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Posts Tagged ‘medical negligence’

The irony of modern medical care is  9/10 times  medical negligence is  defined in terms of  acts of omission  in  required  level of care . In reality  most medical negligence acts are related to knowingly overdoing a futile diagnostic or therapeutic modality.

This irony was never understood by the public, the professionals or  even the judiciary .This remains  the most dangerous issue  facing modern medicine !

Finally some light is appearing in the horizon . A Missouri  Cardiologist is suspended for overdoing things he knows best  . . . namely coronary stenting ! 

This may bring chills over many cardiologist’s spine .

cardiologist stents inappropriate use interventional

http://www.stltoday.com/news/local/metro/missouri-healing-arts-board-issues-first-emergency-suspension-of-doctor/article_205eaffd-1825-5d7d-a9de-a289c010fd65.html

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                                                                                 Image courtesey : Jupeter Images

This  is because  . . .

  1. Doctors live in a  false life of pseudo- perfectionism . “I can never err”  attitude .
  2. Ego !  Their  pride at stake !
  3. Accepting a mistake would affect their further client-age
  4. Feels humiliated  among their colleagues and peers
  5. We are ready to accept  our mistakes in public  but the society  is  not  yet ready to forgive  us . So we hide !

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

  • Implementing transparent medical care , right to information , informed  consent  etc all  demand  honesty. To be precise  . . . extreme honesty ! Ego and honesty are rare companions .
  • How many times we blame it on the disease  and  hide behind the technicalities   for our mistakes and errors.
  • Can  any doctor accept  an  error that occurs  during a surgery or a procedure that  causes  death and  request a  pardon  from patient’s relatives .  I  suspect ,  if there is  such a breed among  doctors   . . . I am sure  he will be branded as  a lunatic by their colleagues !

Coming soon

  • Consequence of  doctors  not accepting errors  !
  • Errors in medical data base and literature.
  • Imperfect  science . Another important aspect of medical error is attributible  to the  vagaries of  science itself. What looks as a perfect modality suddenly becomes  , not only  obsolete but also dangerous . If  a surgeon does a  gastro jejenostomy for  acid peptic disease today ,  his  license  is at risk of  being clipped ,   the same  surgery was a  privilege few decades ago. This aspect  deserves  special debate .

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