Comments on: A runny nose, the PA and a $3 million verdict http://www.kevinmd.com/blog/2008/03/runny-nose-pa-and-3-million-verdict.html Tue, 14 Feb 2012 22:28:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2008/03/runny-nose-pa-and-3-million-verdict.html#comment-84546 Anonymous Wed, 26 Mar 2008 14:03:00 +0000 http://clients.emmense.com/kevinmd/2008/03/a-runny-nose-the-pa-and-a-3-million-verdict.html#comment-84546 I'm guessing you've never made a claim against Wal-Mart. I’m guessing you’ve never made a claim against Wal-Mart.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/03/runny-nose-pa-and-3-million-verdict.html#comment-84541 Anonymous Wed, 26 Mar 2008 04:24:00 +0000 http://clients.emmense.com/kevinmd/2008/03/a-runny-nose-the-pa-and-a-3-million-verdict.html#comment-84541 And Walmart wants to join in on the fray? I guarantee a 100 million dollar missed cancer verdict and the board is going look to string up the guy that came up with a retail clinic in Walmart. There are no deeper pockets than Walmart. And Walmart wants to join in on the fray? I guarantee a 100 million dollar missed cancer verdict and the board is going look to string up the guy that came up with a retail clinic in Walmart. There are no deeper pockets than Walmart.

]]> By: Supremacy Claushttp://www.kevinmd.com/blog/2008/03/runny-nose-pa-and-3-million-verdict.html#comment-84535 Supremacy Claus Wed, 26 Mar 2008 02:32:00 +0000 http://clients.emmense.com/kevinmd/2008/03/a-runny-nose-the-pa-and-a-3-million-verdict.html#comment-84535 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. <br/><br/>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. <br/><br/>If you must have a manual, review it with attorney. Ask that weasel, escape clauses accompany every written requirement. 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.

]]> By: Supremacy Claushttp://www.kevinmd.com/blog/2008/03/runny-nose-pa-and-3-million-verdict.html#comment-84533 Supremacy Claus Wed, 26 Mar 2008 02:25:00 +0000 http://clients.emmense.com/kevinmd/2008/03/a-runny-nose-the-pa-and-a-3-million-verdict.html#comment-84533 Everyone who watched the Gray's Anatomy episode on such a case would immediately know the answer to this differential diagnosis. The patient got his diagnosis after prolonged symptomatology and false treatments. Only the "prolonged" aspect of this case led to the diagnosis. <br/><br/>There is no duty to diagnose weird diagnostic puzzles from TV shows. The chief resident on that show would certainly not appreciate being called a mid-level. Because most of the medical facts on that show are based on actual cases, misdiagnosis seems to be within the standard of due care. <br/><br/>Everyone with a runny nose should not get a brain MRI. The case should get dismissed on policy grounds. The outcome of the case risks inducing this catastrophic standard of care for defensive medicine. Everyone who watched the Gray’s Anatomy episode on such a case would immediately know the answer to this differential diagnosis. The patient got his diagnosis after prolonged symptomatology and false treatments. Only the “prolonged” aspect of this case led to the diagnosis.

There is no duty to diagnose weird diagnostic puzzles from TV shows. The chief resident on that show would certainly not appreciate being called a mid-level. Because most of the medical facts on that show are based on actual cases, misdiagnosis seems to be within the standard of due care.

Everyone with a runny nose should not get a brain MRI. The case should get dismissed on policy grounds. The outcome of the case risks inducing this catastrophic standard of care for defensive medicine.

]]> By: Mikehttp://www.kevinmd.com/blog/2008/03/runny-nose-pa-and-3-million-verdict.html#comment-84527 Mike Wed, 26 Mar 2008 01:23:00 +0000 http://clients.emmense.com/kevinmd/2008/03/a-runny-nose-the-pa-and-a-3-million-verdict.html#comment-84527 All Kevin said is that your midlevels can cost you. And they did in the article.<br/><br/>CAn one person who is flipping out on this comment board explain how anything Kevin said is incorrect??? 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???

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/03/runny-nose-pa-and-3-million-verdict.html#comment-84524 Anonymous Wed, 26 Mar 2008 01:08:00 +0000 http://clients.emmense.com/kevinmd/2008/03/a-runny-nose-the-pa-and-a-3-million-verdict.html#comment-84524 Ya... your right! The Doctors defense should have been that the PA screwed up really bad and PAs really aren't as good as doctors. That would have worked real well! Of course they are going to say the PA didn't screw up. The truth of the matter is that they aren't better because they really don't have as much experience is the vast majority of cases. <br/><br/>Disclaimer: Please spare me the story about the super PA that you know because these are 1 in a million especially with the way they train them now compared to how they used to be trained (medic, etc.). Ya… your right! The Doctors defense should have been that the PA screwed up really bad and PAs really aren’t as good as doctors. That would have worked real well! Of course they are going to say the PA didn’t screw up. The truth of the matter is that they aren’t better because they really don’t have as much experience is the vast majority of cases.

Disclaimer: Please spare me the story about the super PA that you know because these are 1 in a million especially with the way they train them now compared to how they used to be trained (medic, etc.).

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/03/runny-nose-pa-and-3-million-verdict.html#comment-84522 Anonymous Tue, 25 Mar 2008 23:26:00 +0000 http://clients.emmense.com/kevinmd/2008/03/a-runny-nose-the-pa-and-a-3-million-verdict.html#comment-84522 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.<br/><br/>this case says nothing about PAs and med mal or PAs in/competence relative to physicians. 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.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/03/runny-nose-pa-and-3-million-verdict.html#comment-84521 Anonymous Tue, 25 Mar 2008 23:01:00 +0000 http://clients.emmense.com/kevinmd/2008/03/a-runny-nose-the-pa-and-a-3-million-verdict.html#comment-84521 Anonymous : 4:43 PM <br/><br/>Nice irrelevant argumentum ad hominum. Anonymous : 4:43 PM

Nice irrelevant argumentum ad hominum.

]]> By: DDx:dxhttp://www.kevinmd.com/blog/2008/03/runny-nose-pa-and-3-million-verdict.html#comment-84520 DDx:dx Tue, 25 Mar 2008 22:36:00 +0000 http://clients.emmense.com/kevinmd/2008/03/a-runny-nose-the-pa-and-a-3-million-verdict.html#comment-84520 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...<br/>Universal access, single payer would of course solve the malpractice issue, but it's hard to let go of that nut inside the coconut... 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…

]]> By: GingerBhttp://www.kevinmd.com/blog/2008/03/runny-nose-pa-and-3-million-verdict.html#comment-84519 GingerB Tue, 25 Mar 2008 22:30:00 +0000 http://clients.emmense.com/kevinmd/2008/03/a-runny-nose-the-pa-and-a-3-million-verdict.html#comment-84519 No, I thought the point of the article was that their agreement called for a physician to see ever patient the PA saw, and they failed to do that.<br/><br/>So "set your rules and live up to them" is the moral of the story.<br/><br/>Had the patient seen the Dr., even if he/she had done the same thing they wouldn't have felt that the Dr. office short-shifted them and sued. <br/><br/>The article starts out saying the patient went to see the Dr., but got a PA instead. <br/><br/>When I make an appointment, even a same day one, I am told clearly by the clerk if I will be seeing a Doctor, and NP or a PA. If I don't want to see an NP or a PA I have the opportunity to see a Doctor (often at a later time). <br/><br/><br/>I think these doctors were lax in the way they ran their operation. No, I thought the point of the article was that their agreement called for a physician to see ever patient the PA saw, and they failed to do that.

So “set your rules and live up to them” is the moral of the story.

Had the patient seen the Dr., even if he/she had done the same thing they wouldn’t have felt that the Dr. office short-shifted them and sued.

The article starts out saying the patient went to see the Dr., but got a PA instead.

When I make an appointment, even a same day one, I am told clearly by the clerk if I will be seeing a Doctor, and NP or a PA. If I don’t want to see an NP or a PA I have the opportunity to see a Doctor (often at a later time).

I think these doctors were lax in the way they ran their operation.

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