After yet another horrible experience with a member of the esteemed medical community – I feel compelled to share a letter I wrote to the offending physicians office and all of his partners voicing my displeasure in the quality of treatment and the lack of concern for the reason we came to see him.  I feel strongly that we must all be our own advocate for our health and those physicians that do not “measure up” should be called out and held accountable when they fail to provide quality care.  Now I am not asking them to heal all ills – I am just asking them to be careful and attentive to a patients needs.  My husband I and are both very vocal when we go to see a doctor and there is never any question about our communication skills which is one of the reasons this situation came as such a surprise!  As a result of this physicians lack of care, we are seeking the assistance of another physician and I will happily keep you updated as to the results.

 

Digestive Disease Consultants

623 Maitland Ave #2200

Maitland, FL 32701

Re:  Michael Maley, Patient

 

To Whom It May Concern:

My name is Jesse Maley.  My husband was referred to Dr Lebioda by our primary care physician, Dr. Gary Sturn whom we have been going to for close to 10 years.  We think very highly of Dr. Sturn and do our best to follow his instruction for our health care.

About 18 months ago my husband suddenly came down with a bout of diarrhea that wouldn’t go away.  It continued to get worse and worse and – after having some preliminary tests completed at the request of Dr Sturn to make sure there was no obvious parasite or bacterial infection that would be causing it, we were referred to Digestive Disease Consultants of Central Florida for a colonoscopy and some further testing.  The first available appointment was with Dr Popli.

We filled out the required paperwork and were seen relatively promptly.  My husband told him he was having 15 to 20 explosive bouts of diarrhea everyday – even waking him up at night.  Dr Popli didn’t seem overly concerned about this obvious abnormal activity nor for the obvious discomfort this daily experience was causing my husband and asked a few cursory questions, gave him a prescription for some anti-diarrhea medication and scheduled the colonoscopy appointment.  We both felt he was a little short and dismissive but since a requirement for a good doctor does not include a good personality, we followed his advice.  He didn’t seem particularly concerned since my husband was not complaining of being in any pain.  He suggested that the 1000 units of Vitamin C he took every day might be the culprit.  He did not make any suggestions as to dietary changes that could possibly improve the situation.  My husband did tell him that he was experiencing very low energy and Dr Popli recommended that he drink Gatorade to make sure he was properly hydrated.  It would turn out that this would be about the best advice we were ever going to get from Dr. Popli.

The anti-diarrhea medication gave my husband horrible cramps so we called the automated phone system and three days later after finally figuring out the combination of numbers one had to push in order to actually speak to a human being – were advised that they had called in another prescription to our pharmacy for another pill to stop the cramps.  This immediately caused concern for me and my husband as it seems unwise to any normal person to treat the side effects of one pill with another pill.  But again – he’s the Doctor.  We did as he asked.

After the colonoscopy in April of 2010 – and NO improvement in the diarrhea situation, he informed us that he didn’t see any problems from the procedure and would wait for the lab reports.  And then he prescribed another pill.  This pill was $600 for a months supply and also did nothing to improve the diarrhea.

At the follow up appointment, he discontinued the third pill since it wasn’t working and prescribed another pill and gave us a weeks worth of samples of this fourth pill.  When we went to the pharmacy to fill the prescription, it was over $1000 for a months supply.  We called the automated phone system and asked for an alternative and received no response.  I finally went to the office and announced that I was going to sit in the waiting room until I received more samples of this expensive medication because I wanted to make sure it would work before I spent two car payments on it.  Eventually they gave me another two weeks supply when it was clear I wasn’t leaving.

At the next appointment, we told him this fourth pill series wasn’t doing anything either to improve the situation and we declined to fill the prescription at the pharmacy.  Dr Popli said he didn’t know what was wrong and said to continue to take the first and second pills (which hadn’t worked) and suggested we call to make another appointment in a month or so.  We left the office feeling pretty depressed that we had no resolution but we had managed – through this very expensive series of Doctors visits and procedures to completely fulfill the annual deductable so we knew that most of the follow up would be at the cost of the insurance company.  We called a month or so later to inform Dr Popli that there had been no improvement but no one ever returned our calls to complete the appointment process.  We called several times with no return calls.  They also never responded to our requests to call in refills for the first two pills.  We resigned ourselves that this whole diarrhea thing was just something we would have to live with.  Dr. Popli said nothing was wrong, so maybe it was all in his head.  Or maybe it was stress related.  Or maybe the moon is made of cheese.

Interestingly enough, in November of 2010, my husband saw a commercial asking for patients who had diarrhea with no diagnosis to come in for a clinical trial at a local clinic.  After making sure there was no chance there would be a placebo used, he went to the clinic and signed all of the paperwork, some of which was asking for the release of records from previous Doctors.   They wanted him to stop taking one of the medications he was taking for an unrelated issue before starting him on the clinical trial and we scheduled an appointment to come in to start the trial after he had been off this medication for a month.  When the month had transpired, we returned to the clinic to start the trial full of hope that someone was going to help my husband with this aggravating problem which had not improved in the least since it had begun.

The clinician brought us both into her office and began to go over all of the material that had been faxed to her from Dr Poplis office.  There we saw – in three different places – a diagnosis of “Colitis”.  There were also notes from Dr Popli speaking of how well my husband had responded to the fourth and final medication and how he felt the problem was “solved”.

We were appalled.  Solved?  After 18 months of non stop bowel explosions – sometimes numbering in the double digits – and Dr Popli was patting himself on the back and considering the case “solved”?  In what Universe is it normal to have 15 to 20 explosions of diarrhea on a daily basis – and what kind of Human Being – never mind a Doctor – no – a digestive specialist – wouldn’t – at the very least – tell his patient what his diagnosis was?

I was in tears.  My husband came very near tears himself.  The doctor who was conducting the clinical trial was choking back tears seeing that my husband suddenly understood that all this time he was suffering and knowing that you people knew he was suffering and had not done anything to alleviate his condition.  We couldn’t understand how there would be any reason that you wouldn’t tell us what was wrong and offer a solution.  Even the clinician was without any kind of explanation as to how this could “slip” through a such a large organization such as Digestive Disease Consultants.  Is Colitis not “disease” enough for Digestive Disease Consultants?  Were you hoping for something more exciting?  More disturbing?  Was it not disturbing enough for you that my husband has gone through nearly 18 months of unexplained and untreated diarrhea?  Were you hoping that this was something that would just “go away” much as you dismissed us from your office without so much as a how-do-you-do?

We referred to another doctor – at another digestive specialist clinic – by the clinical trial people with the assurance that this referral would be with a doctor who would consider the importance of the distress this diarrhea was causing my husband and would be diligent about seeing it through to the end.

I feel that – due to your negligence in providing the diagnosis to my husband – we are entitled to a full refund for all money that was paid out of our pocket for services rendered at your clinic.  I believe this is in the area of around $1500 but are willing to accept whatever your records reflect.  This money will be given to our new digestive specialist who has definitely impressed us with his thoroughness.  You can keep what ever you got from the insurance company.  We are having to start meeting our $3000 deductible all over again and we wouldn’t have had to do this if you had stepped up to the plate and completed the process that is expected when a person visits a specialist for an issue and a doctor gives the diagnosis to everyone EXCEPT the patient. 

Really?  Really!

I am not asking you to admit any wrong doing and I certainly am not expecting an apology for your lack of professionalism.  I don’t intend to sue as long as this doesn’t turn into one of those negligence cases where the patients life could have been saved had you guys been on your game.  At the end of the day it is the responsibility of the physician to see to it that every “i” is dotted and every “t” is crossed.  There should have been some follow up phone call to check on the patients well-being.  It’s a simple courtesy.  Delaying or ignoring a diagnosis is bad enough but having a diagnosis and completely denying the patient this information is the very definition of negligence.

I would challenge you, Dr. Popli, to set your watch to go off 15 times tomorrow and imagine how miserable my husbands quality of life while he was rushing to find bathroom so that his bowels could literally explode into the toilet and decide for yourself whether you think a refund is a reasonable request. 

Sincerely Pissed:

 

Jesse Maley

cc:        David Lebioda, M.D.

            Richard J. Straker, M.D.

            Barry R. Katz, M.D.

            Harry H. Shephard, M.D.

        Raaj K. Popli, M.D.