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On Dec 10th, a state Supreme Judicial Court in Mass ruled that a doctor can be sued over a car accident caused by his patient while driving since that doctor prescribed numerous medications to the driver. Some of those meds included narcotics. The patient hit and killed a 10-year-old boy after he fell asleep at the wheel. The mother of the boy alleges that the doctor failed to warn his patient about the side effects of the medication and the potential danger of driving while taking them. This ruling greatly expands the potential liability for the medical profession. This is all described in detail in a recent Boston Globe where Justice Roderick L. Ireland ”compared a doctor who fails to warn a patient about a drug's side effects that could endanger others to a bartender who serves a drunk customer” . What is even worse is that this is Massachusetts’s highest court making this ruling.
These are very scary times for doctors. Now we are accountable for every possible scenario that can happen from taking a medication. The patient who fell asleep had been taking multiple meds, many of which can cause drowsiness, and hadn’t reported any side effects in the months before his accident. The article went on to say that the two dissenting justices “worried the ruling would drive up medical malpractice rates”. You think? Forget the fact that recent studies show that long term use of narcotics does not impair driving ability. I mean who needs science? Let’s just keep suing and pick up the pieces later.
These are very scary times for doctors. Now we are accountable for every possible scenario that can happen from taking a medication. The patient who fell asleep had been taking multiple meds, many of which can cause drowsiness, and hadn’t reported any side effects in the months before his accident. The article went on to say that the two dissenting justices “worried the ruling would drive up medical malpractice rates”. You think? Forget the fact that recent studies show that long term use of narcotics does not impair driving ability. I mean who needs science? Let’s just keep suing and pick up the pieces later.
6 comments:
Document document document.
"The patient was warned about the possible side-effects and/or adverse reactions of this medication and the patient voiced understanding."
"The patient was warned that by not having [colonoscopy/DEXA scan/diabetes screening/lipid screening/chest XRAY, etc etc] that the patient would run the risk of having their condition deteriorate causing excessive morbidity and/or their mortality, and the patient voiced understanding."
"The patient voiced understanding and agreement with the above treatment plan."
and my favorite, when I send that prior auth letter to the insurance companies:
"P.S. This letter should also serve as notice that I will not be held responsible for any deterioration of this patient's condition (including death) which results from the patient being denied access the above medication by your company. In that event, the Medical Director of [insurance company] assumes liability for this patient's clinical deterioration and/or death.
COPY TO CHART."
The last one actually holds no weight in a court of law, but is a gateway for the trial lawyers to go after the insurance company in the event of a bad outcome. Although the insurance company would eventually win out in that circumstance, they would have to spend a LOT of money on lawyers to defend it against the blood-sucking John Edwards types. Seeing this, they usually will approve whatever you need (within reason.)
This makes me fear depression even more. I see an adolescent with depression. I get sued for not prescribing an antidepressant because of the black box warning linking antidepressants to suicide and he commits suicide because he's depressed. Or, I get sued because I did prescribe an antidepressant but he committed suicide--obviously because of the medication. Can't win.
In recent years I have infuriated a number of folks by pointing out that physicians increasingly see patients as opponents, and the patient-physician relationship is barely a collaborative effort, but more a contest in which both hope they can emerge unharmed. Tough beans gang, it's the truth. These days I advise prosepctive medical students to stay the hell away from this profession, with no apologies. It is a constant erosive to deal with the irrational and potentially vengeful every day, and to be treated in a way I would NEVER treat an auto mechanic or realtor. Society has come to regard us as technicians whom they can hold to an impossible standard of perfection even as they devalue our skills. It is sad but no less true that every time I see a story about physician shortages, a patient who could not be seen in the ER by a specialist, angry seniors who no longer get hot-and-cold running "free" medical care, or politicians selling more of this devolution...I smile.
This also makes us only more likely to not treat pain with any pain medication that may have a possible side effect and then they say doctors don't adequately treat pain. When is the american public going to wake up! We can't treat patients as we see best because you are always watching your back trying to CYA in case someone decides to sue you. It all boils down to a societal problem that is spilling over into medicine. The american dream now is not a home, a car, and a good job. It has deteriorated into trying to get disability so you can sit on you fat ass and get fatter and then sue the doctor when they don't "adequately treat" your obesity related issues of heart disease, diabetes, HTN, CVA, cellulitis or when someone does not have a seat in a movie theater that is rated for a small elephant. That the patient would have not gotten obese in the first place if they would have gone out and gotten a job and become a productive member of society. Either that or they try desperately to try to sue someone (not just doctors) so they can win the so called "lottery" that our court system supports everyday because money hungry lawyers get a cut of every settlement. They should see that it is the lawyers that they should be suing who have more money than any of us doctors. Where is this going to stop? Will they sue the drug company for making the drug, the car company who made the car they were driving, the city who provided the street they drove on, the person they hit, and the water company that provided the water they drank to wash down the medication? When do people take personal responsibility for their own actions? In America rarely. No wonder other countries hate us. We have more money, luxuries, food, and health care of any other country in the world and we still want more of what someone else has (other peoples money, etc). I remember a time magazine cover in the recent past that showed a obese crying baby pointing fingers at everyone else. Well this sums up our societal degradation well. It is sad, real sad.
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