It’s happening more frequently: Requests for medical advice by email. The more I do, the more people I meet. The network grows and friends of friends learn about what I do.
So junior has a little pain and shows at the local ER where the requisite CT shows a little thickening of the ileum. Someone suggests that the family drop me a line. Here’s the problem: There’s more to this than digital correspondence will allow.
While the statistical reality of this child’s situation is that this finding represents a little edema from a virus, the differential is precarious: Crohn’s disease, lymphoma, tuberculous ileitis, eosinophilic enteropathy.
A case of this type requires the thorough exploration of a child’s story and a compulsive exam that takes into consideration the problems in the differential. Worrisome considerations need to be framed and discussed in the context of the child’s total presentation and real likelihood of occurrence. The sensitive dialog surrounding our diagnostic approach to this child requires a relationship. And the various approaches require an element of negotiation with the family. All of this takes time, emotional intelligence, and good clinical judgment.
Children are complicated creatures. Parents are more complicated. Loose, off-the-cuff advice based on shotty information shortchanges both parties.
Of course the easiest response to these regular queries is that my employer, malpractice carrier, and the Texas State Board preclude offering medical advice without an established relationship or the maintenance of a medical record available for peer review. Everybody understands legalese. Few, however, understand the complexity of a properly executed medical encounter.
*This blog post was originally published at 33 Charts*
Most of our posts here deal with gadgets physicians or other medical professionals would use, but the New York Times has published an article about issues stemming from the patient or the family bringing cameras into the delivery room.
Now, as anyone who’s been made to watch a video of a friend’s delivery during a party can attest, this isn’t a new phenomenon. However, since almost any device can record video now and it’s easiest to share the video online, medical-legal considerations are leading some hospitals to restrict any and all recordings of live births.
We’d be interested to know what our readers think. Do you let patients film you while you work?
Comedian Stephen Colbert, who says he is “a huge supporter of the Susan G. Komen for the Cure foundation,” nonetheless took a sarcastic swing at the organization this week “for spending almost a million dollars a year in donor funds to sue…other groups” for using the phrase “for the Cure” in their promotions.
Then in December, the Huffington Post reported that “Komen has identified and filed legal trademark oppositions against more than a hundred of these Mom and Pop charities, including Kites for a Cure, Par for The Cure, Surfing for a Cure and Cupcakes for a Cure — and many of the organizations are too small and underfunded to hold their ground.”
Colbert said: “If they don’t own the phrase ‘for the Cure,’ then people might donate money thinking it’s going to an organization dedicated to curing cancer, when instead it’s wasted on organizations dedicated to curing cancer.”
Mediation has been cited as a way to lower the cost of litigation and compensate injured patients without going through the ordeal of a trial. In a post from the WSJ Health Blog, the problem is that few doctors are participating.
That’s a problem. A study from a law journal looked at 31 cases that went to mediation and found that,
of those cases, 16 were settled at mediation, 5 settled afterward and 10 weren’t settled. While defense attorneys were less likely to agree to mediation than plaintiff attorneys, lawyers who did participate reported satisfaction with the process, as did “plaintiffs, hospital representatives and insurers,” the study finds.
The authors write that in no cases did physicians participate in the mediation.
Many times, patients resort to suing their physicians simply to find out what happened. In a recent post here, attorney Brian Nash provided perspective from the legal standpoint, and in the comments (now 150+ strong), you can see the dissonance between the malpractice viewpoints of the physician, attorney, and patient. Read more »
*This blog post was originally published at KevinMD.com*
Flush from their big win in the midterms, the Boehners are vowing to repeal and replace the Big O’s health reform law. They pose a legitimate threat, but an even larger one lies in the courts, where suits challenging the constitutionality of the law have been popping up like fireflies on a late August night.
In Virginia for example, Republican-appointed Federal District Court Judge Henry Hudson has indicated that the Individual Mandate — a key provision of the law that has been challenged in a suit filed in his court by the state’s Republican Attorney General — might not pass his sniff test.
Hudson said he’d rule on the matter this month. If he deems the provision to be unconstitutional, he might (it’s unlikely, but he might) enjoin the law altogether until higher courts rule on the matter. Holy Kazakhstan, Batman!
An official at Camp Obama, who spoke with the New York Timesunder the condition that his name not be WikiLeaked, acknowledged that Hudson’s thumbs appear to be pointing downward, indeed. Read more »
*This blog post was originally published at Pizaazz*
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