Never give medical advice outside of an office visit. Not over the phone. Not in the parking lot:

Although Herbert O’Rourke had diabetes, Norma said he often woke at 5:30 a.m. to walk four or five times around nearby Heckscher Pond. So she was concerned when he complained of shortness of breath and chest pains on Nov. 6 after a quick walk to the mailbox.

The next morning, O’Rourke stopped at North Shore Medical Group, on Park Avenue in Huntington, to see Nakamura, who had given O’Rourke a routine checkup on Oct. 21.

Nakamura was off that day but had stopped to pick up the mail when the two ran into each other in the parking lot.

Schlitt said Nakamura prescribed Nitrostat, a drug that studies advise should be used cautiously in diabetics. He then scheduled a stress test for O’Rourke on Nov. 23.

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  • Anonymous

    Stoopid, stoopid, stoopid.

    Never give out undocumented, poorly thought out advice to ANYONE in any place other than the apropriate venues.

    I attended a dinner party a few weeks ago in which the wine flowed freely. At the end of the evening, one of the guests (a delightful, sexy lady) asked my wife to hide a few sleeping pills the host (a retired surgeon) had GIVEN her, so that her husband wouldn’t find out. This story is messed up on so many levels. The part that got to me the most was how this retired doc could put himself at such risk by this insane behavior.

    BTW Kevin, you’ll be happy to know that on other medblog sites people complain about how this site is full of ranters and ravers who drive up the BP’s of innocent bloggers. I congratulate you on having a site where we CAN come to rant and rave and blow off the steam which constitutes day to day medical practice in our present age.

  • Anonymous

    md should have called 911…the patient would say he was overreacting, go back home, have his mi, and the 911 call would have been recorded and spared this fool years of torture…

  • Anonymous

    This article was taken off a webiste called “the injury helpline”, run for and by the sodomites. ALl you have to do is put in some info, and a sodomite will contact you to let you know if you have a shot at the malpractice lottery. So you don’t know what really happened in this case.

  • SarahW

    Heh. And the patient might even still be alive.

  • Anonymous

    It’s true that we don’t know what happened in this case…but I tend to believe it is close to what is written…
    I have people ask me for medical advice all the time outside when I am walking to go home in my building; I have had people come up to me when I am literally walking out and locking the office door asking me to evaluate some condition. I for the most part refuse. A number people think I am an a-hole because of that, but I don’t care. They may not come back, I don’t care. Notice I said for the most part. I think all of us are guilty of giving “free advice” to friends and the like on occasion. After reading this I am re-evaluating whether that will ever happen again except family or very close friends…

  • Anonymous

    Even when you are in the office, you could potentially get screwed by a scenario like this…

    a lot of cardiologists and other docs write in the note “NTG SL rx given to patient and patient advised to call 911 if symptoms increase or worsen) until they can get to the outpatient stress test. This doctor didn’t have the chance because he wasn’t in the office. This could have happened to any of us…although with a diabetic I probably would have sent him to the ER…at least from now on I will!

  • Anonymous

    So much for the old saw about how patients are unlikely to sue you if you maintain good relations with them. The doctor here had been this patient’s doctor for 20 years.

  • Dan R.

    There’s another reason for this… concentration.

    When you see someone in the office, you have your “doctor” hat on. The hx and ros and exam is complete, you have prior tests to refer to, and your thinking about that patient.

    When seeing someone “on the cuff” you are more likely to skip a portion of your normal office visit routine — thus leading to poorer outcomes.

  • Anonymous

    By definition the dr is in violation of med board regulations (prescribing without documentation or a pe)…but how many primary care docs do the same-eg dx a uti over phone and call in abx.

    Question about “To make matters worse, he prescribed Nitrostat, which the literature warns against prescribing for a diabetic”???

  • Anonymous

    “but how many primary care docs do the same-eg dx a uti over phone and call in abx.”

    As more Primary cares get sued for this practice, it’ll happen less and less. PCPs should refer every phone call to the ER (ah the job security for us ER Docs)

  • Anonymous

    I give out only normal lab/test results over the phone. Any finding which requires action other than notification means an office visit for a face to face discussion. No exceptions.

  • jerry

    I work for a large democratic partnership ER group. Collectively our group has had two lawsuits where a nurse or other hospital worker wanted a free medical consult on the side for themselves or for a loved one. We used to be helpful to co-workers at a matter of courtesy. Now if you want a doc to look at a throat, look in a ear, look at a urine dip you will need to sign into the ER like everyone else, generate a chart, get naked and into a gown and pay your ER visit co-pay.

  • Anonymous

    I recently had a housekeeping woman in the hospital come up to me and ask for a prescription for her daughter’s sore throat. This isn’t even someone I know. What ever happened to manners in this country??