Judge to patient: "Stay away"

This doctor had to convince a judge that a 77-year-old with arthritis posed a danger.

By Jon C. Liprie, MD
Internist/Oklahoma City

When the judge issued the protective order I'd requested, I looked over at my former patient. He was acting oblivious—like someone sightseeing on a tour bus through the courtroom. My lawyer and I pondered this odd ending to a bizarre tale of patient harassment.

So how did I become a victim? My story began in a geriatric psych unit with a 77-year-old patient who had been admitted for depression and paranoid ideation. I was consulted for the patient's hypertension and chronic back pain. After his release, the man started coming to me as an outpatient.

Sort of; he rarely kept his appointments. Yet he was always on the phone or writing letters requesting narcotics. This defined our relationship from August 1999 to February 2001. In May 2001, he pushed me too far with a barrage of letters requesting an electric wheelchair I felt he didn't need. He was able to walk up to two blocks, and I'd seen him use a wheeled walker in my office. So I declined to give my approval. He became very abusive to my staff. Thus ended our doctor-patient relationship.

I wrote a tasteful letter discharging him from my practice. It was promptly mailed back to me covered in vulgar commentary. About the only clean lines were, "You have got to be the most ignorant and the most incompetent doctor in our 50 states!" and my personal favorite, "I would have canceled you out long ago except the fact that I needed my hydrocodone pills."

Similar messages appeared on my voice mail at work and the business line at home. He would occasionally call under an assumed name, but caller ID displayed his name and phone number.

Then he began writing to each of my partners and leaving messages on their voice mail as well. So my lawyer and I drafted a letter asking him to stop the harassment. It, too, was promptly mailed back covered in vulgarities. Each of her partners at the firm got a similar letter.

That's when I decided to seek a protective order. Violation is punishable by a fine or jail time. In my jurisdiction, you can file a temporary order with a notarized request. To get a permanent order—which I did—you must go before the judge and plead your case.

That's why I found myself trying to convince a judge that this arthritic old man posed a risk to my well-being. Fortunately, the patient's many letters and phone calls did the majority of my work.

"Are you going to continue bothering this man?" the judge asked my former patient.

"I don't know," he said. "I'm sorry I ever met the man—I hesitate to call him a doctor."

"I am sure he's sorry he ever met you," the judge replied. And with that, he granted the permanent order.

Although I had "won," I found victory unsettling. Did I do the right thing? Did I do enough? I decided the answer to both questions is Yes. What's more, the whole process had been a valuable learning experience.

From now on, I will immediately discharge abusive patients who won't make regular appointments. This patient admitted he was using me only for narcotic refills. Someone like this is merely an expensive drain on office resources and a potential liability.

I also learned to act decisively in response to abusive behavior. I'm positive this patient would not have stopped if I'd ignored him. In fact, his calls and letters had increased with each passing month. But I've tried hard not to take his abuse personally. Yes, I got angry when he attacked my character, but I kept all other personal feelings out of the way—especially the desire for revenge. I could have sued for slander, but decided not to. As physicians, I feel we're held to this higher standard.

 

Jon Liprie. Judge to patient: "Stay away". Medical Economics Jul. 25, 2003;80:56.