More support for defensive medicine

I regularly receive the Cortlandt Forum and only recently realized they’re on the web. It’s an eclectic magazine, but has interesting malpractice cases. Here’s another one.

Basically, it’s a patient who came in with dyspepsia. The PCP ordered an upper GI series and it was read as normal. However months later, the symptoms continued, and an EGD found terminal stomach cancer. The verdict: 62% of the fault was directed against the hospital and radiologist who misread the UGI series, 38% of the fault directed against the PCP.

The risk-management principles eloquently speaks volumes and further cements the practice of defensive medicine today:

Politicians, employers, and insurance companies want inexpensive medical care. Patients and plaintiff lawyers expect complete and exhaustive care. Physicians are caught in the middle and need to adjust their level of caution to accommodate modern guidelines. Whereas insurance companies ask primary-care physicians to look after increasingly complex cases themselves, juries have more respect for a defendant who refers early and often, even if he or she takes the patient back for long-term care.

. . . Although in some instances, better medicine may mean cheaper medicine, physicians should be aware that jurors do not consider the cost of medical care in the liability equation. They expect physicians to recommend the most potent, not the most cost-effective, course of action.

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