Submissions from Victoria Nicholls
David L Meyers
dm0015 at COMCAST.NET
Fri May 6 15:26:32 UTC 2016
On 5/6/2016 6:04:41 AM EDT, Vic Nicholls wrote
This is why harmed patients are an integral part of this process, because you can't sell us an answer we're not a part of, nor one that the medical side refuses to recognize isn't at the root of the problem. It is our comments & view points that are different that will continue to fuel discord because we are not listened too when you know physicians are on the same side of the treatment, like pilots are.
I can think of an MD/MD couple who takes their child to THREE ER's before they are diagnosed correctly. They understood it once it happened to them, and then were trashed on by the medical profession for admitting it.
Totally sad. Its why I continue to speak out. Good docs who see it don't deserve tarring and feathering. They've earned that.
On 5/5/2016 6:30 PM, Vic Nicholls wrote:
" and the knowledge that their fate is the same as the fate of the airplane" since they do suffer the same consequences of their errors as the person, you've got a major reason why they will be careful.
On 5/5/2016 8:19 AM, Vic Nicholls wrote:
1) what if the diagnosis given is *part* of the cause of death, not all? Is that considered wrong? Who decides that answer?
2) autopsy first? Wouldn't a physical exam seem more appropriate than sort of guessing? I mean medical professionals usually run regular tests, like a strep test, before diagnosing someone. Are we going to consider what they ran before the death sufficient or an autopsy included? Who pays for the autopsy?
3) considering the constant refrain I hear from harmed patients about lawyers not pursuing cases, with proof doctors win an overwhelming majority of the time, why are doctors the only professional group needing litigation law changed?
4) What is the diagnosis for old age? Obesity related causes? Are we going to have a (legal/society) problem because someone put down obesity or untreated sphyilis as a cause or partial cause of death and it makes someone mad because they don't want their relative/friend/loved one to have that on legal record?
5) If you do 1000 autopsies and find out people die, say of, stomach cancer more often? Do you (over)test for stomach cancer or wonder if it was just luck of the draw?
6) Scenario: person goes to urgent care. Urgent care refers to specialist. While waiting, person dies. Who's fault is that? They couldn't get care from the specialist? Didn't go to the doctor before it was too late? The urgent care who didn't refer to A&E (which doesn't treat that issue, not an emergency?).
7) At what point do you say that a health care professional should have remedial education? Specialist who misses 2 diagnoses? 2 deaths? PCP's who miss it while testing out prescriptions for the problem?
8) One study noticed previously is bariatric surgeons that filmed surgeries and critiqued themselves, got some of their own issues/patterns of problems/potential problems. So how do we pay for someone to record those things and who is chosen to do that, how do we pay them for that expertise?
9) How do you "fix" the problem? Do you simply give the, say, nephrologists' name and X diagnoses of kidney cancer they missed? That sort of data the public is going to go crazy over knowing. The bigger issue when there are problems are when administration/risk managers/lawyers cover it up and then it comes out what happened. That sort of data should be given to us automatically, so we make the decision of who we want treating us. Maybe a nephrologist is better in diagnosing diabetes related kidney issues because that is what they see 90% of the time, compared to kidney cancer. How do you present that?
Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine
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