death certificates

Elias Peter pheski69 at GMAIL.COM
Fri May 6 13:52:14 UTC 2016


Sounds like we are from the same generation, though my area is family practice.

We have a built-in systemic paradox and need to decide the purpose of the death certificate.

If the purpose is to certify that the patient is dead, does not require special treatment to prevent a public health issue (can go to funeral home), and does not need police involvement or medical examiner, then it makes sense to require that certification quickly and by the most accessible clinician. I long ago stopped worrying about the long term data implications of what I put on a death certificate. The system makes it impossible to achieve data accuracy.

If we want a system that accurately reflects how and why the person died, we will need a different system.

Peter


> On 2016.05.06, at 9:17 AM, Tom Benzoni <benzonit at GMAIL.COM> wrote:
> 
> Permission to ask a poking question?
> All on this list who actually, today, fill out death certificates?
> I do, and I can't believe how archaic they are. And how much useless nonsense they contain and don't contain.
> 
> I'm an old ER doc. Permission to rant?
> I remember when GP's knew their patients and didn't mind having their names in the family bible. (That's where death records were stored.)
> When I'd declare a patient dead, I'd fill out the certificate that they were, indeed, dead, and the GP would fill out their history. (I don't have the history, so I can't attest to any more than their heart stopped.)
> 
> Now, no one but me talks to the family, offers condolences, and fills out the certificate.
> I put in what little nonsense I know and the family must be content to see some stranger's name for generations to come.
> See a problem? And I hear this from all the ER docs with whom I speak.
> I'd like to hear if this is common cause or special cause variation.
> 
> And I don't think data from death certificates is worth the paper they're on, whether physical or electronic paper.
> 
> tom
> 
> PS: anyone done a study on death certificates comparing entered data to Medicare Diagnosis Database, non-deidentified? I.e., are the diagnoses Medicare has on their beneficiaries appearing on death certs?
> 
> 
> 
> On Thu, May 5, 2016 at 12:39 PM, Elizabeth Regan <lizregan53 at gmail.com <mailto:lizregan53 at gmail.com>> wrote:
> I would not favor adding medical error to death certificates for a variety of reasons but the chief one being that it is so hard to define and while is obvious to those who want to see improvement, it is less obvious to those who want to avoid the concept.  At the point where there is broader consensus on how to identify and reduce medical error (especially diagnostic error) I think it will be easier to record and track the event.
> 
> I believe strongly that it is critical to do that, but we are not there yet.
> 
> I have just completed a project to adjudicate cause of death in nearly a 1000 deaths for a large cohort study.  The project involves reviewing both death certificates and medical records.  At that level of review I did not see evidence of diagnostic error or other errors.  Now that I consider the project in light of this discussion - I guess that is interesting.
> 
> I don’t interpret this to mean that none of those subjects experienced error, but rather to reflect on the invisibility of error in our record keeping.
> 
> I wonder about the feasibility of re-reviewing the data with a more critical eye and finding more.  However, I don’t really think I would find much.
> 
> Liz Regan
> To unsubscribe from the IMPROVEDX:
> mail to:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG <mailto:to%3AIMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>
> or click the following link: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
> 
> Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
> 
> For additional information and subscription commands, visit:
> http://www.lsoft.com/resources/faq.asp#4A <http://www.lsoft.com/resources/faq.asp#4A>
> 
> http://LIST.IMPROVEDIAGNOSIS.ORG/ <http://list.improvediagnosis.org/> (with your password)
> 
> Visit the searchable archives or adjust your subscription at:
> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX <http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX>
> 
> Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine
> 
> To unsubscribe from the IMPROVEDX list, click the following link:<br>
> <a href="http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1 <http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1>" target="_blank">http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1 <http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1></a>
> </p>
> 
> 
> 
> 
> To unsubscribe from IMPROVEDX: click the following link:
> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1 <http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1>
> 
> or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
> 
> Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX
> 
> 
> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine
> 
> To learn more about SIDM visit:
> http://www.improvediagnosis.org/
> 







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


HTML Version:
URL: <../attachments/20160506/85bfc756/attachment.html>


More information about the Test mailing list