When doctors abuse patient trust



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Ombudsman helps when doctors abuse their patients' trust

Cases of abuse by doctors keep making headlines - for example, a gynecologist from the Palatinate, who is said to have photographed and filmed hundreds of patients during the examination, or an anesthetist from Bavaria, who is accused of abusing nine girls aged ten to twelve was sentenced to three and a half years in prison. In order to offer support to those affected, the State Medical Association of Hesse has now set up an “Ombudsman for Cases of Abuse in Medical Treatment”, which has been very popular in the first few weeks since it was founded.

Abuses in medical practices or clinics are often concealed. Border violations and abuse also occur where patients should actually feel safe: at the doctor. But even though cases such as those in the Palatinate or Bavaria are fortunately relatively rare, attacks in medical practices or clinics start much earlier, because "this is not only about sexual abuse, but also about the exploitation of the patient's dependency and abuse of power" , said the State Medical Association of Hesse.

First ombudsman for cases of abuse in medical treatment in Hesse since March. Since such attacks occur again and again, but are often kept secret, in March of this year the State Medical Association of Hesse became the first medical association in Germany to have an ombudsman for cases of abuse in medical treatments, to which those affected can now turn directly, unbureaucratically and, above all, with confidence - this is particularly important, according to the Medical Association, because "many patients have great difficulty dealing with experiences of abuse during treatment." Some would For example, those affected assume that they have to file a criminal complaint immediately, including all the associated police and legal consequences - but "they usually do not want to or cannot take such a step, be it out of shame or feelings of guilt, fear of shame during such a procedure or a Also to protect the doctor in question from emotional attachment and dependency, ”continues the Medical Association.

So far, about 25 cases for the ombudsman As part of the ombudsman's office, those affected now have a neutral discussion partner with whom they can discuss what happened and clarify possible follow-up steps - the presidium of the State Medical Association named Dr. med. Meinhard Korte, specialist in psychosomatic medicine and psychotherapy and specialist in general medicine. Since the advice center was created in mid-March, the offer has been used about 25 times, "there was only a clear misuse of the doctor-patient relationship [.]," Said Meinhard Korte to the dpa news agency

In most cases, patients would instead complain about a lack of empathy or poor interpersonal treatment, the physician says - but it would also tell about actual cases of abuse from the past. For example, a mother looked for help because she was unsure whether the behavior of her disabled daughter's doctor was still "correct".

Counseling center shows great need for discussion According to Ombudsman Korte, a "major need for discussion" could be accounted for after the first two months - so far there would have been no criminally relevant cases, but this would not call into question the necessity of the counseling center. Instead, his central task is to clarify together with those affected whether or not it is a case of abuse or border violation. To clarify this question, the doctor's motive was decisive: "Abuse is when the doctor-patient relationship is used to satisfy a personal need," said the Ombudsman. Accordingly, the question must be asked: "Does the doctor's action serve the treatment or does it contradict this goal?"

In rare cases, doctors are also victims. In very rare cases, according to Korte, the reverse would also happen - because patients could also use the relationship with their doctor. Accordingly, doctors could also contact the ombudsman “to deal with questions and problems with border guarding and abuse in treatments and to seek advice,” said the Medical Association. For example, according to Korte, there was the case of a psychotherapist who sought advice because a patient accused him of abuse - after which he had refused her desire for an intimate relationship. The lady had reported the doctor, who was able to convince the court of his innocence.

Criticism: institution should be completely independent The new advice center is also a sensible institution for the President of the German Society for Insured and Patients, Wolfram-Arnim Candidus - but in order to be able to actually help those affected, such institutions would have to be completely independent, So instead of being directed by a doctor and financed by taxes, it is more likely to be located at a non-medical office, says Candidus. In his opinion, there was a small risk that this could be a "window event" of the State Medical Association, which could even serve to prevent those affected from seeking police or legal help.

Idea: A general ombudsman for all problems in medical care. According to Dr. Korte is by no means intended, but nevertheless a frequent reaction to the advice, because "if those seeking advice have the experience that they and their concerns are being taken seriously, alternatives to the legal review can also come into focus", the ombudsman told dpa For example, the contact to the appropriate doctor should also count, which Korte can produce at the patient's request, but for Candidus an ombudsman "for all problems in medical care" would be a more sensible solution than individual solutions, such as abuse or treatment errors, because then patients could Submit a complaint or find advice in all other areas, for example if there is no doctor's appointment in the event of acute complaints. (no)

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