Friday, August 17, 2007

"Defensive medicine"


There's a CNN article up today called "Med student struggles to preserve her idealism". Check out these two paragraphs:

We are taught about malpractice from Day 1. I remember countless times in the anatomy lab when we were digging for arteries and nerves, our teachers saying, "Now if you cut this in real life, you would be sued," phrased in terms of a legal consequence instead of the repercussion that the patient might die.

This "art of defensive medicine" infiltrates the classroom too. We are taught how to ask questions of our patients and treat them in such a way that minimizes our risk of a lawsuit. We are trained what kind of patients to be wary of. Basically, we are taught that we can't trust our future patients, which is confusing to first-year medical students. How can we expect our patients to trust us if we can't trust them?


I don't know what I think about this. I think people in the medical profession need to be held accountable. I've heard plenty of horror stories from my own clients about medical people high on drugs and/or being basically careless, unconcerned and incompetent. On the other hand, I think we in this country have an unrealistic belief that life ought to carry with it guarantees. Something's seriously wrong.

1 comment:

  1. Anonymous3:52 PM

    The wrong bit is easy to spot: it's that the consequence is phrase in legal terms *because it misses out a step*.

    When I lived down in south London, I used to get annoyed at signs on the backs of buses, "Do not drive in bus lanes; fine £80". Of course, it may be so. However, it's a LUDICROUS over-simplification; what matters is that driving in the bus-lane has ramifications for the flow of traffic around the town that could inconvenience and cause chaos to many other road users. Additionally, there is a hole in the logic: if a bus-lane has time limits on it, you *may* drive down it and not get fined. It might also be that the lane has to be used in an emergency situation, therefore I would contest any such fine. Finally, the way these details are omitted reads like the government telling the populace "you're not supposed to know about the flow of traffic, leave it up to us".

    Now spot the analogy: the bit where the patient dies is the consequence that is unexplained. It does not always necessarily follow that a patient's death will result in legal action; people might just die on the operating table regardless of your best efforts.

    ReplyDelete

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