Clinical Policies/Policy Statements

[DeadCactus]

So I hear a lot that you should be well versed with the official policies of the major organizations relevant to your practice. Not necessarily that you have to abide by them but that you need to be familiar with them and know very clearly when you are deviating and why because if you end up in court, it's the policies that will be cited as evidence of your malpractice.

So then I have a few questions.

Is there anywhere to get a compilation of the current ACEP policies or do you have to pull them off the website one-by-one?

What's the difference between a policy statement and a clinical policy? Political vs medical?

What other major policies are relevant to emergency physicians? Basically the major common illnesses? AHA for ACS, ASA for stroke, ACCP for pneumonia, etc?

Thanks.

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[RustedFox]

So I hear a lot that you should be well versed with the official policies of the major organizations relevant to your practice. Not necessarily that you have to abide by them but that you need to be familiar with them and know very clearly when you are deviating and why because if you end up in court, it's the policies that will be cited as evidence of your malpractice.

So then I have a few questions.

Is there anywhere to get a compilation of the current ACEP policies or do you have to pull them off the website one-by-one?

What's the difference between a policy statement and a clinical policy? Political vs medical?

What other major policies are relevant to emergency physicians? Basically the major common illnesses? AHA for ACS, ASA for stroke, ACCP for pneumonia, etc?

Thanks.

Good, good question. I only know a loose smattering myself.

 

[Birdstrike]

In court, the so called "experts" define the moving target that is the "standard of care". Plus, there are too many societies that have policy statements to memorize them all, even multiples within specialties that may differ. An "expert" is not necessarily an expert, but any "doctor" the the plaintiff's attorney can pays thousands of dollars to say whatever he can get him to say, to sell you down the river so they can win money from your malpractice insurance carrier. Of course,you are not considered an "expert." An "expert" can be from any speciality, not necessarily your own, judging you. Their specialty "guidelines" may be different than yours (i.e. controversial subjects ripe for lawsuits, tPA, steroids in SCI, etc) or they may make up their own "opinion" for the purpose of that court case. When your jury is selected, anyone with medical experience is specifically thrown out by the plaintiff's attorney because, of course, any medical experience which would actually allow them to understand the complex medical issues better is, "biased, after all!" Whichever "expert" this jury decides is right, ends up being "right".

 

[RustedFox]

Here in Florida, however - our medmal laws state that expert witnesses must be in the same specialty as the defendant (you).

There are some states that I won't ever even consider practicing in. Shame.

 

[DeadCactus]

In court, the so called "experts" define the moving target that is the "standard of care". Plus, there are too many societies that have policy statements to memorize them all, even multiples within specialties that may differ. An "expert" is not necessarily an expert, but any "doctor" the the plaintiff's attorney can pays thousands of dollars to say whatever he can get him to say, to sell you down the river so they can win money from your malpractice insurance carrier. Of course,you are not considered an "expert." An "expert" can be from any speciality, not necessarily your own, judging you. Their specialty "guidelines" may be different than yours (i.e. controversial subjects ripe for lawsuits, tPA, steroids in SCI, etc) or they may make up their own "opinion" for the purpose of that court case. When your jury is selected, anyone with medical experience is specifically thrown out by the plaintiff's attorney because, of course, any medical experience which would actually allow them to understand the complex medical issues better is, "biased, after all!" Whichever "expert" this jury decides is right, ends up being "right".

While in the end everything comes down to what the 12 people decide, I still see the importance of policies constantly reiterated. I obviously have no experience with the issue but the impression I get is that acting in accordance with your hospital policies or the policies of your national specialty organization provides a relatively strong legal defense while straying from them injudiciously or thoughtlessly quickly opens you up to legal peril.

Which makes sense to me. It's one thing to convince a jury you're some kind of cowboy who doesn't play by the rules and caused harm to a patient. It's another to convince them that an entire hospital or the entire specialty failed a patient. Granted I'm sure there is a whole sub-argument that takes place on whether you really did follow the policy but that's a different issue.

As I said, I have no personal experience with the issue. I'm more thinking out loud than anything...