Last week, a former patient came back to see me after spending several months with another doctor at a practice where I once worked. During our visit, the patient seemed uneasy and told me that the other doctor had made disparaging comments about me. I did not believe the patient meant to hurt me by sharing this. Still, the words stung. More importantly, the patient had been placed in an uncomfortable position between two doctors and left to decide whom to trust.
The experience was personal, but the issue is larger than reputation. What does a patient hear when one physician criticizes another? What does professionalism require in these situations? And when does taking the high road begin to look like doing nothing at all?
Research suggests this behavior is not rare. In a 2013 study published in the Journal of General Internal Medicine, physicians commented on a patient’s prior care in about 4 out of 10 encounters. When they did, the comments were more than twice as likely to be critical as supportive. The study was small, but it identified an important problem: Criticism of another physician can become part of the patient’s clinical experience, with potential consequences for trust and quality of care.
When a patient hears negative comments about a previous doctor, the message may spread beyond that physician. The patient may begin to wonder: Was my treatment wrong? Was I wrong to trust that doctor? Is this new recommendation really about my health, or about disagreement between physicians? The patient is left to sort out a professional dispute without the records, context, or expertise needed to resolve it. A clinical visit can become a reconsideration of past motives rather than a discussion of present needs. History may be filtered to avoid taking sides. Tests may be repeated because prior work is no longer trusted. Communication across a transition of care may become more guarded just when it needs to be strongest.
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We do not have evidence that every disparaging comment causes measurable harm. But we do know that distrust can interfere with care. A 2026 systematic review of cancer-care studies found that patients who distrusted their clinicians were more likely to have problems with treatment adherence.
That does not mean physicians should avoid discussing concerns about prior care. Sometimes patients need to know that an earlier decision should be reconsidered or that a different approach may now be safer. The distinction is between explaining the clinical concern and attacking the physician who made the earlier decision. Saying, “Based on the records, I would recommend a different approach” gives the patient useful information. Saying, “That doctor did not know what he was doing” turns a clinical disagreement into a judgment about competence or character.
Professional standards recognize both obligations. The American Academy of Neurology’s Code of Professional Conduct states that physicians should not unjustifiably criticize a colleague’s judgment, training, knowledge, or skills, while also making clear that incompetence or professional misconduct that could jeopardize patients must not be ignored. The Joint Commission similarly identifies unjustified negative comments about another licensed practitioner’s care as disrespectful behavior and warns that such behavior can interfere with collaboration, communication, teamwork, and safe care.
Taking the high road does not mean staying silent. It means responding in the right way, to the right person, through the right channel, and for the right reason.
With the patient, that might sound like: “I’m sorry you were placed in that position. I wasn’t present for that conversation, but I can review your history with you, explain my reasoning, and address any concerns about your care.” Correct inaccurate information calmly, but do not cross-examine the patient or recruit the patient as a witness.
When it is safe and appropriate, speak directly with the colleague: “A shared patient told me that you described me as a bad doctor who made bad decisions. I wanted to ask you directly rather than make assumptions. Is there a clinical concern that needs review?” If the report is confirmed, the boundary can remain clear: Clinical disagreement is legitimate. Using a patient to attack another physician’s character is not.
Turning the other cheek becomes a mistake when silence begins protecting the behavior rather than the patient. A single unclear report without an urgent safety concern may warrant a direct conversation. Repetition, retaliation, interference with care, serious falsehoods, or a broader pattern may require involvement of a department chair, medical director, professionalism office, peer-review group, or another formal process.
The state medical board should not be the first stop for every insult. Its role is to protect the public, not to settle personal disputes between physicians. When conduct threatens patient safety, violates licensing requirements, or persists despite appropriate intervention, formal reporting may be necessary. The appropriate threshold depends on the seriousness of the conduct and the laws of the jurisdiction.
So who was really hurt in my situation? I felt the sting of having my judgment and character questioned. But the patient was left uncertain about past care and unsure whom to trust going forward.
Professionalism does not require silence, and it does not require retaliation. It requires enough restraint not to use the patient as a messenger, enough courage to address problems directly, and enough judgment to know when keeping things private may place others at risk.
Timothy Lesaca is a psychiatrist in private practice at New Directions Mental Health in Pittsburgh, Pennsylvania, with more than forty years of experience treating children, adolescents, and adults across outpatient, inpatient, and community mental health settings. He has published in peer-reviewed and professional venues including the Patient Experience Journal, Psychiatric Times, the Allegheny County Medical Society Bulletin, and other clinical journals, with work addressing topics such as open-access scheduling, Landau-Kleffner syndrome, physician suicide, and the dynamics of contemporary medical practice. His recent writing examines issues of identity, ethical complexity, and patient–clinician relationships in modern health care. Additional information about his clinical practice and professional work is available on his website, timothylesacamd.com. His professional profile also appears on his ResearchGate profile, where further publications and details may be found.
