Death Certificates

Pete Dayton pdayton at PTWFL.COM
Thu May 5 16:43:38 UTC 2016


Hi folks, my first post…It probably won’t be used as a cause of death as this is sometimes subjective unless one performs a formal autopsy. Secondly malpractice risk, who would assign that liability willingly to themselves on a death certificate, it’s human nature ? Lastly people dying of multisystem disease sometimes die of multiple simultaneous issues all of which may not have been thoroughly investigated. Is that an error, slip or malfeasance? Calling a PE a rib bruise is one thing, but my experience is that it is seldom that clear. Hindsight is always 20:20 and yes I agree the Errors are happening at an alarming rate. Stop paying doctors for piece work and stop depending on the EMR to mention every possible drug interaction east of Eden , make the docs be Doctors! High volume , alarm fatigue and distractions all clearly recognized as potential opportunities for error in aviation and not in medicine. Docs need cockpit resource management , RCM , skills and need to slow down, study the drugs they prescribe well, see fewer patients , especially complex internal medicine patients, take better histories, listen to patients, become astute at physical diagnosis again and enjoy the practice of medicine! Yes they will make less money but pay them for outcomes not volume and this will improve. I don’t think we should rely on the ERM and the internet for everything. I have used an EMR for 10 + years and it is helpful but a double edge sword. I teach medical students and make them get their heads out of their phones and actually learn the stuff. The harder one  works to solve the problem the better the lesson. Make answers too easy and I think you lose a lot. Students come through their  general surgery rotations come to my GYN service and can’t write post op orders because of automated order sets. When I see them we pull a blank piece of paper out of the printer and they write the orders. It is amazing the deer in the headlight looks I get! 

 

Just my 2 cents

 

Love your show Joe! 

 

Peter M. Dayton MD

Medical Director of Patient Safety and Quality

Martin Health Systems

1815 Kanner Highway

Stuart, FL 34994

772-288-2992 Office

772-285-4020 Cell

772-288-2999 fax

 <mailto:pdayton at ptwfl.com> pdayton at ptwfl.com

I Peter 3:15

 

 

 

From: Joe Graedon [mailto:jgraedon at GMAIL.COM] 
Sent: Thursday, May 05, 2016 8:36 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Death Certificates

 

This is a very interesting concept. 

 

Just out of curiosity, has anyone ever asked the question or sought an answer to the question: 

 

How many times does "Error in Diagnosis" show up on death certificates? If I were a betting person I would guess rare to never. 

As to the second "Error in Medicine" I would guess never. 

 

To change that one would need to change the culture of medicine. 

 

Joe


Sent from my iPad


On May 4, 2016, at 11:11 PM, robert bell <0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG <mailto:0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG> > wrote:

It is not common practice to put either Error in Diagnosis, or Error in Medicine on a death certificate. They seem to require some kind of diagnosis even if it may be incorrect.

 

Could this Society change that with action and recommendations or would you have to first change litigation law to achieve that?

 

Are there any other solutions that would be acceptable? 

 

This would seem to be part of that data lack that plagues the Error in Medicine discipline.  

 

Robert M. Bell, M.D., Ph.C.

 

 

 

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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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