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Medical Ethics/Doctor Responsibility in Follow-Up?


QUESTION: Hello,  
I am wondering how much responsibility a doctor holds in following up with a patient after prescribing a test.
When I was 47 years old, I saw my general doctor for my yearly well woman exam. She did the exam including a breast exam. She told me she wanted me to get a mammogram. She gave no indication that her reason for doing so was anything other than routine because of my age.
Unfortunately I procrastinated, for which I take full responsibility. About a year after this exam, I was diagnosed with Stage 3 breast cancer. The tumor was 3.5 cm.
I am not looking to blame anybody or do not carry around anger or frustration over this. I am thankful and blessed to be alive and doing fabulous at this point 3+ years from my diagnosis.
The wonderful physicians involved in my treatment find it hard to believe that due to the grade of my tumor, it was not something that would not have been palpable at the time of my last exam.
I wonder what a physicians responsibility is to disclose full information to a patient (were there reasons other than my age for her recommendation to get mammogram), and also their responsibility to follow-up to make sure the test was done, and to request test results.
It certainly does not change the course of the way things went for me, and I thank God for every blessed day I have ahead.
Just has me thinking and wondering though. Would be good information to have in the future.
Thank you


I am sorry to hear about your diagnosis and think you have a positive outlook regarding the situation.  With regards to your questions, it is obviously a physician's fiduciary duty to disclose relevant information.  I suspect that your physician was ordering a routine mammogram (every year or 2 years) depending on the articles which the physician relies upon.  However, the physician should have reported to you if she felt there was an additional reason for the test.

As far as following up, many physicians leave the responsibility to the patient.  This practice complies with the standard of care unless there is a positive test result in which the standard mandates the information be conveyed to the patient.  

I wish you the best,

Paul D. Friedman, M.A., Ph.D., J.D.

---------- FOLLOW-UP ----------

QUESTION: Hello Dr Friedman,
In your opinion, do you see any good coming from my putting any further time and energy into trying to establish whether or not the physician I initially saw felt there were factors other than my age present when she told me to get the mammogram?
This unanswered question does bother me sometimes, but I really do try to pick my battles and focus on the positive. I don't know that having an answer one way or the other, will bring me any additional peace; which is my daily goal.
Thank you so much for your time,


Thank you for the positive feedback.

If you are curious, you can always contact your physician to determine if she suspected something out of the ordinary.  I suspect the answer is that it was just a routine test she recommends every year or two.  It certainly cannot hurt so you may wish to find out.

I wish you the best.  Please keep your positive outlook.

Very truly yours,

Paul D. Friedman, M.A., Ph.D., J.D.

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Paul D. Friedman, M.A., Ph.D., J.D.


In addition to my law degree, I have a master's degree in bioethics and a doctorate of philosophy involving comparative medical, legal and business ethics. I am an adjunct professor at a medical school teaching ethics to healthcare professionals and graduate students.

I can answer questions dealing with general ethics principles, including medical ethics, research ethics and bioethics. I am not a moralist and do not interject subjective values such as what is morally right and wrong. Also, I do not give legal advice over the internet.

For more information, you can view my webiste at WWW.EXPERTETHICS.COM


I have been a civil trial attorney since 1989 with a masters degree in bioethics and a doctorate of philosophy involving comparative ethics.

State Bar of Arizona
State Bar of Colorado (inactive)
District of Columbia Bar (inactive)
Federal Bar
Licensed in the Arizona District Court
Licensed in the Ninth Circuit Court of Appeals
licensed in the United States Supreme Court
American Bar Association
American Association for Justice
Arizona Trial Lawyers Association
American Society for Bioethics and Humanities
Kennedy Institute of Ethics

A list of my copyrighted publications and presentations is contained at WWW.EXPERTETHICS.COM

Bachelor of Arts 1985
Juris Doctorate 1989
Master of Arts in Bioethics 2004
Doctorate in Philosophy 2006

Awards and Honors
Phi Beta Kappa
Multiple Who's Who
Outstanding Achievement Award in Bioethics from Midwestern University

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