CONTENTS:
Perspective: Futility
Too few patients seem to realize that eventually, at some point, further treatment is futile. Like taxes, death is certain.In my many years of emergency medicine practice, some of my most difficult experiences have been those in which patients (or their families) have approached their last days of life woefully ill-prepared for their departure. Far too often, both physicians and attorneys see the sad outcomes of that lack of preparation. But what is futility, and how should a physician address it with his/her patients? For more, click here.
Medicare wants its money back
Beginning in July, 2009, S. 2499 requires that plaintiffs receiving awards in liability cases repay Medicare for payments made by Medicare on the plaintiff’s behalf as a result of injuries for which damages have been recovered. Section 111, paragraph (8) is titled “REQUIRED SUBMISSION OF INFORMATION BY OR ON BEHALF OF LIABILITY INSURANCE (INCLUDING SELF-INSURANCE), NO FAULT INSURANCE, AND WORKERS’ COMPENSATION LAWS AND PLANS.” Liability insurers and attorneys representing plaintiffs in such cases will have to report if an individual filing a claim against the insurer is a Medicare beneficiary. If the beneficiary receives any form of settlement or award, Medicare wants 100% of its money back out of the proceeds. This may put a damper on smaller claims by older individuals and increase the disclosure requirements of plaintiff attorneys.
Flaps – check. Brakes – check. Airspeed – check. Can surgeons learn something from pilots?
Research from Harvard University suggests a 19-item checklist may help reduce surgical deaths and complications by as much as 40%. Included are things such as
- Introducing each member of the surgical team
- Assuring the right body part is marked
- Having x-rays in the room
- Administering any needed pre-op antibiotics
For a New York Times article on the report and the checklist developed by the World Health Organization, click here.
“Informal” consults can lead to malpractice claims
A “Malpractice Consult” in Medical Economics asserts that the standard of care is the same for informal advice as it is for formal, for billed care as well as for free care. One must use the same diligence, knowledge, skill, and research, and must act as a “reasonable physician in your specialty,” whether the consultation takes place in the elevator or at the bedside.ational average) emergency departments per 1 million people. The report also faults the medical liability climate for (1) being one of only 20 that have not instituted a medical liability cap on noneconomic damages, (2) only partially abolishing joint and several liability, and (3) for not requiring expert witnesses to be of the same specialty as the defendant.