I don’t care what you call it -chatting, rapping, asking, consulting (the term in the article) – GET THE FRIGGING INFO and read it yourself and factor it into your decision-making.

The before/after distinction was the one I explicated. This is the stuff of risk/benefit trade-off and complex decision-making.

When I say “obviously proven wrong” I am referring to the presence of some perceived risk of inaction (Is it ACTUALLY there or not?). This dos not mean that the overall decision to look was “wrong.” If every expert and doctor on earth agreed that all the signs/symptoms/data pointed to a blockage and a very very heavy risk of rupture, but there in the end of the day there was not, they would have all been WRONG as to the presence of the blockage, but the risk analysis would have been “correct” because the risk of inaction (based on the available info) outweighed the risk of action.

Lets say that a doctor walked up to me on the street and told me he “clinically felt” that I need to be scoped “just to make sure.” Sure, “How would he know unless he looked?” would be technically accurate, but silly. My response would be that we’ll just wait and see (an alternate that would clearly be justified) and if the window of concern passes . . . we know I was right and he was proven wrong – after the fact. More importantly, the doctor’s cost-benefit decision-making would have been “flawed” ex ante because “no test has zero risk.”

Now compare that with this statement: “Aspirating at a colonoscopy is a rare thing. But it has nothing to do with the decision to do the test.” Well it should, given that “no test has zero risk.” Which is it? The statements are logically incoherent unless you are only talking about the specific risk of aspiration. If you are talking of the overall risk inherent in any such procedure (as I would hope), then it sure as hell better have something to do with that decision. That is not me practicing medicine, that is bloody logic.

Obviously this is a professional judgment call, but the question at issue is whether it was reasonable at the time to order the test given all the factors discussed (regardless of outcome).

To not properly assess and/or factor these risks (as determined by some professional standard – before the fact) may or may not = “malpractice,” but it sure as hell is just crappy and illogical decision-making.

To address some specifics: “How would he know without putting the camera in. Now you’re saying he should have KNOWN there was 100 percent chance of no obstruction, even though clinically he felt there was a risk.”

No. I said no such thing as I have tried to explain and it worries me that a doctor can not understand the distinction. Just because he “clinically felt” there was a risk DOES NOT per se make it reasonable, especially if no other doctor would have “clinically felt” that risk.

Please try to “rationally” interpret my words and the logic of my argument rather than “clinically feeling” them.

Aspirating at a colonoscopy is a rare thing. But it has nithing to do with the decision to do the test.

If only we could be as prescient as the lawyers.

If the GI doc had been right, then the radilogists would have been sued for getting it wrong..

You guys just dont get it. THE PATIENT HAD A BAD OUTCOME!! END OF STORY!!! No lawsuit should occur. And yet it does. But I’m sure we’
re just making it all up and there are no frivolous lawsuits, because Mr Spector says so.

This is not a good alternative for Drs. to be taking. Kind of like biting the hand that feeds you.

They do. Read the article.

The husband’s argument is that in this situation the risk of action (test) was greater than the risk of inaction (no test).

The doctor’s argument is that the risk of rupture was greater than any risks in not performing a colonoscopy.

The doctor was obviously proven wrong in his assessment of the risks of doing nothing as there was no blockage.

The question is whether it was negligent not to made the “correct” decision in light of the following: (a) the pertinent info he ignored by never consulting the radiologist, (b) the other relevant information he DID have; WHICH IS WEIGHED AGAINST (c) the inherent risk of the procedure.

So far (from the article):
1 J.D. and 1 M.D. = yes
1 J.D. and 1 M.D. = no

Seems a fair question nonetheless . . .

Oh lawyers, when will you share your magic crystal ball with us to predict who will have a rare outcome and who won’t. Oh geniuses and empathizers of mankind. Please help the deluded and evil doctors. Save us from ourselves.

“Kill all the lawyers”. As true in Shakespeare’s time as it is today.

And I feel bad for the husband. If it was my wife, I’d be devastated. But no test has zero risk. Jesus, why doesn’t anyone get this fact.

Are there any articles of faith/nonsense left for physicians to hold on to?