Medical Malpractice Bulletin – June, 2015

Perspective: If you’re a “nice” doctor, you won’t get sued
By Ryan Padgett MD FACEP & Charles A. Pilcher MD FACEP
June, 2015

Do hospital ratings matter? Is a “nice” physician with good behavior less likely to get sued than others? Physicians have long been skeptical of the value of patient satisfaction ratings but a recent study shows that physicians viewed as “nice” by their patients really do get sued less often. However, the study also found that:

  • a higher rate of hospitalization,
  • greater cost of care,
  • more prescription drug usage and
  • a higher mortality rate.

Thus, more care does not equal better care, so patients need to be careful what they wish for and demand. Continue ->

Hospital credentialing lags technology
As technology changes, hospitals need to adapt physician credentialing to these changes, according to an editorial in JAMA by Pradarelli et al. from the Center for Healthcare Outcomes and Policy at the University of Michigan. Credentialing must assure that doctors are adequately trained to use the many new devices coming to market. The article focuses primarily on the surgical robot manufactured by Intuitive Surgical and a lawsuit that held the hospital rather than the manufacturer liable for a patient’s injuries. The authors conclude that “the medicolegal responsibility for training, credentialing, and privileging surgeons to use new technologies belongs to physicians and the hospitals (or other institutions) where they work.” Read JAMA article ->

Off-hours care carries higher risk
In a study by Gonzalo et al in the Journal of Hospital Medicine, off-hours care was found to carry a much higher risk of mis-communication and quality of care/safety issues than care during normal business hours. This is probably intuitive, but the study/survey provides enlightening details about the causes of the risk profile. Abstract available here ->

Can antibiotics cure appendicitis? In some cases, yes
A recent meta-analysis of 5 studies of antibiotic treatment of appendicitis revealed that surgery can be avoided in some patients with use of antibiotics alone. The paper by Dr. David Flum was published last month in NEJM. Of 1000 patients studied, about 70 percent were successfully treated with antibiotics alone. Those later requiring surgery had no more complications than those who went directly to surgery. Journal article here ->

Another excuse to over-use antibiotics for strep throat
Speaking of antibiotics, a new rapid strep test recently gained FDA approval. While the “Alere i Strep A Test” is touted as providing a definitive answer in < 8 minutes to the question “Is this sore throat caused by strep?” The manufacturer claims this will “empower healthcare professionals to initiate the right treatment [and reduce the] unnecessary prescription of antibiotics.” Since other studies show that the major reason to treat strep throat – acute rheumatic fever – is no longer valid and that antibiotic treatment shortens the duration of symptoms by < 1 day, there is really no longer any real reason to treat strep throat any different than a viral infection. Article from MedScape here.



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