Just inserting a reality check.

The idea that doctor’s decisions are not heavily influenced by what they hear, read and experience both first and second hand from legal cases and even the media makes about as much sense as the idea that doctors would read legal briefs to make decisions.

For example, is there anyone here who doubts the old adage that you are less likely to be sued if your patient LIKES you? … where’s the EBM in that?

The truth is, we all practice the best medicine we can based on a mix of the science we learned in school, the clinical skills we’ve picked up from 3rd year on and, our own experience which includes research, reading and… frankly… gestalt that comes from dealing with similar situations repeatedly.

Maybe this was a useless rant, but it seems to me that we’re pretending to have good answers to what are just very bad questions – namely, that people always sue based on outcome and not on practice. EBM is just us pretending we can standardize the practice… when in reality we will always be sued on the outcome. This is why EBM fails and doctors end up practicing defensively when necessary. ~JCM

maybe, but I doubt it. I have never heard of it in 10 years but I can’t speak for every member in the group.

What’s the name of that group, because I strongly doubt that?

Are you referring to per defendant numbers or per claimant? And all suits filed still doesn’t tell you the story, because I’m sure you pay on claims pre-suit, don’t you?

Yes. The only people qualified to question my judgment are people prepared to understand that even very good guidelines cannot capture every situation. Clearly that is not you.

another CJD inserted assumption.”

Not an assumption at all. A malpractice trial MUST have a physician testify to the standard of care. That is a fact, my friend.

“In summary: All physicians want EBM. EBM guidelines can be helpful. Problems with EBM guidelines are that the science and data is always changing, sometimes conflicting, and are often drawn up with professional society bias or pharmaceutical money bias. Often individual medical situations defy placement into a guideline. In those situations we have to think of the potential juror/lawyer “guideline” for self preservation so consequently defensive medicine runs amok.”

In summary: You just contradicted yourself. You say we all ant EBM, but then we don’t want it to apply when we don’t want it to apply.

“For someone who is seemingly smart and seemingly has an ongoing interest in these topics it is quite saddening that you can’t grasp some common realities apart from your preconcieved agenda.”

You mean the agenda of inserting some inconvenient facts in your continued quest to keep your patients from holding you responsible?

“Yes we study trial outcomes and how they differ from standard practice and knowledge. Wouldn’t you study outcomes related to your business practice?”

Can you give some examples? It appears we are finally getting somewhere. Maybe some cases you have reviewed the transcript and medical evidence in and disagreed with the finding?