What We Can Learn from Dr. Tufts

First off, as a physician I have so much sympathy for Dr. Tufts. I can’t imagine what she is going through facing this much public scrutiny for things like a comma being misplaced or prescribing Zoloft for anxiety.

As a medical community, we need to walk away from this case underscoring the importance of any and all medical documentation being a legal document. She at times stated things like Lindsay being “close to SI,” which did not make sense. You either have SI or you don’t.
There were points where I was concerned Lindsay needed an extended stay at an inpatient psych facility while her medications were optimized, yet she only stayed at a facility <1 week.
I wonder if Dr. Tufts consulted a more experienced psychiatrist for such a complex case? We do this all the time in medicine, where attendings in their 40s will ask those in the 60s what to do.

Second, I have difficulty understanding how Lindsay was prescribed over a dozen psychiatric medications (including Zoloft, Seroquel, multiple benzos, Ambien, Benadryl, Trazodone) over only a few months. Does Massachusetts not have a state medication registry for controlled substances? There is rumor she never took them long enough for them to work, yet her messages to her psych providers included a concern of benzo addiction? If my patient is seeing multiple physicians, I often ask them to choose ONE PCP for something even as simple as HTN management. So the fact that Lindsay was able to see multiple psych providers to get several psychotropic meds is a medical error in and of itself.

Third, while I empathize with Dr. Tufts, she was grossly unprepared for cross-examination. It’s obvious why the public is not empathetic to her. She was not eloquent in explaining her medical decisions in layman’s terms. She was scared and lacked confidence even for the things she did right. When asked about Zoloft, she simply said it was the standard of care. That’s not a good answer for the general public. Stating that it is FIRST-LINE for anxiety in breastfeeding women and giving other supportive medical facts would have helped her significantly. She made it seem like she did not think through these medication choices clearly. When questioned on why telehealth only and why she has never met Lindsay in real life, Dr. Tufts should have highlighted that it makes psychiatric care more accessible for a busy mom. She did not answer any of these questions well! She became defensive, rolled her eyes, and sighed often. It was hard to watch her lack of public communication skills. I’m really shocked her psychiatric practice did not prepare her for the stands.

I think we all have a lot to learn from what she’s going through whether that’s documenting better, asking for help, being more thorough about patients’ medications, and improving our public communication skills.