Kate Steadman thinks defensive medicine doesn’t exist:
The bottom line is that while the evidence isn’t crystal clear that defensive medicine plays no part, there’s nothing that shows defensive medicine is dictating doctors’ behavior. More contemporary research needs to be done (the majority of these projects were in the late 1980’s and early 1990’s), but there’s no indication of a rash of doctors performing unnecessary procedures and tests because of their fear of frivolous lawsuits.
Please educate her. (via Overlawyered)
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{ 36 comments }
Out of those 100,000 people who die each year of medical error, how many families file a lawsuit? Does anyone know? I bet the answer would surprise some of the doctors who believe everyone files them.
Also, how does someone get a death listed as being “Caused by medical error”? Aren’t most of them covered up? I’ve never heard of any Dr. saying that he would be happy to list the cause of death as being his fault.
These reports of 100,000 people dying each year from medical errors is such fallacy.
An 80 year old diabetic with a 80 pack year history of smoking languishes in in the ICU after a heart attack and pneumonia with renal failure. She dies. A reviewer scours the chart and finds that she was given a medication an hour late or given the wrong dose. Most of these are medically insignificant but nevertheless classified as an “error”. Did it directly lead to the death of the patient? No, death can’t be stopped.
The C-section rate is rapidly approaching 30%. That’s at least twice what it ought to be, and last I heard babies have not doubled in size and fetal distress has not doubled in incidence. If that’s not defensive medicine, I don’t know what is.
The first commenter is right. All we do in hospitals is commit medical errors. We actually plan them. I pray to god every night when I go to sleep the lawyers sue us even more to completely cause the system to collapse (not that we’re that far from it, with the patient volume increasing every day) and then once the system completely collapses, it can be fixed, sans the lawyers.
Amy: I wouldn’t use my real name if I were you. Lawyers have been known to cut comments from weblogs and use them in court.If you’re an OB, I could see one of these guys using the above comment if you deliver a baby with Birth defects by NVD as evidence you should have gone the C-section way. They’d just have to google you. Just be anonymous like the rest of us. Unless you’re lucky enough to be practicing in the Great White North.
Did you check amy tuteur’s weblogs linked under her name? All she does is rail against doctors…don’t feel to protective of her.
Anonymous 9:57 is a very, very smart guy. Everyone should listen to him.
Even if defensive medicine does exist, so what? Short of absolute immunity, there is nothing that is going to change its existence.
At best, it’s all anecdotal evidence that it exists, at worst (for the patients) some things get caught that wouldn’t otherwise. The docs still get paid for it, or at least don’t get paid at a rate any higher than what they otherwise would.
Doctors believe it exists, and they don’t need any actual proof thereof. Again, so what? What does it prove and what does it change? Nothing. They’ll do it with or without tort reform, and they will never get immunity.
CJD
CJD: Canada: No lawyers. (Well, lawyers, but they wear funny robes and more importantly, they practice law, not appear on TV asking “Did you slip and fall in the Walmart?) No Defensive medicine. This post has nothing to do with “socialized”medicine, just the fact that in other countries, you cut out the Lawyers, you cut out the defense.
cjd is a smart guy…everyone should listen to him. He is absolutely right, no matter what you people do, tort reform, or not, you’re going to get scanned, x-rayed, biopsied, catheterized, endoscoped, cystoscoped and then finally placed on a ventilator with the levophed and neosynephrine wide open…enjoy!
Canada: No need for damages to pay past and future medical bills. You cut out the need to pay for medical bills, you cut out the vast majority of med mal claims.
Wanna make the trade? Remember, you get paid what they do, too. And the government doesn’t just control you partly, it owns you fully.
Of course, they might start measuring your performance a little more closely, too.
CJD
I knew you would answer with an argument against socialized medicine. I was answering your argument: You said if we got rid of the lawyers, we would still practice defensive medicine. I answered with the example of a country which has neither. You changed the subject. As I predicted you would.
To repeat:
“This post has nothing to do with “socialized”medicine, just the fact that in other countries, you cut out the Lawyers, you cut out the defense.”
OMG, you’re right! Tuteur’s entire Blog rails against ER’s. She wouldn’t even have gotten in from the waiting room at my hospital in the 7 hours it took for her sons’ care to be screwed up in her story, all the ER’s fault, not the Ortho departments. But then again, she “knew” it wasn’t busy.
It’s not an argument AGAINST socialized medicine. It’s simply pointing out how silly your post is when you cite Canada. You might have well have said that because there were fewer convertibles sold in Canada, that means less defensive medicine.
CJD
This is off topic, but…
if anyone thinks a 7 hour wait in an emergency room is acceptable for a patient who is essentially a direct admit, you’ve demonstrated the entire rationale for my blog.
It is medically and administratively unnecessary and happens because doctors have no clue how long patients wait, and don’t think they need to care about it.
As to how I “knew” that the ER wasn’t busy, I did not have to draw on my years of experience working in ERs; all I had to do was to look and see that there were very few patients present.
To anonymous 10:13, don’t worry, Amy Tuteurs’ husband according to her blog works in a law office…so, he’s probably a lawyer.
“if anyone thinks a 7 hour wait in an emergency room is acceptable for a patient who is essentially a direct admit, you’ve demonstrated the entire rationale for my blog.”
You sound like a lunatic. Do you even practice medicine? Patients wait because other patients come in without appointments and screw up the remainder of the schedule for the day.
I know non-physician patients who had physician friends who arranged for them to be admitted and promptly worked up within minutes to hours…you must have no pull at that hospital…if you were a real doctor you would have some connections at a hospital or friends who would have taken care of your son…maybe instead of writing a blog all day you should practice real medicine then you would get to know other physicians who could help you in your time of need so you wouldn’t have to wait liek the masses…or maybe the other doctors know about your blog so they intentionally make your family wait…I would if I knew who you were…
For those interested the 100,000 thousand deaths per year statistic goes back to the “To err is Human” article from the Institute of Medicine. What they negate to mention (unless you dig through the data) is they use numbers going back to early 80’s research. They don’t actually do the orginal research themselves. In reality they don’t have a clue.
“if anyone thinks a 7 hour wait in an emergency room is acceptable for a patient who is essentially a direct admit”
Amy either a patient is a direct admit or not. Going through the ER is NOT “essentially a direct admit”. If it isn’t a direct admit the ER does your footwork for you while you are in bed. If the wait ticks you off so much I suggest you admit a REAL direct admit yourself.
You are avoiding my point. In my professional and personal opinion, 7 hours is too long to wait in that situation. Instead of reflexively insisting that the ER is always perfectly run, you need to explain under what conditions a 7 hour wait is acceptable. If those conditions aren’t met, then the wait isn’t acceptable. It just falls under the heading of: “if you choose to come to the ER, you’ll wait until we’re damn well ready to see you.”
no one said emergency rooms are perfectly run. Idiot patients and patients without primary care physicians come to the er for non-emergent problems and clog it up. Even you, supposedly a physician, could have directly admitted your own family member but instead chose to go through the er and further clog it up. The people who get priority are people who are crashing and trauma patients/cva/mi’s, etc. A child with an infected arm that is not septic can wait…what world are you living in?
Amy is being a mom not a doctor…understandable. But I do believe it is clouding her opinion on the matter. Though the waiting room wasn’t busy we all know it only takes one or two sick sick people to eat up alot of time and people.
Blah, Blah, Blah anon ER Doc your song and dance is getting old. Why not give it a break. You attack every person, physician or otherwise, if they dare to disagree with you. I hope that one day you need medical care and you receive as good as you give, disposition and all. I also hope your ass has to wait in an ER some where for hours on end.
Anon 1:23, you should tell all those idiots waiting in the ER what you think of them so they can go to some other ER and save you the bother. Of course, you probably shouldn’t tell them that you are playing around on the PC while they are waiting for care and probably bleeding all over the waiting room.
“You sound like a lunatic. Do you even practice medicine? Patients wait because other patients come in without appointments and screw up the remainder of the schedule for the day.”
In your whole life, have you ever taken responsibility for anything? No wonder you’re so deathly afraid of being sued – you might find out you are actually responsible for something.
at worst (for the patients) some things get caught that wouldn’t otherwise.
CJD, are you so completely clueless? Do you truly believe extra tests are harmless? I am a patient and I don’t want more tests than absolutely necessary. Why do you think you hava a right to decide for me?
At worst, I’ll suffer side effects of the test – get an infection from an unnecessary biopsy for example or worse. At worst, I’ll get treated for a non-progressive desease and suffer or even die of side effects of the treatment. At worst, a child will get cancer 10 years after a few unnecessary cat scans. Granted this is rare, but if the benefits are also rare than …
Lawyers have been known to cut comments from weblogs and use them in court
Here is a thought. Maybe patients not wishing defensive treatment should post under their names. This way, doctors will always be able to use their posts as the proof that they knew the consequences of their refusal to undergo some tests.
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