my take: ...i can see the argument of why some poeple do and why
...it only makes sense, to me there is nothing unethical about that
now in terms of how the acgme sees it based on the "rules" its still not allowed
Residents are trained and protected under the rules as outlined by ACGME & ABMS. A resident that creates a new patient medical number to double count a patient for additional procedure logging on the same patient is falsifying the log.... it is lying. That is unethical and contrary to the rules & regs & likely your residency contract. All that equates to being unethical. You/residents have agreed to train under these rules and regs. There is no argument. It is a lie and it does go to character and ethics. It is a slipperry slope to start rationalizing why you break one set of rules and then another. I have heard the same about insurance billing and patient charting. Again, it is a concious and deliberate decision to create a patient medical record number to allow you to then take credit for additional procedures. This is lying.
...what case did someone get sued over their operaive log, and for what reason did they get sued?...
They were not sued over their operative log. They were sued over a specific case. The plaintiffs lawyer, in preparing their case asked the resident about their "training experience". The line of questioning went to issues of hospital credentialing, resident experience, autonomy and number of cases. This lead to "how many cases" have you done..... When the whole ball of wax was unraveled, the lawyer, per what the resident and PD said, made the comment, "so, you make up patients to lie about how much experience you actually have....". It wasn't the log, it was the credibility. This went on and on down the path of, "if you lie then, if lie about that, if, if, etc.... why should we believe you are telling the truth about x, y, z?"
...as far as figuring out a programs numbers im ok with double counting trach/peg, bilat mastectomy, egd/colon, but not other things where is differents parts of the same procedure and certainly not multiple residents on the same procedure
it only makes sense, to me there is nothing unethical about that
now in terms of how the acgme sees it based on the "rules" its still not allowed...
You are describing self-serving, situational ethics and rationalization. It is very easy to get roped into this type of thought process. Be very careful. Residents are pushed into it about the 80hrs/wk rules too.... again, "just rules". Residents get convinced they need to break them, then lie about them for patient safety, program accreditation, etc....
In the end, when you make the deliberate decision to fabricate a new patient identification number to bypass the rules of the logging and operative credit system, you are choosing to lie.
... doing one mastectomy and then doing another on the same patient is doign a whole procedure twice, and the acgme dosent have a code for bilateral mastectomy...
Another point everyone is missing on this double logging crap is this.... The ACGME/ABS/etc... have definitions as to what you log. That definition takes into account post-operative care. Taking "complete" or "full" credit for a case assumes the assessment and post-op care. Bilateral mastectomy is
the same post-operative care... thus you can not double log it because you think the otherside equates two "cases". That is to say, you should not be logging as if you are an itinerant surgeon for one breast... while taking operative and post-operative care for the other.
