'Anesthesiologist trashes sedated patient — and it ends up costing her'

[Stagg737]

@jl lin , I'm not trying to be insulting, but some of your posts are absolutely ridiculous and the standards you use should not be used to determine the general laws set forth for society. The fact that you stated that previous arguments were trumped by "the gold rule" then proceeded to post a bible quote as evidence shows a severe lack of basic understanding of the current societal construct.

There is a difference between ethics and laws. Ethics are moral code we establish to determine what we intrinsically consider right and wrong and which govern how we conduct our lives as individuals. Law is the written legislation which are enforced through social institutions and which result in consequences, determined by society instead of the individual, when they are broken. There are plenty of laws involving defamation of the person or slander, but in this case the written law (at both the federal and state level) was upheld in regards to the statements made. Whether or not the statements made were unethical or just plain mean does not apply. What applies is whether those statements that were made were meant to be said as fact and were seen as true when they were not. Since the majority of the statements were opinions and those that were stated (like TB of the penis, which is obviously not true to anyone that's even sniffed a clinical setting) were obviously said in jest (the fact that the joking was malicious doesn't change the fact that it was a joke) should have made the legal implications of that part of the case moot. I've already addressed the other parts of the case, so I'll leave it at that.

What I find most disturbing about your posts is your continuous inability to differentiate between how people feel and what the law actually states. Were these people unethical, unprofessional, and downright rude? Absolutely, and as you stated, the damage this will do to their reputations and ultimately their careers will follow them forever. And it should. As you said, TRUST is the cornerstone of the doctor-patient relationship, and these people made it very clear they can't uphold that. However, saying "this patient deserves money because these physicians broke the law and hurt him" is very, very different than saying "this patient deserves money because I feel the doctors didn't respect him". To be blunt, the latter of the two statements is just plain ridiculous. Everyone is allowed to have their own opinions about everyone else, even if those opinions are incredibly negative. It's a freedom they are entitled to based on federal law in the U.S. and awarding this patient money because he didn't like the medical team's opinion of him could easily be seen as encroaching on the civil liberties granted to them. There were plenty of laws they did break in this case that they deserve to be legally punished for, but talking negatively about the patient isn't one of them.

I agree with you completely that their statements do warrant consequences, just not legal ones. As you said yourself, the state licensing boards should have become involved. I'm assuming the only reason they did not is because this case was taken before a court, but that should not have stopped the state from getting involved. As you said yourself, what goes around comes around. This case will likely destroy their reputation for the duration of their careers. The anesthesiologist was already fired from a position she took in Florida after this incident, and I'd guess this case played a pretty significant role in it. All I'm saying is that we can't just let people's feelings govern the standards set for them by society, at least not in terms of actual legal statutes.

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[jl lin]

@jl lin , I'm not trying to be insulting, but some of your posts are absolutely ridiculous and the standards you use should not be used to determine the general laws set forth for society. The fact that you stated that previous arguments were trumped by "the gold rule" then proceeded to post a bible quote as evidence shows a severe lack of basic understanding of the current societal construct.

I only have time to parse through one thing at a time Stagg. OK, so, ^ that was in direct response to someone that opened that door--i.e., the member named FFP. (Good name. I favor the careful use of FFP.) Anyway, it was a response to his/her (not sure) post.
OK. And once again, chalk it up to reading; but I stated in my response to FFP's comment to me that she/he opened that door. Do you see what I mean? He/she addressed that. I countered it in the same vein. That's it. You take issue w/ that, scroll past it.

Regardless, the golden rule is something that is pretty well accepted, and it would be utter insanity to take offense or go against the Golden Rule. You are kind of going out there in terms of your response with that. What's more, you, again, didn't understand the responsive context in which it was given.

As to your other points, well for now, only the part of what is law versus what people feel--you have missed it over and over, and I don't know how I can help you understand this.

Once more, standards of practice are what the law indeed looks at in litigation--specifically violation of them. Treating patients inhumanely, w/o respect, dignity, autonomy is both a violation in ethics and in law b/c of the expectation of following standards of practice. Treating patients w/ dignity at all phases of care and treatment is an accepted standard of practice; therefore the jury was well within it's place to render such a decision. And now that they have, it is another case on the books to support the accepted standards of practice; hence take great caution in how you communicate and treat patients at every point of interaction and at every phase of care--regardless of what their level of consciousness is. Furthermore, it would be wise to include that attitude toward patients' family members as well.

Treat patients and families in a less than respectful manner and be prepared to face consequences on perhaps multiple levels, and yes, that may well include legal consequences, depending upon the particulars and such.

There is no need to even fathom rationalizations or loopholes for this. It should be a given to treat patients and families with respect at all levels of care. You don't have to wine and dine them. Just treat them with respect and dignity through out all phases of care. That is the expectation--that is the standard. Violate that and be prepared to deal with consequences to your career and or bank account. Again, medical boards need to crack down on this as well. If they did a better job, perhaps outside legal options wouldn't be necessary. I don't know if you are aware of this but all this talk about litigation happy people is well overstated. Litigation is expensive, highly stressful, lengthy, and just a huge pain in the ass. Anyone with a ml of sanity would want to do anything they could to avoid it--and many people do--or they want to limit the pain of it such that they are often enough eager to settle out of court. Most people want to live their lives without that kind of added stress.

Good night.

 

[pd1112]

FYI I know that. And that is expressly WHY I posted more than one sources re: medical ethical standards. If you didn't see that or the connected points, well, I don't know what to say to you. Wow.

"Unfortunately, these particular physicians found no need to uphold AMA principles." - It's pretty clear that you didn't know. You posted two sources, and neither has any binding or application to these physicians and most others.

 

[jl lin]

"Unfortunately, these particular physicians found no need to uphold AMA principles." - It's pretty clear that you didn't know. You posted two sources, and neither has any binding or application to these physicians and most others.

View attachment 193427

There are a number of reasons as to why your statements are incorrect. At the very least, this for now should suffice:

It (aforementioned rights and expectation of rights) and standard of practice are written into every single patient bill of rights for every hospital or healthcare institution. These exist in every hospital and health organization, and in that alone, it is a given expectation for the standard of practice--as well as what the boards of medicine have set as standard. Now,privileges to work at these facilities means you as a healthcare provider agree to practice within those standards. And regardless there is case law for it. So . . .

That's all I can address for now.

 

[WholeLottaGame7]

re-mic drop.

If you have to use the term "mic drop," you are definitely not the one dropping the mic. Particularly if you have to say it twice. I'm sure it sounded pretty sweet while you were typing it, though.

 

[DOFOSHO]

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[WholeLottaGame7]

There is no need to even fathom rationalizations or loopholes for this. It should be a given to treat patients and families with respect at all levels of care. You don't have to wine and dine them. Just treat them with respect and dignity through out all phases of care. That is the expectation--that is the standard. Violate that and be prepared to deal with consequences to your career and or bank account. Again, medical boards need to crack down on this as well. If they did a better job, perhaps outside legal options wouldn't be necessary. I don't know if you are aware of this but all this talk about litigation happy people is well overstated. Litigation is expensive, highly stressful, lengthy, and just a huge pain in the ass. Anyone with a ml of sanity would want to do anything they could to avoid it--and many people do--or they want to limit the pain of it such that they are often enough eager to settle out of court. Most people want to live their lives without that kind of added stress.

I think you're lumping all litigation into one big pile here without looking at the details. I don't care if this patient won his defamation suit, or received punitive damages, or whatever else. He probably deserved something, and he got something. What I take issue with is the malpractice side of it and how it was applied. Again, treating patients poorly or breaching the standard of care is not enough to be considered malpractice. There has to be a standard of care, that standard of care has to be broken, and there have to be deleterious consequences resulting from that action.

Many of the posters here rightfully are doubting that that is how the jury decided to award malpractice damages, based on the one juror's quote, and rather used a definition of malpractice as something along the lines of "the doctor did something stupid and she should be punished." And you obviously agree with them. Which is fine. "An eye for an eye" has a fairly long history of serving as a basis for a justice system and is still in use in many parts of the world.

But that is not how we as a country have decided to work our legal system, for better or worse. I personally think better, you may think worse. So to see a ruling like this, where decisions are made based off emotion rather than reason, troubles me.

 

[WholeLottaGame7]

it was sweet, especially doing it twice, i like to mix it up a bit.

So for the second one, do you pick the first mic back up, or do you drop an entirely different mic? Also, is there an upper limit to mic drops, or can you just keep doing it indefinitely? Does doing it more strengthen or weaken the effect? Since you're a medical student, I'm basically asking if mic-dropping is more like myasthenia gravis or Lambert-Eaton syndrome.

 

[DOFOSHO]

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[jl lin]

/

I think you're lumping all litigation into one big pile here without looking at the details. I don't care if this patient won his defamation suit, or received punitive damages, or whatever else. He probably deserved something, and he got something. What I take issue with is the malpractice side of it and how it was applied. Again, treating patients poorly or breaching the standard of care is not enough to be considered malpractice. There has to be a standard of care, that standard of care has to be broken, and there have to be deleterious consequences resulting from that action.

Many of the posters here rightfully are doubting that that is how the jury decided to award malpractice damages, based on the one juror's quote, and rather used a definition of malpractice as something along the lines of "the doctor did something stupid and she should be punished." And you obviously agree with them. Which is fine. "An eye for an eye" has a fairly long history of serving as a basis for a justice system and is still in use in many parts of the world.

But that is not how we as a country have decided to work our legal system, for better or worse. I personally think better, you may think worse. So to see a ruling like this, where decisions are made based off emotion rather than reason, troubles me.

Its not emotion. That is what YOU REFUSE to get. It is based in accepted and expected STANDARDS OF PRACTICE! HELLO!!!!!

I am very sorry that you and some others are missing the fact that abusive treatment--any type of abusive treatment is indeed malpractice. Unless there was an EMTALA issue, this ologist would have been FAR better off refusing to take this patient's case.

All points of care require adherence to and respect for patient dignity, autonomy, and decency in treatment as HUMAN BEINGS. This is, without question, without deviation, the STANDARD OF PRACTICE. The law will look at deviations from the standards of practice. This ologist's violations of these standards were so obvious and grievous, nonetheless, the jury made a compromise. The plaintiff didn't get the whole 1.7 mil or so. She got a SIGNIFICANT REDUCTION.

Practioners will and should be held accountable on all levels of care THROUGHOUT THE ENTIRE COURSE OF CARE AND TREATMENT. Gees, I just can't emphasize this enough to get through the wall that is blocking this in some folks' minds.

The jury's rendering was on target. It is another one now on the books. It is now a part of case law. There is nothing else to say about this.

If you feel that it is too grievous for you to treat patients, even difficult ones, with dignity and respect throughout the whole spectrum of healthcare, then I have to tell you that you have chosen the wrong field. It is just that simple. This is not complicated--at all. Not even a little.

Skip the emotional crap you are interjecting. It is the standard of practice that will be viewed and expected to be held by the courts. I don't know why you are having trouble with this. This is also core for public policy. LOL. Again no one is expecting you to be best friends with your patients and families. There are professional boundaries that need to be upheld in clear balance--they should not go too far either way---i.e., getting too emotionally involved with patients and families versus being devoid of basic respect, human dignity and autonomy.

Be professional. Exercise sound judgment in both direct care and scope of practice AS WELL AS RESPECTFUL TREATMENT OF PATIENTS AND FAMILIES. IF any doctor does this, in all probability and demonstrated statistics, he, she, they will not have a problem!

Be wise in this. Sometimes it's tough with certain patients. Sometimes you want to vent and as humans we can get annoyed with certain patients and families. Trust me, I so totally get that.

At the end of the day, our feelings of frustration leading to disrespect and deficiency in application of dignity and respect for patient autonomy do NOT trump that of the patients continued right to those things.

Again, unless it's an EMTALA patient--and for those, I have to say, I have a lot more tolerance for the ED docs and what they often have to put up with--but anyway, if you have the ability to choose to not take on certain patients b/c you don't think you can deal with them, then just DON'T. If you do accept them under your care and you lose it--especially in the extremely obnoxious and uncalled for way that this ologist did, there is INDEED legal justification for you getting an extreme penalty. Again, remember, this ologist didn't get the full penalty asked for by the attorney and plantiff. She got way less than half.

What is beyond shameful is that the board of medical examiners has not put any sanctions on these two physicians. They totally deserve it. If this was a nurse/nurses, you better believe he or she or they would have had sanctions listed against him/her. Why should the standards of dignified practice be any less for physicians--of all people? That's just insane.

It boggles my mind that some physicians want more respect and limit to midlevel overstep (understandable, mind you), yet they don't get the very basic, most fundamental aspects and standards of practice. In this case, NO! You don't get to have it both ways. Why should you?

But the law will not side with your perspective, and indeed for the stake of patients, the public, and your profession, it should NOT.

 

[Psai]

standard of practice is a nursing term
doctors have standards of care
standard of care was not breached
this doesn't change, no matter how many times you mash the shift key

 

[WholeLottaGame7]

Wall of text

I'm fairly sure that some of our misunderstanding deals with educational background. I'm guessing nurses don't have to deal with malpractice in the sense that physicians do, so the concept is not as familiar. Which might be why you didn't actually reply to my comment but rather repeated things that you have previously stated and which I have agreed with.

One thing I learned from a conflict resolution/public apology class I took in undergrad (that I never thought would actually be useful), is that to have any meaningful discourse you have to be talking about the same thing. I (and many of the physicians on the thread) are talking about whether or not what the anesthesiologist did constitutes malpractice. You are talking about whether what she did was disrespectful and STANDARD OF PRACTICE and unprofessional.

 

[jl lin]

I'm fairly sure that some of our misunderstanding deals with educational background. I'm guessing nurses don't have to deal with malpractice in the sense that physicians do, so the concept is not as familiar. Which might be why you didn't actually reply to my comment but rather repeated things that you have previously stated and which I have agreed with.

One thing I learned from a conflict resolution/public apology class I took in undergrad (that I never thought would actually be useful), is that to have any meaningful discourse you have to be talking about the same thing. I (and many of the physicians on the thread) are talking about whether or not what the anesthesiologist did constitutes malpractice. You are talking about whether what she did was disrespectful and STANDARD OF PRACTICE and unprofessional.

Actually on this point re: patient bill of rights and required use of dignity and respectfulness, etc, NO. There is no difference, regardless of the educational background. LOL

WLG, this is well established, and I can only suggest you research it a lot more--talk to some reputable legal people--read more journal and legal/ethical books and articles on it. Look at case law. Refer to books on the combined establishment of BOTH LAW AND ETHICS--they do go together--in medicine in healthcare as well as business.

I just don't know what to say to you; b/c you seem incredibly recalcitrant in understanding the essence of patients' rights and standards of practice with regard to patient treatment.

I trust this will never be an issue for you. At the same time, you should not tolerate it as an issue from your colleagues--no matter what. Boys's club or not. Set the tone and speak out against this sort of thing. You are just as much a patient and family advocate as I am. And this is the expectation of all physicians and nurses and case managers for that matter. Advocacy.

 

[VA Hopeful Dr]

standard of practice is a nursing term
doctors have standards of care
standard of care was not breached
this doesn't change, no matter how many times you mash the shift key

Bingo. Standard of Care is what we physicians use, and its entirely based on the care that was given. If the MD had used propofol with no advanced airway supplies in the building, that could be considered a breach of standard of care. Talking **** about a patient who is under anesthesia is NOT a breach of standard of care.

I suspect it IS a breach of medical ethics, but that would be the realm of the state medical board to decided - not a court of law.

 

[VA Hopeful Dr]

Actually on this point re: patient bill of rights and required use of dignity and respectfulness, etc, NO. There is no difference, regardless of the educational background. LOL

WLG, this is well established, and I can only suggest you research it a lot more--talk to some reputable legal people--read more journal and legal/ethical books and articles on it. Look at case law. Refer to books on the combined establishment of BOTH LAW AND ETHICS--they do go together--in medicine in healthcare as well as business.

I just don't know what to say to you; b/c you seem incredibly recalcitrant in understanding the essence of patients' rights and standards of practice with regard to patient treatment.

I trust this will never be an issue for you. At the same time, you should not tolerate it as an issue from your colleagues--no matter what. Boys's club or not. Set the tone and speak out against this sort of thing. You are just as much a patient and family advocate as I am. And this is the expectation of all physicians and nurses and case managers for that matter. Advocacy.

Patient Bills of Rights have no effect on Standard of Care, which is what malpractice cases are about. This is 100% a medical ethics issues, and both us and the lawyers have our ethics dealt with by our licensing bodies not a jury trial.

 

[WholeLottaGame7]

Actually on this point re: patient bill of rights and required use of dignity and respectfulness, etc, NO. There is no difference, regardless of the educational background. LOL

WLG, this is well established, and I can only suggest you research it a lot more--talk to some reputable legal people--read more journal and legal/ethical books and articles on it. Look at case law. Refer to books on the combined establishment of BOTH LAW AND ETHICS--they do go together--in medicine in healthcare as well as business.

I just don't know what to say to you; b/c you seem incredibly recalcitrant in understanding the essence of patients' rights and standards of practice with regard to patient treatment.

I trust this will never be an issue for you. At the same time, you should not tolerate it as an issue from your colleagues--no matter what. Boys's club or not. Set the tone and speak out against this sort of thing. You are just as much a patient and family advocate as I am. And this is the expectation of all physicians and nurses and case managers for that matter. Advocacy.

I will take your word for the recalcitrant thing, because you seem to be an expert in the field. Though personally, I am starting to feel disrespected by your unwillingness or inability to read what I am saying. You seem to be a compassionate person, though, so I am willing to keep trying to help you out. To that end, I will repeat part of my earlier post in the hopes that with repetition, it will start to sink in.

One thing I learned from a conflict resolution/public apology class I took in undergrad (that I never thought would actually be useful), is that to have any meaningful discourse you have to be talking about the same thing. I (and many of the physicians on the thread) are talking about whether or not what the anesthesiologist did constitutes malpractice. You are talking about whether what she did was disrespectful and STANDARD OF PRACTICE and unprofessional.

 

[Stagg737]

I only have time to parse through one thing at a time Stagg. OK, so, ^ that was in direct response to someone that opened that door--i.e., the member named FFP. (Good name. I favor the careful use of FFP.) Anyway, it was a response to his/her (not sure) post.
OK. And once again, chalk it up to reading; but I stated in my response to FFP's comment to me that she/he opened that door. Do you see what I mean? He/she addressed that. I countered it in the same vein. That's it. You take issue w/ that, scroll past it.

Regardless, the golden rule is something that is pretty well accepted, and it would be utter insanity to take offense or go against the Golden Rule. You are kind of going out there in terms of your response with that. What's more, you, again, didn't understand the responsive context in which it was given.

As to your other points, well for now, only the part of what is law versus what people feel--you have missed it over and over, and I don't know how I can help you understand this.

Once more, standards of practice are what the law indeed looks at in litigation--specifically violation of them. Treating patients inhumanely, w/o respect, dignity, autonomy is both a violation in ethics and in law b/c of the expectation of following standards of practice. Treating patients w/ dignity at all phases of care and treatment is an accepted standard of practice; therefore the jury was well within it's place to render such a decision. And now that they have, it is another case on the books to support the accepted standards of practice; hence take great caution in how you communicate and treat patients at every point of interaction and at every phase of care--regardless of what their level of consciousness is. Furthermore, it would be wise to include that attitude toward patients' family members as well.

Treat patients and families in a less than respectful manner and be prepared to face consequences on perhaps multiple levels, and yes, that may well include legal consequences, depending upon the particulars and such.

There is no need to even fathom rationalizations or loopholes for this. It should be a given to treat patients and families with respect at all levels of care. You don't have to wine and dine them. Just treat them with respect and dignity through out all phases of care. That is the expectation--that is the standard. Violate that and be prepared to deal with consequences to your career and or bank account. Again, medical boards need to crack down on this as well. If they did a better job, perhaps outside legal options wouldn't be necessary. I don't know if you are aware of this but all this talk about litigation happy people is well overstated. Litigation is expensive, highly stressful, lengthy, and just a huge pain in the ass. Anyone with a ml of sanity would want to do anything they could to avoid it--and many people do--or they want to limit the pain of it such that they are often enough eager to settle out of court. Most people want to live their lives without that kind of added stress.

Good night.

I have a final tomorrow, so I'll address this more thoroughly later if needed, but standards of care (not standards of practice) involve the actual treatment administered, not whether you respected the patient or were nice to them. Those are 2 completely different things, only one of which is covered by law.

If you want to say that the physicians were disrespectful jerks to the patient then no one here is going to argue with you, and most of us agree that their actions deserve consequences. However, what you're arguing only applies to the moral and ethical aspect of this case and is irrelevant to the legal side of the argument. I would challenge you to find any piece of legislation or any case (other than this one) anywhere that states that a physician treating a non-psychological case must be respectful and kind to the patient, because as far as I've seen in medical bioethics classes those laws just don't exist.

 

[jl lin]

Patient Bills of Rights have no effect on Standard of Care, which is what malpractice cases are about. This is 100% a medical ethics issues, and both us and the lawyers have our ethics dealt with by our licensing bodies not a jury trial.

This is not correct:

"Initiating and Discontinuing the Patient–Physician Relationship
At the beginning of and throughout the patient–physician relationship, the physician must work toward an understanding of the patient's health problems, concerns, goals, and expectations. After patient and physician agree on the problem and the goals of therapy, the physician presents one or more courses of action. The patient may authorize the physician to initiate a course of action; the physician can then accept that responsibility. The relationship has mutual obligations. The physician must be professionally competent, act responsibly, seek consultation when necessary, and treat the patient with compassion and respect, and the patient should participate responsibly in the care, including giving informed consent or refusal to care as the case might be."--The American College of Physicians
http://www.acponline.org/running_practice/ethics/manual/manual6th.htm#initiating

And now that there is more in case law to support this, it something physicians should carefully consider more than ever.

Take note also:

https://www.fsbpt.org/Licensees/EthicalConduct/TenEasyWaystoLoseYourLicense.aspx


Arguing this is just a waste of time. It's beyond ridiculous.


More reading; but it is ridiculous to attempt to fight what you think is "the letter of the law" on this. How you treat a patient, including how you speak to them or about them is a part of YOUR PROFESSIONAL PRACTICE. It's troubling that you are attempting to argue heads on the end of a pin, rather than look at what is expected standards of professional practice. It's seriously troubling.


The following, submitted by David Goguen, J.D.:

[Emotional distress damages can be a major component of recovery in a personal injury case. If you are injured and file a successful lawsuit, you can get compensation for pain and suffering in addition to any economic damages (medical bills, lost wages, etc.) related to your injuries.

The amount and availability of non-economic damages such as emotional distress damages can vary greatly depending upon the nature of your injuries and the jurisdiction in which your personal injury lawsuit is filed. Even if you don’t file suit for your injuries, you may be able to negotiate a settlement with an insurance company that includes damages for emotional distress. Read on to learn more.

What are Emotional Distress Damages?
Emotional distress damages in a personal injury case are monetary damages designed to compensate you for the psychological impact your injury has had on your daily life. The list of manifestations of emotional distress is long and varied.

Sleep loss, anxiety, fear -- these all fall under the umbrella of emotional distress. So, too, do some cases of depression, crying jags, humiliation and fright. Emotional distress is a very subjective type of damage, and it changes from person to person. There is no hard and fast definition, so if you are experiencing psychological symptoms after an accident, note them (more on this in the next section). Those symptoms may be compensable. What is distressing to someone else may not be distressing to you, and vice versa.

Documenting Emotional Distress
If your injuries have reached a level that has spurred you to file a claim, it is likely that you’re seeking medical treatment (which is important for any injury claim in general). Tell your doctor about any psychological symptoms you’ve experienced since the accident that caused your injuries. Medically documented emotional distress is a powerful tool in both lawsuits and claims with an insurance company.

It's also a good idea to keep a daily journal or diary in which you record how you're feeling in light of the accident and your injuries, and the (big and small) ways in which your life is affected.

The more evidence of your emotional distress you can assemble, the stronger your claim will be and the higher the likelihood of recovery.

Does the Severity of My Emotional Distress Matter?
In a word, yes. It is safe to say that everyone experiences a degree of emotional distress after an injury. The severity of your emotional distress has a direct impact upon your potential for recovery. As a result, it is important to document any feelings your're having, through a medical provider if at all possible.

Generally speaking, you’ll need to show that your emotional stress is ongoing, affects the basic way you go about your life, and is directly related to the physical injuries the defendant caused you to suffer. While people with pre-existing psychological conditions are not precluded from collecting emotional distress damages in a personal injury claim, it is far easier to do so if you can definitively show that your emotional distress did not begin until after your accident.

Intentional Infliction of Emotional Distress
In some cases, you may wish to include a separate claim for intentional infliction of emotional distress. While not as common as a simple claim for emotional distress damages, in some personal injury cases (particularly auto negligence cases) you may be able to prove that the defendant was either "grossly" negligent or clearly intended to cause emotional distress as well as physical harm. Road rage cases are prime candidates for separate emotional distress causes of action. In these types of cases, your recovery for emotional distress could be significantly higher.

Emotional Distress and Damage Caps
Many states now have laws limiting how much you can be paid for non-economic damages, including emotional distress. Depending on the severity of your injury, the type of case, and the law of your particular jurisdiction, you may find that emotional distress damages aren’t even an option. In no-fault states, for example, you will commonly find that all non-economic damages are subject to statutory caps.

Emotional distress is a very real result of being injured. While there is, in certain circles, a healthy portion of skepticism heaped upon any claim for emotional distress, the fact of the matter is that physical injuries very often have serious psychological ramifications. Fear of driving after a car accident, agoraphobia after an assault and depression during a long rehabilitation -- these emotional conditions are real and distressing, and they are also compensable as part of your injury claim.]

 

[jl lin]

BTW VA, Sadly, the licensing board has not put sanctions or actions against these doctors--the most distressing is the failure of them to do so w/ re: to the anesthesiologist.

Again, medicine and this woman's colleagues at the institution/hospital, failed to carefully police their own. If medicine or the board won't do it; it is CERTAINLY right to do so through civil law. Again, thankfully, this one is on the books now.

The answer isn't to hide away from proper documenting (even highly technological documenting, such as audio-video). Neither is it to blow it off or cover up or ignore the poor conduct of your colleague. The jury had the right to render the decision it did, and it shows prudence on their part that they did.

Police yourselves of such grievous breaches in standards of practice.

 

[IlDestriero]

You have to go way, way across the line for anyone to even consider action at the level of the medical board. Much more likely would be internal sanctions or revoking privileges at the local level. This case should have been handled locally and by the state medical board in my opinion and not the court. I suspect that you don't get the med board newsletters where they list the sanctions to see what they get involved with. There are a lot of "bad" physicians out there.
I will never agree, no matter how ridiculous this case was, that the verbal abuse component of the case was malpractice. It has a definition and required components, and I don't think you understand it, and I don't think the verbal abuse, defamation, etc. met the criteria. And not having read the actual text of the ruling, I'm not sure they considered it malpractice either. Plenty of arrogant dickholes have fantastic careers in surgery and I'm sure legions of patients will say "he's a real ass hole, but he's a great surgeon" and recommend them to their neighbors.

I don't buy what you're shoveling.
Feel free to put me on ignore without notice btw.

There is one other reason to be nice, patients tend to not sue physicians that they like, even when they may have a case. I have a great story that illustrates that clearly, 2 actually, but I can't post them here. The take home point in both is that there were bad outcomes and the families chose to pursue litigation against the "less personable" physicians and not the ones they liked, who would have made an easier target because their actions were linked to the downward spiral that lead to the bad outcome. Being nice, direct, affable, etc. kept them from being sued, without question. I have no doubt that their attorney pointed out that they would be an easier target repeatedly, yet they were not named.
We will see how this does on appeal.

PS your quoted text above deals with personal injury cases which is not the same as malpractice.

 

[WholeLottaGame7]

PS your quoted text above deals with personal injury cases which is not the same as malpractice.

I'm pretty sure she doesn't know what malpractice actually is, which is where all this confusion is coming from. I presume that ji lin has ignored me by now, as well, as part of her quest to block everyone that disagrees with her. But if you're still reading this, I want you to know that I agree with your stance on physician behavior. The Golden Rule is one of the earliest things my parents imparted to me, and a good life philosophy in general, medicine notwithstanding. But the rest of us have grown up and realized that morality does not always equal legality. I believe murder is immoral and it is illegal. I believe adultery is immoral but it is not illegal. If you want to live in a society where morality and legality are one in the same, well, those places exist. But not here.

Back to the matter at hand: this does seem like something that should have been settled with a report to the state medical board and maybe a private settlement by the anesthesia company/surgery center. That it was not also makes me think there was an ulterior motive on behalf of the plaintiff. I do wonder why the anesthesiologist would fight the case given how damning the evidence was, however. I presume she figured she would not be charged with malpractice, but would you want to risk your career having that type of behavior aired out in public?

 

[charmiedermie]

You have to go way, way across the line for anyone to even consider action at the level of the medical board. Much more likely would be internal sanctions or revoking privileges at the local level. This case should have been handled locally and by the state medical board in my opinion and not the court. I suspect that you don't get the med board newsletters where they list the sanctions to see what they get involved with. There are a lot of "bad" physicians out there.
I will never agree, no matter how ridiculous this case was, that the verbal abuse component of the case was malpractice. It has a definition and required components, and I don't think you understand it, and I don't think the verbal abuse, defamation, etc. met the criteria.

But what about the false diagnosis she put down of hemorrhoids, "I’m going to mark hemorrhoids even though we don’t see them and probably won’t. I'm just going to take a shot in the dark."? It might be normal to where everyone has it, but on the tape she's clearly saying that it wasn't even seen. I'm assuming if it was seen the GI doc would have noted it. Does that not count at all towards the malpractice verdict, as they probably falsely billed for that diagnosis also?

 

[67552931811]

Nvm

 

[67552931811]

/

Its not emotion. That is what YOU REFUSE to get. It is based in accepted and expected STANDARDS OF PRACTICE! HELLO!!!!!

I am very sorry that you and some others are missing the fact that abusive treatment--any type of abusive treatment is indeed malpractice. Unless there was an EMTALA issue, this ologist would have been FAR better off refusing to take this patient's case.

All points of care require adherence to and respect for patient dignity, autonomy, and decency in treatment as HUMAN BEINGS. This is, without question, without deviation, the STANDARD OF PRACTICE. The law will look at deviations from the standards of practice. This ologist's violations of these standards were so obvious and grievous, nonetheless, the jury made a compromise. The plaintiff didn't get the whole 1.7 mil or so. She got a SIGNIFICANT REDUCTION.

Practioners will and should be held accountable on all levels of care THROUGHOUT THE ENTIRE COURSE OF CARE AND TREATMENT. Gees, I just can't emphasize this enough to get through the wall that is blocking this in some folks' minds.

The jury's rendering was on target. It is another one now on the books. It is now a part of case law. There is nothing else to say about this.

If you feel that it is too grievous for you to treat patients, even difficult ones, with dignity and respect throughout the whole spectrum of healthcare, then I have to tell you that you have chosen the wrong field. It is just that simple. This is not complicated--at all. Not even a little.

Skip the emotional crap you are interjecting. It is the standard of practice that will be viewed and expected to be held by the courts. I don't know why you are having trouble with this. This is also core for public policy. LOL. Again no one is expecting you to be best friends with your patients and families. There are professional boundaries that need to be upheld in clear balance--they should not go too far either way---i.e., getting too emotionally involved with patients and families versus being devoid of basic respect, human dignity and autonomy.

Be professional. Exercise sound judgment in both direct care and scope of practice AS WELL AS RESPECTFUL TREATMENT OF PATIENTS AND FAMILIES. IF any doctor does this, in all probability and demonstrated statistics, he, she, they will not have a problem!

Be wise in this. Sometimes it's tough with certain patients. Sometimes you want to vent and as humans we can get annoyed with certain patients and families. Trust me, I so totally get that.

At the end of the day, our feelings of frustration leading to disrespect and deficiency in application of dignity and respect for patient autonomy do NOT trump that of the patients continued right to those things.

Again, unless it's an EMTALA patient--and for those, I have to say, I have a lot more tolerance for the ED docs and what they often have to put up with--but anyway, if you have the ability to choose to not take on certain patients b/c you don't think you can deal with them, then just DON'T. If you do accept them under your care and you lose it--especially in the extremely obnoxious and uncalled for way that this ologist did, there is INDEED legal justification for you getting an extreme penalty. Again, remember, this ologist didn't get the full penalty asked for by the attorney and plantiff. She got way less than half.

What is beyond shameful is that the board of medical examiners has not put any sanctions on these two physicians. They totally deserve it. If this was a nurse/nurses, you better believe he or she or they would have had sanctions listed against him/her. Why should the standards of dignified practice be any less for physicians--of all people? That's just insane.

It boggles my mind that some physicians want more respect and limit to midlevel overstep (understandable, mind you), yet they don't get the very basic, most fundamental aspects and standards of practice. In this case, NO! You don't get to have it both ways. Why should you?

But the law will not side with your perspective, and indeed for the stake of patients, the public, and your profession, it should NOT.

How do you have so much time to post novel length responses? Must be slow on the floor at your shop, eh? Or, do you just ignore the patients yelling "nurse" like every other RN?

 

[DrOwnage]

I honestly don't know how this whole escapade wasn't considered entrapment. Also has anyone asked the question how this guy was able to have his phone with him in the room in the first place. Doesn't he strip down to a gown?

Step 1. Act like a douche/whiny patient
Step 2. Record anesthesiologist who talks #$%^ (as anyone in any profession does about any of their clientele, lets be honest)
Step 3. Profit.
Step 4. Send a message of entitlement to every American and raise the cost of health care.

This Anesthesiologist was in the wrong, but when this guy gets another colonoscopy 10 years from now I hope they perforate his a$$hole with the scope.

 

[jl lin]

How do you have so much time to post novel length responses? Must be slow on the floor at your shop, eh? Or, do you just ignore the patients yelling "nurse" like every other RN?

I type fast. Always have. Not w/o a ton of typos though. Gratis work today, totally gratis--and that is for one stable patient.

I won't ask why you asked this irrelevant question. That's pretty obvious and not really cool. And how long does it take to review and quote and paste to post? Much of my work in certain programs was pretty database research and writing intensive...but whatever.

Thanks for asking. . .I. . .um. . .guess.

 

[jl lin]

I'm pretty sure she doesn't know what malpractice actually is, which is where all this confusion is coming from. I presume that ji lin has ignored me by now, as well, as part of her quest to block everyone that disagrees with her. But if you're still reading this, I want you to know that I agree with your stance on physician behavior. The Golden Rule is one of the earliest things my parents imparted to me, and a good life philosophy in general, medicine notwithstanding. But the rest of us have grown up and realized that morality does not always equal legality. I believe murder is immoral and it is illegal. I believe adultery is immoral but it is not illegal. If you want to live in a society where morality and legality are one in the same, well, those places exist. But not here.

Back to the matter at hand: this does seem like something that should have been settled with a report to the state medical board and maybe a private settlement by the anesthesia company/surgery center. That it was not also makes me think there was an ulterior motive on behalf of the plaintiff. I do wonder why the anesthesiologist would fight the case given how damning the evidence was, however. I presume she figured she would not be charged with malpractice, but would you want to risk your career having that type of behavior aired out in public?

I am pretty sure I do; and I am pretty sure some medical-based JDs do as well.

I do not block everyone who disagrees w/ me. You have made points, and I don't find them as somehow arguing just for the sake of arguing or trolling. What I do feel is that you seem to refuse to accept patient treatment--communicative and otherwise--as part of practice, and falling short of that significantly enough will potentially get you into a malpractice/litigation situation. Do what you want. Believe what you want. Enough of this info is out that to support this and support the justification for this case and the legal remedy. The Golden Rule was thrown in there by way of another person's comments as well--but it's not a bad idea to follow. I mean it's not too hard to see that is a core aspect of empathetic respect. You want to be treated with respect, dignity, autonomy, no? You want to trust you healthcare providers--whether you are in a chemically induced state of unconsciousness or some other reason for your unconscious state, correct?

I see no need to continue on with this; b/c really, what else can be said? It has nothing to do with you personally or whether or not I agree with you. Standards of practice are looked at in law suits and practicing standards of respect are accepted and expected.

Good luck in your fellowship. I honestly wish you the best.

 

[jl lin]

I honestly don't know how this whole escapade wasn't considered entrapment. Also has anyone asked the question how this guy was able to have his phone with him in the room in the first place. Doesn't he strip down to a gown?

Step 1. Act like a douche/whiny patient
Step 2. Record anesthesiologist who talks #$%^ (as anyone in any profession does about any of their clientele, lets be honest)
Step 3. Profit.
Step 4. Send a message of entitlement to every American and raise the cost of health care.

This Anesthesiologist was in the wrong, but when this guy gets another colonoscopy 10 years from now I hope they perforate his a$$hole with the scope.

So terribly sad. Wow.

 

[pd1112]

There are a number of reasons as to why your statements are incorrect. At the very least, this for now should suffice:

It (aforementioned rights and expectation of rights) and standard of practice are written into every single patient bill of rights for every hospital or healthcare institution. These exist in every hospital and health organization, and in that alone, it is a given expectation for the standard of practice--as well as what the boards of medicine have set as standard. Now,privileges to work at these facilities means you as a healthcare provider agree to practice within those standards. And regardless there is case law for it. So . . .

That's all I can address for now.

Then why did you try to apply things that don't apply in lieu of ones that do? All it did was give your comments less credit than they would otherwise have, which, judging by the numerous posts opposing you in this thread alone, appears to already be astoundingly low.

This is not correct:

"Initiating and Discontinuing the Patient–Physician Relationship
At the beginning of and throughout the patient–physician relationship, the physician must work toward an understanding of the patient's health problems, concerns, goals, and expectations. After patient and physician agree on the problem and the goals of therapy, the physician presents one or more courses of action. The patient may authorize the physician to initiate a course of action; the physician can then accept that responsibility. The relationship has mutual obligations. The physician must be professionally competent, act responsibly, seek consultation when necessary, and treat the patient with compassion and respect, and the patient should participate responsibly in the care, including giving informed consent or refusal to care as the case might be."--The American College of Physicians
http://www.acponline.org/running_practice/ethics/manual/manual6th.htm#initiating

And now that there is more in case law to support this, it something physicians should carefully consider more than ever.

Take note also:

https://www.fsbpt.org/Licensees/EthicalConduct/TenEasyWaystoLoseYourLicense.aspx


Arguing this is just a waste of time. It's beyond ridiculous.


More reading; but it is ridiculous to attempt to fight what you think is "the letter of the law" on this. How you treat a patient, including how you speak to them or about them is a part of YOUR PROFESSIONAL PRACTICE. It's troubling that you are attempting to argue heads on the end of a pin, rather than look at what is expected standards of professional practice. It's seriously troubling.


The following, submitted by David Goguen, J.D.:

[Emotional distress damages can be a major component of recovery in a personal injury case. If you are injured and file a successful lawsuit, you can get compensation for pain and suffering in addition to any economic damages (medical bills, lost wages, etc.) related to your injuries.

The amount and availability of non-economic damages such as emotional distress damages can vary greatly depending upon the nature of your injuries and the jurisdiction in which your personal injury lawsuit is filed. Even if you don’t file suit for your injuries, you may be able to negotiate a settlement with an insurance company that includes damages for emotional distress. Read on to learn more.

What are Emotional Distress Damages?
Emotional distress damages in a personal injury case are monetary damages designed to compensate you for the psychological impact your injury has had on your daily life. The list of manifestations of emotional distress is long and varied.

Sleep loss, anxiety, fear -- these all fall under the umbrella of emotional distress. So, too, do some cases of depression, crying jags, humiliation and fright. Emotional distress is a very subjective type of damage, and it changes from person to person. There is no hard and fast definition, so if you are experiencing psychological symptoms after an accident, note them (more on this in the next section). Those symptoms may be compensable. What is distressing to someone else may not be distressing to you, and vice versa.

Documenting Emotional Distress
If your injuries have reached a level that has spurred you to file a claim, it is likely that you’re seeking medical treatment (which is important for any injury claim in general). Tell your doctor about any psychological symptoms you’ve experienced since the accident that caused your injuries. Medically documented emotional distress is a powerful tool in both lawsuits and claims with an insurance company.

It's also a good idea to keep a daily journal or diary in which you record how you're feeling in light of the accident and your injuries, and the (big and small) ways in which your life is affected.

The more evidence of your emotional distress you can assemble, the stronger your claim will be and the higher the likelihood of recovery.

Does the Severity of My Emotional Distress Matter?
In a word, yes. It is safe to say that everyone experiences a degree of emotional distress after an injury. The severity of your emotional distress has a direct impact upon your potential for recovery. As a result, it is important to document any feelings your're having, through a medical provider if at all possible.

Generally speaking, you’ll need to show that your emotional stress is ongoing, affects the basic way you go about your life, and is directly related to the physical injuries the defendant caused you to suffer. While people with pre-existing psychological conditions are not precluded from collecting emotional distress damages in a personal injury claim, it is far easier to do so if you can definitively show that your emotional distress did not begin until after your accident.

Intentional Infliction of Emotional Distress
In some cases, you may wish to include a separate claim for intentional infliction of emotional distress. While not as common as a simple claim for emotional distress damages, in some personal injury cases (particularly auto negligence cases) you may be able to prove that the defendant was either "grossly" negligent or clearly intended to cause emotional distress as well as physical harm. Road rage cases are prime candidates for separate emotional distress causes of action. In these types of cases, your recovery for emotional distress could be significantly higher.

Emotional Distress and Damage Caps
Many states now have laws limiting how much you can be paid for non-economic damages, including emotional distress. Depending on the severity of your injury, the type of case, and the law of your particular jurisdiction, you may find that emotional distress damages aren’t even an option. In no-fault states, for example, you will commonly find that all non-economic damages are subject to statutory caps.

Emotional distress is a very real result of being injured. While there is, in certain circles, a healthy portion of skepticism heaped upon any claim for emotional distress, the fact of the matter is that physical injuries very often have serious psychological ramifications. Fear of driving after a car accident, agoraphobia after an assault and depression during a long rehabilitation -- these emotional conditions are real and distressing, and they are also compensable as part of your injury claim.]

See above. More random googling. More commentaries/editorials/sources that don't apply. So, I'm curious: when you don't understand malpractice laws in a profession outside of your own, do you try to or even want to understand in order to not continually make yourself seem incapable of basic comprehension of what members of that profession are explaining to you, or do you skip that and consciously decide to continue to tell them that you're right and they're wrong?

 

[deleted500612]

But what about the false diagnosis she put down of hemorrhoids, "I’m going to mark hemorrhoids even though we don’t see them and probably won’t. I'm just going to take a shot in the dark."? It might be normal to where everyone has it, but on the tape she's clearly saying that it wasn't even seen. I'm assuming if it was seen the GI doc would have noted it. Does that not count at all towards the malpractice verdict, as they probably falsely billed for that diagnosis also?

Medical malpractice is defined as "any act or omission by a physician during treatment of a patient that deviates from accepted norms of practice in the medical community and causes harm to the patient." If the patient was not harmed as a result of the breach in standard of care, then by definition medical malpractice did not occur. Similarly, false billings would be classified as fraud and not malpractice.

 

[Psai]

How do you have so much time to post novel length responses? Must be slow on the floor at your shop, eh? Or, do you just ignore the patients yelling "nurse" like every other RN?

the weirdest thing is that she has time to write out ten paragraphs but somehow is unable to write out the word anesthesiologist, instead putting ologist (wtf?)

 

[VA Hopeful Dr]

This is not correct:

"Initiating and Discontinuing the Patient–Physician Relationship
At the beginning of and throughout the patient–physician relationship, the physician must work toward an understanding of the patient's health problems, concerns, goals, and expectations. After patient and physician agree on the problem and the goals of therapy, the physician presents one or more courses of action. The patient may authorize the physician to initiate a course of action; the physician can then accept that responsibility. The relationship has mutual obligations. The physician must be professionally competent, act responsibly, seek consultation when necessary, and treat the patient with compassion and respect, and the patient should participate responsibly in the care, including giving informed consent or refusal to care as the case might be."--The American College of Physicians
http://www.acponline.org/running_practice/ethics/manual/manual6th.htm#initiating

And now that there is more in case law to support this, it something physicians should carefully consider more than ever.

Take note also:

https://www.fsbpt.org/Licensees/EthicalConduct/TenEasyWaystoLoseYourLicense.aspx


Arguing this is just a waste of time. It's beyond ridiculous.


More reading; but it is ridiculous to attempt to fight what you think is "the letter of the law" on this. How you treat a patient, including how you speak to them or about them is a part of YOUR PROFESSIONAL PRACTICE. It's troubling that you are attempting to argue heads on the end of a pin, rather than look at what is expected standards of professional practice. It's seriously troubling.


The following, submitted by David Goguen, J.D.:

[Emotional distress damages can be a major component of recovery in a personal injury case. If you are injured and file a successful lawsuit, you can get compensation for pain and suffering in addition to any economic damages (medical bills, lost wages, etc.) related to your injuries.

The amount and availability of non-economic damages such as emotional distress damages can vary greatly depending upon the nature of your injuries and the jurisdiction in which your personal injury lawsuit is filed. Even if you don’t file suit for your injuries, you may be able to negotiate a settlement with an insurance company that includes damages for emotional distress. Read on to learn more.

What are Emotional Distress Damages?
Emotional distress damages in a personal injury case are monetary damages designed to compensate you for the psychological impact your injury has had on your daily life. The list of manifestations of emotional distress is long and varied.

Sleep loss, anxiety, fear -- these all fall under the umbrella of emotional distress. So, too, do some cases of depression, crying jags, humiliation and fright. Emotional distress is a very subjective type of damage, and it changes from person to person. There is no hard and fast definition, so if you are experiencing psychological symptoms after an accident, note them (more on this in the next section). Those symptoms may be compensable. What is distressing to someone else may not be distressing to you, and vice versa.

Documenting Emotional Distress
If your injuries have reached a level that has spurred you to file a claim, it is likely that you’re seeking medical treatment (which is important for any injury claim in general). Tell your doctor about any psychological symptoms you’ve experienced since the accident that caused your injuries. Medically documented emotional distress is a powerful tool in both lawsuits and claims with an insurance company.

It's also a good idea to keep a daily journal or diary in which you record how you're feeling in light of the accident and your injuries, and the (big and small) ways in which your life is affected.

The more evidence of your emotional distress you can assemble, the stronger your claim will be and the higher the likelihood of recovery.

Does the Severity of My Emotional Distress Matter?
In a word, yes. It is safe to say that everyone experiences a degree of emotional distress after an injury. The severity of your emotional distress has a direct impact upon your potential for recovery. As a result, it is important to document any feelings your're having, through a medical provider if at all possible.

Generally speaking, you’ll need to show that your emotional stress is ongoing, affects the basic way you go about your life, and is directly related to the physical injuries the defendant caused you to suffer. While people with pre-existing psychological conditions are not precluded from collecting emotional distress damages in a personal injury claim, it is far easier to do so if you can definitively show that your emotional distress did not begin until after your accident.

Intentional Infliction of Emotional Distress
In some cases, you may wish to include a separate claim for intentional infliction of emotional distress. While not as common as a simple claim for emotional distress damages, in some personal injury cases (particularly auto negligence cases) you may be able to prove that the defendant was either "grossly" negligent or clearly intended to cause emotional distress as well as physical harm. Road rage cases are prime candidates for separate emotional distress causes of action. In these types of cases, your recovery for emotional distress could be significantly higher.

Emotional Distress and Damage Caps
Many states now have laws limiting how much you can be paid for non-economic damages, including emotional distress. Depending on the severity of your injury, the type of case, and the law of your particular jurisdiction, you may find that emotional distress damages aren’t even an option. In no-fault states, for example, you will commonly find that all non-economic damages are subject to statutory caps.

Emotional distress is a very real result of being injured. While there is, in certain circles, a healthy portion of skepticism heaped upon any claim for emotional distress, the fact of the matter is that physical injuries very often have serious psychological ramifications. Fear of driving after a car accident, agoraphobia after an assault and depression during a long rehabilitation -- these emotional conditions are real and distressing, and they are also compensable as part of your injury claim.]

OK, let me lay this out for you. You are not a physician and clearly don't understand how things work in our world. I don't mean this in a condescending way, just laying it out there.

First, the ACP has absolutely no power over physicians. They are a specialty society (think of it like the Rotary Club for internists), they don't even have as much power as the ABIM - which still can't really discipline physicians. They can suggest how we should act, but that's about it. In fact my specialty board (not society, but board) the ABFM leaves the "Professionalism" part of my board certifications entirely up to the state(s) where I am licensed.

Second, your second link (about losing a license) is exactly my point. The state medical boards (or the state bar if you're a lawyer) are the ones who deal with ethical issues. Your over-capitalized "Professional Practice" is exactly what the state boards are designed to police.

Third, I don't think many of us would have argued about an emotional distress lawsuit. I think it would have been somewhat frivolous, but I wouldn't have had any problem with it by a legal standpoint like I do with calling this malpractice.

Fourth, about this being case law - I bet if this gets appealed if will get shot down. I have no issue with this MD getting punished, but a malpractice suit isn't the way to go about it.

 

[VA Hopeful Dr]

BTW VA, Sadly, the licensing board has not put sanctions or actions against these doctors--the most distressing is the failure of them to do so w/ re: to the anesthesiologist.

Again, medicine and this woman's colleagues at the institution/hospital, failed to carefully police their own. If medicine or the board won't do it; it is CERTAINLY right to do so through civil law. Again, thankfully, this one is on the books now.

The answer isn't to hide away from proper documenting (even highly technological documenting, such as audio-video). Neither is it to blow it off or cover up or ignore the poor conduct of your colleague. The jury had the right to render the decision it did, and it shows prudence on their part that they did.

Police yourselves of such grievous breaches in standards of practice.

I bet the patient in question never reported the doctor to the board. Most medical boards wont'/can't investigate something without a complaint.

The problem with policing ourselves, barring just God-awful stuff, is that you then worry about with reprisals. Its also a matter of maybe the doctor in question was just having a really bad day and isn't usually like this. If you report them, what's to stop them from doing the same to you if you just have a really bad day? We are still human and we do make honest mistakes sometimes.

 

[WholeLottaGame7]

I am pretty sure I do; and I am pretty sure some medical-based JDs do as well.

I do not block everyone who disagrees w/ me. You have made points, and I don't find them as somehow arguing just for the sake of arguing or trolling. What I do feel is that you seem to refuse to accept patient treatment--communicative and otherwise--as part of practice, and falling short of that significantly enough will potentially get you into a malpractice/litigation situation. Do what you want. Believe what you want. Enough of this info is out that to support this and support the justification for this case and the legal remedy. The Golden Rule was thrown in there by way of another person's comments as well--but it's not a bad idea to follow. I mean it's not too hard to see that is a core aspect of empathetic respect. You want to be treated with respect, dignity, autonomy, no? You want to trust you healthcare providers--whether you are in a chemically induced state of unconsciousness or some other reason for your unconscious state, correct?

I see no need to continue on with this; b/c really, what else can be said? It has nothing to do with you personally or whether or not I agree with you. Standards of practice are looked at in law suits and practicing standards of respect are accepted and expected.

Good luck in your fellowship. I honestly wish you the best.

Maybe you do understand, but your responses in this thread suggest otherwise. You continue to perseverate on patient treatment and the lack thereof getting you into trouble, when that is only a portion of the definition of malpractice. It would be a much more interesting and relevant discussion to continue talking about whether or not the patient actually suffered any actual long-term consequences from the anesthesiologist's actions.

For instance, if I induce a patient in the operating room without an ambu-bag or suction, then I have violated 2 out of the 3 parts necessary for malpractice. There was a standard of care (to have certain equipment and backup equipment in the room), and I violated that standard of care. If the patient then aspirated and developed ARDS, or there was a power failure and I couldn't ventilate the patient, then those would be open for a malpractice case. If, however, everything goes like it usually does, and I intubate the patient without incident, I notice the missing equipment and get it in the room, and the case proceeds uneventfully, then that is not a malpractice case. Even though the vast majority of my colleagues would agree that I violated the standard of care.

Does that make more sense?

 

[IlDestriero]

the weirdest thing is that she has time to write out ten paragraphs but somehow is unable to write out the word anesthesiologist, instead putting ologist (wtf?)

It's not even clear as there are a lot of -ologists in the hospital, including the gastroenter-ologist involved in this case. It's probably a not so clever slang she picked up on the job.

 

[jl lin]

Medical malpractice is defined as "any act or omission by a physician during treatment of a patient that deviates from accepted norms of practice in the medical community and causes harm to the patient." If the patient was not harmed as a result of the breach in standard of care, then by definition medical malpractice did not occur. Similarly, false billings would be classified as fraud and not malpractice.

Abuse is harmful treatment.

 

[jl lin]

OK, let me lay this out for you. You are not a physician and clearly don't understand how things work in our world. I don't mean this in a condescending way, just laying it out there.

First, the ACP has absolutely no power over physicians. They are a specialty society (think of it like the Rotary Club for internists), they don't even have as much power as the ABIM - which still can't really discipline physicians. They can suggest how we should act, but that's about it. In fact my specialty board (not society, but board) the ABFM leaves the "Professionalism" part of my board certifications entirely up to the state(s) where I am licensed.

Second, your second link (about losing a license) is exactly my point. The state medical boards (or the state bar if you're a lawyer) are the ones who deal with ethical issues. Your over-capitalized "Professional Practice" is exactly what the state boards are designed to police.

Third, I don't think many of us would have argued about an emotional distress lawsuit. I think it would have been somewhat frivolous, but I wouldn't have had any problem with it by a legal standpoint like I do with calling this malpractice.

Fourth, about this being case law - I bet if this gets appealed if will get shot down. I have no issue with this MD getting punished, but a malpractice suit isn't the way to go about it.

You have missed it repeatedly. It doesn't matter if you are a licensed physician in that you clearly don't understand. I can't help you to understand. Do the research on your own. I have a licensing board over me as well, so indeed I do understand.

Also, I find it hard to believe that the facility or the plantiff/his rep, did n't make a formal c/o to the ME board.

 

[VA Hopeful Dr]

You have missed it repeatedly. It doesn't matter if you are a licensed physician in that you clearly don't understand. I can't help you to understand. Do the research on your own. I have a licensing board over me as well, so indeed I do understand.

Also, I find it hard to believe that the facility or the plantiff/his rep, did n't make a formal c/o to the ME board.

I have done the research, its required to get a medical license in my state. Your research that you posted was just flat out incorrect in terms of disciplining doctors.
Let me try and make this simple for you.

This was not malpractice. It was unethical but not malpractice. The jury got it wrong. If its appealed, I'd be shocked if its not overturned.

Ethical violations are handled by the state medical boards. Individual hospitals can also take action if they choose. Medical societies can do nothing to discipline members.

Look up the Virginia Medical Board and you can see if there was any action taken against this doctor.

 

[VA Hopeful Dr]

Abuse is harmful treatment.

Abuse is not treatment in the malpractice sense. You could maybe make that argument for a psychiatrist, but not really anyone else.

Medical treatment is different from social treatment.

 

[jl lin]

Maybe you do understand, but your responses in this thread suggest otherwise. You continue to perseverate on patient treatment and the lack thereof getting you into trouble, when that is only a portion of the definition of malpractice. It would be a much more interesting and relevant discussion to continue talking about whether or not the patient actually suffered any actual long-term consequences from the anesthesiologist's actions.

For instance, if I induce a patient in the operating room without an ambu-bag or suction, then I have violated 2 out of the 3 parts necessary for malpractice. There was a standard of care (to have certain equipment and backup equipment in the room), and I violated that standard of care. If the patient then aspirated and developed ARDS, or there was a power failure and I couldn't ventilate the patient, then those would be open for a malpractice case. If, however, everything goes like it usually does, and I intubate the patient without incident, I notice the missing equipment and get it in the room, and the case proceeds uneventfully, then that is not a malpractice case. Even though the vast majority of my colleagues would agree that I violated the standard of care.T

Does that make more sense?

Listen, you need to talk with the attorney and jurors over this case. I can't continue back and forth in this forever. I do, however, respect the fact that you have taken a respectful, reasonable tone, and that''s a superb example to your colleagues.

It's a part of case law. Do you actually think this physician is going to appeal, and if she does, do you actually think she will win?

There are public policy issues here to consider. Yes, she actually harmed the patient--all harm is not physical harm. With such hateful commentary and plotting and malicious statements, I think that is a red flag about how this physician needs help or needs to be monitored very closely in the future.

The ruling will stand, and it should. It should stand to make it clear to those that otherwise don't get it--that don't get that the impact of what they say and how they treat families and patients matters. Again, a public policy matter. Do you actually think any patient would want such a physician treating them? Really?

There is a boy's club, and it is problematic. I don't think it is necessarily as bad as it used to be, but that varies I suppose. If the department of HHS mandates dignified, humane, and respectful treatment of patients at all points of care, WHY in the world would you expect the standard of practice for physicians to be any less? Just think about this. Yes, it is a public policy issue as well.

 

[jl lin]

Abuse is not treatment in the malpractice sense. You could maybe make that argument for a psychiatrist, but not really anyone else.

Medical treatment is different from social treatment.

This is completely and absolutely untrue. Seriously, do more education on this. I can't help you with it.

 

[jw3600]

I really don't know how I managed to be on SDN for several years and never notice this poster before. This is the second thread this week that jl lin has annihilated with wall of texts posts using strange diction and analogies I personally do not think she understands.

 

[Psai]

I believe she has been going on ranting rampages ever since that thread about the case western guy who was punished for a rape allegation but it could be earlier than that.
I'm just shocked that you guys have the patience to explain the same basic concepts over and over to someone who not only does not understand them but refuses to do so.
She's a premed who hasn't even applied to medical school yet, not even a physician or a lawyer, but seems to think she knows better about medical standards and malpractice

 

[deleted500612]

This is completely and absolutely untrue. Seriously, do more education on this. I can't help you with it.

Abuse is harmful treatment.

Have you even taken a medical ethics course? The "emotional abuse" of a doctor making rude comments does NOT constitute malpractice. Sorry but you simply have no clue what you are talking about here.

 

[WholeLottaGame7]

It's a part of case law. Do you actually think this physician is going to appeal, and if she does, do you actually think she will win?

I don't know how the appeals process works, so I'm not sure. I would guess no. I think this plaintiff was very smart (being a lawyer and all), and covered all his bases. He knew to go see a psychologist/psychiatrist and start on meds, which would substantiate his "emotional damages" claim. I'm more curious to see what he is doing in a year or two or three, and see if he is unemployed, still seeing a shrink, on meds, etc, or is he back at work lawyering?

Could it all be legit? Of course. The fact that I suspect it is not is based on a pessimistic/realistic view of the world, while yours seems to be more optimistic. Fair enough, we need people with rose-colored glasses running around to balance everything out. Some of it is also based on my past experiences/training. If I recall, you are an ICU nurse, so most of your patients have legitimate medical/surgical issues. There might be a little bit of malingering on the edges, but they have real problems underneath.

Meanwhile, in medical school, and internship, and definitely in chronic pain clinic, you see all sorts of "fabricated" medical problems. People who walked up 4 flights of stairs to ask for disability and a powered wheelchair, asking you to falsify worker's comp paperwork, etc etc. I'm not saying these people don't have problems, but it's an underlying psych/social/cultural issue and not the medical one that they are claiming and that a physician is going to be able to help them with. And that's coming from someone who is trained in anesthesia. The FM, IM, OB/GYN, surgeons on here (and who have also chimed in) have seen all that and more, which is why there are a lot of other pessimistic people posting.

Trust me, the majority of physicians are compassionate, professional human beings. Obviously not all of us are, or this wouldn't be an issue. But neither are all nurses, airline pilots, firefighters, teachers, preachers, politicians, or lawyers. You can argue that there is a higher standard for physicians, and I agree with you, and I think there is, but it is never going to be 100%.

 

[WholeLottaGame7]

I believe she has been going on ranting rampages ever since that thread about the case western guy who was punished for a rape allegation but it could be earlier than that.
I'm just shocked that you guys have the patience to explain the same basic concepts over and over to someone who not only does not understand them but refuses to do so.
She's a premed who hasn't even applied to medical school yet, not even a physician or a lawyer, but seems to think she knows better about medical standards and malpractice

She is an ICU nurse, so has some medical knowledge. And I would say personality-wise she is not atypical for a lot of nurses that you will meet in your training. They will misunderstand you, question you (sometimes appropriately, sometimes not), they will ignore you, they will go around or behind you, they will antagonize you. Same for patients. It's not all malignant or intentional, but it exists nonetheless and you have to decide how you're going to respond. And how you decide will dictate what your work- and patient-relationships will be like, what your evals will be like, and what the public and program perception of you will be like.

My general philosophy is that if I have the time, I try to explain as much as I can. Not only is it the professional thing to do, it helps educate people and avoid future problems for you (and your colleagues) down the road. Now, it's not always possible, given how busy you are and the acuity of what is going on. I don't have time to discuss the pros/cons of succinylcholine vs rocuronium when a patient needs to be intubated. And if I said I had never gotten frustrated or short with a patient or nurse and you believed me, then I have a bridge to sell you. It is just up to you to try your hardest to keep your emotional barometer in mind at all times. I think one thing I do do fairly well is recognizing when a situation is going poorly or escalating and extricating myself as soon as possible.

 

[cbrons]

I am the type of person who hates the ambulance chasing scum lawyers, and I usually have no sympathy for the vast majority of civil litigants.

That being said, I just listened to the audio of what was said, and I found the anesthesiologist and the GI to be so unprofessional and disgusting it made me literally sick to my stomach.

No this greedy lawyer (and that is exactly what he is, lets not kid ourselves) does not deserve millions of dollars and no the anesthesiologist should not lose her license (those of you who say she should can go jump off a bridge - you holier than thou types are truly unbearable).

That being said there should definitely be punishment for this behavior, and there's simply no excuse for commenting on penile lesions with nurses while the patient is unconscious in front of you. And regardless of what the bros say, the O.R. is not a locker room.

(and it does not take a surgeon or hospital administrator to be able to figure out the distinction between the two)

Also I noticed in that video the anesthesiologist chatting about annoying/troublesome patients with nurses. You should be careful about this my friends, because nurses can get away with a lot more than you, can say ridiculous things, act unprofessional as hell, and in some states they can strip naked in the middle of the hospital and chirp like a bluebird and still not lose their job (thanks to their unions). When you feel like "venting" on the wards you might do well to remember that because fair or unfair you are #HeldToAHigherStandard.

 

[charmiedermie]

Medical malpractice is defined as "any act or omission by a physician during treatment of a patient that deviates from accepted norms of practice in the medical community and causes harm to the patient." If the patient was not harmed as a result of the breach in standard of care, then by definition medical malpractice did not occur. Similarly, false billings would be classified as fraud and not malpractice.

Thank you. Then I agree there is no medical malpractice but diagnosis and billing fraud.

 

[Psai]

Unfortunately this case doesn't change what has always been true in medical malpractice. Your ability to communicate with a patient will have a greater determination of if you get sued or not than your actual outcomes. For better or worse, free speech isn't (and has never been) speech without consequences.

so i just found out that your name refers to st. luke, patron of physicians and surgeons

 

[pd1112]

I really don't know how I managed to be on SDN for several years and never notice this poster before. This is the second thread this week that jl lin has annihilated with wall of texts posts using strange diction and analogies I personally do not think she understands.

I believe she has been going on ranting rampages ever since that thread about the case western guy who was punished for a rape allegation but it could be earlier than that.
I'm just shocked that you guys have the patience to explain the same basic concepts over and over to someone who not only does not understand them but refuses to do so.
She's a premed who hasn't even applied to medical school yet, not even a physician or a lawyer, but seems to think she knows better about medical standards and malpractice

It's been going on for years, just getting more frequent and dogged these days.

My first exposure has been great. Is there any value in repeated exposure or is ignore the way to go?