Bedside Manners

August 31st, 2005 by

Let’s paraphrase an old joke: a woman walks into the doctor’s office for an examination. “You’re too fat.” the doctor says. “I want a second opinion,” says the woman. “You’re ugly, too,” says the doc.
An interesting firestorm is brewing in New Hampshire over the comments of Dr. Terry Bennett, a Harvard trained physician who prides himself in “telling it like it is.” When the story first broke, it appeared that the woman patient had brought a complaint against the doctor for simply saying she was fat. An immediate groundswell of support emerged for the doctor, whose candor, the pundits felt, was in the best interests of the patient. Anti-attorney websites railed at yet another frivolous lawsuit defaming a sincere and well-meaning physician.
As is so often the case in these situations, the first take on the story was somewhat over-simplified. According to a recent article, the NH Board of Medicine is looking into a complaint related not to the comment about being fat, but the racial slur that accompanied it. Here’s the quote from the good doctor as presented by the board: “You need to lose weight. Let’s face it. If your husband were to die tomorrow, who would want you? Well, men might want you, but not the types that you want to want you. Might even be a black guy.”
If that indeed is what Bennett said, you could certainly argue that his comments go well beyond the normal bounds of medical protocol. (The good doc would probably enjoy a recent movie release entitled “The Aristocrats” — an homage to bad taste in which the same basic — and obscene — joke is told by dozens of comics, but that’s a different story.)
Bennett is no stranger to this type of controversy. In another case going back to 2001, a patient accused him of suggesting she commit suicide. The documents paraphrased what Bennett, 67, allegedly told the patient, who was suffering from the effects of brain surgery. “(Bennett) spoke to the patient in an unprofessional manner suggesting that she purchase a pistol with which to commit suicide as a means of putting an end to her life.”
Bennett denies doing anything wrong. “They’re trying to make me the poster boy for bad medicine,” he said. “I’m making them the poster boys and girls for insane law enforcement … for interference of my First Amendment rights.” Bennett has his supporters, including many of his patients, among whom is a black man who calls Bennett a personal friend.
So what’s the issue here? And is there anything wrong with the candor of Dr. Bennett?
Boundary Issues
I am all for candor in communication. There are undoubtedly some obese people who need to be confronted with the life-threatening risks inherent in their situations. Such confrontation, when done in a caring and supportive manner, can be an effective way of getting someone’s attention, especially if they are in denial. But if the quotes are accurate, Dr. Bennett needs a course in communication skills. He has not just violated the standards of good taste. By inappropriately bringing up his patient’s sex life — and by demeaning her further through disparaging references to blacks — he has crossed a boundary that exists not just in the doctor – patient relationship, but in employer – employee relationships as well. His comments reveal a hostility and an edge that is totally inappropriate. Many of us enjoy a good joke, but Bennett’s comments appear to be less an attempt at humor than at gratuitous humiliation. That’s just bad medicine. And regardless of what the first amendment pundits say, the Board is doing the right thing by investigating the situation.