supervision and running own case in emergency?

[Planktonmd]

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Malpractice litigation is part of the game and it will always be there because that's how these lawyers make a living.
Actually the fear of malpractice litigation and the fear of predatory credentialing entities (Joint commission and others), are the main reason we spend more than 50 % of our day filling up stupid forms and buffing the chart rather than actually taking care of patients.
It's not going to get better and the sooner you accept that fact the better for your sanity.

 

[TaoistDoc]

Malpractice litigation is part of the game and it will always be there because that's how these lawyers make a living.
Actually the fear of malpractice litigation and the fear of predatory credentialing entities (Joint commission and others), are the main reason we spend more than 50 % of our day filling up stupid forms and buffing the chart rather than actually taking care of patients.
It's not going to get better and the sooner you accept that fact the better for your sanity.

Yeah. Ce la vie. Everything in life has risk. All we can do is try our best to minimize it. I drive defensively so I dont end up in the trauma bay. I practice defensively so I don't end up in court. But they could still happen.

Can't cower under the cover all day due to fear of risks. Its no way to live.

 

[amyl]

I was in this situation at my old job... No crna... It was just me. I was in a semi urgent case and a stat c/s walked in. They expected me to leave the or where I was come up and dose the spinal and return to my original case. And they wonder why I left - I of course said no

 

[Twiggidy]

The moral of all of these stories is you can't leave a patient that is under an anesthetic whether you're in a C section or in the OR

 

[Planktonmd]

I was in this situation at my old job... No crna... It was just me. I was in a semi urgent case and a stat c/s walked in. They expected me to leave the or where I was come up and dose the spinal and return to my original case. And they wonder why I left - I of course said no

So what happened to the patient? and the baby?

 

[amyl]

Told surgeon 1 to hurry his ass up. Told ob to team to be ready to roll ASAP - get all my stuff etc n call any of my partners to see if someone was available n sober. Luckily the baby waited. Dodged a bullet

 

[TaoistDoc]

Im curious. If we are tied up in a case and refuse to do an emergency due to responsibilities to our current patient and a bad outcome happens to the emergency due to lack of anesthesia, are we at all liable to that outcome. E.g. baby develops brain injury bcuz OB is not comfortable doing csec under local

 

[IlDestriero]

You bet, assuming you're group has a contract to provide OB services.
The guideline is decision to incision time of 30 min.
If there was a bad outcome because of waiting the ACOG guidelines will hang you all.
At best I would think you would be on the hook for only 50%. Probably all.

 

[pjl]

Amyl is a hospital employee if I am not mistaken, so I would think if they choose not to staff for OB during times there are cases running in the OR it would be on them, not her. However it would be interesting to see someone who actually knows what they are talking about would say.

 

[IlDestriero]

That's an interesting wrinkle. It's possible the hospital administration would decide that the risk of a rare lawsuit and pay out will cost less than an extra $500k/yr for a 2nd call anesthesiologist.

 

[Arch Guillotti]

Luckily the baby waited. Dodged a bullet

So it really wasn't all that stat.

 

[amyl]

Yes stay here sometimes means something n sometimes doesnt

 

[Planktonmd]

Yes stay here sometimes means something n sometimes doesnt

That's the case everywhere... when OB says STAT it could be real stat or "soft" stat 😉

 

[pjl]

We rank ours based on how "stat" they are.
Lvl 1: Drop food on floor and run (<15 min)
Lvl 2: Finish food then go (<30 min)
Lvl 3: Go out for 5 course dinner then go (goal <2 hours, but later acceptable)
Then the OB department discusses cases at their meeting regarding classification if any concerns are brought up.

 

[Mman]

Also, now I feel like my 1 mil malpractice cap may be inadequate.....

malpractice is a completely state dependent issue. Florida is a terrible state to be a physician in, but others are far more doc-friendly when it comes to malpractice.