Shut up or sue

What happens after doctors make mistakes? An article in the New York Times examines the importance of communication between doctors and patients even after mistakes have been made, noting that keeping communication open can reduce the threat of litigation. One expert on the subject said,"Everyone loathes litigation, but it's the only alternative we've ever given anybody."

Not long ago I made an attempt to re-open communication with my family doctor, writing a letter explaining why I am considering switching to a different practice. It was a calm and friendly letter and I specified right up front that I am not at all interested in litigation; instead, I wanted to express my concerns and hear his responses. So far, I have had no reply. Perhaps I'm expecting too much.

For the past year, all my medical needs have been cared for at the Cancer Center, but if I should develop, say, an ear infection or a bad bout of pain in my arthritic hip, the oncologist is the wrong person to call. I need a family doctor for that, but I'm reluctant to return to the practice of a doctor whose only response to my symptoms year after year after year was "you ought to lose some weight" or "that's a natural part of the aging process" or "you ought to just tough it out until menopause."

I explained my concerns to my (ex?)doctor, but I'm not sure what I want in return. I'm not asking for an apology ("Oops, guess we missed your cancer! Sorry!") and I'm not interested in lawsuits or compensation. What I would really like is for the doctor to say something like, "You know, you're right: we could have taken your concerns more seriously and we'll try to do better in the future."

But I know why he won't reply: because any admission that mistakes were made could be used as evidence in a lawsuit. The fear of litigation shuts down communication, so I'm left dangling out here with no way to find closure except to shut up or sue. Neither option appeals to me, but what else can I do?