, doctor too has the privilege of giving his opinion. Patient has the liberty to choose the treatment from the doctor he/ she trusts.However, patient or his relatives have NO RIGHT to malign the first opinion/ defame the doctor on the social networking sites. It is also a punishable offence under section 66 (A) of the Information Technology Act for causing damage to public image.

A patient is brought to a hospital with an ankle injury. Orthopaedic Surgeon examines the patient, after X Ray, patient is advised to undergo internal fixation by surgery. However, patients husband decides to seek second and third opinions, where non operative management was advised. Upon hearing the second and third opinions, patients husband posts the x ray with his version of the story, ridiculing the first opinion, thereby indirectly suspecting the motives, ethics of treatment of the hospital/ surgeon who gave the first opinion.
The post goes viral on the Facebook (in fact patients husband runs an application based on facebook- besides the point!), within 2 days with 22000 shares.

Question here:
is not about the validity of first/ second or third opinions on the patient/ x ray in question. It is about the gross misuse of a social networking site, for maligning an institution- hospital, defaming an orthopaedic surgeon of repute. Sadly, Dr Attique Vasdev (Manipal University Alumnus) who was at the receiving end of the facebook post, is not on facebook. He came to know about the post through his friends & Orthopaedics- Manipal University Alumni group on facebook. All efforts to post Dr Attique`s version of the incident, were promptly removed by the patients husband.

Dr Attique Vasdev`s version:
“The patient was referred to me by an old patient and came into the ER on the eve of 18th of November. I recommended an X-ray which indicated a Lateral Malleolus Fracture with Syndismotic Disruption. In view of the fact that this kind of fracture can lead to degenerative changes or painful joints, as per the AO [Arbeitsgemeinschaft für OsteoDePuy Synthesefragen or translated to Association for the Study of Internal Fixation ] guidelines of fracture management for ankle injuries the recommended strategy is surgery as the best course of action. My opinion was in the best interest of the patient, and the patient alone. I did not at any point state whether this was a ‘grade 3 fracture’. That is not terminology we use and was not used in your case.”
Dr Ashok Rajgopal, Chairman, Bone and Joint Institute, Medanta :The Medicity has reviewed the case and his view is as follows, "I am honestly shocked at the contents of the post going viral. The x-rays show a very clear indication for intervention. Anyone with experience in fracture treatment and who has attended any AO [Arbeitsgemeinschaft für OsteoDePuy Synthesefragen or translated to Association for the Study of Internal Fixation] course, which is the bible of fracture treatment, would endorse, whole heartedly, the opinion given by Dr Attique."
Medanta Medicity (post on FaceBook):(however removed by the patients husband): 
“It is extremely unfortunate that irresponsible statements of this nature have been disseminated. We uphold the highest standards of professionalism and ethics. Your post attempts to malign the reputation of the doctor concerned and the institution, on the basis of allegations that are patently false.”

Note from this Blog Editor:

Of late it has become a fashion to criticize the treatment protocols, treatment options suggested by the doctors. Remember that medical profession is guided by many regulatory bodies apart from highest level of practice of ethics by the professionals. There are periodic checks to ensure adherence to current treatment protocols. It takes many years for a surgeon, before he can build his practise & repute. It is also true that difference of opinion is common in the medical science, hence the patients have been provided with the privilege of second opinion, under patients charter of rights. Now, professional bodies (IMA, MCI, State Medical Councils) should pass resolution, that if a doctor is defamed on the social networks before complaining to the statutory bodies, the complaint should not be registered.

Defamatory posts on social networking sites, can do little damage to the reputation of the surgeons/ hospitals, however it can definitely cause a major damage to the most essential link in the treatment chain – TRUST.