I saw a specialist (let’s call him “Dr X”) in 01.2021. He charged $460. I explained my symptoms and asked for them to be investigated. Dr X declined and instead began to Rx’d a benzodiazapine (tamezepan), which I declined. He then Rx’d a tricyclic antidepressant which he claimed works like a sleeping aid when taken in small doses. He handed me the Rx. I was not happy. He saw that and said 'well in that case, take the meds for 2 months and if you still have problems, we’ll investigate then". “Sure” I thought. “You’ll fleece me for another $460 for a needless consult and who knows how much for the investigation which by that time would be late if my problems need solving now”.
His secretary made the follow up appointment for 2 months’ time.
When I got home I thought, “no way will this solve the problem as in 2 months’ time any investigation will analyse not my true state but by state on meds”. I cancelled the f/u appointment and went for a study elsewhere, with “Dr Y”. That meant I had to pay another specialist for an initial consult.
That study produced data that proved my allegation that I have significant health symptoms that need to be addressed.
Recently I sent “Dr X” a demand for a refund of the (circa $250) being the out of pocket costs based on the results of “Dr Y”'s test. I sent a copy to the hospital where he works.
Of course I should have demanded he replay Medicare as well for the misdiagnosis and inappropriate Rx’ing of meds.
The 10 days I gave him to pony up the refund came and went earlier this week.
What are my next steps?
Complaining to the NSW Health Care Complaints Commission or somewhere else?
Note I recall years ago a friend made a complaint to a hospital which was “resolved” by one doctor “reviewing” the behaviour of a colleague. No ribbons for concluding that complaint went nowhere.
Reality is GPs and surgeons make calls on their own experience and training, and very unfortunately not always on the knowledge of their patients. Yet it is seen as a judgement call not malpractice more often than not.
The medical field protects its own and it is only when there are enough complaints lodged against a doctor, and often if it also hits the press, before anything is done.
You did well to walk from Dr X. Make a complaint,
expect nothing, and move on. Finding a good practitioner is gold in itself.
I hear you. The problem in Oz is that most patients shy from complaining.
Recently I met a fellow who saw the same specialist 5 years ago and his malaise was not treated correctly. His illness remained and his bills mounted. His health was poor so he at time did not have the energy to complain.
Prior to this unfortutnate episode, I saw this same specialist (8 years ago) for a related illness and at that time he did investigate and put me on what are clearly the right meds. I think with age he has lost interest in his works. It was his investigation at that time that convinced me to see him again.
As you stated he works at a Hospital, you can also make a complaint to the Hospital Management regarding the Specialist’s behaviour. You can also contact your State Health Department as Doctors still need to often register in the State/States they practice in, Federally you can contact the Medical Board of Australia as they also undertake performance reviews You can also lodge a complaint with the Specialist’s College of practice eg for a Psychiatrist this would be the RANZCP., Surgeons use RACS, Physician would be the RACP.
You could directly complain to your State’s Health Minister separate to the Health Department process.
Thanks for the feedback. Very good advice. So far when I handed his receptionist my complaint, I gave a copy to the hospital affiliated clinic’s (where he works) chief executive.
What you wrote is indeed most folk’s attitude, but I think it’s not good enough. Consumers of health care services should not just accept losing the out of pocket expense (in my case $230) not to mention, having to fork out another $400 to another specialist to run the test I wanted.
Look at it from the perspective that although you were correct, you do not have medical qualifications. The specialist with medical qualifications used his best judgement.
The tests were paid by Medicare in part or full I presume. Would you prefer taxpayers fund whatever tests every patient wants, or as with everything else Medicare, the funds are allocated to deliver the best for the most, using the best advice available to make that determination? The best advice is usually but not always right.
Your $230 paid for the specialists training, knowledge, and experience applied to the highly variable and incompletely understood human condition. Some doctors are better than others, and one might get it right one time and not right the next, and vice versa. Some patients know their bodies well, and some not well at all. How does a doctor differentiate during a 15 minute visit?
If you consider the norm not good enough I encourage you to find a doctor willing to put their support for your refund in writing. or a lawyer to take your case, or the AMA or HCCC to side with you.
A physician refunding a patient for misdiagnosis is unheard of although significant and successful lawsuits for surgeons getting it wrong happen. Doctors are possibly the most protected and insular of professions. Does that make it right and should that be changed? That is an interesting question.
I thought the matter over more, given 14 days have expired since I wrote to him seeking a refund of my out of pocket expense. I mentioned I wanted the refund within 10 days. That is, I sought the full amount paid less the medicare rebate. I copied this to the clinic director, the clinic is a unit of the hospital.
Now you are claiming malpractice. If you have evidence that he knowingly gave a false diagnosis take the evidence to the AMA. Have you got another opinion that says this, if not how do you know? If you don’t have any evidence consider if you are doing the right thing making such accusations.
Check out Doctor Reviews on Google. I noticed a while back Australia had begun copying the USA by reviewing surgeons etc and I’m not sure how far this went. But worth a look anyway.
From a Health Complaints side firstly, complain that you contacted Doctor X (insert date) to resolve a dispute yourself. Secondly, give the background about the issue (misdiagnosis etc). Thirdly, Doctor X has not bothered to reply. The main issue of a refund may not go anywhere. BUT, the fact that you tried to resolve the issue yourself, the issue was about misdiagnosis and lack of reply means that HC are obligated to investigate. Just make sure you put the complaint in those steps and in that order. Moreover, the complaint ends up on the annual HC Report which may scare Doctor X into contacting you. Note that it will take a couple of months to investigate. The State Website should advise approx. time to respond.
Thanks for the detailed reply. You make excdellent points.
I think my complaint should have credibility because of my history with this specialist. It is not as though this is the first time I saw him and he merely offered a diagnosis.
The facts are:
I saw him 9 years ago about a similar complaint and he followed what I consider is correct protocol - he investigated and Rx’d non addictive drug that works;
In the last couple of days the specialist replied. by letter. Denying any wrongdoing. What else should I have expected? He corrected me (I claimed he wanted me on a certain drug for 2 months and then an investigation may take place if he thought warranted). He wrote “it was one month”. He is correct. I erred.
In reply to my claim that I went elsewhere because I thought an investigation was urgently needed and he categorised my condition as generic, he replied “you did not return after a month for a follow up and that was your choice”.
Of course it was my choice to go elsewhere. This so-and-so would have taken a long time to agree to an investigation, IF he’d agree to it. And hence then any treatment would be delayed.
Writing to the Health Care Complaints Commission makes sense. Interestingly when I spoke to NSW Fair Trading about going to NCAT for a refund, they recommended one avenue at a time ie NCAT or HCCC. I thought approaching both simultaneously would be more efficient,
And so we have an “I said”, “he said” dispute. You are going around in circles unless you can get another medical opinion that says your specialist was in error. You appear to not have this. You can write more letters to the specialist or others but without any evidence for your view it isn’t going anywhere.
I was unclear, sorry. There is no dispute. I thought he wanted me to return in 2 months to see how the meds were working. In fact, he asked me to return in one month.
As to the nuts and bolts of my claim: the investigation I underwent elsewhere supported my hypothesis. There is something going on which is not a “generic” condition as the first specialist argued.
I would have an appointment and tell him / her that I did not take the medication, and attended an other specialist, who helped. That the medication he /she prescribed had a risk. Ask on what ground was the prescription made. It probably was not based your history. You can ask him directly to repay the consultation fee.
If he does not do it, make a complaint to the Australian Health Practitioner’s Registration Agency. Ground: 1) doctor did not take history of presenting problems,
2) did not provide you with informed consent, 3) did not take your presenting problem seriously. You can tell him on the consultation that you are going to do this. Perhaps pay the Medicare charge for this consult.
Would like to know 1) How are you, 2) do you feel better with your chosen treatment, 3) do you trust your doctor who is treating you now?
That could be not only counterproductive but also bad financial advice as that consult would be billed like any other and could make an unsatisfactory relationship become confrontational.
I doubt that would be an option if the specialist wanted to collect their fee. They will invoice the posted amount for the consult and expect to receive it; it is a condition of treatment in most offices. Collection could be done if the specialist desired, to a mark on the respondent’s credit history.
Based on the information presented how have you come to those conclusions? Making unfounded or unsubstantiated accusations that at the end of the day may be no more than personal opinions in the legal sense can become a civil offence in Australia, especially if they meet the test for defamation.
In answer to your points in italics, with my reply following:
I would have an appointment and tell him / her that I did not take the medication, and attended an other specialist, who helped.
I thought of that, but at $240 a consult of which I expect no more than $40 M/care reimbursement, it would be too costly an exercise.
That the medication he /she prescribed had a risk. Ask on what ground was the prescription made. It probably was not based your history. You can ask him directly to repay the consultation fee.
In fact I asked him by letter to repay me that part of the fee that M/care did not reimburse me. He finally replied claiming “no refund as I acted professionally”.
If he does not do it, make a complaint to the Australian Health Practitioner’s Registration Agency.
I plan to do so. So far I complained to big cheese in the medical facility where he works and while I chased up an answer, I was told “we posted a letter last Thursday to you”. I will wait to see what the facility replies.
Would like to know 1) How are you, 2) do you feel better with your chosen treatment, 3) do you trust your doctor who is treating you now?
My problem is complex. I have done quite a bit of reading on the topic and in order to have a hope of getting the correct diagnosis and hence correct treatment, there must be no ambiguity about my symptoms - both its type and its duration. I went into the study with a strong hypothesis of my situation and all aspects of it i.e. the symptoms, duration etc were proven correct. Now that I have the raw data, I am seeing another specialist to address these issues. If she cannot treat them, at least she will confirm that there is a serious issue which requires someone with more experience than she has in order to get to the root of the illness. And then appropriate treatment and monitoring will be indicated. Like my GPs, she is convinced that a Rx for benzodiazepines or similar on a daily basis to merely alleviate the symptoms is far from the correct course to take.
As I understand you the $450.00 fee is one aspect of your problem, the other aspect can be that you may feel cheated, robbed and taken for granted by a health professional. Trust is broken, and probably with this doctor it will be never reestablished again. This must be a very hard thing to bear, You may still consider making a complaint to AHPRA.
You’re spot on regarding trust. In the last few weeks I found a friend of a friend who endured this same specialist and felt strung along, milked for superfluous consultations and ended up finding another doctor. But as he is n ot so young, he did not have the time or energy to make a fuss like I am.
I have every intention of complaining to NSW Fair Trading, HCCC and as you suggest AHPRA. i just want to be in receipt of the letter the head of the clinic where this so-and-so works says he sent me last week before I go in guns blazing.
