Perspective: Would “no fault” be a better way?
By Charles A. Pilcher MD FACEP
Last month I reported on the defense verdict in the case of a Bellingham woman left with brain damage as a result of a surgical complication. The case bothers me.
The patient’s injuries were major and her family devastated. Future expenses will be huge. The woman likely remains in a nursing home, and a “medical bankruptcy” would be a predictable outcome as the costs of her care mount. Her attorney did his best, but a jury agreed with the defense.
So, for the past few weeks I’ve been asking myself “Isn’t there a better way?”
Medicine is not a perfect science nor is the human body a perfect organism. Things go wrong, just as they do with car accidents and building fires, and bad outcomes will never be eliminated completely. Thus, I wonder if we are using the money paid in malpractice premiums in the best possible way. Why should only a small percentage of injured patients recover the huge majority of those funds? Could the medical equivalent of an insurance adjuster resolve these situations more equitably? For the rest of my thoughts, click here >>
Attorneys to blame for MRSA epidemic?
A study published in the American Journal of Therapeutics questions whether the MRSA epidemic (methicillin-resistant staphylococcus aureus) might be caused by physicians who defensively prescribe antibiotics where not medically indicated. The study found a direct correlation across Europe, Canada and the US between the density of attorneys in an area and the prevalence of MRSA infections. The authors also “confirmed that the vast majority of providers were far more concerned with the potential of being sued for refraining from prescribing antibiotics than for doling them out prematurely.” A layman’s summary is reported at Time.com.
Stroke patients more likely to receive tPA on the weekend. Survival unchanged.
In the continuing debate about the value of tPA in the treatment of stroke, a paper in the Archives of Neurology reports that stroke patients admitted to hospitals on Saturday or Sunday were more likely to be given a clot-busting medication known as tissue plasminogen activator (tPA). There was, however, no difference in the in-hospital mortality rate between the two groups. While investigators pondered a variety of reasons to explain this somewhat unexpected finding, they seemed to belittle a possibly obvious explanation: tPA makes little if any difference. For more on the evaluation and management of stroke, check out three “Perspectives” articles on Stroke/TIA listed in the left sidebar.