Tuesday, November 24, 2009

Health Care Reform

House or House MD is a fictional show, which interestingly enough is a good example of what is wrong in our medical world.

In real life, House would not be a Doctor. He couldn't get any malpractice insurance, no one would insure him. His medical license would be revoked, and he would be stuck flipping burgers, with lawyers following him to make sure he didn't so much as advise someone to take an aspirin.

If you've never watched the show, it goes something like this. A patient comes in and has a strange set of symptoms. The Doctors start testing, and coming up with theories, and they start treatments based upon the diagnosis. Inevitably the patient gets worse, and by the time House stumbles on the right answer, inevitably a very rare condition or disease, the patient is knocking on the door to death. In the end, they almost always make a full recovery, with a few notable exceptions.

After the fictional Doctor House treated his first patient, in real life, he would have been sued, and had people screaming for his license. A slick talking lawyer like John Edwards would have convinced a jury that House was a renegade and failed to follow proper precautions and established normal practices. The jury would have awarded millions on the basis of this slick talking lawyer, and House would have been effectively out of a job.

So the question is this. What is malpractice? In my opinion, it's not when the Doctor is doing his very best to try and help/heal you. If he removes the wrong leg, that's malpractice. If he ignores symptoms and perform even a cursory exam, that's malpractice. If he thinks you have one disease, and treats, only to find you have another far more rare condition, that's not malpractice. Sometimes, you play the averages. The average citizen who speaks to you and says they have flu like symptoms has the flu. As close to 100% of the time as you can imagine. There is no need to put them into a full quarantine procedure because the symptoms could also be early stage Ebola.

Fever, aches, some stomach discomfort. You have the flu, especially if it's in your neighborhood or place of employment. You have the flu. No need to see a specialist to determine that it really isn't Ebola. Once in a while, someones not going to have the flu. They're going to have a rare condition or disease. There's a reason we're not looking for that, it's a rare condition. Ebola is very rare, and I would object to suggestions that I had contracted it if I had flu like symptoms.

The trick is for the Doctors to work hard to try and heal you. The other half of that coin, is for you to admit that Doctor's aren't supposed to be perfect, and it might take a few trials and errors to get to the point where you are again healthy or whole. So if you're ever on a Jury in a Malpractice trial, ask yourself this. Is it reasonable to assume the Doctor was trying hard at the time the so called "Mistake" happened? Was he using his best judgement and all of his knowledge and experience? If the answer is yes. Then we have nothing more we can ask of a person. We can't ask that they give us more than their very best.

1 Comments:

Anonymous Anonymous said...

If you refuse to address a patient's pointing out oozing infections from a surgical wound, knowing your hospital is facing serious lawsuits regarding their OR infection rates, throw a series of antibiotics at it and don't follow up with enough concern, even IV rounds, then have to have a director of infectious diseases in the region FORCE the doctor to remove a plate that housed the staph infection causing bone death and rending the leg no longer viable, is that malpractice? Because the hospital protocol was followed, so everyone said no.

Probably because he was cheaper dead then alive to them.

10:21 AM  

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