Doctors can bully patients with disabilities: Goar
It takes a lot to stop Margaret Lumchick.
Polio didn’t. It left her with paralysis in her lower limbs. But she learned to get around using crutches and a wheelchair, got a good education and trained as a teacher.
Working in a wheelchair-inaccessible two-storey school didn’t stop her. She taught Grade 3, kindergarten and served as the school’s librarian.
A traffic accident that threw her out of the driver’s seat of her hand-operated car didn’t stop her, either. She underwent spinal surgery, got a motorized wheelchair, applied for Wheel-Trans and became an energetic member of ARCH, the legal aid clinic for people with disabilities.
Cancer didn’t — but the battle was much tougher than it should have been.
Lumchick’s family doctor referred her to a surgeon who refused to remove her 2-centimetre colorectal tumour. Dr. David Mumford, who practises at the Trillium Health Centre, ascertained that the tumour was malignant using a colonoscopy. As the sedative wore off, Lumchick heard him tell the nurse she had cancer, but the treatment would be radiation only, no surgery.
At her follow-up appointment, Mumford informed her she had rectal cancer. Surgery was standard treatment, he said, but she would receive only radiation because she had post-polio syndrome (which can include breathing problems). If he operated, Mumford warned, she might never get off a respirator. He said this was the decision he would make for his own mother.
Lumchick tried to explain that her post-polio weakness was confined to the lower body. She said getting to the hospital five days a week for radiation was onerous for a person in a wheelchair. She said she wanted surgery. “He became very irritated,” she recalled. “He signed a prepared form and told me I would go for radiation. Then he abruptly got up from his desk and opened the door as a signal for me to leave.”
Dr. Mumford recalls the consultation differently. “My recollection is that it went well. I answered all of Ms Lumchick’s questions in detail. I was not pacing as she suggests. We discussed various treatment options, including surgery and radiotherapy. This is a big operation with a significant risk of morbidity and a risk of death and I explained this to Ms Lumchick along with the increased anaesthetic risk associated with post-polio syndrome.”
When Lumchick got home, this is what she wrote: “I am a woman. I am 74 years old. I am handicapped. I am alone. I am disposable.”
Her gloom didn’t last long. She went back to her family doctor and asked for a second referral. This time she was sent to Dr. Robin McLeod at Mount Sinai Hospital, who took a full medical history, consulted an anaesthetist, ordered an MRI and found that the tumour had already grown by a centimetre, compromising her lymph nodes. After one week of radiation, she removed the tumour and performed a colostomy. The operation was successful. Lumchick’s last checkup showed “no convincing evidence of metastasis.”
But that is not the end of the story. Seeking to protect other disabled people from what she endured, she filed a complaint against Dr. Mumford to the College of Physicians and Surgeons of Ontario. After a five-month investigation, the regulatory agency decided to take no disciplinary action. It advised Dr. Mumford of the “importance of a full discussion of treatment options, including listening to a patient’s concerns and obtaining comprehensive expert advice when necessary to help the patient make an informed decision.”
Lumchick was crestfallen. “A little tap on the fingers to tell him he’s been a naughty boy won’t change anything.”
But she wasn’t defeated. She resolved to take the case to the Health Professions Appeal and Review Board. That meant hiring a lawyer and convincing the board that the complaints committee of the College of Physicians and Surgeons had done an inadequate investigation and reached an unreasonable decision. Lumchick contacted David Baker, who specializes in disability law. (She met him years ago at ARCH, where Baker once worked as legal aid lawyer.)
The hearing took place last Tuesday. Baker and his associate Emily Shephard arrived early with an exhaustively researched, tightly argued case, hoping to set a precedent. Lumchick was already there, trying to keep her expectations in check.
Dr. Mumford didn’t show up. He was represented by a lawyer from the Canadian Medical Protective Association, which provides legal defence and liability protection for physicians.
A decision is expected within two to three months.
Lumchick knows her chances of winning are slim. Even if she does, she won’t get a penny. The board doesn’t have the authority to award damages.
Her aim is to show people in the disabled community they can stand up to doctors who bully, patronize or silence them. Her ultimate objective is to change the pattern of medical discrimination against patients with disabilities.
Carol Goar’s column appears Monday, Wednesday and Friday.
