Comments on: When you go above and beyond . . . and still get sued http://www.kevinmd.com/blog/2008/06/when-you-go-above-and-beyond-and-still.html medical blog Sun, 22 Nov 2009 19:59:44 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: pelican http://www.kevinmd.com/blog/2008/06/when-you-go-above-and-beyond-and-still.html/comment-page-1#comment-86388 pelican Thu, 19 Jun 2008 18:00:00 +0000 http://clients.emmense.com/kevinmd/2008/06/when-you-go-above-and-beyond-and-still-get-sued.html#comment-86388 While I am familiar with the likely insurer in this case, and have absolutely ZERO good to say about them, I'd also toss out that this patient does have some responsibility here:<br/><br/>doc (with worried voice): "You need to go to the ER right now to get an MRI, you could die or be paralyzed if you don't! You could have a life threatening infection or fast-growing cancer!"<br/>pt: "No, if I go to the ER, I'm going to have to wait for five hours and I don't want to do that." <br/>doc: "....?"<br/><br/>All this from a patient who came in demanding an immediate angiogram? Where did he think he was going to get *that* procedure, other than through the emergency department? <br/><br/>That moment of refusal to go to the ED was the moment where, in a fairer legal system, "loser pays" damages would have been triggered if this patient then brought a suit. While I am familiar with the likely insurer in this case, and have absolutely ZERO good to say about them, I’d also toss out that this patient does have some responsibility here:

doc (with worried voice): “You need to go to the ER right now to get an MRI, you could die or be paralyzed if you don’t! You could have a life threatening infection or fast-growing cancer!”
pt: “No, if I go to the ER, I’m going to have to wait for five hours and I don’t want to do that.”
doc: “….?”

All this from a patient who came in demanding an immediate angiogram? Where did he think he was going to get *that* procedure, other than through the emergency department?

That moment of refusal to go to the ED was the moment where, in a fairer legal system, “loser pays” damages would have been triggered if this patient then brought a suit.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/06/when-you-go-above-and-beyond-and-still.html/comment-page-1#comment-86281 Anonymous Mon, 16 Jun 2008 14:33:00 +0000 http://clients.emmense.com/kevinmd/2008/06/when-you-go-above-and-beyond-and-still-get-sued.html#comment-86281 You glean all this from a newspaper article? You don't need to see the pleadings or evidence? <br/><br/>Do you practice medicine this way? It's amazing how doctors piss and moan about the poor quality of medical journalism (at least when it doesn't beatify physicians), but think the media gets legal journalism right every time. You glean all this from a newspaper article? You don’t need to see the pleadings or evidence?

Do you practice medicine this way? It’s amazing how doctors piss and moan about the poor quality of medical journalism (at least when it doesn’t beatify physicians), but think the media gets legal journalism right every time.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/06/when-you-go-above-and-beyond-and-still.html/comment-page-1#comment-86247 Anonymous Sat, 14 Jun 2008 18:14:00 +0000 http://clients.emmense.com/kevinmd/2008/06/when-you-go-above-and-beyond-and-still-get-sued.html#comment-86247 Do the attorneys have their own website? Because anon 3:11 needs to stick to them. The point of the matter is that the patient wanted to sue THE DENTIST and not to sue the doctor, yet the atty's basically told the patient that he had to sue all. So exactly what is misleading? This patient/client wanted "justice" (as he saw it) from the dentist, and was "forced" by the atty's to seek a suit against the doctor, against the client's obvious wishes. Yes the client had to give permission, but with those conditions,the client had little choice. And please don't argue the point that there is no case without filing against the doctor, because if that is the case then the atty's should have just told the pt./client he had no case! Do the attorneys have their own website? Because anon 3:11 needs to stick to them. The point of the matter is that the patient wanted to sue THE DENTIST and not to sue the doctor, yet the atty’s basically told the patient that he had to sue all. So exactly what is misleading? This patient/client wanted “justice” (as he saw it) from the dentist, and was “forced” by the atty’s to seek a suit against the doctor, against the client’s obvious wishes. Yes the client had to give permission, but with those conditions,the client had little choice. And please don’t argue the point that there is no case without filing against the doctor, because if that is the case then the atty’s should have just told the pt./client he had no case!

]]> By: Anonymous http://www.kevinmd.com/blog/2008/06/when-you-go-above-and-beyond-and-still.html/comment-page-1#comment-86228 Anonymous Fri, 13 Jun 2008 20:11:00 +0000 http://clients.emmense.com/kevinmd/2008/06/when-you-go-above-and-beyond-and-still-get-sued.html#comment-86228 "The headline is somewhat misleading, because the attorney needed his client's permission to file suit against the doctor"<br/><br/>Misleading headlines are Kevin's stock in trade on this subject. He's not really interested in objectively reporting the facts on this issue, as much as he criticizes all lawyers for doing the same thing according to him. “The headline is somewhat misleading, because the attorney needed his client’s permission to file suit against the doctor”

Misleading headlines are Kevin’s stock in trade on this subject. He’s not really interested in objectively reporting the facts on this issue, as much as he criticizes all lawyers for doing the same thing according to him.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/06/when-you-go-above-and-beyond-and-still.html/comment-page-1#comment-86218 Anonymous Fri, 13 Jun 2008 11:32:00 +0000 http://clients.emmense.com/kevinmd/2008/06/when-you-go-above-and-beyond-and-still-get-sued.html#comment-86218 The answer to "why" is too long for a blog--no one would read it--and involves a long series of court cases and legislation.<br/><br/>Bottom line, the medical care is the physician's responsibility-period. No matter who else isn't doing their job, or who in doing their job is obstructing things, it is the physicians ultimate responsibility to move them, run over them, or go around them..<br/><br/>Believe us when we tell you, that is the way it is. Frustrating it is, but all patients will rue the day when no one has the final responsibility for the outcome, when physicians, like everyone else, is responsible only for process and not outcome. The answer to “why” is too long for a blog–no one would read it–and involves a long series of court cases and legislation.

Bottom line, the medical care is the physician’s responsibility-period. No matter who else isn’t doing their job, or who in doing their job is obstructing things, it is the physicians ultimate responsibility to move them, run over them, or go around them..

Believe us when we tell you, that is the way it is. Frustrating it is, but all patients will rue the day when no one has the final responsibility for the outcome, when physicians, like everyone else, is responsible only for process and not outcome.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/06/when-you-go-above-and-beyond-and-still.html/comment-page-1#comment-86216 Anonymous Fri, 13 Jun 2008 04:27:00 +0000 http://clients.emmense.com/kevinmd/2008/06/when-you-go-above-and-beyond-and-still-get-sued.html#comment-86216 this probably shows my ignorance, but why is a physician liable if they order a "stat" test and the insurance denies it? Shouldn't the insurance company be liable since they disregarded the physician's expertise that this test be performed? This is totally confusing to me. this probably shows my ignorance, but why is a physician liable if they order a “stat” test and the insurance denies it? Shouldn’t the insurance company be liable since they disregarded the physician’s expertise that this test be performed? This is totally confusing to me.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/06/when-you-go-above-and-beyond-and-still.html/comment-page-1#comment-86212 Anonymous Thu, 12 Jun 2008 23:47:00 +0000 http://clients.emmense.com/kevinmd/2008/06/when-you-go-above-and-beyond-and-still-get-sued.html#comment-86212 A good reason to be selective about what plans, if you any, you sign on to. A good reason to be selective about what plans, if you any, you sign on to.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/06/when-you-go-above-and-beyond-and-still.html/comment-page-1#comment-86198 Anonymous Thu, 12 Jun 2008 18:33:00 +0000 http://clients.emmense.com/kevinmd/2008/06/when-you-go-above-and-beyond-and-still-get-sued.html#comment-86198 This is another pitfall to the "outpatient" only doctor world. as a fp that still admits, I see op doctors ordering stat op tests when one can reasonably ascertain that the patient will need inpatient care. Medicare reimbursement/lack of respect in hospitals/lack of work ethic/etc have made this possible. Good primary care (inpt. including) that is adequately compensated to stay in such settings would have allowed this man to be cared for more quickly. Why lament about prior auth refusals when the ct scan stat in a hosp acute setting would have directed this better. OP only doctors lose this perspectiveat times because they have no control over the situation. However, this doctor was let down to some extent by his ED, and he should have directly communicated to the doctor there about his concerns. This is another pitfall to the “outpatient” only doctor world. as a fp that still admits, I see op doctors ordering stat op tests when one can reasonably ascertain that the patient will need inpatient care. Medicare reimbursement/lack of respect in hospitals/lack of work ethic/etc have made this possible. Good primary care (inpt. including) that is adequately compensated to stay in such settings would have allowed this man to be cared for more quickly. Why lament about prior auth refusals when the ct scan stat in a hosp acute setting would have directed this better. OP only doctors lose this perspectiveat times because they have no control over the situation. However, this doctor was let down to some extent by his ED, and he should have directly communicated to the doctor there about his concerns.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/06/when-you-go-above-and-beyond-and-still.html/comment-page-1#comment-86195 Anonymous Thu, 12 Jun 2008 17:10:00 +0000 http://clients.emmense.com/kevinmd/2008/06/when-you-go-above-and-beyond-and-still-get-sued.html#comment-86195 Or, just admit the patient directly from office. If a life threatening spinal abscess was at the top of this MD's DDX, why mess with the outpatient work-up? Would have saved a lot of time and hassle. Or, just admit the patient directly from office. If a life threatening spinal abscess was at the top of this MD’s DDX, why mess with the outpatient work-up? Would have saved a lot of time and hassle.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/06/when-you-go-above-and-beyond-and-still.html/comment-page-1#comment-86193 Anonymous Thu, 12 Jun 2008 16:05:00 +0000 http://clients.emmense.com/kevinmd/2008/06/when-you-go-above-and-beyond-and-still-get-sued.html#comment-86193 What should have been done is for his doctor to call the ER that he wanted the patient to be checked in as a patient and he, himself, would take care of the patient, not the ER doc, and order a CT of neck with contrast. The radiologist would see the abscess and he would recommend an MRI and the Neurosurgeon would want an MRI prior to surgery. This would have been more efficient and would not have caused any delay. Every party involved including the insurance company would be happy. What should have been done is for his doctor to call the ER that he wanted the patient to be checked in as a patient and he, himself, would take care of the patient, not the ER doc, and order a CT of neck with contrast. The radiologist would see the abscess and he would recommend an MRI and the Neurosurgeon would want an MRI prior to surgery. This would have been more efficient and would not have caused any delay. Every party involved including the insurance company would be happy.

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