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Mediation For Medical Malpractice: Why Doctors Should Embrace It

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*

Why Doctors Should Be Less Like Chuck Yeager And More Like Captain Sullenberger

A recent medical error of a wrong-site surgery that occurred in one of the country’s best hospitals, Massachusetts General, reminded me why doctors need to be less like Chuck Yeager and more like Captain Sullenberger.

Growing up, I always wanted to be a fighter pilot, years before the movie “Top Gun” became a part of the American lexicon. My hero was World War II pilot Chuck Yeager, who later became one of the country’s premier test pilots flying experimental jet and rocket propelled planes in a time when they were dangerous, unpredictable, and unreliable.

Much like the astronauts in the movie “The Right Stuff,” Yeager and his colleagues literally flew by the seat of their pants, made it up as they went along, and never really knew if their maiden flight in a new aircraft might be their last. They were cowboys in the sky wrangling and taming the heavens.

Fast forward to January 2009, when shortly after takeoff, a one-in-a-million chance, a double-bird strike completely disabled a US Airways jetliner. Captain Chesley Sullenberger, with the help of his co-pilot Jeff Skiles, ditches the aircraft in the Hudson River in under four minutes even as the nation surely expected a tragedy. But not on that day. Not with that pilot. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

When Doctors Make Mistakes: About Humanness And Perfection

The best part of doctoring is its humanness. Machines can’t do it — not even Apple products.

But that’s the worst part, too. Since humans practice medicine, there will be “medical errors.” And when doctors err, people — not spreadsheets or profits — are hurt. That’s the rub. Like any endeavor, the greater the reward the greater the risk.  Those cards were put on the table in medical school.

“Don’t want mistakes? Don’t do anything. Don’t make any decisions. Don’t do any procedures. Then, there will be no errors,”  the grey-haired, Swiss-born cardiac surgeon counseled me many years ago after an imperfect ablation.

The headline was about a doctor’s error. It was a doozy. But for me, the story belies the headline. A Boston Globe reporter called a surgeon’s public admission of performing a wrong operation “an unusual display of openness.” I would call it something else: Breathtaking. Unprecedented. Courageous. Read more »

*This blog post was originally published at Dr John M*

Medical Errors: Discuss Them Or Switch Doctors?

Patients won’t confront doctors if they think there’s been a mistake. They’ll just find a new doctor, even if there’d been no medical error.

Researchers looked at adult visits to seven primary care practices in North Carolina during 2008. They asked patients about their perceptions of medical mistakes and how did it influence the choice to switch doctors.

Of 1,697 patients, 265 (15.6 percent) reported a mistake had been made, 227 (13.4 percent) reported a wrong diagnosis, 212 (12.5 percent) reported a wrong treatment, and 239 (14.1 percent) reported changing doctors as a result. Results appeared in the Archives of Internal Medicine.

But anecdotes cited by patients as mistakes were often normal diagnostic or therapeutic challenges. A typical scenario might be the patient reported symptoms, the doctor did not correctly diagnose it at first presentation, and a specialist or second physician offered a specific diagnosis. Other scenarios included medication trials or side effects from the prescription. Read more »

*This blog post was originally published at ACP Internist*

Patients Starved For Time With The Doctor

If you’re into health care consumerism, you’ll enjoy my guest blog post at CDHC Solutions magazine. CDHC Solutions focuses on consumer-driven health plans. Consumer-driven plans are a form of “high deductible” health coverage that is more popular than ever. For whatever you want to say about these plans, one thing is clear: They don’t solve the fundamental problem of patients not having enough time with their doctors.

Here’s a taste of what I wrote:

Researchers have been trying to pinpoint the impact of this time starvation on the quality of medical care, and they’re finding disturbing results. A recent study in the Annals of Internal Medicine found that because of time pressures and related factors, doctors deliver “error-free” care as rarely as 22 percent of the time. The researchers called this a “failure to individualize care,” which is a nice way of saying the doctors just weren’t paying enough attention to the needs of their patients.

Read the whole blog post here.

*This blog post was originally published at See First Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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