It sounds unbelievable to say that a doctor, a member of the caring profession, who has taken the Hippocratic oath, swearing to apply measures for the benefit of the sick, to keep them from harm and injustice could ever do a patient harm. Sadly it happens. And it happens all too often. The elderly are more susceptible to abuse than others, simply because age has made them more frail, slower and weaker. Additionally, they may also be impaired by ailment or illness, particularly dementia. American Psychological Association reported an estimated four million Americans are victims of this kind of this abuse (read the report here). However, these figures also hide the fact that for every single case of abuse that is reported, 23 more are undetected.

Often elderly abuse is a lack of basic care, often it is much worse than this. For those who experience abuse, their declining health is often made exponentially worse. Research suggests that those who are victims of abuse die earlier than those who are not. Read our previous articles on elderly abuse and signs here and here.

What is Patient Abuse?

In the very simplest terms it is the neglect of a patient. It is the failure to act to prevent suffering, misery or harm to a patient.

This would include:

• Physical abuse such as striking or hitting a patient.
• Mental abuse
• Sexual assault.
• Financial abuse.
• Abuse by withholding of necessary food, physical care, and/or medical attention.
• It takes into account abuse that occurs in all medical or care settings such as in hospitals or clinics. But that might also occur during a home visits and on those who live institutional settings such as our nursing homes.
• Additionally, patient abuse also incorporates medical abuse which, rather than focusing on abuse by neglectful means, relates to harm caused by improper medical treatment given. All of this would be inclusive and regardless of whether the patient chose to be a patient of the abusing medical professional or not.

Was a Doctor Being Abusive?

Abuse can take many forms. For further guidance, here are some examples of what patient abuse might look like.

• Physical examination: A doctor carrying out a physical examination should be professional at all times. Ideally, during an intimate examination the doctor should be accompanied by a member of the nursing home staff acting as a chaperon. If a doctor touches a patient in any way that makes the patient feel discomforted sexually, for example if a doctor touches areas that need not be touched, touches in a sexual nature or for longer than necessary for the purposes of treatment or diagnosis; this is abuse.
• Failure of care to refer: If a doctor examines a patient or is told of symptoms of a disease that requires the care and in-depth knowledge of a specialist, it is his duty to make a referral. Read American Medical News for senior treatment and referrals. If a doctor fails to refer a patient on to a specialist where necessary, this is abuse. It is essentially malpractice.
• Failure to make the correct diagnosis: The elderly are susceptible to falls. They are also susceptible to break bones very easily. Nothing should be assumed to be just bruising or a sprain. Failure to notice or treat appropriately is abuse.
• Failure of care in managing pain and suffering: Abuse can be the neglect of the doctor to properly manage a patients pain thereby causing continued and unnecessary pain and suffering. One landmark case, the first of its kind for under-treatment of a patients pain, concluded that the doctors’ failures to manage an elderly patients pain had as such had violated the state of Californians Elder Abuse Statute. Although the patient was, by the time the case was brought deceased, the family were awarded $1.5million. Interestingly the family also sought an order that required the doctor to receive pain management education.

What Do You Do If Doctor Patient Abuse Is Suspected?

If you have suspicions the advice normally given would be to contact the patients primary health care doctor, social worker, or other member of the immediate health care team. However in a case of patient abuse this may not be appropriate if they were involved or suspected of being the abuser. One of the biggest, most unsettling problems when abuse of this kind has been reported is the need to move the patient to a practitioner. The victim may be frightened and is already in a vulnerable condition.

Even though their current situation may be awful, the patient may fear getting to know another doctor and lack confidence. They are likely to feel isolated, alone and vulnerable. Any change should be handled with the greatest possible care.

Always keep in mind that the patient has been betrayed. Their abuser, a person who was in one of the most trusted and privileged of positions. The victim is likely to be confused, hurting, bewildered and afraid so accompanying them and attending as chaperon to any medical appointments or examinations will help.

We hope it never happens to you. But, if it does, if you have any doubt at all, seek the advice of a knowledgeable attorney in elder abuse law.