http://www.kevinmd.com/blog/2007/09/medical-malpractice-verdicts.html medical blog Sun, 22 Nov 2009 22:50:49 -0500 http://wordpress.org/?v=2.8.4 hourly 1 http://www.kevinmd.com/blog/2007/09/medical-malpractice-verdicts.html/comment-page-1#comment-80249 Anonymous Fri, 21 Sep 2007 01:57:00 +0000 http://clients.emmense.com/kevinmd/2007/09/medical-malpractice-verdicts.html#comment-80249 Our lawyer friend cannot understand why defensive medicine might be bad. He things that more of anything must be better. But everything in medicine, just as everything in this world, comes with risks and side effects. <br/>Here's defensive medicine from my perspective as an anesthesiologist:<br/>you were in an accident and are comming to my OR for repair of your femur fracture. Your neck films are OK, (but no final reading by an attending radiologist), and your clinical neck exam seems OK, and clinical criteria for considering your cervical spine not at risk are met, but well just to be extra safe, let's place your breathing tube in your lungs while you are still awake with a fiberscope rather than the more usual way of sleep first then intubate. <br/>Or your wife presents for labor epidural and consistent with some recently published worries (no evidence, just mussings in print by a few) that the low lumbar tatoo might pose some hypothetical risk if an epidural were used for analgesia. Defensive medicine calls for ignoring current best practice and not providing the epidural. <br/>Or at its extreme, I could decide that since no anesthetic drug is labeled for use in infants under 2 months, that your child presenting for bowel obstruction will receive only drugs FDA approved for their age, which would be not a whole hell of a lot. <br/>Defensive medicine does not mean that the patient gets more good stuff; because 'stuff' in medicine is almost always bad and you really only want it if you really need it. Our lawyer friend cannot understand why defensive medicine might be bad. He things that more of anything must be better. But everything in medicine, just as everything in this world, comes with risks and side effects.
Here’s defensive medicine from my perspective as an anesthesiologist:
you were in an accident and are comming to my OR for repair of your femur fracture. Your neck films are OK, (but no final reading by an attending radiologist), and your clinical neck exam seems OK, and clinical criteria for considering your cervical spine not at risk are met, but well just to be extra safe, let’s place your breathing tube in your lungs while you are still awake with a fiberscope rather than the more usual way of sleep first then intubate.
Or your wife presents for labor epidural and consistent with some recently published worries (no evidence, just mussings in print by a few) that the low lumbar tatoo might pose some hypothetical risk if an epidural were used for analgesia. Defensive medicine calls for ignoring current best practice and not providing the epidural.
Or at its extreme, I could decide that since no anesthetic drug is labeled for use in infants under 2 months, that your child presenting for bowel obstruction will receive only drugs FDA approved for their age, which would be not a whole hell of a lot.
Defensive medicine does not mean that the patient gets more good stuff; because ’stuff’ in medicine is almost always bad and you really only want it if you really need it.

]]> http://www.kevinmd.com/blog/2007/09/medical-malpractice-verdicts.html/comment-page-1#comment-80246 Anonymous Fri, 21 Sep 2007 00:48:00 +0000 http://clients.emmense.com/kevinmd/2007/09/medical-malpractice-verdicts.html#comment-80246 there is not an endless supply of healthcare. every doctor, nurse, and technician working continuously can only see so many patients and run so many tests. if you use their services on tasks that are unnecessary you increase the demand for their services. what happens in economics when demand for something increases? the price goes up!!! end result is people with the least money end up not being able to afford coverage, medicare/-caid can afford less services etc. this is not a good thing. there is not an endless supply of healthcare. every doctor, nurse, and technician working continuously can only see so many patients and run so many tests. if you use their services on tasks that are unnecessary you increase the demand for their services. what happens in economics when demand for something increases? the price goes up!!! end result is people with the least money end up not being able to afford coverage, medicare/-caid can afford less services etc. this is not a good thing.

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