Comments on: Malpractice fears influence cardiology decisions http://www.kevinmd.com/blog/2010/05/malpractice-fears-influence-cardiology-decisions.html Wed, 15 Feb 2012 00:27:00 +0000 hourly 1 By: TrenchDochttp://www.kevinmd.com/blog/2010/05/malpractice-fears-influence-cardiology-decisions.html#comment-133375 TrenchDoc Fri, 07 May 2010 23:29:48 +0000 http://www.kevinmd.com/blog/?p=43759#comment-133375 Caths are being done because of defensive medicine, reimcursement AND patient expectations. If you had a needle inserted into your leg and dye squirted through your heart and the test is normal that for most patients is more reassuring than being told by their PCP based on clinical reasoning that they do not have heart disease. A malpractice attorney can always get some other MD to argue the opposite opinion but a negative picture is worth a thousand words. There is less malpractice risk to the doctor to do the cath than not to do it Caths are being done because of defensive medicine, reimcursement AND patient expectations. If you had a needle inserted into your leg and dye squirted through your heart and the test is normal that for most patients is more reassuring than being told by their PCP based on clinical reasoning that they do not have heart disease. A malpractice attorney can always get some other MD to argue the opposite opinion but a negative picture is worth a thousand words. There is less malpractice risk to the doctor to do the cath than not to do it

]]> By: RP15http://www.kevinmd.com/blog/2010/05/malpractice-fears-influence-cardiology-decisions.html#comment-133230 RP15 Thu, 06 May 2010 15:18:45 +0000 http://www.kevinmd.com/blog/?p=43759#comment-133230 This is a bit silly to cite such a "study". It is based on purely hypothetical cases, and survey responses. Look at actual cardiologist behavior, if you want to study this issue. That being said, I think it's telling that peer pressure was a *greater* factor than medical liability concern in deciding to cath a patient. Lastly, cardiac caths are not without liability themselves. A cardiologist can just as easily be sued for a complication of a cardiac cath as for not doing a cath when it might have been appropriate. This fact makes arguing that caths are being done as part of "defensive medicine" a bit disingenuous. This is a bit silly to cite such a “study”. It is based on purely hypothetical cases, and survey responses. Look at actual cardiologist behavior, if you want to study this issue.
That being said, I think it’s telling that peer pressure was a *greater* factor than medical liability concern in deciding to cath a patient.
Lastly, cardiac caths are not without liability themselves. A cardiologist can just as easily be sued for a complication of a cardiac cath as for not doing a cath when it might have been appropriate. This fact makes arguing that caths are being done as part of “defensive medicine” a bit disingenuous.

]]> By: Doc99http://www.kevinmd.com/blog/2010/05/malpractice-fears-influence-cardiology-decisions.html#comment-133008 Doc99 Tue, 04 May 2010 16:44:43 +0000 http://www.kevinmd.com/blog/?p=43759#comment-133008 Persistence of defensive medicine will erase any savings obtained via P4P. Wonks have ignored the elephant in the room. Without limited immunity for following "Best Practices," P4P will be a dismal failure. Of course that's just my opinion. I could be wrong. Persistence of defensive medicine will erase any savings obtained via P4P. Wonks have ignored the elephant in the room. Without limited immunity for following “Best Practices,” P4P will be a dismal failure. Of course that’s just my opinion. I could be wrong.

]]> By: Happy Hospitalisthttp://www.kevinmd.com/blog/2010/05/malpractice-fears-influence-cardiology-decisions.html#comment-133006 Happy Hospitalist Tue, 04 May 2010 16:18:37 +0000 http://www.kevinmd.com/blog/?p=43759#comment-133006 I have blogged extensively about this. The standard of care is what others in the community would do under similar circumstances. Because all physicians would cath does not make it right. But the standard says it is.That's why standard of care as a basis for determining negligence is faulty logic to the core. It's like Nazi Germany. Just because all the other guards were killing people doesn't make it right or the standard to follow. I have blogged extensively about this. The standard of care is what others in the community would do under similar circumstances. Because all physicians would cath does not make it right. But the standard says it is.

That’s why standard of care as a basis for determining negligence is faulty logic to the core. It’s like Nazi Germany. Just because all the other guards were killing people doesn’t make it right or the standard to follow.

]]> By: jsmithhttp://www.kevinmd.com/blog/2010/05/malpractice-fears-influence-cardiology-decisions.html#comment-133003 jsmith Tue, 04 May 2010 16:10:03 +0000 http://www.kevinmd.com/blog/?p=43759#comment-133003 It would have been very surprising if the threat of malpractice lawsuits had not affected doctors' behavior. According to my lawyer buddies, affecting doctors' behavior is supposed to be one of the main functions of malpractice lawsuits, some others being compensation, information, etc. The real question is whether, on net, the threat of malpractice is good or bad. Don't have the answer to that one. It would have been very surprising if the threat of malpractice lawsuits had not affected doctors’ behavior. According to my lawyer buddies, affecting doctors’ behavior is supposed to be one of the main functions of malpractice lawsuits, some others being compensation, information, etc.
The real question is whether, on net, the threat of malpractice is good or bad. Don’t have the answer to that one.

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