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The choice of lawsuits and overtesting for emergency physicians

Jan
16

Date: January 16th, 2014

The many difficulties that physicians face in the emergency departmentJust like most of the physicians out there, those of you who read this blog regularly are well familiar with the rather difficult choices that doctors in emergency department have to make. In fact, this is one of the most dreadful places you can get to work in at the hospital and you have no idea of what will happen next. As the Associated Press continues with its rather excellent series on the subject of overtesting, we are now discussing the fears of lawsuit which is the driver leading to these unnecessary tests.

Emergency room tests

To start with, just consider chest pain for instant, which is among the most common symptoms present in the emergency department. Patients who are having suspected heart attacks usually receive a lot of what is offered by the emergency physicians ranging from the multiple blood tests which can easily get costly to EKGs and X- rays to the expensive CT scans that are nowadays become like a routine for most hospitals ERs that diagnose heart attacks. Actually, the testing battery could after all be paying off. Just some few decades ago, statistics released by insurers showed that nearly 5 % of heart attack cases didn’t make it to the emergency room. Currently, this now stands at less than 1 percent, according to Dr. Robert Bitterman, who heads the medical legal committee of American College of Emergency Physicians. But Bitterman was quick to add that missing them can get you sued.

The idea of AMA to provide protection to doctors engaged in malpractice where he or she has followed the evidence based, standardized guidelines really make a lot of sense in such cases. In addition, this can significantly help reduce significance of practice variation which most reformers in the health industry have continued to focus on. Now, just combine this with the demand for tests by patients. The president of American College of Emergency Physicians, Angela Gardner, notes that the society has been putting a lot of weight on technology at the expense of physical exams. He asks patients why they would believe doctors who just examine them when they are getting an X- ray, which can for sure tell them something.

The risk of making a patient unhappy

Refusing such demands only makes patients unhappy and the worry that an unhappy patient is going to sue the physician has always been the main concern in emergency rooms. A patient can really help by simply asking the necessity of a proposed test and any kind of risks that could result from the test not being done. Better still, a patient could specifically ask how the test is going to change the treatment plan of the doctor. A physician should make an informed decision in order to avoid the risk of malpractice.

 

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