Physician

Nadya Suleman’s fertility specialist Michael Kamrava, and how he’s able to stay in practice despite a poor history of successful implantations

The furor over the California octuplet case refuses to die.

Attention has recently been focused on her doctor, one Michael Kamrava. MedPage Today cites a LA Times story, shedding more light on the physician and his Beverly Hills practice.

In addition to the Suleman case, another one of his patients his currently hospitalized with quadruplets. Apparently, in reproductive medicine, any result greater than twins is …

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Do you know the name of your hospital doctor?

And if you don’t, does it really matter?

Bob Wachter discusses a recent study concluding that very few could actually name their hospitalist one month after an admission.

Ideally, “patients need to have a personal connection to their physicians, particularly at times of great need and uncertainty,” writes Dr. Wachter.

I agree, but the health system has incentives geared towards giving more disjointed, fractionated care. Hospitalists …

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Some lawyers say defensive medicine isn’t real, but this doctor shows us otherwise

Lawyers and left-leaning policy wonks often discount how pervasive defensive medicine is.

WhiteCoat, an emergency physician, is almost convinced by those who call defensive medicine a figment of the medical profession’s imagination.

Then he starts his shift working in the emergency department, an experience that most lawyers and policy experts do not have by the way, and cites specific examples where he made a decision specifically to thwart …

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Being sued for malpractice, for doctors it’s personal

What is it like to be sued for malpractice?

Although many say “every physician gets sued,” and, “never to talk about it,” how does it affect doctors?

As I’ve written before, being sued for malpractice is a traumatically scarring experience. So much that up to 10 percent of doctors in this situation contemplated suicide.

George Hossfeld writes about his malpractice ordeal (via Dr. RW) …

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Hospitalists are here to stay, or look how ER physicians are thriving

Hospitalist medicine is the fastest growing medical specialty in history.

Will they having staying power? This piece (via Dr. RW) describes how doctors in the 60’s and 70’s didn’t want to practice in the emergency department, leading to the birth of emergency medicine specialists.

The same is happening now, as primary care doctors are loathe to practice in the hospital. This is even spreading to general …

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An apology for medical errors, this lawyer says don’t do it

Apologizing after medical errors is the moral and ethical thing to do, but this attorney says otherwise.

Saying sorry can deny malpractice coverage, says attorney Steven Kern, and from a legal perspective, “saying I’m sorry is an admission. An admission is an exception to the hearsay rule, so anyone who hears it can be called to testify against you, should legal action ensue.”

What about the 35 states …

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Physicians don’t trust the malpractice system and why doctors order too many tests

I’ve wrote an op-ed in the USA Today this past April about how defensive medicine wastes medical dollars.

Today, the editorial staff takes on the issue themselves, with a fierce piece decrying the current malpractice system as “arbitrary, inefficient and results in years of delay.”

The recent Massachusetts Medical Society’s study on defensive medicine was prominently included, as it was reported that “83% of its doctors practice …

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Texas malpractice reforms are working too well

The malpractice cap that Texas instituted in 2003 is leading to an influx of doctors.

That’s good for patients who benefit from the access provided by the new physicians. However, the Texas Medical Board can’t keep up with the pace of new registrations, despite increasing their staff by 28 percent over the last six years.

This is leading to a delay when dealing with patient complaints, which …

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How malpractice attorneys decide which cases to accept

Plaintiff attorneys receive contingency fees only in a successful outcome, or if the suit is settled out of court.

That’s why it’s important for lawyers to be discerning as to which cases to accept. “Big ticket” cases like “bad babies, paraplegia, and death of a wage-earner” often have influence.

Here are other factors that attorneys consider, including “the sympathy value of the plaintiff, the credibility of …

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Defensive medicine wastes money and hurts patients

Defensive medicine has always been highly controversial, but there is mounting evidence confirming its major contribution to health care spending.

The Massachusetts Medical Society released a pivotal study today quantifying some of the costs of defensive medicine (via White Coat Notes). For background, I refer you to previous discussions on the issue, as well as last year’s piece on the CBS Evening News that I …

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“Uniquely American tort laws” contributing to health costs

Prominent economist Uwe Reinhardt explains why health care costs are rising. Here’s how he defines defensive medicine, which is among his four identified major cost drivers:

. . . higher treatment costs triggered by our uniquely American tort laws, which in the context of medicine can lead to “defensive medicine” “” that is, the application of tests and procedures mainly as a defense against possible malpractice litigation, rather than …

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How doctors should deal with an aggressive prosecutor

Not an uncommon situation for the unfortunate physician on the stand. One recommendation is to “protest such inappropriate behavior yourself,” and “never allow an attorney who is questioning you to raise his voice or speak to you sarcastically or rudely.”

Attorney Ronald Miller says that’s terrible advice:

The playing field is tilted in favor of the doctor. The very best way for a doctor to blow that lead is tell …

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Medical malpractice in Saudi Arabia

Think doctors here have it tough? More details are emerging from last week’s story of the Egyptian doctor who prescribed narcotics to a Saudi princess:

Raouf Amin el-Arabi, a doctor who has been serving the Saudi royal family for about 20 years, was convicted last year of giving a patient the wrong medication. Egyptian newspapers reported that he was accused of driving a Saudi princess “to addiction.”

He initially was …

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Hospital takes a shot at a malpractice jury

The head of the Dana-Farber Cancer Institute responds to the $13.5 million verdict awarded to a family during a malpractice trial:

We all know that cancer is a terrible disease that still claims far too many lives. Unfortunately, even as we work intensely to develop newer, more effective treatments, we aren’t always successful and complications can arise. That does not mean that we did anything wrong, something that juries less …

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Misreporting lab results leads to malpractice

“See your primary care doctor” isn’t good enough advice anymore, since not all patients have one, or will follow-up on their own.

A workers’ compensation physician noted a markedly elevated ferritin level, and was successfully sued for missing hemochromatosis. He had told the patient to follow up with his primary care doctor.

The same scenario could easily happen in the emergency or specialist setting. Actually making …

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Sued for failing to provide an interpreter

A solo rheumatologist was not willing to pay the $150 to $200 per visit fee an American Sign Language interpreter would have cost to treat a deaf patient, especially in the setting where Medicare paid only $49 per visit.

He was sued as the patient didn’t understand the side effects of the medications he was prescribing for her lupus:

But the patient claimed she never really understood the side-effects …

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Single payer to fix malpractice?

Advocates are saying that a single payer system man be an answer to solve malpractice woes:

She noted that if health care was guaranteed through government funding there would be no need for malpractice suits and settlements to take into account the future health care costs of plaintiffs. This is particularly important in obstetrical cases given the future medical interventions and life expectancy of these babies.

For physicians to …

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Op-ed: Wasted medical dollars

The following op-ed was published on April 23rd, 2008 in the USA Today.

A recent analysis by PricewaterhouseCoopers concluded that more than half the dollars in our $2.2 trillion health care system are wasted.

Medical errors, inefficient use of information technology and poorly managed chronic diseases were all cited as factors. Dwarfing these reasons is a phenomenon in which doctors order tests to avoid the threat of a …

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The candidates on tort reform

The whole issue of tort reform is pretty much DOA now. If it couldn’t be done in the past 8 years, it’s certainly not going to happen with the next administration. That being said, here’s are McCain and Obama’s take on the issue.

Rather than caps, physicians should be pushing for more expedient compensation to injured patients. No-fault malpractice would be an ideal solution, providing quicker …

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Baseless lawsuits

Why is Shadowfax’s physician group settling baseless lawsuits?

What can we do? When you are at Yellowstone, they tell you not to feed the bears because it just encourages them. But that metaphor doesn’t work when the alternative is to let the bear maul you and hope that he won’t get all of your food.

What is more concerning is the lengthy process of the proceedings. Patients who are …

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