Doctor Refused My Surgery Due to Smoking?

by Anonymous

After injuring my foot and going to the emergency room, the physician on duty said I fractured my heel. He said he was going to put my foot in a cast and see how it healed. He sent me home and said to call for a follow up visit in a couple of weeks. On my return visit, he said my foot was healing nicely, and said the same on my next visit.

With ample time for my foot to heal, I was still having problems walking with limited movement, unable to kneel down at all and constant moderate to severe pain, especially after the doctor took me off my pain medicine (saying I didn't need it anymore).

After explaining I was still having problems and lots of pain, I asked him what the problem was. He told me that my heel did need surgery when I fractured it, but he did not do surgery because I smoked cigarettes! He said with me being a smoker, if he had performed surgery, I most likely would have lost my foot.

He said I was released to go back to work and would have to live with my discomfort. I asked him if I would ever walk normal again and he said not without surgery. He told me if I quit smoking for about three months, I could come back and he might refer me to another surgeon, and that was all he was going to do for me!

Do I have any legal rights to do anything about this?

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ANSWER for "Doctor Refused My Surgery Due to Smoking?":

Anonymous (USA):

Our research shows nicotine causes blood vessel constriction which reduces blood supply to the skin and organs. Although smoking can cause blood flow restriction, the effects of smoking and subsequent healing times hasn’t been clinically proven.

When a person smokes his white blood cells are lessened and as a result have a difficult time fighting bacteria which could lead to infection. Although this information is well known to surgeons, we haven’t been able to find any examples of surgeons refusing to do foot surgery on a patient who smoked.

Saying he chose not to perform surgery because your smoking would have caused you to lose your foot is rather a stretch. A doctor has a right to decide not to perform surgery if he believes doing so would harm the patient. Maybe you should have sought a second opinion.

If you can find a surgeon who will support your position that the first surgeon’s refusal to operate because of your smoking was unfounded, you will have found the right surgeon for you. Absent any proof the original surgeon’s actions harmed you, it will be very difficult for you to have any claim against him.

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.

Best of luck,

Judge Calisi

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Comments for Doctor Refused My Surgery Due to Smoking?

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Obvious rationing
by: Anonymous

I was referred to the Portland VA dental clinic for evaluation to see if I could have implants since they ripped out my teeth without first determining if I could tolerate a denture.

Upon completion of the examination I was told by the dentist that did it I was an EXCELLENT CANDIDATE for the procedure but that it was VA policy not to do dental implants on anyone who smokes. You are required to be smoke free for 6 months before you can be scheduled.

This does not take my health or medical background into account, it is a blanket restriction on all vets based upon policy not on your ability to heal. I have had other surgeries and healed fine, Lasik, Basel cell carcinoma removal, not to mention the original removal of the teeth in a single day. They did not care when they were taking them out if I would be able to heal.

So, I went to private practice dentists and was told the same thing, excellent candidate, they have no such restriction on smokes and say it is entirely spurious, as long as smokers abide by the extra precautions post surgery they have no added complications. But they also charge (here) $24,000 for what the VA would do for free for non smokers.

I also want to point out that the law makes treatment for qualified vets an entitlement and NOWHERE in the law does it allow clinics to change that entitlement.

This is a slippery slope we are on, what next? Obese vets denied care? They have provable complications from being overweight. Black vets because some of them may have sickle cell anemia that prevents healing? Female vets because they might have differential blood counts due to monthly cycles?

I plan on suing the VA for malpractice in the original case of ripping out my teeth against my will, and then denial of care afterward based on a blanket policy that is blatant and illegal rationing.

by: Anonymous

In the first place, there is no evidence of a cause and effect relationship between smoking and poorer post-surgical outcomes. There is evidence that a smoker has a higher statistical risk for longer healing times, infections, comorbidities, and other complications.

But there is also evidence that some smokers have post-surgical outcomes as good as, or in at least one stugy, better than those of nonsmokers.

In plain English, nonsmokers have a better chance of good outcomes than do smokers, but not that nonsmokers will have good outcomes or that smokers will have poorer outcomes.

Is denial of treatment justified merely because someone has a higher than normal likelihood, not surety, of a less than optimal outcome?

All that aside, however, the growing movement towards denying surgery to smokers, even necessary life saving procedures such as coronary artery bypasses, which began in the 1990s and is spreading throughout the world, is contrary to medical ethics as expressed by numerous organizations, from the World Medical Association, World Health Organization (a UN agency) to the U.S. National Institutes of Health.

This trend has been based, in some cases directly and in some indirectly, on cost/benefit analysis, that of the physician or the health providing entity, rather than on benefit to the patient. It has been able to exist and grow because of society's current view of smoking and smokers, who are seen as suffering from a self-inflicted problem, and undeserving of care.

As for self-inflicted, perhaps. But what about the smoker who started in the early 1970s or earlier, when the vast majority of people smoked, society encouraged it, and the public knew nothing of the health dangers? Can he be said to have made an informed choice?

And even most who started smoking at a time when the dangers had become widely known are in a situation where, in almost all cases, he is unable to just decide to quit and then do so.

Smokers have a physical addiction to nicotine. Cessation of smoking causes withdrawal symptoms. The severity of those symptoms varies, based on the individual's body, degree of addiction, and other factors.

The plain, scientifically proven truth is that, whether the substance is nicotine, alcohol, heroin, cocaine, or any other addictive substance. some can quit with minimal discomfort, some go through a very difficulty and even painful withdrawal, and some just cannot quit.

Unfortunately, the attitude of society today is that smokers who do not quit are somehow flawed, and are morally bad and/or weak willed.

This is a slippery slope. Today it is smokers and the obese. Where does it stop? Should an NFL player with a broken arm be refused treatment because he willingly played a dangerous game and will return to it after the arm is healed, with a chance of further injury?

That may sound ridiculous, but it's the exact same logic that is used to refuse smokers medical treatment. The only difference is that the football player belongs to a group which society approves of, while the smoker or the obese person belongs to a group of which society disapproves.

Listen to your doctor
by: Anonymous

The reason doctors don't operate on smokers is because the risk of complications and death is so much higher (around 17% higher for death).

This is not only expensive and time consuming, but also very emotionally difficult for the surgeon doing it. They know that there is an unnecessary high risk of death from what are normally simple procedures.

You put your life in their hands under surgery, they have the right to ask for some effort on your part. Most doctors say that 8 weeks of not smoking is enough to perform the surgery, but many ask for as little as a week. I don't think this is unreasonable.

I understand quitting smoking for good is difficult, but if you require treatment and are serious about it then you need to take some responsibility for your health.

Cardiologist dismissed me...
by: Anonymous

He drew a picture of my arteries after an exploratory procedure, and he told us I need 3 more stents. He said a Vascular Surgeon would do it. When I went back he never mentioned the other doc procedure or surgery.

This was last October, I never heard from him after that. I thought I would have it done in a week or two. He dismissed me.

I had a physical and the family doctor insisted I see this heart doctor, and he sent me for an oral stress test. I got a letter saying the Stress test was satisfactory, and if I had any questions to call the office.

Dr refuses hernia surgery because I smoke...
by: Anonymous

I went to a surgeon because of a hernia. He said he could do an MRI but that he wouldn't operate on me because I smoke, that I would cough and return in a year "mad" that it re-herniated.

I'm wondering why this doctor's office didn't tell us when we made the appointment that he doesn't do surgery on smokers.

Had I known his personal convictions on smokers I would have not wasted my money on this consult. I don't feel I should have to pay the office visit consult.

He misrepresented himself to me and he had ample time to disclose to me before being seen that he doesn't do surgery on smokers.

I feel that this is discrimination and I'd like to get my money back from this doctor.

In the same boat
by: Jeff Hall

I have been refused back surgery by the Veterans Administration in Louisville KY because I smoke. I have considerable trouble walking. I am 58. After being denied hernia repair by this same hospital for a year, (2010) I am getting angry.

Is this just another trick to deny treatment for Veterans?

The Government sold me cigarettes for 10 cents a pack from sea stores when I was in the Navy. They never said "We don't want you out at sea on our submarine because you smoke".

Doctor also refused my surgery due to smoking...
by: Anonymous

I am having the same problem now. I broke my foot in July 2013, they call it a Jones Fracture. I was told this is a very serious fracture and I needed an x-ray every 2 weeks. I came to stay with my mother for awhile to have some help and had to find a foot and ankle surgeon here.

I had an MRI done which also showed nerve damage, torn ligaments and scar tissue around the break. This doctor was very rude to me, he said what other problems you have, high blood pressure? None of that was his business at the time. I was there for a broken foot, but he told me the same. He said that I need surgery because a Jones Fracture will not heal on its own, but he will not help me at all unless I stopped smoking.

So he was basically saying, "I will not help you because you smoke, and I will not help you unless you stop smoking." But he will see me back in 2 months just to see if anything has healed.

Why would I even think of going back to a doctor that treated me like I was an animal just because I smoke? I do not know where to go from here. It took me time to find him with my insurance, but I have to suffer until I can find a surgeon that will treat me as a person.

This is wrong and people should not be treated this way. What would happen god forbid it was surgery or death? A doctor will let you die if you smoke?!?!

Hypocratic Oath Contents Ignored...
by: tom baker

I was refused surgery by a doctor on 1/8/2013 due to the fact I am a smoker. I was given a choice to quit and in 30Days he would do a urine test if I was nicotine free he would then consider operating.

My wife and I both sensed the arrogance of his Phys asst he sent in first to do the initial interview. He never washed his hands nor did he wear gloves and after he handled my feet he proceeded to touch my neck and jaw and facial area so when he left the room I washed myself off. (Keep in mind a Physician's assistant is a person that did not finish school or left just two years shy of being a MD. And in most cases they could not pass the final exam and that is why they are not Doctors!)

So then we meet "the best in the state" Of course he was somewhat friendly but very arrogant and condescending. After he informed me he does not operate on smokers I had three questions that went unanswered:

1. When you took you oath to help people did it say everyone but smokers?

2. When you got your student loans did you make sure that none of the money came from tax payers that smoke? (His age would dictate that when he took our money about 70% of Americans smoked.)

3. Since I was failed to be notified you do not operate on smokers when the appointment was made, can I have the Co-pay of $45.00 back also the $60.00 in fuel and the $125.00 in pay my wife lost for taking off work for half a day?

My primary care Dr in Florence, Alabama is the most compassionate, friendly and detail orientated man I have ever met. He is not a specialist but yet he was the only one, after 20 years of pain and suffering, that found the problem.

Will I quit smoking? I doubt it. Will I find a surgeon that will operate on me and will I not smoke while I am healing? Most definitely.

This "I am God" syndrome that these Dr's have will get so bad they will only operate on people that are in perfect health, and we can only hope that one day it will be them or their family members going untreated by a doctor that does not agree with their personal choices.

With this train of thought and arrogance being carried out against the citizens of our state and country, sooner or later your overall health will be determined on the whims of the person rather than the documented medical needs of a patient.

by: Anonymous

I have been in a lot of pain for the last 10 years and the doctor says I have blocked arteries in my leg. He asked me if I smoked and I said yes. I have been smoking since I was 9 and I'm 77 now. He told me he could not do anything for me unless I quit, so I did for a short time.

I went back to him after 1 year. I was in his office 2 minutes and he again said he couldn't do anything for me.

It is getting to the point where I can hardly walk, so I thought "to heck with him" and I went back to smoking. I think that pretty soon they will be putting me in a wheelchair. This seems hopeless and I don't understand why the doctor refuses to help me.

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