A general surgeon in Florida evaluated a patient for hernia repair. The patient confided he was HIV positive. The surgeon asked about the patient’s medication regimen. The patient explained that on the medication his viral titers were non-detectable.

The surgeon stated that that was good for both of them. For the patient, of course. And for the doctor, should he be accidentally stuck with a needle during the case.

The patient went home and sent the doctor a note stating his comment was offensive and discriminatory. He was thinking of filing a complaint with the Medical Board and the federal agency that oversees complaints related to the American with Disabilities Act. And the cherry on the sundae. He was speaking to an attorney.

The surgeon wrote back calmly. He reminded the patient that he had always ready, willing, and able to perform the hernia repair. Nothing about the patient’s condition gave him pause. Indeed, he thought the patient was ready to schedule the case.

The surgeon apologized if his comment had been construed as anything offensive and was prepared to discount his professional fee by 25% as an act of good will.

The patient responded he wanted the whole procedure performed gratis. This included not just the surgeon’s fee. But also the anesthesiologist’s fee and the surgi-center fee.


Let’s deconstruct this.

The surgeon did nothing that violated the law. He did not violate any professional norms. At no time did he suggest he would not treat the patient. And he did not say he would treat this patient any differently than any other patient – whether or not such a patient was HIV positive.

He made a single statement that was true. If a surgeon accidentally sticks himself with a needle and the patient’s HIV viral titers are high, the likelihood of transmission is higher than if viral titers are non-detectable. The surgeon was stating the patient’s situation was good – for the patient – AND the surgeon.

The surgeon was also being a nice guy – offering good will to a patient. Apparently, that was not enough. The patient wanted everything done for free.

The patient seemed to think the surgeon was vulnerable to a host of administrative complaints and litigation. This says more about the patient than the surgeon. While the patient may trigger any number of actions, I doubt they will go anywhere. If the patient were smart, he’d graciously accept the surgeon’s bona fide offer of good will and move on. What do you think?

Let us know in the comments below.

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