Posted in bio ethics, cardiology-ethics, tagged hippocrates, medical errors, medical ethics on February 11, 2012| Leave a Comment »
Doctors would simply hate this book because it tries to expose them !
I would n’t agree with the tone and conclusion of this book . But one should soul search , why such books are written in the first place ?
The medical professionals definitely need to ponder over this issue .
I stumbled upon this book in Amazon book store
http://www.amazon.com/Medical-Blunders-Amazing-Stories-Dangerous
How frequently doctors make blunders ? What is your take ?
Would you like to vote in this poll ?
Posted in cardiology-ethics, tagged error in judgment, errors in medicine, ethics and doctors, hippocrates, medical errors, medical mistakes, medical negligence, procedural complication, side effects of drugs vs doctors on July 29, 2011| 1 Comment »
This is because . . .
Answer
Though all the above contributes for this behavior . It is the response 2 that plays havoc on patient care !
Discussion
It is a well-known fact millions of medical mistakes happen every year across the globe .Most of them are committed by medical professionals and equal number of them result from untoward effects of drugs, complications of procedures and surgeries.
Apart from these , laboratory errors in reporting and interpreting diagnostic tests happen on hour to hour basis in any hospital . Many of them could have serious implication in patient outcome . Though doctors do periodic auditing the incidence continue to galore and there is very little data to suggest the overall incidence has reduced in any significant fashion .
In many sense doctors do share some similarities with drugs and devices . Like the ubiquitous drugs and devices , diagnostic tests, , doctors too cause side effects by their action or inaction . It is referred to as , undesired response, complications, error in judgement , negligence , ignorance etc ( Read a related article in my site)
Like the famous quote of ( Osler I think )
A drug which causes no side effect will not have the desired effect as well . . . a doctor who has not caused any injury to their patients can never be considered as an accomplished doctor !
Drugs like statin which is supposed to reduce cholesterol in blood misbehaves with liver and can even result in fatality .We accept it .The matter ends with a FDA box warning .
If a ventilator crashes due to a soft ware problem , we accept it . We can boldly admit medical errors if it is a fault of a drug or machine. But , errors by doctors are rarely pardoned ! So it is natural they are swept under the carpet.
When doctors do delicate cardiac surgeries , it takes only a fractional loss of concentration to cut the aorta and that could cause serious after effects .
These can be called as errors, mistakes or negligence in whichever way you like to call it. The problem is , these minor events (Which occur in thousands every day ) are not recorded, logged , or disseminated to our patients . Even medical law makers and judiciary is blinded to most of thing that happen inside the medical institutions.
So , the world will never know the reality .When we want transparency in all walks of life , we should at least fight for a minimum transparency from doctors.(Why cant they conduct the customary internal auditory meeting in the public domain !)
If only doctors admit their mistakes with courage medical profession will get more respect .Living behind veils never liberates . This traditional suppression of facts make the medical professionals high risk for guilt when truths unfolds .There is one Tamil proverb which says A half doctor is the one who has killed at-least 1000 patients . Still , a minuscule of doctors are ready to accept their mistakes .(Especially to their patients and their relatives , though they admit in private !)
Final message
Coming soon
Posted in bio ethics, medical quotes, tagged department of error, ethics in medicine, medical communication, medical errors, osler on December 23, 2010| Leave a Comment »
Doctors are obsessed with science . Science is man-made , often , the quality of which is far from perfect (Apart from scientific inaccuracies , personal and commercial conflicts creep in ) .Hence , patients may not get the true benefits of genuine science today . This has a huge moral and economic implications .
The entire life time savings of our population , is threatened to be consumed by the vagaries of modern medicine. A recent WHO report reveals , the major cause for poverty is attributable to the frivolous and greedy modern health care delivery system. Many times, bulk of the nation’s wealth is being spent on prolonging the final few months of lives(Often unproductive ! ) of their fellow citizens.
The irony is , many of these expenditures have questionable benefits.
Does your patient aware of all those uncertainties ! Why is it so difficult for us to communicate the above facts to our patients ? Mankind can benefit , if we put across the following doctrine to our public domain.
A medical non intervention can be as safe as an intervention , but one has to accept the occasional complications arising out of a non intervention . In this context it should be realised , we never hesitate to accept the consequence of a modern intervention.
Why and how our mind is readily accepting even deaths during an inappropriate procedure , while we struggle to accept even a temporary set back for not doing a needy intervention.
What is the solution ? We need to uncomplicate medicine . . . simplify them .When doctors intervene with common sense as a weapon to tackle the scientific excesses patient is bound to benefit.
Don’t ask don’t tell dogma should be replaced by ‘”Tell without asking” .Be transparent about the limitation of science.
Documenting and adhering to protocols is satisfying for upholders of science , but one should realize being unscientific also can help our patients many times.
When your hospital protocol says check for hypoxia in every patient with dyspnea , mind you it may land your patient to a totally unwarranted ventilator assistance for a very transient hypoxia reported your fellow over phone.
Here is an article that reveals , how a few oral words of advice could help both financially and academically in critical care.
http://chestjournal.chestpubs.org/content/138/6/1475.abstract
Final message
William Osler said ” Lesser is better” in medical communication . It may not apply today.
Did Osler was referring to falsehoods in medicine ? , Then , probably he is 100 % is right . . . for the current times !
Posted in bio ethics, cardiology-ethics, general medicine, tagged annals of internal medicine, bio ethics, cecil, conflicts, davidson, diagnosis, doctor, ethics, harrisons, health care, jama, lancet, medical errors, medical science, medical student, medicinehippocrates, mmodern medicine, nejm, principles of practice of medicine, pseudo science, who on December 9, 2008| Leave a Comment »
One of the important principles of medicine is “Diagnosis should always precede treatment”
This quote , though appear reasonable , can not be practiced always especially in emergencies, where we have to first stabilise the patient without a prior diagnosis .(Like administering IV fluids in hypotension , acetaminophen for fever , etc)
Modern medicine considers treating a patient without a diagnosis as unscientific.
But, it is a well recognised fact , millions of decision in everyday medical practice is not based on scientific diagnosis but on clinical acumen and empirical therapy . There are many instances wherein , we are never near the diagnosis even after exhaustive investigations.
Ironically , in this era of evidence based medicine , when we are unable to conclude , we are forced to do the most funniest thing , namely converting patient’s symptom itself as disease entity and be happy in labelling them. Like , Motion sickness , poly-arthritis, , chronic fatigue syndrome, adult respiratory distress syndrome , pre mature ejaculation, fever of unknown origin , attention deficit disorder , etc (The list is endless . . .)
This happens because physicians always feel guilty if they are unable to label a patient with a disease entity.
Is the guilt justified ? Not necessarily so ! Symptomatic treatment without diagnosis is the most dominant theme even today (Fever, pain etc ).So don’t feel unduly negative* when one is not able to fit a patent’s symptom into a disease entity but ensure he gets relief from his symptom.
*Except of course , one has to rule out a serious disorder.
Comments welcome
Dr.S.Venkatesan MD 