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Trisha Torrey

"Worst Doctor of the Year" Reveals Himself Through Social Media

By December 5, 2012

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As thousands (maybe millions?) of people rely on doctors ratings sites to help them choose a doctor, I continue to maintain that those sites don't always give us the information we need. While yes, we can learn how long a doctor has been in practice or where he or she went to medical school, what we need to know about their personalities can't be revealed through check off statements.

Enter social media. From blogs to Twitter, from Facebook to Pinterest - when doctors participate in social media, you can get more than a glimpse into who they are as people and whether you want to hire them to manage your care.

And here's a perfect example.

While I rarely ever focus on (or, more like, chastise) one individual doctor, I will do so if that doctor has put himself in a position to be called out. This is the second time in my writing career I have done so in a negative way. But it's a perfect example of a doctor revealing his personality and why patients should do their due diligence before selecting a doctor.

Dr. Larry Greenbaum of Greenwood, Indiana, blogs for Rheumatology News. In his post from November 30, 2012, entitled "Kiss My... " he discusses his interface with a patient in a variety of condescending and derisive ways:

  • He begins by discussing how he is BILLING his patient. That's a giveaway right there. When a doctor leads with the category he BILLS you in, you are not a person to him - you are a dollar sign.
  • He continues by describing that billing as his highest income designator (a "5") which he uses "for patients with huge volumes of records, patients who take an inordinate amount of time, or patients who annoy me in some other extraordinary fashion." [Depending on what he defines as an "inordinate" amount of time, that might be OK. But annoying? Seriously?"]
  • He then goes on to describe WHY he billed this patient at the highest level. "I charged him level 5 for taking so much of my time, for bad-mouthing his previous doctors, and for incessant whining. Although he had developed RA only about a year and a half ago, he gave a long and ruminating description of his treatment, or mistreatment, as he saw it." And later.... "He didn't seem demented or hateful, just weird."

So how did I discover Dr. Larry's true confessions? The existence of this blog post was brought to my attention by someone I follow on Twitter. It took me about 30 seconds to find that others I follow have also brought Dr. Larry to the attention of others. Michael Weiss questioned whether the post is a HIPAA violation and called Dr. Larry the "Worst Doc of the Year." Kelly (RAWarrior) Young said her fellow rheumatoid arthritis sufferers' felt this doctor is "insulting, horrible, deplorable, arrogant, and condescending" and had concerns about him giving good rheumatologists a bad name."

In fairness, and to see how well the doctors' ratings sites measured up against how Dr. Larry Greenbaum revealed himself through his blog post, I did check out both Vitals and HealthGrades. Vitals gives him 1.5 (out of 4) stars. HealthGrades shows that his patients are "not sure" about his physician capabilities. Actually, I'm surprised (but pleased) to see how accurate they are.

The bottom line - is that yes, sometimes you can gain far better insight into the care you might receive from a doctor by using social media.

Learn more about using social media to learn about your doctor, or a doctor you are considering.

Understand why doctors ratings sites may not give you the information you need.

As for Dr. Larry Greenbaum... in my (not so) humble opinion, it might be time for him to rethink why he is in medicine. I agree with Kelly Young's followers - he's giving other rheumatologists a bad name.

(Follow Up: To tickle your funny bone... Shortly after posting this, I found reference to this cartoon entitled How do patients choose doctors online? from Webcina.)

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Comments
December 6, 2012 at 2:39 pm
(1) Dennis G. Grace says:

Sounds like a no-brainer, but Dr. Greenbaum actually hits on one reason many doctors and medical office staffers would argue is a valid reason for extra billing: time-wasting.

I can’t recall ever hearing a patient express contentment with the doctors always being late. The scheduling people tell us to be there at a specific time–even insist that we arrive early if we have extra paperwork, yet the doctors are always late. A two o’clock appointment typically means that the nurse will bring you back to take vitals at 2:15, after which you dutifully sit in the freezing exam room, reading the various anatomical posters supplied by drug companies, until the doctor strolls in at 3:20. If you ask the support staff why this happens–and I’m surprised at the number of patients who patiently (pun intended) unquestioningly accept this temporal abuse– they will tell you that the doctor’s appointments are scheduled somewhere between seven and fifteen minutes apart. The backlog occurs because some patients take too long. They arrive late, meander, socialize, can’t recall everything they beefed to discuss, keep asking questions or simply don’t understand he answers, and the seven-minute appoint stretches to a half-hour or more.

The problem here, some believe, can be solved punitively. In truth, that’s asinine on many levels. First, unless we’re talking about a concierge doc, the patients never know they’ve been financially spanked. The insurance company establishes the co-pay, tells you what they paid, and tells you what you may be billed. They never say: you were billed at the maximum rate for wasting time.

December 6, 2012 at 2:40 pm
(2) Dennis G Grace says:

Second, most of these time-wasters never know they’ve done anything wrong. Okay, so I’m fifteen minutes late. It’s not like they’re going to be ready on time. I took longer than the allotted time? What allotted time? No one told me there was an allotted time? Preparations for the visit? What preparations? I didn’t know what they were going to ask.

See, I’m not saying Rosenbaum was right to bill those patients for breaking the rules. I’m saying that he–like every other doctor I’ve ever seen–NEEDS TO TELL THE PATIENTS WHAT THE RULES ARE. Time management is too often the elephant in the room when it comes to acquiring anything like open, honest communications between doctor and patient.

December 6, 2012 at 4:33 pm
(3) Trisha Torrey says:

Dennis,

I agree that the patient did not seem prepared and that it might be fair that Dr. Greenbaum would bill more for the visit because it took extra time.

But let’s not miss the important point of this post. Dr. Greenbaum turned around and did PUBLICLY what he punished (by billing extra) his patient for: he whined about the time and dissed his patient – exactly what he was complaining that his patient did. Furtherm he may even be in violation of HIPAA – which is a true offense and punishable if he is.

Yet Dr. Greenbaum is considered the professional? Seriously. Quite the double standard.

If he simply billed extra for the patient and kept his mouth (typing fingers) silent – I would have no beef. But his cavalier, punitive and public attitude is simply appalling.

Trisha

December 6, 2012 at 7:47 pm
(4) Peggy Zuckerman says:

Whether or not this is a HIPAA violation, is there not a million Medicare and Medicaid rules which prohibit arbitrary billing codes. since many are based on time and the treatment given, etc, whether simple issues complex, the guidelines may well have been breached.

I do hope that someone local to the doctor can contact newspaper or local RA group for their public input.

December 9, 2012 at 5:31 pm
(5) gemdiamondintherough says:

Agreeing with the comments posted, I will add this one!
WHY DO FELLOW DOCTORS NOT TURN THIS DOCTOR IN TO THE STATE BOARD??????
Usually, they stick together in some type of unwritten code.
I can understand that for some minor items, BUT things that are actually illegal!!!!!!!!!! I think they are just as guilty as HE is, if they do not report him.
To me it is in the same category as ABUSE!! We are mandated to report this and we are certainly mandated to report abuse in the Medicare and Medicaid Systems, if not ALL ABUSE!!
This is not a gray area! It is black and white! DO WHAT IS RIGHT!!!!!
We will all pay the consequences if we sit back and do nothing!!!!!
I am sad to say, he is not the only one out there, like that. He was just silly enough to put it in writing!!!!!!!!!!!!!

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