Little things happen in surgery which are of no consequence but which can look very serious when blown up on a screen. A simple bleeder here or there. Pulling out a suture and having to replace it. If it were possible to have it all seen in context, I’d not object. But any lawyer worth his contingency fee could make it look horrible, don’t you think? In training, an attending told me of a small incisional infection a patient had had which eventually healed with no consequence. He went to a lawyer early on, had a photograph taken, which the lawyer had blown up into a huge gooey poster and placed it before a jury. After puking, they awarded the man 25K. In those days, that was a lot of money. My point is this: being darn close to human, most surgeons would feel pressure under the circumstances, and that could lead to making decisions for the camera as opposed to for the patient. If I were a patient I’d prefer to have my surgeon single-minded when working. But that’s just me.

When the meter reader comes to read our electicity meters, I go down in the basement with her. I don’t actually think she’s going to steal anything – I am certain the novelty of other people’s screwdrivers and scrap wood wears off within the first couple of weeks on the job – but it’s reassuring to her. If I’m watching her read my meters, then I can’t call Hydro later and accuse her of pilfering. So she can feel ok about the visit to my basement: she knows for sure there will be no repercussions later on.

I understand there are differences in practice between meter-reading and surgery. I can tell if my meter-reader is pocketing something, but it would be nearly impossible for me to judge whether my surgery was being conducted improperly. That’s one. Another is that meter-reading is fairly straightforward. The most likely mistake for a meter-reader to make is kicking scrap wood on the floor. She wears steel-toed boots, so it’s not a big deal for her, and it’s of no consequence to the reading of the meter. But in a long and complicated surgery I imagine that many little mistakes are made that ultimately have little consequence to the patient. If an antagonistic lawyer were to magically have access to all the little mistakes, I would be unable to distinguish between the mistakes that were truly of no consequence and those that resulted in harm.

So while in practice I think videotaping is unlikely to help, or help much, I don’t see the proposal as being inherently antagonistic. If it could be implemented accurately and fairly (and I agree, it probably couldn’t), videotaping should have the effect of protecting surgeons from frivolous, malicious or misguided malpractice suits. I don’t see the need to raise a big fuss about barriers between patients and doctors, or lack of trust, or antagonism. A practical discussion of the barriers to implementation should do.

If you’re so convinced you’re doing everything right and all your brethren are never negligent, why would you want to hide it? Reminds me of when cops didn’t want interrogations videotaped.

Oh, and lawyers do have a complete record made of their appearances in court. What do you think the court reporter is doing?

bravo Gasman. that made me chuckle.

Great idea….let the lawyers go first.

I will have to watch every word I say, tone I use, and every little blood vessel.

It would put an undue strain on myself as well as my whole operating room team and likely lead to more errors, not less.

Id like to see lawyers have a video and audio recorder following them around the courtroom and watching them at work in the office to see exactly what they are doing in their bill-able hours.