MISS10Medical-LegalCases.ppt.pptVIP

* You Experience Self-doubt Self-worth issues Difficulty sleeping and sleepless nights A propensity to become angry quicker than normal (with your family, staff, and patients) A feeling of being out of control * Remember the Clinical Debate Gallbladder management in the WLS patient ? Assess for gallstones routinely and perform cholecystectomy if stones are present, even in the absence of symptoms? Perform routine cholecystectomy in all patients having a weight loss procedure ? Provide six-month course of therapeutic pharmaceutical intervention? Assess for gallstones only when symptoms are present, treating only symptomatic patients No clear answer on the best approach  * Coupled with the Aggravating PL Circumstances Death of a young woman with newborn Self-pay patient Failure to document after hours call Lack of acknowledgement by patient of pregnancy discussion Lack of documented risks of surgery including gall bladder disease * Self pay Get documented patient understanding of patient financial responsibility Not only the surgery, but also any potential complications Provide the patient with a list of costs (anticipated and potential) * Spouse Acknowledgement of Risks Spouse: “She didn’t understand the risks; if she had, she would not have had the surgery; or she would have had you remove the gallbladder during the bariatric surgery.” What can you do? Family advocate/Spousal acknowledgement * Procedure-Specific Informed Consent Form: Bariatric All risks Witness Intro Patient * Addressing the Gallbladder Disease and Pregnancy Issues * Procedure-Specific Informed Consent Lap Chole * After Hours Calls * Strategies for Documenting After Hours Calls Hand held dictation device Dedicated telephone line to answering machine for dictation Telephone note pad (kept at bedside) Use of office voice mail system * Litigation Stress Data: 70% to 86% of physicians surveyed reported tension, depression, frustration, and anger 16% experienced physical illness