• Incompetence in a physician is a scary thing! Doctors deal with problems of life and death and try to heal you with dangerous tools. But how do you know who’s on their game and who’s falling down on the job? It’s tricky for patients because they often don’t know enough about medicine practice to judge competency. This makes putting your body under the care of any doctor scary.
• So scary, in fact, that an entire malpractice industry has sprung up to reassure patients that incompetent doctors will be severely punished. Unfortunately malpractice usually ends up a witch hunt that can burn good doctors at the stake and let bad ones go
• Judge not, lest you be judged
• Competence is not always as black and white as you might think. There is a good bit of gray and ambiguity involved. The real world practice of medicine involves a lot of educated guessing and trial and error. Even the best doctors occasionally make mistakes or use unorthodox treatments.
• The real dangerous doctors are the ones that recklessly disregard patient safety and don’t even care about doing things right.
• Incompetence may be common, but it is hard to prove. Doctor D occasionally sees signs of suspected incompetence in patients that have been treated by other docs. An incorrect diagnosis or an unorthodox treatment that seems way out of the expected margin of error and puts a patient at risk.
• The medical Gestapo
• But there are some doctors that are all too happy to accuse their colleagues of incompetence. These docs believe there is only ONE competent way to practice medicine, and it is the way THEY practice.These doctors want to be the secret police who keep medicine in line. They are typically jerks with a massive god-complex. Doctor D has had encounters with the medical Gestapo. They shoot first and ask questions later. They see the world in black and white. There is no gray area for them.

Dealing with Dr. Danger
Witch hunts both from within and without medicine have soiled the names of a lot of good doctors. So Doctor D is always careful about fingering another doctor as a dangerous doc, even when he has his suspicions. I’ve been a target of the Medical Gestapo myself, and I know how damaging misguided doctor purges can be. I’m not blowing the whistle on Dr. Danger unless I know beyond a shadow of a doubt that he’s really what I think he is.
Subtle warnings

• Although I’m not absolutely certain he’s incompetent, I wouldn’t want any of my family seeing Dr. Danger. It would be too much of a risk! I can’t flat-out denounce him publicly, but I do want to steer patients away from the danger I suspect.
• This is where subtlety comes in handy: I might say “Dr. Danger does some really unorthodox things.” Or I might just fail to praise him, while my facial frown indicates I might not be totally cool with Dr. Danger. Or I could just change the subject and suggest you see Dr. Awesome instead.

Read more at  http://www.kevinmd.com/blog/2011/03/doctor-opinion-physician.html