March 4, 2006

Is it time to step up the defense?

The tabloid Boston Herald writes a lawyer-friendly medical malpractice piece, showing conscientious plaintiff lawyers busy diagnosing cancer that radiologists have missed:

The article implies that doctors are clearly not achieving the 100% accuracy rates that lawyers and patients are demanding:

Doctors in the medical mecca of Boston are missing cancer diagnoses at a troubling rate, lawyers for both patients and doctors charge, and more critically ill patients and their families are lining up at state courts to press claims.

“We have some of the best hospitals in the world and some of the very best are making some of the very worst of mistakes,” said Boston malpractice attorney Robert C. Gabler. “It is undeniable that there is more failure to diagnose going on.”

Failure-to-diagnose represents 1/3 of all malpractice claims. Think of the malpractice savings if doctors just endoscoped, CT’ed, MRI’ed, PET scanned, and catheterized every complaint.

Many doctors are already doing this – and are thankful they are, proud that they are practicing defensive medicine. From a physician standpoint, the benefits of overtesting greatly outweighs the consequences.



Related posts:

  1. Poll: Should doctors apologize after a medical error?
  2. Medical errors: Impact on physicians
  3. Expecting perfection in medicine
  4. Some hospitals and nursing homes are asking patients to sign arbitration clauses prior to admission
  5. Bed sores: Result of poor care?
  6. Medical waste
  7. Texas malpractice caps: Readers react


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{ 87 comments }

1 Anonymous March 5, 2006 at 11:01 pm

Out of curiousity CJD, how many times have you been sued?

2 Anonymous March 6, 2006 at 4:42 am

except for sarahW, cathy, RL and CJD, why is everyone ANONYMOUS? I would love to see a cat fight with names and IPs on it! Is it possible in blogging?

I’ll post next time, I enjoy reading this.

ANONYMOUS TOO

3 Anonymous March 6, 2006 at 6:29 am

except for sarahW, cathy, RL and CJD, why is everyone ANONYMOUS? I would love to see a cat fight with names and IPs on it! Is it possible in blogging?

Last thing I need is a sodomite like CJD tracking me down and suing me for libel for something I wrote on this blog. I do this to release tension about lawsuits, not add to my risk. If you made docs sign in, they’s leave.

4 Anonymous March 6, 2006 at 6:38 am

Anonymous 11:01, I have been sued once. Well, twice if you count small claims by a tenant.

CJD

5 Anonymous March 6, 2006 at 6:42 am

“Please CJD fills us in on the evidence to back up that statement.”

I was referring to small claims cases like hers. You mistake “frivolous” with cases you don’t agree with.

Besides, most of the time you’re not even paying out of pocket for the direct costs of your attorney, so really it would be your insurer’s decision to pursue the claim.

CJD

6 Anonymous March 6, 2006 at 7:49 am

“If I insist, they will go for the test but I’d better be right about the need for the test !”

You sound kind of clueless…a physician can almost always justify the need for a test…the insurance companies just put up these hurdles, like you have to call “1-800-dildo” or whatever, and press a whole lot of numbers in succession, then you get to some high school graduate who asks you asks you questions off a computer template for whatever test you’re ordering. If you say the patient has chest pain, you think they won’t allow a stress test? Or if you say rule out appendicitis, you think a cat scan wouldn’t be approved? Every test I have ever ordered has been approved, you just have to put up with the nonsense of wasting time on the call.

7 Anonymous March 6, 2006 at 8:24 am

just to get back to the post that started this whole thing, I usually send almost everyone for a colonoscopy. Even a 20-year-old with rectal bleeding and obvious hemorrhoids (maybe they are the 1:1000000 who have colon ca)… it’s a shame this is what we have to do because of the lawyers and patients…

8 diora March 6, 2006 at 11:57 am

Litigiousness is part of America, because we grant more individual rights than any other country. It’s how we settle our disputes, as opposed to barrel of a gun. We believe that the responsible party should pay for harm they cause, and we have put this system together as the most fair way we can think of to apportion harm and preserve these rights.
Unfortunately, this is not the only reason for lawsuits in the US. A few lawsuits are legitimate, more are driven by greed, most malpractice lawsuits are probably driven by pain, anger and ignorance.
In fact, I believe ignorance drives most malpractice lawsuits – patients truly believe they were wronged because of what they saw on TV or heard on the radio or what their “expert” doctor told them. Unfortunately, in the majority of cases this is not the case. A lot of us don’t realize that tests are not risk-free, even fewer understand how ambiguous the results of biopsy may be and how difficult a diagnosis often is. I only understood it recently, and I don’t believe I am stupid.

Another reason for lawsuits that I think is specific to America is that many people don’t take responsibility for their own actions. If I didn’t get test results in the mail, it is my responsibility to call and to check. Even if somebody promised to call. I might be upset that they didn’t do as promised, but it shouldn’t be grounds for lawsuit IMHO because I know how to use the phone. If I refused a test/prescription it is my responsibility to live with consequences. Just like if I decided to swim far in the ocean and drowned. It’s great if a lifeguard saves me, but if not it is my fault. But for some reason here in America people don’t like to blame themselves. Not all Americans, maybe even the minority, but enough to make life worse for all of us.

9 Anonymous March 6, 2006 at 12:12 pm

“A few lawsuits are legitimate, more are driven by greed, most malpractice lawsuits are probably driven by pain, anger and ignorance.”

This statement has literally no basis in fact.

“In fact, I believe ignorance drives most malpractice lawsuits – patients truly believe they were wronged because of what they saw on TV or heard on the radio or what their “expert” doctor told them.”

This is half right. Because ignorance is partly responsible. The ignorance stems from the unwillingness of medical providers to spend enough time with their patients when something does go wrong. Instead, they clam up.

“Another reason for lawsuits that I think is specific to America is that many people don’t take responsibility for their own actions.”

Absolutely true. If people would take responsibility for their actions and pay for the harm they’ve caused (or more accurately, if their insurers would), then the need for lawsuits would be lessened. As it is, businesses are responsible for the vast majority of lawsuits filed in the US.

Now, if you think people failing to take responsibility is a uniquely American thing, then you’re fooling yourself. Why you don’t hear as much about lawsuits in other countries is that the need for them is alleviated by the vast social safety network. Our litigation system is largely about burden shifting to the responsible party. In many other countries (at least Westernized ones), there is no burden to shift as the taxpayer picks up the tab.

CJD

10 Anonymous March 21, 2006 at 9:05 am

My cancer was not diagnosed, despite alot of symptoms, including 35 pound weight loss – tumor that was present throughout the weight loss was ignored, then when I finally got them to biopsy– the node was misread as benign. The doctors, who granted did lots of tests, missed what was going on–but– the mailman in my office was spreading rumors that I had cancer because of the drastic weightloss and how awful I looked. It was obvious to the mailman that something big time was wrong.

I did not sue when I was finally diagnossed several years later, at a later stage. I was less angry at the pathologist, who made a flagrant error, than the internist who decided I was a hypochondriac and treated me as such, although prior to the these symptoms, Id been rather doctor avoidant. Had I sued, she would have been my target. Better to say “we dont know” and treat the patient with respect, than to blame the patient for failure to diagnose.

And, supposedly, I didnt go to bad Drs– all were on the so called “best of” lists”

11 Shannon April 13, 2006 at 1:05 pm

Dr. Bad Shift,

Can I talk to you for a book I’m writing?

My email: shannon.brownlee@comcast.net

Thanks

12 Anonymous October 25, 2008 at 4:25 pm

All physican’s are human just like the patient. Rad Doc’s read over 100 to 150 films a day. It’s bad that in this life bad things happen to good people. My husbands been a Rad Doc for 14 years. He has felt bad when he’s missed something. The problem is the money can never replace what was lost on both ends. Most Doctor’s that I know don’t get up in the morning and say to themselves let’s miss diagnose someone today. They have families and the government doesn’t make it easy for the patient or the doctor anymore. Patient’s some of the times have grave news and it’s bad. They get angry and up set at the out come. I’ve personally been missed diagnosed and so has my husband. Requirements are getting harder and more patients come in that need more help. It’s said but lawyers don’t care. I’ve seen them laugh and know they were going to get a Doctor for everything. I’ve seen lawyers that think it’s funny that they run the country. Look at capitol Hill. Both the patient and the Doctor loss.

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