One of the most discomforting situations in life is for a family member to be in pain and to feel as though you don't have any options to help; especially when it appears a major part of the problem is an authority figure such as a doctor or the hospital that stands behind him or her.

As explained often in this column, the essence of "Winning Without Intimidation" should never be misconstrued as being so nice that you lose. No, it's being nice and getting what you want.

During those rare times when niceness alone becomes exhausted without the desired results, we need to be prepared to do what we must in order to protect ourselves and our loved ones (as well as clients, friends and others we feel a responsibility to help).

In past issues, I've suggested and provided examples of tactful letters that can be written to difficult-to-deal-with people in order to elicit their cooperation without causing defensiveness that would most likely have unintended and negative results. And, ways to converse in person that can achieve win/win results.

While the person in today's article first tried to ask questions and reason with the doctor, she did not attain the necessary satisfaction to feel good about the situation. (I believe it will be self-explanatory.)

I appreciate her allowing me to use her letter and my response. Of course, no names will be used.

She wrote....

Heartrending letter from a daughter in distress

"Dear Bob,

"If you get any spare time, wondered if you could give me your thoughts on a problem we have.

"My Dad recently went in for 'simple' shoulder surgery at a highly rated hospital with a highly recommended doctor. However, the doctor didn't do a preliminary test he should have, and the surgery was much worse than expected.

"Then, somehow, a large area of my Dad's shoulder and back was somehow badly burned during the surgery. We don't know if they accidentally put him on some hot surface, or spilled something, or what, but he's got terrible 2nd degree burns.

"Then they gave him a penicillin-based antibiotic, even though he had the bracelet on warning that he was allergic to it. So he was vomiting for 3 days, on top of the pain of the surgery and burns.

"I just don't know what to do. Dad is so miserable. Every day it takes my Mom and me an hour to change the bandages on his back.

"The skin is bloody and raw, and the blisters are the size of fried eggs. He can't sleep for the pain. He is such a great guy, and doesn't deserve this.

"At the hospital, they asked the doctor what happened, but he was very evasive, said he'd never seen anything like that. When they went for a checkup this week, they said they didn't want to cause any trouble, they just wanted some answers. But, he lied and said 'Oh, sometimes fractures cause burns like this.'

"They are afraid to confront the doctor any more, because they still have to depend on him for further care once my Dad's arm/shoulder brace is off.

...And this is how I replied

My response:

Dear __________,

I'm so sorry you are having to go through this very uncomfortable situation. My heart goes out to your entire family and to your Dad. What a shame that happened.

I am sure there are options. I'm also understanding that your parents don't want to exercise some of the options that are presented.

Being neither a doctor nor a lawyer, I can't speak intelligently in those two areas but can provide some very elementary thoughts regarding the potential handling of the situation.

One thing I'll suggest right off the bat is that you get pictures - very graphic pictures - of your Dad's back, shoulder, and anywhere else where there were mistakes made during the surgery and/or post surgery.

In the event you do decide to sue (which, although I am not a litigious person by any means and believe suing should be a very, very last option - it might turn out to be the most viable option in this case), you want to have as much documentation as possible. Please write down every conversation you've had and keep a running log of future calls and conversations with the doctor and any and all hospital personnel.

I would also speak with a lawyer right away...again, if only to explore and discuss options.

There is a basic rule of negotiation that says "most of us believe we have fewer options than we actually have while believing the other side has more options than they actually have."

In other words, we underestimate our own power and overestimate the other's. Especially when they are in a "position" of authority.

Regarding the care of your Dad while in the hospital, your family obviously has concerns regarding "upsetting the apple cart" right now, making the doctor angry and causing him to not provide your Dad with the proper care.

I don't blame you at all for that. I don't know this doctor, I don't know the size of his ego, and how he responds to such things.

You might want to explore various options such as speaking with someone who can help without it getting back to the doctor. Or, see if you can find another doctor. Since I don't know your unique circumstances I'm not qualified to advise in that area.

If you feel this doctor is still the best one to care for your Dad during recovery, then fine. I would, however, go see a lawyer right away and find out what your options are. Again, the good news is that typically we have more options than we think.

Sometimes we might get intimidated by a big, powerful hospital/doctor. I have a feeling, however, that they are more afraid of you, right now, and what you might be able to do to them.

So, while I truly hope it can be worked out in a way that satisfies everyone involved, please know that you are not in a powerless position.

Let me know what happens,

Bob

A health professional's input

P.S. Before sending my answer, and wanting to make sure my advice was not "off the mark"

I wrote and asked for some guidance from my dear friend, Pamela McBride, a Registered Health Information Technician and Certified Coding Specialist with the American Health Information Management Association. She is also in a management position with a hospital in Oklahoma and has been in this field for over 20 years.

Here's Pamela's comments:

"Bless these people's hearts. Many hospitals have patient advocates, ethic committees and pastoral care on staff. These people could be a lot of help. Yes, they do work for the hospital, but their main goal is to keep patients and their families happy.

And if they know of something, they will bend over back wards to help. A lawyer may be able to get these people help financially, but an ethics committee, will hold the physician accountable.

"If this hospital has a good Risk Manager, they could contact that person.

Many, many times, monetary gain is afforded and satisfaction attained in knowing that a negligent, evasive physician can be punished within the hospital. If this is not a good hospital, they should find out pretty quickly by the way their problems are handled by the committees aforementioned.

"Also, if the hospital is a member of a Joint Commission, that would be a wonderful resource for these people.

"Sometimes, rocking the boat saves the passengers. I would rock every boat I could find. Once they contact Risk Management, Joint commission, the ethics committee, patient advocate, etc., this doctor wouldn't dare cross the line of what is appropriate. Because they will be watching...We have had doctors kicked off staff because of negligence.

"There are so many options, and I think it is good to remind people that being kind does not mean allowing others to be negligent / unaccountable or whatever.

One more thing, lawyers can grab your hand, jump in the water, over your head before you're ready. Be prepared to jump in with pictures and everything else."

Hope this helps

Pamela

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Thank you Pamela. It helps, very much!