Mr. Leonhardt’s article is a good-faith effort to discuss both sides of an emotional issue. It acknowledges the fact that a majority of wrongfully injured patients never seek compensation. That means that culpable doctors get away with medical negligence.
Under our system of justice no doctor is held to account for a “mistake,” but only for falling below the established standard of reasonable medical care — that is, being negligent.
Some believe that the most effective reform would be a cap on damages — an artificial limit on negligently injured patients’ compensation. No state that has imposed such limits, to my knowledge, has seen a reduction in medical negligence or even a meaningful reduction in doctors’ malpractice insurance premiums.
Saying to a child or any patient who, because of negligent medical care, sustains permanent brain damage that his or her inability to have a normal life should be “fairly” compensated with $250,000 or $500,000 (for noneconomic damages) reduces medical negligence to a determinable cost of doing business for insurance companies and negligent doctors. Such “reform” is unfair to patients. Patrick J. Kenneally
I have been retained to represent a 79 year old woman in a dental malpractice case. The woman visited her Chicago area periodontist to have a single dental implant placed. During the procedure it was necessary for the dentist to extract the tooth that would be replaced with the implant. She explained to me that during the extraction her head and neck were twisted and contorted with what she felt was considerable force. Nevertheless, after the procedure she felt fine. She got up from the chair and walked out of the office with her husband under her own power. They spent the rest of the afternoon shopping before heading home for a quiet evening of television. She had no sense that something had gone wrong during her dental visit.
The next morning, however, she was unable to move. She had completely lost the ability to move her arms and legs. She was taken via ambulance to the nearest emergency room where she was diagnosed with Central Cord Syndrome, an injury to the cervical (neck) area of the spinal cord. The injury tends to occur when the neck is extended (bent back) or flexed (bent forward) beyond its normal position. Hyperextension of the neck can result in CCS when the spinal cord is pinched between the front of the cervical vertebrae and the ligament on the back of the cervical vertebrae. The elderly, who often have degenerative changes in the neck to begin with, are particularly prone to this sort of injury. CCS usually causes extensive motor weakness that is generally worse in the arms than the legs. My client spent many months in therapy learning to use her limbs again. She can now walk and use her left arm and hand. However, she remains unable to use her right arm, a condition that is likely permanent.
Elderly dental patients should discuss this risk with their dentists and periodontists. Appropriate steps should be taken to ensure that the neck is not hyperextended or hyperflexed during procedures. Also, if the patient has a prior history of neck or back problems the dentist should be made aware. He or she may wish to screen the patient by ordering tests to determine the degree of risk involved.
CNN is reporting this morning about a group of lawyers and physicians who allegedly conspired to inflate lawsuit damages by encouraging accident victims to undergo questionable surgical procedures. I don't know if there are attorneys in Chicago who refer clients to doctors for treatment. It would not particularly surprise me if there are. (I'm cynical that way.) But an attorney who would refer you to a doctor for a specific treatment is someone you should stay away from. Obviously, any physician who would go along with a lawyer's recommendation on treatment is also someone you should run from as fast as your legs can carry you. Doctors and lawyers who would participate in such an arrangement are simply not going to be at the top of the food chain. They will be the bottom dwellers who are likely to provide you with poor, if not dangerous, medical care and legal representation.
It needs to be made clear that an attorney can, and in some circumstances should, refer a client to a physician for medical evaluation. In order to get a clear picture of the full nature and extent of an injury victim's damages it may be necessary to send the client for noninvasive medical testing. Examples that come to mind are: MRIs to test the extent of a soft tissue injury, a neurological exam for the severity of nerve damage, and neuropsychological testing to determine the impact of a traumatic brain injury on cognition and memory. Sometimes a client's existing treating physician(s) will have already done this sort of testing. Other times more answers are needed. Understand that what I am talking about is not medical treatment. I cannot think of a circumstance in which a doctor and lawyer should conspire to provide treatment. If you are being represented in a personal injury or medical malpractice case by a lawyer that wants to refer you to a physician make sure you ask him or her why. A referral for evaluation and testing is perfectly acceptable and often advisable. A referral for treatment is not.
There appeared in yesterday's Houston Chronicle a thoughtful editorial describing what consumers can and should do to protect themselves against medical errors. The piece urges patients not to be shy with their doctors and to ask questions before submitting to care. Click here to read the article.
Hearst Newspapers has completed a remarkable investigation into medical errors nation wide. The news organization has created a web site dedicated to the story.
You know that mama bear or papa bear feeling you get when you sense something or someone posing a threat to your child? If you're a parent, of course you do. Well, you need to wear that feeling on your sleeve when your child is hospitalized. Every physician and every test performed is a potential threat and you need to rise up on your back haunches and protect your cub. Hyperbole aside, you need to aggressively ask questions, and seek information from his or her care providers when your child is hospitalized. Here is a link to a very good post on the Wall Street Journal's Health Blog about this subject.
Abortion. The word evokes strong emotion whenever it is uttered or written. As a trial lawyer representing persons injured due to shoddy medical care, I see it as a health care issue. Abortion is an invasive medical procedure. Physicians performing them owe a duty to their patients to do so with reasonable competence. The goal of the pro-choice movement has been to keep abortion safe and legal. They have argued that women will get abortions regardless of whether it is legal or not. If it is illegal women will seek out unscrupulous and less-than-skilled physicians in "back alleys" to perform them, placing their lives at serious risk. Therefore, they argue, abortion should be kept legal so that women need not undertake undue risk to have the procedure. The pro-life folks, on the other hand, tend to view abortion as murder pure and simple. I suspect that a pro-lifer would bristle at viewing abortion as a medical procedure at all. They believe that abortion should be illegal. Some pro-life advocates have used intimidation and violence to compel physicians to give up performing abortions. Not long ago I represented a client profoundly injured while undergoing an abortion. My experience with that case led me to conclude that we now have a situation that no one can be happy with: Abortion is legal, but it is often unsafe.
My client agonized over whether to terminate her pregnancy. She was from a good family, but like most they had their ups and downs. They did not have a lot of money. She and her loyal and decent boyfriend of many years had three young children together. When she became pregnant with their fourth child she felt that another would be too much for the family to handle financially and perhaps emotionally. Without her partner's knowledge she decided to terminate the pregnancy. Unfortunately, considerable time passed before she finally made her decision, and the fetus developed into its second term. Second term abortions are legal in Illinois. However, few physicians here perform them. She found a clinic in Chicago willing to do it. The outcome was tragic. The procedure she underwent was called dilation and extraction which requires that the patient be sedated. Anesthesia service at the clinic was not provided by a physician, but by a nurse. The nurse, evidently not knowing what he was doing gave the patient too much of a drug called Propofol and failed to protect her airway. As a result the oxygen level in her blood plummeted, causing a hypoxic event. In short, her brain was not receiving enough oxygen. She would never awaken and today remains in a vegetative state requiring 24/7 care.
My firm filed a lawsuit against the nurse anesthetist, the clinic and the surgeon alleging medical malpractice. In the course of the litigation which followed I immersed myself into the world of abortion; and "it" does seem to have its own world. Doing serious medical research on the topic was tough. I was constantly led to dark websites with photos of dismembered fetuses and containing ominous threats against doctors performing abortions. I learned that those willing to help me get information and find experts were often working with a political agenda I was not comfortable with. Apparently, parts of the pro-life movement support medical malpractice lawsuits against doctors who perform abortions. The strategy seems to be to try to sue them out of practice. The biggest obstacle I needed to overcome was just finding another physician somewhere in the United States who performed second term abortions. In Illinois, a plaintiff can only proceed to litigation against a physician with an expert who works in the same area of practice as the defendant doctor. I needed a physician with experience performing this procedure. There are very few anywhere.
From a lawyer's prospective, the case should not have been a difficult one to prosecute. The negligence was pretty apparent. In fact, not long into the discovery process I received a call from the defendants' attorneys, both very experienced and decent lawyers, who said they had been told by their own experts that the case was indefensible. To receive such an honest admission in a medical malpractice case from defense counsel is extremely rare. The case settled for the full amounts of the applicable insurance policies. However, I came away from that case horrified at the state of this area of medicine. With so few physicians performing abortions, especially second term abortions, one has to wonder whether women have access to the kind of good, competent physicians that are available for other kinds of gynecologic procedures. It's hard to blame doctors for not wanting to do pregnancy terminations. Given the threats -- sometimes carried out -- against the lives of abortion doctors, a physician would probably have to be nuts to want to have anything to do with the procedure.
So where does that leave the woman who feels compelled to terminate her pregnancy? In a difficult spot frankly. Be extra careful before having an abortion. You simply must take the time to look into the background of the physician who will perform the procedure. Click here for a list of good patient resources or look along the right side of this blog for helpful health care links. You should ask plenty of questions before hand. Understand the nature of the specific procedure you will undergo. All abortions are not performed in the same way and will depend on how far along the pregnancy is, as well as other factors. All surgical procedures come with risk, especially where sedation is necessary. Know who will will be responsible for administering anesthesia. If it is to be a nurse, will he or she be supervised by a physician knowledgeable in anesthesiology? Pregnancy termination seems at this time to be exceptionally risky so proceed if you must with extreme caution.
We want you to call us. Call us to vent. Call us to explain your situation. Call us to just talk. It's OK. It's what we do; talk to many, many people everyday and listen to their dilemmas, their problems and make judgments about which problems may justify legal action. We listen to highly educated people, and folks with little formal schooling; stable people and nutty people; working people, and nonworking people. We listen to everyone all the time. If you have a feeling -- and it can be just a feeling -- that a physician or other health care provider did something wrong to you or someone you care about, call an attorney.
But. . .
There are good ways and bad ways to initiate dialogue with an attorney about a potential medical malpractice case. Consider these points:
Keep it brief and succinct. Remember that lawyers talk to lots of people everyday about potential cases. To be honest, some people that contact us (and I don't think it's just us. . . I hope) are a little nutty. Whether by email, letter or telephone, we sometimes receive long, rambling stories in which folks seems to complain about everyone and everything all at once. We tend not to focus much attention to these. Before contacting an attorney, sit down and think about how to state your prospective case in a sentence or two. Your story probably cannot be told with complete accuracy in such a brief manner. That's OK. But providing the lawyer with a short and to-the-point summary upon first contact you will get his or her attention and the attorney will likely be compelled to spend time talking to you, asking questions, eliciting important information. Also, by approaching an attorney in this way you are helping to establish your credibility as someone the attorney would like to work with and for.
Be frank and forthcoming. Never hide information from an attorney. Even before you formally enter into an attorney/client relationship a lawyer with whom you speak during an initial consult, even if it's over the telephone, is bound to keep what you tell him or her confidential. Sometimes the details of a potential case or the people involved can be difficult to talk about, or even embarrassing, but the lawyer simply must know everything in order to serve you adequately. You need to be honest. If you are not frank in the beginning the attorney will almost always learn what you failed to disclose down the road. This could harm your relationship with your attorney and damage your case.
Be prepared to ask questions. The attorney will undoubtedly have lots of questions to ask you. Likewise, you should ask lots of questions of the attorney. Again, before contacting a lawyer take a few minutes and think about what questions you would like answered. Ask about the attorney's fee, ask about how much experience the attorney has handling medical malpractice matters, ask what has to happen before a lawsuit can be filed, ask how the attorney will go about determining whether you have a case or not, etc. Doing so will provide you with helpful information, and will also bolster your credibility as someone the attorney would like to represent.
Entering into an attorney/client relationship is in many ways like entering into any other human relationship. Initial impressions are important and it can take some time for a bond based on trust and mutual admiration to form. When both attorney and client keep that in mind the relationship will likely be productive and pleasant.
Just when I thought I could not be more jaded about health care insurance companies comes a story out of New Jersey about an insurer intimidating patients in the hospital. Bayonne Medical Center has filed a lawsuit against Horizon Blue Cross Blue Shield of New Jersey alleging that the insurer routinely sent couriers to the hospital to convince patients to leave the facility or risk being overcharged for care. Read the story here.
I suppose this could happen anywhere. If it happens to you let hospital staff know. Also, this highlights a point I've made before: If you need to go to the hospital, bring someone you trust with you. A good friend or family member can help you deal with this sort of annoyance.
A tragic story appears in this morning's Washington Post about a 44 year old man who died because hospital physicians failed to timely diagnose and treat his bowel perforation. The hole in his bowel allowed fecal matter to leak into his abdomen, causing dangerous toxins and bacteria to be released into his blood stream. Adding to the tragedy was the fact that the man's wife, herself a nurse, suspected that he had a perforation and begged hospital staff unsuccessfully to order a CT scan of her husband's abdomen. Read the full story here.
One of the things that struck me about this piece was the ordinariness of the events described in the story. I hear similar tales of frustration often. Communication breakdown leads to medical errors. Medical providers often do not listen to their patients or they hear them and have contempt for what they have to say. Though often difficult and aggravating, patients and their families must be persistent and composed when dealing with health care providers. If there is something that needs to be said, say it; again and again if necessary.
Repeat after me, "Doctor, why are you ordering this test?"
Simple. To the point. You should receive a straight forward, clear and concise answer to this question every time. When you pose this question to your physician you are doing two helpful things: (1) You are participating in and learning about your own health care, and (2) you are helping to reduce the overall cost of health care, which helps everyone.
Many doctors are blaming the perceived need to practice "defensive medicine" as a significant contributor to ever increasing medical costs. Their argument is that out of fear of getting sued they feel compelled to order tests for their patients that are not really necessary. Apparently, the logic behind this is that if it seems that the doctor is doing something to care for his or her patient, even if unhelpful or nonsensical, then if the patient ends up with a bad outcome the doctor will not get sued. This approach to medicine is stupid for two reasons: First, the doctor is not protecting himself or herself from liability in the slightest by ordering unnecessary tests or procedures. Secondly, and more importantly, the physician is exposing the patient to undue risk.
In Illinois a physician may be found liable for medical malpractice or medical negligence (they mean the same thing) when he or she fails to act as a reasonable physician would under the same or similar circumstance. At a medical negligence trial, a jury determines what was reasonable under a given set of circumstances by listening to the testimony of experts who practice medicine in the same field as the defendant doctor. To offer an obvious example, if called upon to amputate one of a patient's legs, a surgeon would reasonably be expected to check the chart to determine whether the left or right leg needed to be removed. In that circumstance, a failure to do so resulting in the patient having the wrong leg amputated amounts to medical negligence. Under the law, ordering unnecessary or unhelpful tests does nothing to protect a physician from liability. A reasonable physician must perform procedures and order testing appropriate to the circumstances. A failure to do so which results in harm is medical negligence. Furthermore, many diagnostic tests and procedures come with risks. For example, contrast dye sometimes used in CT scans can bring about a significant allergic reaction. A colonoscopy can result in a perforated colon. Patients should not shy away from these usually safe procedures, but they should not be done unnecessarily either.
When it comes right down to it "defensive medicine" is a nonsensical term. It's just another phrase that means negligent medicine.
It seems that many pregnant couples* drift up to and past delivery due days without having a serious discussion with the woman's doctor about induction. Apparently, some doctors waive off induction, and encourage waiting for nature to take its course. This is not always a good idea. As the delivery due date approaches patients should be proactive regarding labor induction. According to The Mayo Clinic, "In the United States, an estimated one in five labors is induced." Sometimes, delivering sooner rather than later is better. If the baby is far enough along that its lungs are mature, the cervix has started to prepare for delivery, and the woman has not had a prior c-section, the doctor should be asked about scheduling an induction. There are significant risks sometimes associated with carrying a fetus beyond its due date. Generally, a fetus should not be carried two weeks beyond the due date. Click here to read an informative guide on the pros and cons of induction from The Mayo Clinic.
*(These days women aren't pregnant, couples are. Yeah right.)
I have seen many instances where the wrong medication was administered to a patient -- or the right medication was given in the wrong manner or dose -- resulting in terrible consequences. Medications errors continue to be a huge problem. This is especially so for older patients who often take numerous drugs prescribed by several different physicians who may not communicate with each other effectively. I came across an informative article in Senior Times Magazine about a means for reducing medication errors. Read it here.
The physician who misplaced so many radioactive seeds in prostate cancer patients, Gary D. Kao, M.D., has admitted to making some errors, but denies that he violated the standard of care owed to his patients. While stating to a senate panel that "we can do better," Dr. Kao also said, "Brachytherapy was and still is an evolving field" (code for Hey, surgery is complicated. What do you want from me?). What's more disturbing, however, is that he "acknowledged that he never informed patients when he missed the prostate or delivered insufficient doses."
Read the full story from the Associated Press here.
She wasn't exactly waiting by the phone, but the call was never far from her mind. Linda was anxious and hopeful. She wanted to learn the results of her recent medical tests asap. She wanted to be ok. Most of all she wanted to just move on and get back to living her life with her husband and 12 year old son. She was diagnosed with endometrial cancer years earlier when she and her family lived in a different state. The treatment had been difficult and exhausting, but now she had been cancer free for two years. Linda was in a different place, felt terrific and was optimistic about her future. She was only 44 years old.
Shortly after moving to the Chicagoland area where her husband's job had led the family, Linda sought out a well regarded cancer specialist to screen her, to check for any return of the disease. When she saw her new doctor he preformed a phyical exam, did a pap smear, ordered blood work and CT scans of Linda's chest, abdomen and pelvis to see if the cancer showed up in other parts of her body. The blood work and CT scans were done in short order. All that remained was for Linda to receive the results, for the telephone to ring and a voice on the other end to give her the news.
There was cancer in Linda's lungs. Microscopic endometrial cancer cells had traveled through her body to her lungs and had multiplied and grown. Her new doctor knew that, but that is not what Linda was told when the phone finally rang. Instead, the doctor's nurse on the end of the line told her that everything was fine, that the tests were negative, that she was cancer free. Linda's relief would not last. Nearly a year later she developed a troublesome cough. At first she associated it with her history of allergies and saw her family physician for treatment. Soon though the cough became severe enough that she felt compelled to go the emergency room at a nearly hospital. There a chest x-ray showed "multiple lesions consistent with metastatic cancer." The lesions were more numerous and much larger than they had been a year earlier. Linda was quickly referred to a new cancer specialist who confirmed that she had cancer in her lungs which had spread there from her endometrium. He started her on the chemotherapy treatment that she should have had a year earlier. After a few months the number and size of the cancerous nodules had been reduced signficicantly and her disease was declared stable. That stability did not last, however, and 14 months later Linda died.
After Linda's passing, her husband called me. We hired experts to look at her medical records. They concluded that Linda's cancer doctor failed her by not expeditiously making her aware of the findings from her chest CT scan. His failure to do so, they felt, delayed the start of chemotherapy and very substantially reduced the effectiveness of her treatment. The doctor, and his nurse, cost her years of time with her husband and son.
During the litigation which followed, the defendants could never adequately explain why the true test results were not communicated to Linda. What I found upon investigating was shocking indifference regarding doctor-patient commuincation and arrogance. When I took the deposition of the defendant doctor he told me that he did not think it was particularly important that Linda be informed that her cancer had spread. Apparently, in his mind she was a goner regardless. Here is a portion of his deposition testimony:
Q. What does it mean for cancer to metastasize?
A. It means a spread of cancer from the organ of origin to a distant site in the body.
Q. And when we are speaking of metastatic disease, we are making reference to this spread, this process, correct?
A. Yes.
Q. Finding of cancer spread or metastasis is something a patient should be informed of promptly.Would you agree with that?
A. Depending on the clinical circumstances.
Q. But as a general principle, you would agree with that?
A. I don't -- there are no, you know, general principles. Every case is different.
Q. So there are -- can you give me an example of a circumstance in which it would not be important to communicate promptly to a patient that their cancer had spread or metastasized?
A. If you take, for example, a patient that -- if we can follow the example of [Linda], a patient who metastasized to the lung in July of 1999 and in July of 2001, there is an equivocal X-ray and I plan to follow that with serial X-rays and the metastatic pattern is such that the patient is categorically incurable, I don't have to report that instantly to the patient.
Q. I didn't say instantly. We are talking about promptly.
A. That is what I mean.
The doctor's lack of caring, the nurse's incompetance and the medical facility's lack of procedures for communicating test results to patients took something from Linda and her family. She probably wasn't going to live to a ripe old age, but she was entitled to more time with her family.
It was reported earlier this week that, according to a recent study in the Archives of Internal Medicine, doctors failed to inform patients of abnormal cancer screenings and other test results 1 out of 14 times. This is truly disturbing. Modern medical break-through treatments for cancer and other diseases mean nothing if communication between physicians and their patients breaks down. The medical community obviously has to fix this situation. Patients too need to take the bull by the horns. Many people - especially those awaiting potentially bad news - wishfully assume that no news is good news. When waiting for medical test results, however, you must be aggresively pro-active with your doctor's office. If you do not hear, call. If you are forced to leave a message, call again, and again. Linda was in an especially tough position because she was notified of her test results; only they were not accurately reported to her. Make sure you speak with your doctor, not simply a member of his or her staff. Ask questions too. Doing so should provide you with greater detail about your condition and will serve to test the credibility of the results being reported to you. Also, make sure you schedule a follow up appointment to return to your physician. Whatever the medical concern was, it's a good idea to follow up in person before too long.
Here is a link to some additional advice on this topic:
Hearings are being planned in connection with the malpractice committed at a Philadelphia Veterans Hospital involving brachytherapy. Senator Arlene Specter, who has taken charge in the matter, has said that the case involves "more than medical malpractice." Read the full story in the Philadelphia Inquirer.
A truly horrifying story appeared in Sunday's New York Times about a cancer unit in a veteran's hospital in Philadelphia. According to the story, one of the unit's doctors, Gary D. Kao, M.D., on numerous occasions improperly implanted radioactive seeds in patients with prostate cancer causing serious complications. Usually, during this relatively common procedure known as brachytherapy, a surgeon places radioactive seeds close to a cancerous tumor. The procedure is often done in place of or in conjunction with external beam radiation. According to an investigation by the Times and federal authorities, during brachytherapy Dr. Kao was often placing the seeds in the wrong organ then attempting to cover up his errors.
My reading of the story offered two clues for how patients seeking to undergo this procedure can protect themselves from surgeons like Dr. Kao. The story noted that there was no peer review at the V.A. hospital. All good hospitals have some kind of peer review procedure wherein physicians at the same institution look over each others' shoulders, reviewing one others' work. Bad outcomes are discussed openly and frankly with the goal of avoiding them in the future. Ask your surgeon if the hospital where your surgery is to take place has peer review procedures in place.
The other way you can protect yourself is to ask your surgeon about his or her experience performing that particular procedure. The Times article pointed out that Dr. Kao had a medical degree from an outstanding institution and was board certified in radiation oncology. However, he had "limited experience in brachytherapy."
The U.S. Food and Drug Administration has warned consumers not to use the cold medicine Zicam. It could cause a permanent loss of smell. Read full story here.
As we walked into the doctors' lounge heads turned to meet us. I recognized faces which just a few minutes earlier had been staring (or perhaps glaring) at me from the back of the hospital's conference room. One of the young residents walked over to greet us.
"Great talk. Very interesting topic," he said to me. "But, let me ask you: Say I am concerned that a patient of mine has skin cancer. If I do not order screening tests can I be held liable?"
"Of course," I replied firmly.
"Absolutely," answered the experienced physician next to me. "You must order proper testing if you suspect your patient has cancer!"
Even after years of suing bad doctors for horrible screw-ups I was not quite prepared for the utter stupidity of this young doctor's question. I had just spent about 45 minutes talking to residents about how to avoid committing medical errors in the primary care setting. At the end of my seminar, during which all those present stoically seemed to listen to what I was saying, no one had any questions; not, that is, until I ran into the young resident in the doctor's lounge. What, I wondered, does this young man think about when he sees patients? Is he contemplating providing the least care possible to avoid getting sued? Does he lack the knowledge of what tests are appropriate to assist in diagnosing various diseases and ailments? Is he thinking at all?
Hopefully, the resident that questioned me was an aberrant example of a young physician in training. However, residents tend to be responsible for a large share of medical errors made each year. My advice: avoid residents like the plague. I appreciate that they have to learn. All good physicians were green residents early in their careers. Fine. It is reasonable to allow a resident to see you, take your history and examine you. Just make sure that everything he or she does is repeated by an experienced attending physician. The physicians who are residents will be (or should be) identified on their name badges. If you are unsure whether the doctor treating you is a resident, ask.
Of course, there are good residents out there, but by definition they are always going to be inexperienced. Several years ago I went to the hospital with a dislocated elbow. An experienced emergency department doctor appeared along with a young resident to set it. Thankfully I was sedated, but my wife who was present told me later what happened as my elbow was twisted, pushed and pulled back into place. The young resident became queasy during the process and the attending had to take over.
Be kind and tolerate to young doctors, just make sure an experienced, guiding hand is nearby.
A very interesting op-ed piece appears in today's New York Times about the pros and cons of U.S. patients going overseas to receive medical care. The authors note that there is some reason to believe that the care received in many hospitals in other countries is at least equal to that received here. Also, patients usually receive care at much lower cost, which is usually the point of seeking overseas care to begin with. However, the authors smartly note some risks. Patients may be at far greater risk should complications arise. If they find themselves victims of medical malpractice they may be out-0f-luck in seeking compensation for the harms and losses inflicted by a foreign physician.
Here is an excellent list of online resources patients can use to learn about their health care providers. The list comes from Victoria Powell, a nurse consultant and blogger in Arkansas.
Do not allow yourself to be victimized by companies offering so-called medical discount cards. They are a complete scam. Click here to read story from CNN.
Even a trial attorney must remember that it is no small thing to sue a physician, or anybody else for that matter. Sure, doctors are generally covered by medical malpractice insurance. Still, it's got to be hard not to take getting sued personally. So when should you consider suing your physician?
When your injury is both permanent and profound. Medical malpractice lawsuits are no small undertakings. They are time consuming and expensive. These cases are won when the person bringing the claim (the plaintiff) can demonstrate that the physician, nurse, or other provider failed to abide by the standard of care, that is failed act as a careful doctor, nurse, etc. would under the same or similar circumstances. To prove what the standard of care required experts must be hired. Also, the plaintiff must prove that the defendant's negligence actually caused the injury. Proving causation usually requires hiring even more experts. All these experts get mighty expensive, so, to put it bluntly, the case has to be worth it. Anyway, all of us ought to be able to endure minor injuries even if caused by another person's error. If a doctor screws up and you get hurt but heal quickly and completely, get over it and move on.
Soon after you become suspicious about some sort of medical wrongdoing as a cause of the injury or death. In all 50 states there is a time limit on when you can file a medical malpractice lawsuit. In Illinois, you will have two years from the date that you knew or reasonably should have known that you (or your loved one) was the victim of medical wrongdoing. However, the lawsuit cannot be filed more than four years from the exact date of the wrongful conduct or omission. (Remember, all states have different filing deadlines.) This time limiting deadline is longer in Illinois if the injury involved a minor. Two years sounds like a long time, but it really isn't. Your attorney will need to acquire all of your medical records, hire experts and do a thorough investigation before any lawsuit is filed. This takes considerable time, so see an attorney as soon as possible.
Even if you think your doctor or health care provider made an honest mistake. Many of us like our doctors. I do (except when he makes me wait). But if the injury is severe, or if a family's wage earner dies due to medical negligence, the harms and losses caused by the error need to be compensated. This need is not esoteric, it's real. Medical negligence often deprives victims and their families of the ability to earn a living for themselves and their loved ones. Also, in my experience medical malpractice lawsuits better the practice of medicine generally. I have been told by more than one doctor that while they hate medical malpractice lawsuits generally, they tend to make physicians more careful about the way they go about diagnosing and treating their patients. Many excellent physicians get involved with serving as expert witnesses in order to learn from the mistakes made by others. Exposing errors, especially those types of mistakes that tend to occur over and over again is far better, in my estimation, than sweeping those errors under the rug, or burying them. Medical errors, mistakes, negligence, malpractice all mean exactly the same thing under the law, and all are compensable. A health care provider need not have acted with an intent to do harm (and virtually none do), for his or her conduct to give rise to a medical malpractice lawsuit.
Once you decide to contact a lawyer, contact one with a lot of experience in handling medical malpractice cases. These cases tend to be quite complicated. A lawyer that handles personal injury cases but has little experience with medical malpractice would not be an appropriate person to handle such a case. As when choosing a doctor, use the internet to do your homework when choosing an attorney. Most good, experienced law firms have websites on which they list the kinds of cases they handle and offer a sampling of their successes. Also, attorneys are licensed by state and most states offer the means online for the general public to check the status of an attorney's license. (Illinois' website can be checked by clicking here.) All medical malpractice attorneys should work on a contingency basis, meaning that there is no fee unless your case resolves successfully. Initial consultations should always be free.
You and your doctor are partners. You are both responsible for taking care of you. For the patient to carry his or her own weight in this symbiotic relationship, the acquisition of knowledge is key. If you don't learn as much as possible about your particular disease or ailment and the treatment options available you will not be able to contribute to the partnership, the goal of which is your good health. I recently became aware of a very interesting website that helps patients learn about their own health needs by reviewing the detailed health care history of other patients with the same or similar needs. The site is called Patients Like Me. The website takes a counter-intuitive approach toward patient privacy in order to provide what just may be a tremendous service. On the site patients provide each other with detailed descriptions of themselves, their health issues, treatments, symptoms, medications, etc. The idea is that a participating member with say ALS can review the experiences of other patients with ALS in order to get a sense of what worked and what didn't. In this way the information from the community can be shared with your physician to decide upon and tweak a personalized treatment plan. The website allows searches by symptom, disease and particular treatment. According to the site's developers a research team has been retained to post about specific medical studies of interest to the community.
As will services like Google Health, members of the Patients Like Me community arguably give up something in order to participate. Whenever you post personal data on the internet there is a risk that persons that you may not wish to have such information will. That important concern noted, it seems to me that for many patients the reward my well be worth the risk.
Read a great article on protecting yourself against receiving tainted body tissue transplants on another attorney's blog. Read the full story at www.medical-attorney-blog.com.
I was working with an executive at a local media outlet on a marketing campaign for our law firm. We spoke on the phone and met in person quite a bit to discuss the project. In doing so we developed a cordial, friendly relationship. In the course of some chit chat with her one day, she mentioned that she and her husband were attempting to have a baby with the aid of a Chicago area fertility doctor. At the time I was working on a medical malpractice case arising out of the death of a young woman caused when the fertility specialist she was seeing negligently damaged her bowel during a surgical procedure. In light of my involvement with that case I asked the executive who her doctor was. It turned out that she was seeing the same physician whom we were suing. Though I was at first a little reticent about doing so I decided to tell her about my case. I figured that she was entitled to know what I knew about this physician. When I did, she confided that she had had her own concerns about the doctor. She and her husband ended up adopting a child instead.
People look into the backgrounds of their babysitters and plummers. All too often, however, patients do not take a few moments to look into their physician's background. All 50 states and the District of Columbia allow patients to look up the status of a physician's medical licensure. Some states will even show you online whether a doctor has been disciplined. There is simply no reason not to take advantage of this service when seeing a new doctor.
I have put together a link (located on the right side of this blog) that will take you to a list of all 50 states and the District of Columbia. Click on a state and you will immediately be taken to that state's medical license look up service.
Over the last 13 or so years, I've worked with many families who have just lost a loved one. There is so much that goes through your mind when that sort of tragedy strikes; so much to think about and so much you do not want to think about. In my experience these overwhelming feelings are compounded when the death takes place in a health care facility under confusing or suspicious circumstances. Family members tend to feel anger (what did the hospital/doctors do or not do) and guilt (is there something I should have done differently), in additional to the sense of terrible loss. Getting answers that uncover why and how the death occurred when it did often seems to help family members cope with many of these emotions. The best pathway to understanding "why" is to have an autopsy performed.
Often the last thing on many people's minds when they have lost a loved one is submitting the deceased's body to the autopsy process. Frankly, it is a gruesome thought. However, nothing is better for uncovering answers, for getting to the bottom of why. If a medical malpractice lawsuit is to follow, an autopsy will be extremely helpful in putting together the case against the hospital, doctors and nurses.
I recently read an article in the New York Times written by a physician that offers a very nice explanation of the benefits of autopsy. You can read the article by clicking here.
Many doctors get sued for malpractice. Some good doctors even get sued more than once. However, there are some bad doctors out there, physicians who should be denied the privilege (it is not a right) of practicing medicine. This morning's Chicago Tribune exposes one such doctor, Mayer Eisenstein. I am quite familiar with this character as I sued him many years ago for pediatric malpractice. We alleged that Dr. Eisenstein and another physician in his group failed to take action in response to a baby whose head was growing in circumference at an unusual and alarming rate. They documented the disturbing growth, and we felt that they should have seen that it was literally off the charts. We alleged that because they did nothing, the child experienced a severe seizure. She ended up with profound and permanent brain damage. The pediatric expert that I hired to review the medical records was astounded by what he saw. He could not believe that any licensed physician could ignore such profound growth. Tragically too, the treatment to relieve the pressure in the child's head would have been simple and would have prevented the unfortunate outcome that befell her.
We sued Dr. Eisenstein and his group only to find that he had no medical malpractice insurance. It was a situation in which the family needed millions to take care of their daughter for the rest of her life, yet there would be no way for them to be adequately compensated. Dr. Eisenstein would never have to answer the charges against him in a court of law. It was one of the most unfortunate circumstances that I have come across in my career. I often think of that little girl, even today, some 10 years since I took on that case.
Thank you Chicago Tribune for exposing this doctor. Hopefully, today's reporting will warn other families away from Dr. Eisenstein and those of his ilk.
There will always be snake oil salesmen, hucksters looking to separate you from your money in exchange for the drug to cure whatever ails you. Sometimes such folks offer a harmless though ineffective remedy for a mild problem. Sadly, however, on other occasions real doctors offer false hope that can be dangerous and heartbreaking. The Chicago Tribune is reporting this morning about a some doctors who are proposing treatment of autism with a drug called Lupron. There is an untested, unproved theory floating around that autism may be linked to testosterone. Lupron is a drug that has been used to chemically castrate sex offenders. "Children with autism have too much of the hormone, according to the theory, and . . . Lupron can fix that," says the Tribune story. The problem is that this theory is pure quackery. The Tribune noted, "Four of the world's top pediatric endocrinologists told the Tribune that the Lupron protocol is baseless, supported only by junk science. More than two dozen prominent endocrinologists dismissed the treatment earlier this year in a paper published online by the journal Pediatrics."
In the Chicago area patients can apparently get the "treatment" though a family doctor named Mayer Eisenstein, M.D. According to the Tribune story, Dr. Eisenstein has had no experience treating autistic children. He is a physician who runs Homefirst Health Services, which advocates home birth. He has been sued numerous times for alleged medical malpractice. He has been known in the past to practice without any medical malpractice insurance of any kind. One has to wonder what kind of physician practices without malpractice insurance.
Hope is a terrible thing to prey upon. There is no cure for autism. For parents of autistic children the desire to help, to find a cure is undoubtedly strong. For physicians to exploit the vulnerability of hopeful parents and their autistic children is profoundly troubling. The lesson, of course, for parents and patients: Do your homework. Remember the old adage that if it seems too good to be true it probably is. Use the resources available on the internet to research treatments for autism or any other ailment, condition or disease. Though it can be painfully hard, lead with your head and not your heart. Be skeptical, smart and thorough.
Click here to view the American Academy of Pediatrics autism web page.
In preparing to give a lecture to medical residents I came across a journal article from a few years ago studying the causes of errors in the family practice setting. I was interested -- though not too surprised -- to read that "physician stressors" were reported by physicians themselves as one of the main causes for medical errors. The top stressors identified were the physician feeling "hurried," the physician feeling "distracted" and "the time of the visit was stressful to the physician (eg, night, weekend, off-duty hours, quitting time)."
Physicians are people too (though some may see themselves as something close to divine). They get tired, pissed-off, anxious. At quitting time they want to go home. Health problems and medical emergencies don't always occur at convenient hours, and patients are most certainly due good, competent care at all times of the day and night. However, for those visits to the doctor than are not emergencies, schedule an appointment when your doctor is least likely to be stressed. Get the first appointment of the day, and always try to avoid being the last patient he or she sees. Once you've seen your doctor for a period of years you'll get to learn when she's least busy and more likely to give you her undivided attention. Ask your doctor when the best time is to schedule a visit. You'll be better off for it.
Apparently, many doctors are removing the wrong amount of money from many patients' wallets. According to Consumer Reports 80% of medical bills contain errors.
The medical journal, Annals Of Family Medicine, has published the results of a new study categorizing the kinds of mistakes patients may make in the course of their own health care. The study was authored by a group of doctors from New Zealand and Wales, UK and the results appear in the journal's May/June 2009 issue.
The study, titled Patient Error: A Preliminary Taxonomy (a sciency sounding word that means categorization), is controversial in my view not so much for the results -- the errors identified are common sense stuff like "forgetting to take medication" and "nonattendance" at doctor visits -- but rather for the title which sets a tone present throughout the article: Patient Error. The authors themselves admit to an inherent and likely problem with this term, that the term "error" suggests "blame." Certainly, a patient may be to blame for a given failure in health care treatment. There are undoubtedly those who would refuse to follow reasonable, clearly elucidated instructions from a physician. That obvious truth noted, the article seems defensive. "There is a need," the authors note, "to move beyond seeing patient, clinician, and system errors as separate categories of error, since they are interdependent rather than mutually exclusive." I am guessing that this "need" is perceived by the authors out of fear of medical malpractice litigation. If the death or crippling of a patient is usually due to a tangled thicket of errors by patients, doctors and "system[s]" then it is unfair to hold physicians accountable. This is a self serving, cynical point of view. Patients certainly can and should take control over their own health care. However, physicians often, in my experience, commit erroneous acts that no patient could reasonably have protected himself or herself against.
Notwithstanding the title and tone of the article, there is some value to be gained from it. For the patient and physician alike it provides a lengthy list of areas where the doctor/patient relationship can breakdown. The advice the patient can take away is educate yourself, communicate with your doctor, and cooperate where appropriate (education will help with this.) For the physician, the article provides notice of challenges that will often need to be overcome when treating a patient. For example, one of the "errors" patients purportedly make are those involving memory. Some patients are forgetful. Ask your patient if he or she has memory problems. Sometimes you'll even have a strong suspicion, especially when dealing with the elderly. Once the problem is identified, work with the patient on a solution. Have your office call the patient to remind her of an upcoming appointment. Involve a family member in reminding the patient to take his medication daily.
I sincerely hope that the publication of this article does not represent the start of a campaign in blame shifting by the medical establishment. It is undisputed that physician error is an enormous problem. To focus on laying blame for bad outcomes on patients who are often sick and vulnerable would be counter productive.
A physician friend of mine who trains family practice residents at a Chicago hospital recently asked me to come and speak to them about medical negligence. She asked me to speak about the most common errors I see pertaining to family practice/primary care medicine. In anticipation I've been thinking about the kinds of mistakes I have seen over and over made by family and primary care physicians. One trend I have been able to identify is the failure of the family doctor to properly use the process known as "differential diagnosis." This process is how your doctor figures out what is wrong with you. With it your doctor will make a list of possible ailments from which you may be suffering based upon your symptoms. He or she will then examine you and will perhaps order tests in order to rule out the ailments on the list until only one is left standing. That will be your diagnosis. Sadly, however, sometimes physicians get into trouble by ignoring this tenet of good medical practice. Family practice doctors tend to see the same ailments, diseases and complaints day in and day out. This unfortunately leads to laziness in the approach they take with their patients. After seeing the 100th patient in a given week with the same symptoms, the physician may side step the differential diagnosis process and jump right to a single diagnosis, which for patient number 100 may be dead wrong.
This morning I came across a very good article at About.com about how the patient can involve himself or herself in the differential diagnosis process. The crux of the article is that you can and should question, test your doctor in order to determine whether she used the differential diagnosis process or simply jumped to a single conclusion. Click here to read the entire article.
So many cases in which I have been successful suing doctors have revolved around a lack of information; either the defendant physician didn't have it, didn't ask for it or didn't know he or she needed it. The importance of information gathering for proper patient care cannot be overemphasized. If a patient has a past history of diabetes, or recent surgery, or cancer, or stroke that information may be vital -- sometimes the difference between life and death -- to the physician treating the patient. This is one of the reasons that continuity of care is so important. If your physician knows about your health history by virtue of having been your doctor for many years, he or she will have a base of knowledge to use in diagnosing and treating future health issues. If you are seeing a doctor who doesn't know you, you and the physician, are at a disadvantage. So how can you keep your health and medical history well organized and closely at hand to share with those who may need it?
Google to the rescue.
Google Health allows you to keep all of your health care information, including prescription information and your medical records, in one central place. The advantages of this service are that you can share your health information with your doctor, and you can research your own health needs online guided by data contained in your medical records. Say, for example, your physician's office decides to no longer accept your insurance plan. You have to choose someone new. You would be able to quickly, and effectively transfer to the new doctor your entire medical history, including your prescription information. There is also significant value in being able to see your own records. A few years ago I represented a woman who was being screened by a new doctor to determine if the cancer that had been treated by a different doctor in a different city had returned. Test results indicated that it had. However, she never learned that because the new physician's office had communicated the results to her verbally, over the telephone, incorrectly. Had she been able to see the test results for herself she may have been able to take the initiative in getting additional treatment.
Google Health also allows participants to browse an online health services directory to research health issues. For example, a pregnant mom to be could research whether the drugs she is taking for depression are safe for her fetus. A person with hypertension could research drugs and their various side effects so as to have an informed discussion with a physician about treatment options.
This is empowering stuff. Google Health seems to be a tool that truly puts the patient in charge. There are, of course, potential and arguably significant downsides to this service. Whenever I have mentioned Google Health to a friend or colleague the first, inevitable response I get pertains to privacy concerns. Google is, after all, a giant corporation. Why, people have asked me, would I give the most personal details about myself to Google? For its part, Google swears on a stack of bibles that it will safeguard your privacy. But in the end you will need to ask yourself, "Do I trust Google?" Certainly, everyone will have to decide for themselves, but it seems to me that many if not most of us are already sharing this information with big corporations, insurance companies, hospitals, pharmacies and health care networks. Will they be more benevolent in the way they safeguard your data than Google would be? Also, ask yourself what exactly it is that you don't want Google to know or share. Sure you wouldn't want records forwarded to your mother documenting that nasty case of crabs you had, or to your employer that you've been treated for anxiety. But you have to balance the likelihood of something like that happening versus the value of being able to get vital information quickly and efficiently into the hands of a doctor who may need it to treat you.
Another downside of Google Health, at the moment, is that it is clearly in the chicken wire stage of development. Google has very few health care partners presently participating in this project. Notably, the large pharmacy chains CVS and Walgreens allow you to upload your prescription information to Google Health. However, very few doctors offices and hospitals have cooperated. The bottom line is that even were you to sign up tomorrow, you probably wouldn't be able to upload much. You could, of course, obtain paper medical records from your providers and scan them into your Google Health account, but that's a lot of work. I can't imagine many folks choosing to do that.
Notwithstanding the downsides, so far, Google Health sounds promising. Stay tuned.
I have written before about what a patient can do to protect herself against surgical errors. A story in Sunday's Atlanta Journal-Constitution offers some scary examples of surgical negligence, but also some good tips on how patients can protect themselves when going under the knife.
If you're like me and live in a large metropolitan area (Chicago) and have small children (18 months) in school or daycare (the latter), you may be a little concerned about the swine flu. There is no vaccine or cure, it is spreading quickly in crowded environments and it has proven deadly in the very young. I imagine that many pediatric and family practice offices are being inundated with calls from worried parents wondering if little Johnny's or Jane's sniffles could be related to this growing epidemic. I have to admit that I have visited the website of a well-known pediatric office here in Chicago to check on recommendations for dealing with this situation. Should I be stocking up on Tamiflu just in case? The answer, of course, is no for now. Frequent hand washing and avoiding obviously sick people is all one can reasonably do for the moment.
Take him or her to the doctor and request a test for the swine flu, aka the H1N1 virus. A quick test can be done at the doctor's office to determine if your child has influenza (flu). If that test is positive additional testing can be done to determine if it's the H1N1 virus vs. the garden variety flu. Do not allow your doctor to brush you off with comments like, "It's probably just a cold," or "I'm sure she's fine." I appreciate that physicians will likely grow weary of patient concerns about the swine flu, but there is simply no reason for such speculation, especially with regard to young children. Do not allow your concerns to be brushed aside. If your child has flu symptoms, ask for the test. Time is of the essence because Tamiflu, which can reduce the severity of H1N1 virus once contracted, must be given within 48 hours of the onset of symptoms.
Last week I wrote that when it comes to picking a family doctor you don't need the best. What you need is someone who is competent and caring and whom you like and feel comfortable communicating with. To treat a serious ailment, injury or disease the family practice doctor will refer you to a specialist anyway. However, when it comes to picking a hospital, it's a different story. Not all hospitals are the same. The importance of choosing a good hospital is highlighted here.
Choosing a good hospital can be tricky, but the bottom line is that it usually comes down to resources, money. Some hospitals have it, and use it to create fantastic centers for diagnosis, treatment and learning, and others do not. There are some hospitals here in Chicago that constantly seem to be spending money to improve patient services. Northwestern Memorial Hospital just opened its brand new Prentice Women's Hospital and Loyola University Hospital is expanding its Center for Heart & Vascular Medicine. With regard to hospitals like Roseland Community Hospital and St. Bernard I have to wonder how they manage to even keep the lights on. A hospital's wealth is certainly no guarantee that it will provide safe, error free care to all of its patients, but odds are that you'll be better off.
The other thing you'll need to consider in choosing a hospital is they type of care you need. Some hospitals are simply better at treating certain kinds of patients than are others. For example, if you are having a baby I doubt you could do better in Chicago than the aforementioned Prentice Women's Hospital. If you have heart issues, St. Francis in Blue Island (now Metro South) has a good reputation. Once again, no hospital is perfect. I am aware of serious errors committed at each of the hospitals I have mentioned here. But remember, you are playing the odds. Do your homework before you require a significant hospital stay and you will decrease your chances of becoming a victim.
Here is a link to what US News & World Report thinks are the best hospitals in the United States.
Here's a follow up to the story about Veteran's Administration patients who received treatment with contaminated endoscopic equipment. Some have tested positive for HIV.
Several years ago I was sitting in the back of the courtroom during closing arguments in a medical malpractice case tried by two senior and very talented trial attorneys. The case arose from the death of a man who died of meningitis after physicians completely ignored obvious signs and symptoms. The man left a grieving widow and a son. During his closing argument the defense lawyer asked the jury rhetorically, "What is a doctor?" He then preceded to wax on eloquently about the challenges physicians face during their careers. I remember the defendant doctor sitting there emotionless in his expensive looking suit as his lawyer went on, painting him as a tragic hero. I also remember seeing the wife of the deceased sitting at the adjacent table looking forlorn and detached. I was sure that she wanted to be anywhere else. The doctor's lawyer, coming near the end of his closing, again asked the question, "What is a doctor?" clearly feeling that by that point, everyone had received his message that a doctor, his client, was nothing less than a hero. As the lawyer took his seat a tense silence enveloped the courtroom. The judge looked over at the widow's attorney, "Counsel?" The old attorney looked grim as he stood, a bit of anger on his face as he strode slowly to the center of the courtroom to face the jury. "What is a doctor?" he growled; "What is a husband?" His voice trailed as he looked at the jury. It looked as if he might say something else, but he didn't. He turned quietly and returned to his seat next to the widow.
Earlier this week I saw a story in USA Today announcing a new book called The Soul of Medicine by Sherwin Nuland, a former physician. The headline of the story proclaimed the apparent premise and primary subject matter of the book, that A doctor's 'Soul' is tormented by medical errors. Reading that reminded me of the closing arguments in that trial from several years ago. It bothers me too. I have no doubt that some physicians feel haunted by their mistakes. However, I have spent too many years going after arrogantly unrepentant doctors to feel anything but cynical with regard to the medical profession. I remember going to visit a neurosurgeon at his office to discuss a client of mine. I remember being shocked to see clear evidence of his god complex hanging right on his wall:
We all feel haunted by our mistakes. When any of us make a mistake that causes harm to another person the pain we feel is worse. I become deeply troubled, however, by the romanticizing of the medical professional. I feel this way because I frequently witness the impact it has. It makes physicians seem like exalted "others"; like gods among us mere mortals. This falsehood creates an atmosphere of tension, apprehension between doctor and patient. The patient all too often feels intimidated by his caregiver. This is undoubtedly a counterproductive state of affairs.
One of the reasons that we trust our doctors is that there is a perceived difference in social status between them and us. But this is not healthy. It discourages frank and open communication, which leads to poor treatment and an increase in medical errors. The more you communicate with your doctor the more you will see each other as individuals entitled to equal amounts of respect. This will encourage even more communication and openness which will lead to better care and fewer mistakes.
Continuity of care. That concept is vital when it comes to fostering good health care where a minimum of errors are made. What it means is that you should stick with the same doctor for as long as possible. Doing so is often difficult in our current system where patients usually rely on private health insurance to cover costs. Often a insurer will unexpectedly decide to drop a physician or physician group from its plan. Many times a physician's office will decide to no longer except a patient's health insurance. Those significant realities aside, the importance of doing whatever possible to keep seeing the same doctor cannot be overstated. This is especially true when it comes to your primary care or family physician.
A good friend of mine who is a board certified family practice doctor recently forwarded to me a video from ABC News discussing the importance of continuity of care and the family practice doctor. The video can be seen by clicking here. Continuous care with the same family doctor means regular medical follow ups. It means preventative and consistent care for chronic health issues like diabetes and allergies. There are few if any formulas for patient care. Different physicians have different approaches to patient care and treatment. There is nothing necessarily wrong with this. However, when a patient constantly switches from doctor to doctor with their different approaches to treatment and prescribing medication, confusion is all too often the end product. This leads to more medical errors and patient injury or death as a result.
Let's be frank, you do not need the very best doctor to be your family care physician (as if there were a way to measure what it means to be the best.) You need a competent, caring physician who knows you, your body and your medical history. In my view there is nothing more important to safeguard patient safety and to reduce preventable medical errors.
For quite a few years Wisconsin Medical Society has maintained a victim's compensation fund to provide for the harms done to patients due to medical errors. Here is an interesting story about how the State has stolen money from that fund.
The importance of communicating clearly and effectively with your doctor cannot be overstated. This can be a huge problem where you and your physician do not share a common first language. The Chicago Tribute recently reported on an innovation that is meant to help patients and doctors overcome a language barrier. Click here to view full story.
Here at the old firm we often test a case in front of a group of regular people prior to trial to see how they react to various issues. We do this because after years of litigation in which we've focused on minutia we often worry about losing sight of the forest through the trees. Nothing is better, in my opinion, than asking a group of non-lawyers what they think of your case to help prepare for trial. Most often the kind of cases we test in this way are lawsuits brought against doctors, nurses and hospitals; medical malpractice cases. During these tests one question comes up time and again: What is medical malpractice anyway? Is it different from medical negligence? After presenting a case to a focus group we often hear people say that they felt the defendant, i.e. physician, acted negligently but was probably not guilty of malpractice. This tends to leave us scratching our heads. Under Illinois law "medical negligence" and "medical malpractice" mean exactly the same thing. So why is it that non-lawyers, the kind of folks you'd see on a jury, tend to intuitively see the two differently?
A physician is guilty of medical negligence and medical malpractice when she fails to act towards a patient as a reasonably careful physician would in a given circumstance thereby causing that patient harm. The jury must make a determination of reasonableness by listening to expert testimony. What we often see, however, is that many people naturally tend to think that malpractice is something worse than negligence. I frankly don't know why this is. My guess is that malpractice just sounds worse. It sounds like malfeasance, malcontent, malicious, malodorous and other words with the prefix "mal" that tend to have a very strong negative connotation. The problem with this confusion for injured patients and their attorneys is that a jury may be misled into believing that they ought not return a verdict that provides for the harms suffered by the patient unless the physician did something bordering on the intentionally evil. Virtually no medical malpractice cases involve an intent by a physician (or other health care professional) to do harm. All such cases involve an allegation of negligence.
Patients are not entitled to receive the very best care from their doctors, though one would hope that all professionals try to serve their clients/patients to the very best of their abilities. A physician, however, has a duty to at least care for and treat her patients reasonably. This is important to remember. One need not feel as if their doctor intended to harm her before she questions her physician's conduct.
Brendan H. Kevenides Attorney At Law 30 North LaSalle Street, Suite 4030 Chicago, Illinois 60602 312.236.2522 (Main office) 312.236.6188 (Fax) 772.936.8196 (24/7) bhk@kenneallylaw.com
About Me
I am a Chicago, Illinoismedical malpractice attorney who has been representing wrongful death and personal injury victims for thirteen years. The results I have achieved for my clients in all personal injury matters exceed $12 million. I may be reached 24 hours a day. To view a sampling of my successes, read more about me and my law firm I invite you to view my Home Page.
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