A runny nose, the PA and a $3 million verdict

Your “headline” is so sensationalized that I assume you want to start another “mid-level” bashing thread. Haven’t we beat this one to death??

What is the take home here? 1. Prescribe antibiotics for all cases of rhinorrhea & headache 2. Have a physician see every patient that a PA sees because they are bound to screw up or 3. Have physicians better understand the working collaborative/supervisory relationship between either a PA or NP and therefore not make the practice agreements unrealistic?

Based on the limited amount of clinical information in this link, who would’ve really treated this patient much differently?

I enjoy reading your blog however, the constant undertones of “mid-level” incompetence is wearing thin on me. I have see lots of anecodotal comments with regards to NPs/PAs. The reality is every state has different regulatory requirements and then they differ from both NPs & PAs. It is everyone’s responsibility to understand the working relationships between physicians and NPs & PAs, that is, if you have such a relationship. I think there are a vast number of misconceptions out there and I truly hope that this dialogue helps to clear some of them up so that we can respectively continue caring for patients as we’ve been educated and trained to do.

NP, Kevin has an agenda he’s working. Facts are irrelevant. When it’s a verdict for the plaintiff, no matter how sketchy the info in the article, it’s an outrage and another reason to demagogue.

When it’s a verdict for the defense or even a physician accused, the media doesn’t do medicine well and we should wait and see, no matter how egregious the act.

It’s not about you NPs and PAs so much as it is his view of malpractice.

Agree with Anon 4:43 about Kevin’s agenda. But his take is prevalent throughout medicine. Docs whine about how hard it is, what with insurance and the guvmint and all, and still live in fear of the lawsuit. Sounds like a miserable job to me…
Universal access, single payer would of course solve the malpractice issue, but it’s hard to let go of that nut inside the coconut…

Once again, Kevin fails logic. If we accept what was said in the article, the PA acted as the doctors would have. Thus, the problem was not that PAs screw-up (because it is admitted that doctors would have screwed up just as badly), it’s a badly drafted service agreement.

this case says nothing about PAs and med mal or PAs in/competence relative to physicians.

All Kevin said is that your midlevels can cost you. And they did in the article.

CAn one person who is flipping out on this comment board explain how anything Kevin said is incorrect???

If you insist on having a policy manual, make it of the most general, non-committal, inscrutable gibberish type. If you spell out a procedure, lawyers will pounce on the manual for what it is. It is a list of enacted statutes for the entity. A violation of a written policy becomes like a violation of a law or regulation. It makes adverse outcomes, negligence per se. The lawyer no longer needs to prove direct harm, just the violation.

If you hit a kid running out from between cars, you can argue, it was his carelessness that caused the injury. However, be doing 26 mph in a 25 mph zone, and the negligence is per se (automatic). For the entity covered by a policy manual, the claim is similar.

If you must have a manual, review it with attorney. Ask that weasel, escape clauses accompany every written requirement.

I’m guessing you’ve never made a claim against Wal-Mart.