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The Downfall of Tiffany Ingham, M.D. and Tough Climb of Patient Engagement

June 25, 2015
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Can you imagine someone having the gall to tell you they want to punch you in the face while disparaging everything about the way you look and act? If this has happened to you, you probably were at a bar, sporting event, or some other raucous occasion where alcohol is heavily consumed.  

How about the doctor’s office?

Can you imagine if that someone trashing you was a licensed medical practitioner whose care you were in at the time they said it? Not only that, but imagine if they said it while you were under sedation and unable to respond.

That nightmare situation was reality for one patient. There are levels of disrespect and there is what Tiffany Ingham, M.D., the most infamous anesthesiologist in the country did.

As reported in The Washington Post and several other mainstream media outlets, a Virginia man who had a colonoscopy ended up recording his entire surgical procedure by accident. He intended on recording the post-op instructions from his doctors on his smartphone and forgot to stop the device when the procedure started.

As soon as he went to sleep, Dr. Ingham, the anesthesiologist on the procedure, began to lay a verbal lashing against the patient for no reason at all. According to a suit that the anonymous patient filed, Ingham said, “After five minutes of talking to you in pre-op, I wanted to punch you in the face and man you up a little bit.” When an assistant noted a rash on his arm, Ingham told her not to touch it, saying she might get, “some syphilis on your arm or something.”

Ingham and another doctor, who was also charged in the suit but was dismissed from the case, talked about intentionally misleading and avoiding the patient after the surgery was over. Ingham said she’d write hemorrhoids on his chart even though she didn’t see them. She made fun of him for attending Mary Washington College, which used to be all-female school.

The insults didn’t end there and neither did Ingham’s incredibly cynical outlook on patient care. She reportedly said, “People are into their medical problems. They need to have medical problems.” At the end of the day, a jury in Fairfax County, Va. awarded the man $500,000 in damages. Normally, I’m not a fan of our country’s lawsuit tendencies, but in this case she got what was coming to her.

As I noted, the candid camera-style news story has gotten pretty good coverage in the mainstream media. I think it speaks to the innate challenges we see in the evolving doctor-patient relationship. That is, many doctors still look down on us patients.

I’m sure 99.99 percent of doctors are not as outwardly malicious as Ingham, but that condescending attitude is not something that can be dismissed entirely. It’s still there and it’s the biggest barrier to patient engagement. Yes, there may be some technical challenges but as Judy Murphy, R.N. said at a recent conference that was covered by my colleague Rajiv Leventhal, the keys to consumer eHealth are action, access and attitude. Two of those three have little to do with technology and everything to do with shifting behaviors.

Patients want to be engaged but they’re not getting the resources available to do so—or at least they don’t know they are getting those resources. A recent survey of healthcare consumers conducted by researchers from the Johns Hopkins Bloomberg School of Public Health found a gap between what patients want to use and what’s available to use. Fifty-seven percent of respondents want to use websites to access their health information. Only seven percent had done so.

We know these resources are available, in theory. After all, people in this industry talk about portal overload. So what’s causing the gap? My guess is that their doctor isn’t engaging them and patients are being made aware of their options. They aren’t telling them about where they can find their health information, and they’re not educating them or telling them where to find resources. 

When it comes down to it, engaging the patient is a sign of respect from a doctor.  It’s putting the patient on their level.

That quote, “People are into their medical problems. They need to have medical problems,” is a prime example of the challenges patients are facing in this evolving landscape. It comes from a doctor that is immediately dismissive of most of the ailments patients discuss with her.  No one wants the patient to call all the shots, but this holier-than-thou, doctoring from the mountain top attitude needs to go away in order for patient engagement to find success. It’s not going to work—not for the patients, or for the doctors.

Please feel free to respond in the comment section below or on Twitter by following me at @GabrielSPerna



HI Gabriel,
I am a new member of your blog but wanted to say Thank you for covering this disgusting and disparaging conversation. Would you also be able to research and report on a similar situation involving Joan Rivers? I believe the physician or staff who allegedly took a picture of this patient while unconscious, is equally egregious. Public reporting of such behavior needs to continue.

Hi Gabriel, I agree that it is great that the patient got compensated for harm. Additionally, it is really is sad that the health care provider you trust to care for you, understand your situation and assist you in the healing process ends up being one of the people that inflicts harm on you. By God's, as a student nurse, this case is a lesson for me about what type of health care provider I do not wish to ever become, even on my worse day.

Thanks for your article. Obviously, this was egregious and unacceptable behavior on Dr Ingham's part; however, the GI doc was equally as bad and yet had his case dismissed. I find this incredibly sexist (and I am not even a feminist by definition). His remarks were also very unprofessional and highly disparaging but the courts and media solely vilify the female physician. Bad form all around. My two cents.

Thank You Gabriel for the courage to write this post.

"but this holier-than-thou, doctoring from the mountain top attitude needs to go away in order for patient engagement to find success. It’s not going to work—not for the patients, or for the doctors”

While this is surely an isolated incident, it is shockingly indicative of the toxic mindset that most Physicians carry. That mindset is actually not about the patient. It is about the massive discouragement of being a doctor! I see this all too often in my coaching. It represents a huge problem and is feeding the beast of 3rd party interference, patient non-compliance and oversight. Tired of being called just a provider? STOP ACTING LIKE ONE. Recapture the appreciation that the patient is the one affording you the opportunity to practice your craft. Patients are our most valuable teachers, they are not just "consumers" of healthcare, not to be treated like cattle. Want your career to be more satisfying? Learn to re-capture the sacred relationship between you, your patients, and practicing medicine.

In all my research I found 4 Main Toxic mindsets that encourage his behavior:
The 4 Toxic Mindsets of Practicing Medicine in America:

  • Feeling undervalued for your expertise
  • Believing you are powerless in a broken system
  • Feeling inadequate for patients, family, and self
  • Feeling overworked, stuck and limited

When we break through feeling victimized, then we can find that joy of practicing medicine and stop being bitter and taking it out on patients.

What possible harm did this patient suffer? Two physicians made perfectly defensible (private) comments about his stupidity, lack of personal hygiene, and creepy behavior -- and he's entitled to a half-million dollars because his feelings are hurt? I'm sure soldiers and accountants and architects -- yes, even lawyers -- speak candidly among themselves. Tort reform can't come soon enough.

I'm just learning of this interesting story. Like AJ Drexel, I am wondering what the other side of this story is about? I read the Washington Post article, it did not mention the Pre-Op Interview that provoked the doctor's disgust. I'm also thinking of "Mash" type humor, nasty as it can be, at times helps a doctor get through a high pressured day. I hope her side of this story is somewhere to be found, is she a total sociopath? Is she somebody who has done all kinds of good works, the public was not informed about? One of the consumer evaluation sites showed a picture of a Tiffany Ingham, a very attractive young woman, which could account for Dr. Shah's accommodating behavior. What harm did this patient suffer? $500,000.00?? (+) I also noticed that on the medical consumer-review sites, it appeared most of the people evaluating her had never been seen by Dr. Ingham, but were reacting to the news reports. I've encountered nasty doctors, some of them don't even bother closing a door, and letting the whole waiting room, hear them scolding/demeaning a pt. It never occurred to me they could be sued for arrogance. I hope Dr. Ingham's side of the story gets told; there is nothing of substance to be learned from this if we don't have opportunity to hear from her.

I'm (another) physician, so my opinion may not be valued by many, but here goes.

Dr. Ingham's behavior was reckless and unprofessional and, I think, very atypical of the great majority of doctors. Remember that she most certainly had no "relationship" with the patient (unlike the gastroenterologist performing the colonoscopy, who was concentrating on what he was doing) - she probably only met him minutes before the procedure. Most anesthesiologists are caring professionals who try hard to reassure people at a very vulnerable moment. But if you have a poor "bedside manner" (or lack cultural currency with the population you serve) anesthesiology can be a corner of the medical profession to hide in.

I agree that Ingham's comments were totally inappropriate and disrespectful and, if this was a pattern, it was correct to fire her. The episode was surely a public relations disaster for the medical practice/hospital/system she worked for But "malpractice"? What medical harm was caused?

Those who have pointed out that this kind of banter is sort of a "gallows humor" common too most professions are correct, and I think that some occasional discreet joking between surgeons as they're scrubbing up is no big deal. Dr. Ingham's crude commentary was loud and long, reflecting poor judgement, and crossed way over the line of what's acceptable. But it is not representative of business as usual in the ORs and Short Procedure Units in the US.

Perhaps it's easy for you, being a doctor and all, to overlook her placing false information in his medical chart. Perhaps you think when he's asked later about any health issues and fails to note on the form that he was diagnosed with an illness or disease that he never had, that it won't affect his credibility, or his ability to obtain proper care.

As a doctor, you should know better, and if you don't, please let us know your name and specialty so we can avoid you in the future. Do you honestly believe that this was the only incident where she betrayed this kind of attitude? Did anyone seem shocked at her comments from what you could hear from the recording? "You and yours" of like ilk should remember that WE the patient came to YOU the doctor for health concerns, not to be made a joke of. You're indicative of what is wrong in the sphere of doctor/patient relations.