261–270 of 274 posts
Why don't we keep track of refusals as well?
Not a bad idea, per se, but then which is better - the doctor with 0% refusals and 20% deaths, or the one with 20% refusals and 10% deaths?
Note that this also works to improve stats on docs who choose hard cases.
Easily solvable. Have a person whos jobs it is to rank how likely a person is to live. He gets paid based on how accurate he is. Doctors would then be ranked as an offset from this previous mortality prediction.
It targets inflation and unemployment goals.
Goals are measured by the Department of Labour (BLS).
There was a counterintuitive study of obstetricians that I cannot find right now that showed that in one state over many (10?) years the ones who did the most C-sections were the best doctors - because when researchers looked at the underlying data the realized these doctors treated the patients who had the worst predicted outcomes and beat the national odds - I think they theorized that these doctors had the best ab…
This may of course favour unnecessary ops...)
Earlier quoted context omitted.
Absolutely. You can sue for pretty much anything. Winning is another story, but doctor's don't generally make sympathetic defendants. Juries know they have money and that they pay huge insurance fees to cover these cases. Of course, after losing a big case where the insurance company pays out millions of dollars, they likely become uninsurable and unemployable. But hey, the money is good until you hit the anti-lotter…
If he really had a pattern of gross incompetence, wouldn't there have been some other process to stop him doing that? Are courts really that incompetent themselves that they can't understand such simple statistical errors as using survival rate to measure competence?
There are medical boards to remove incompetent doctors, but those influence jury trials primarily through submissions of findings as evidence for consideration by juries. A good lawyer will portray medical boards as a bunch of doctors biased against passing judgement on fellow doctors.
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Can someone really sue their surgeon in the US?
If you undergo a procedure whereby you could die it doesn't mean every cadaver is a paycheck. It means that if your death is a consequence of negligence or malfeasance that family has a recourse. This is entirely reasonable and I cannot imagine how you could have a medical system where you can't? What do you do if your surgeon operates drunk and kills you? Hope that a bunch of other doctors don't close ranks and prot…
Can you see that this introduces a level of recklessness that isn't present in the parents question? Parent is asking about normal death by medical error. That's likely to have complex causes and is rarely as simple as "doctor was negligent".
But assuming that a doctor does kill someone: most relatives don't want a pay out. They want to know that this mistake won't happen again; that people and the orgnisation have learnt from the death; and they want an explanation of what went wrong along with an apology.
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> Nowadays, I'm usually making Doctors aware of advancements in their field... Scary stuff. I don't find that to be too surprising. I can be hyper-aware of my own ailments, but keeping up with an entire field is more difficult. Furthermore, treating to research runs the risk of using treatments where the outcomes haven't been replicated, or there are long-term complications. Unless you've exhausted more conventional…
>I don't find that to be too surprising. I can be hyper-aware of my own ailments, but keeping up with an entire field is more difficult. I do not find the above to be sufficient justification to practice in ANY field without trying to stay aware of the state-of-the-art. Yes, in medicine in particular, there is a justifiable bias toward applying more conservative treatments first. "Hear hoof beats, think horse first,…
It's not a justification of not _trying_ to stay aware of the state of the art, but you always (potentially) stay ahead if you are focused on a smaller sub-field. I doubt it's possible to be completely aware of every single advancement for every condition you might encounter as it happens, nor is it suggesting that you should ignore the chance of zebra - for me, the best doctors have been those who will say "_I_ don't know; I will consult others or the literature", recognising that it's not possible for a single doctor to have exhaustive knowledge.
There was a counterintuitive study of obstetricians that I cannot find right now that showed that in one state over many (10?) years the ones who did the most C-sections were the best doctors - because when researchers looked at the underlying data the realized these doctors treated the patients who had the worst predicted outcomes and beat the national odds - I think they theorized that these doctors had the best ab…
There's a very strong relationship between experience (number of procs performed) and outcomes. High-volume is almost always beetter. This may of course favour unnecessary ops...)
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The one doing the estimate will do so based off the records generated by the doctor doing the surgery.
Not for referrals.
Sounds a bit dramatic but if they think action is genuinely inappropriate, they should make the case to their colleagues, or a Multi Disciplinary Team, and let them have the final say. Together they should be able to enforce the Royal College and NICE guidelines for operating and the CQC —the main monitoring body— should be able to work out (both from data and on-the-ground inspectors) whether hospitals are doing as they should.
I realise that's pretty UK specific but the ACS should be able to achieve something similar.