Preventive Medicine and the Seven Deadly Sins: Avoiding Discipline Against your
Envy n. 1. A feeling of discontent and resentment aroused by another's desirable
possessions or qualities, accompanied by a strong desire to have them for oneself.
I am jealous of those who possess sufficient insight to envision the difficulty
in demonstrating a meaningful correlation between envy, the "3rd Deadly Sin," and
the practice of medicine. The question is: to what level of aberrance will the proverbial
"green-eyed monster" take me? Will I try to discredit and smear my competitors?
Will I lash out violently and attack my computer in a fit of rage? Time will tell.
Everyone experiences envy at some point. Envy can actually be a motivator for success.
Envy can also be a remarkably destructive impetus to try to ruin or inflict psychic
damage on a person. This article will explore two ways we Medical Board investigators
often encounter envy: the physician in the business environment and the psychologically
No one can dispute that we work in a competitive environment. In the medical field,
competition in some specialties is profound. As advertising has gained acceptability
(and legality) in the medical field, competition has become increasingly intense,
especially in the arenas of plastic surgery, hair restoration, erectile dysfunction,
ophthalmology (specifically, laser eye surgery) and most recently, bariatric surgery.
Peruse any major newspaper and you will find numerous advertisements appealing to
a variety of ailments to generate "business." In the spirit of competition, when
physicians engage in behaviors that attempt to impede or sabotage their competitors'
businesses, that is when envy is invoked. This also can be known as an "unfair business
Business and Professions Code section 651 is captioned "Dissemination of false or
misleading information concerning professional services or products; permissible
advertising." It is among the most long-winded sections (five pages of actual text)
we encounter, so I will take editorial liberties and focus on the most pervasive
violations we see:
This includes mail, television, radio, newspaper, list or directory, Internet or
other electronic communication.
The bottom line is, does the advertisement contain a misrepresentation of fact?
Is it intended or likely to create false or unjustified expectations of favorable
results (this includes the use of any photograph or other image that does not accurately
depict the results of the procedure being advertised or that has been altered in
any manner from the image of the actual subject depicted)? Does it fail to fully
and specifically disclose all variables and other material factors relating to fees?
Does it make a claim either of professional superiority or of performing services
in a superior manner, unless that claim is relevant to the service being performed
and can be substantiated with objective scientific evidence?
It is also unlawful to use the term "board certified" unless you are certified by
a board that is an American Board of Medical Specialties
(ABMS) member board or a specialty board approved by the Medical Board of California
as equivalent to an ABMS specialty board.
Advertising violations can result in discipline against your medical license. Ordinarily,
first-time offenders are allowed an opportunity to correct the problem, but continuous
offenders may become the object of a citation and fine or, ultimately, the filing
of an accusation.
An interesting counterpoint is that a substantial number of complaints alleging
false advertising come anonymously. Frequently, we are able to determine that the
complainant is a physician who is in competition with the alleged false advertiser.
Caveat emptor, or should I say caveat doctor: If your advertising is not legally
sound, when the Medical Board is not watching, your competitors may be!
Which leads me to segue not so subtly to the topic of disgruntled complainants.
I want to emphasize that in no way are these next few paragraphs intended to dissuade
someone from filing a complaint. In fact, Business and Professions Code section
2318 affords immunity from civil liability to those who provide information to the
board indicating that a licensee may be guilty of unprofessional conduct. If ever
in doubt, I always recommend erring on the side of filing the complaint.
There are, however, a small number of complaints, often memorable, that are generated
from envy. Some of these complaints are petty. Some are reality-challenged. Some
are veracity-challenged. On first glance, it appears there may be a violation of
law, but upon further scrutiny and investigation, complaints such as these just
reaffirm the adage: "hell hath no fury like a ______ scorned."
Recently, we received a complaint from an envious ex-husband of a physician. The
complaint alleged scurrilous behavior and included videotapes of his wife engaged
in extremely intimate activity with someone who was obviously not this ex-husband.
The complainant in the divorce matter wished to portray his ex-wife as mentally
unstable and drug using. The brief investigation of this matter did not yield facts
to bear out this allegation. What it really established is to what deplorable depths
a person will go to hurt another, whether it is prompted by envy, fear, anger, or
any other emotion. It was an unfortunate use of our resources and could have detracted
from a more serious matter.
Custody disputes are another common source of complaints. These can be particularly
bothersome because some appear to be merely an individual's opportunity to "vent"
on paper. Occasionally, however, one of these complaints will reveal a practitioner
who did depart from the standard of care. The departure, invariably, is
failing to perform a fair, objective and unbiased examination and render a fair,
objective and unbiased opinion. Is this envy transference? The professional is assuming
the envious component of the dysfunctional parent? Levity aside, there is an extremely
severe consequence to this breach in the standard of care. This conduct can deprive
a parent of his or her child.
Finally, there was the "two brothers investigation." These two physicians had been
in practice together and had a falling out. One of the brothers began filing complaints
against the other. Some of the issues raised in the complaint were valid but one
of the aspects that hurt the case was the motivation for the brother filing the
complaint, especially since he had been privy to the offending brother's conduct
long before the complaint was filed. If I'm working for someone, and I'm observing
unethical and illegal behavior but looking the other way until I become jealous,
or mad, that will reflect poorly on my credibility in the legal arena (among other
places). It can generally be overcome, but it is yet another fascinating component
of human nature to contemplate how we sometimes tolerate unacceptable behavior in
others until the unacceptable behavior personally impacts us.
How do you, as a physician, deal with being the subject of a frivolous or a false
complaint? Being licensed means that someone may file a complaint against you. I
can assure you that we are trained to prove and disprove allegations. I
can assure you we will not pursue a meritless case. Although we recognize this can
be extremely frustrating for you, your task in these situations is to resist the
inclination to become angry, and instead exhibit as much patience as you can muster.
Patience, after all, is a virtue!
Coming up next: Anger