Are we not just people?

[Silvertip]

My question- why must those who utilize conventional medicine and physicians expect perfection? I am beginning my first year of medical school next week, and my chief concern is that I will be expected to perform without fault for the next 45 years. There really aren't any other professions with such high expectations from the public. This is evidenced by the high frequency of litigation involving malpractice. If I screw up at work, I jeopardize my practice, while if my brother, the CPA screws up, he is chastised for a day and is not promoted for a month or longer.

I really hope that the people that I serve and help in the future look at me as another human, doing his best at what he has studied and trained for many years to do. Should I make a mistake on a judgement call, I hope that those whom I've dedicated my life to serving do not immediately turn on me like viscious money-grubbers. I'm apprehensive for the future- high malpractice insurance rates may push me away from practicing in many specialties that I find intriguing.

However, I am very excited and realize that I am quite fortunate to even have the opportunity to study and practice medicine in the future. No other profession, maybe excluding the clergy, allows us to have such a profound effect on others lives daily. I only hope that in the future, the courts see fit to closely regulate frivolous lawsuits, as there are too many people out there waiting for their doctor to screw up so that they can nail the insurance company, and raise the rates for all physicians.

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[DrMom]

Originally posted by Silvertip
I only hope that in the future, the courts see fit to closely regulate frivolous lawsuits, as there are too many people out there waiting for their doctor to screw up so that they can nail the insurance company, and raise the rates for all physicians.

You don't actually have to screw up to be sued. In my work I've revied hundreds of medical malpractice cases. Much of the time the people are just mad/unhappy with their (or their kid's) health and the physician is the most convenient person to take it out on.

But, yes, we need some restrictions on these lawsuits!!

 

[FutureM.D.]

Originally posted by Silvertip

I really hope that the people that I serve and help in the future look at me as another human, doing his best at what he has studied and trained for many years to do. Should I make a mistake on a judgement call, I hope that those whom I've dedicated my life to serving do not immediately turn on me like viscious money-grubbers. I'm apprehensive for the future- high malpractice insurance rates may push me away from practicing in many specialties that I find intriguing.

Although I'm only a pre-med, I've always hoped for the same thing when(hopefully) I'm a doctor. I always think, what if when I'm a dr. I mess up? Will I be sued out of house and home? It worries me sometimes.

 

[doepug]

Statistics say that every physician will, on average, kill two patients during his/her career. These will be preventable deaths which occurred due to an avoidable mistake of some kind. Physicians are indeed fallable human beings who make mistakes.

Just food for thought.

 

[PimplePopperMD]

We make mistakes all the time.

That's why it's the PRACTICE of medicine.

We can only do the best we can, and hope for the best possible outcome. You're right; the world expects us to be perfect. Our patients, however, see that we just do the best we can. They forgive a lot, believe me.

As a fourth year student, i've already made many mistakes with the management of my patients. I missed a small bowel obstruction, that my attending caught (thankfully!); I missed a brain bleed, which my attending caught (thankfully!); I don't know what else I may have missed that my attending didn't catch.

And yes, I do stay up at night sometimes thinking about the cases, and what I may have done better.

This is not a job to make money. It honestly isn't. It's something to which we need to dedicate ourselves. And it's exhausting, but it's also exhillarating (sp?)

my 2cents..

 

[none]

Of course, staying up at night worrying about the future does not bode well for one's career! Try your best not to be concerned by this and speak to your med school's psychologist if it becomes a real problem.

 

[PimplePopperMD]

I plan on giving up medicine if I am no longer concerned with the welfare of my patients. This inevitably involves thinking about them off-hours.

Thank you for your unsolicited advice, however. I hope your advice isn't normally given so haphazardly. We as healthcare providers need to be concerned with our own health, including mental health. We all need an outlet.

 

[DuneHog]

Thank you for your unsolicited advice, however. I hope your advice isn't normally given so haphazardly.

Why would someone post a response like this? This is a message board and it's purpose is discussion. In fact, the original poster was looking to hear the thoughts of others on medical malpractice etc. PimplepopperMD, here is some more "unsolicited advice" for you: if you are not interested in hearing the thoughts and advice of others, maybe you should stay off message boards.

 

[Vader]

Physicians should strive for perfection because medicine is unique among occupations. We are entrusted with our patients' health and have a great responsibility to help them. Few other professions deal with life and death on daily basis. Yet those that do, I believe, should be held to the highest standard, since the stakes are at their highest.

Obviously, no one is perfect. However, if you make a critical mistake, you must take responsibility for your actions. Before labeling lawsuits as "frivolous", perhaps it would be wise to consider the situation from the patient's or family's perspective. Many lawsuits arise from doctor-patient miscommunication. It is always important to be emphathic and to ensure that your patients feel empowered in their own medical care. If something goes wrong, it is important to explain the situation in a sensitive manner and even to apologize when necessary.

As long as you always do your best, treat people with honesty and compassion, and make your patients feel empowered, no one can ask more of you (although some will inevitably try). After all, medicine is a human endeavor.

Good luck in medical school!

 

[Silvertip]

Vader-

Thanks for the response. I am in agreement that as physicians, or future physicians, we owe it to those we serve to hold ourselves to a higher standard than many/most other professions.

I certainly did not mean to insinuate that medical malpractice lawsuits are by definition "frivolous." It is imperative that when a mistake is made, open honest conversation regarding the mistake follows between patient and physician. This honest relationship may be the difference between corrective medical actions or a lawsuit.

What worries me, though, is that most malpractice insurance providers put a cap on what they are willing to pay per suit. Should you choose to fight the suit, feeling that you were not negligent, you risk paying over and above what the insurance company is willing to pay. Say the insurance maximum benefit is $1 million per case, and the patient sues for $2.5 million- you are in a quandry- and LAWYERS KNOW THIS!!! So, you may give the insurer the okay to settle for $500,000 so that you personally do not lose everything- even though you may be right, there may have been zero negligence. It seems like very good business for attorneys- physicians are sitting ducks, waiting to be black-mailed into settling. States who are losing rural physicians, i.e. Mississippi as noted recently by President Bush, need to follow the lead of California with TORT REFORM.

 

[kltmd]

We touched on the topic of malpractice suits during orientation... and one statistic came up in the discussion. We were told that there is an inverse correlation between communication and malpractice suits. In other words, the better job that a physician does in communicating well to the patient (and his/her family or friends), being empathetic, etc., the less likely the physician will be sued. Of course, this isn't fool proof. But a family is much more likely to be understanding of mistakes from a doctor they trust and love than they will be with a doctor they feel just blows them off.

 

[Kirk]

Originally posted by kltmd
We touched on the topic of malpractice suits during orientation... and one statistic came up in the discussion. We were told that there is an inverse correlation between communication and malpractice suits. In other words, the better job that a physician does in communicating well to the patient (and his/her family or friends), being empathetic, etc., the less likely the physician will be sued. Of course, this isn't fool proof. But a family is much more likely to be understanding of mistakes from a doctor they trust and love than they will be with a doctor they feel just blows them off.

That sounds great, but it?s a really subjective concept! How can you quantitatively measure communication between doctors and patients in a reliable way? Obviously people who are suing a Dr are going to be mad and claim that the communication was horrible.

 

[Biffer]

yes, medicine is a profound undertaking.. The thought of slipping up is unimaginable-but still happens. Thats why I will become an opthamologist(sp?) -not necessarily life/death situations everyday and still very challenging and rewarding.

much love,
biffer

 

[Spidey]

Originally posted by PimplePopperMD
We make mistakes all the time.

That's why it's the PRACTICE of medicine.

We can only do the best we can, and hope for the best possible outcome. You're right; the world expects us to be perfect. Our patients, however, see that we just do the best we can. They forgive a lot, believe me.

As a fourth year student, i've already made many mistakes with the management of my patients. I missed a small bowel obstruction, that my attending caught (thankfully!); I missed a brain bleed, which my attending caught (thankfully!); I don't know what else I may have missed that my attending didn't catch.

And yes, I do stay up at night sometimes thinking about the cases, and what I may have done better.

This is not a job to make money. It honestly isn't. It's something to which we need to dedicate ourselves. And it's exhausting, but it's also exhillarating (sp?)

my 2cents..

Good post pimplepopper. I imagine I will stay awake some nights and think about what I have learned and could have done better when (if) I'm in your position.

 

[Spidey]

Originally posted by DuneHog
if you are not interested in hearing the thoughts and advice of others, maybe you should stay off message boards.

I can easily see how none's advice could be found offensive... he basically said 'o if you are thinking about your patients in your off-time you have a mental problem' That is so not true as to be offensive. I probably would have reacted the same as pimplepopper.

 

[PimplePopperMD]

Thank you, spidey.

I'm not terribly offended; someone who would imply such a thing hasn't been on wards yet. Even the most detached human being will be nervous about decisions, and think about things even off hours. So although it was meant to be offensive, it demonstrated a lack of experience.

I was trying to emphasize that we all do make mistakes, but as medical students, there is a LOT of backup. There are generally at least two lines of defense, sometimes three; the intern, the senior resident, and the attending (depending on what service you're on). The nature of the practice is that multiple eyes will be examining the issues, with different ideas, and fewer things will be neglected if more people are following the patient. That's generally the case.

Anyway, that's my three cents.

 

[Zoobaby]

Originally posted by Kirk


That sounds great, but it?s a really subjective concept! How can you quantitatively measure communication between doctors and patients in a reliable way? Obviously people who are suing a Dr are going to be mad and claim that the communication was horrible.

That's where the ART comes in. Medicine is FAR from being a pure science. Some things - effective communication with patients being a fantastic example - are by their very nature not quantitatively measurable. I think the point is -- be the scientist, but also be the human (the friend, the caregiver). If you're good at the latter, mistakes made by the former are more forgivable.

 

[DuneHog]

Originally posted by Spidey


I can easily see how none's advice could be found offensive... he basically said 'o if you are thinking about your patients in your off-time you have a mental problem' That is so not true as to be offensive. I probably would have reacted the same as pimplepopper.

You are obviously quite easily offended. Your paraphrase of none's statement is not the way I read it. It sounded to me like he was simply trying to give some kind advice by pointing out that it is probably not healthy to worry about patients so much that you are losing a lot of sleep.

You should also seriously reevaluate your feelings regarding mental health problems. It is actually kind of disturbing that someone in the medical field would be offended by the thought that he might have a "mental problem." Mental illness affects health care professionals as much if not more than the general population and it is not helpful to anyone to promote this kind of stigmatization.

 

[Spidey]

Originally posted by DuneHog
It sounded to me like he was simply trying to give some kind advice by pointing out that it is probably not healthy to worry about patients so much that you are losing a lot of sleep.

He never said he was losing a lot of sleep. He said he sometimes stays awake at night and thinks about his patients. Isn't it only natural to recap your day in your mind before you fall asleep? Maybe not... it is natural for me anyway.

You should also seriously reevaluate your feelings regarding mental health problems. It is actually kind of disturbing that someone in the medical field would be offended by the thought that he might have a "mental problem." Mental illness affects health care professionals as much if not more than the general population and it is not helpful to anyone to promote this kind of stigmatization.

I guess maybe you have a point there... I guess I still have that admittedly somewhat immature "it'll never happen to me" attitude. But with all the insanity that I imagine doctors have to deal with I could easily see how problems could arise.

 

[modemduck]

Yo PimplePopper,

I think it is really great that you take the time to think about your patients even after the job; Honestly, I believe that this sort of dedication and care towards your patients can be "felt" by them and will help you
1) correct any errors and improve the chances for future patients
2) help your patients know that you really care, because you actually do.

We just had our white coat ceremony a little while ago and Ben Carson was Keynote speaker, and he had views that are along the same lines.

PimplePopper, best of luck in yer 4th yr!

DuneHog n None: chill out.



- Modemduck
Columbia P&S 06

 

[modemduck]

Originally posted by Kirk


That sounds great, but it?s a really subjective concept! How can you quantitatively measure communication between doctors and patients in a reliable way? Obviously people who are suing a Dr are going to be mad and claim that the communication was horrible.

Hey Kirk,
Thats a really great pt! Actually, I used to train ppl for a suicide and crisis hotline and we had to take measures of our calltakers empathy and nonjudgementalness. We did this through using simple score evaluations like # of interruptions, # of reflective statements, proper opening/closing, open-ended questions, etc

I can give you an example of a doctor patient conversation that would go well and one that would go terribly if you would like.
But I do agree w/you overall that the level of communication between two people is hard to measure... but there are some obvious signs of a good communicator and semi-accurate ways to measure them.

- Modemduck
Columbia P&S 2006

 

[LJoo83]

Thank you all for helping me realize that I truly am not the only one who is concerned about what the consequences are if I happen to screw up. Self-centered, I know, but I wasn't sure if I were the only one who was worried about that. I'm not too worried about the money factor as far as malpractice suits go; but I was so much more concerned about whether something I did I could have done better in order to prevent a death that could have been avoided. A physician kills two patients in their career-God forbid that would ever happen. What a heavy and serious burden it is to have on your shoulders-to think that you had the power to save a life and due to whatever reason you couldn't save it. Wow.

Thank you all for also helping me realize that practicing med is much more than science and text book matters; it's about communicating not only the doctor to the patient but the patient to the doctor, expressing their needs and wants.

Seems as though communicating is the key to everything that is important...