Thats.00002 % incidence of "wrong site/wrong pt" not exactly an epidemic , nor do we know that any of those cases involved the same doctor or even the same hospital.
While i agree that at face value " wrong site/ wrong pt " should be malpractice let's not jump to conclusions.
While "wrong pt" is harder ( but not impossible) to justify , i can think of quite a few reasons why one might operate on the wrong site.
After all the problem with assessing malpractice is that it always involves the use of 100% diagnosticly accurate HINDSIGHT.
The benifit of 100% diagnostic accuracy is something that doctors almost never have.
Completely removing doctors from responsibilty is something many propose..."lets model england or canada" they say... doctors in countries with socialized medcine have vast immunity.
" we need a nationwide HMO"...until people realize that suing a HMO or it's doctors is almost impossible.
As someone who has attended and testified in many medical malpractice trials i can say that the current method for dealing with medical mistakes and malpractice is dreadfully broken.
This issue i was trying to make with the earlier post was one of context . The common person hears "medical mistake" and leaps to "malpractice". That very leap is the first thing we need to change.
I would like to think that the slashdot crowd is above such base assumptions. While this may be a silly position, my last shred of optimism tells me that the best place for rational change to begin is the smarter then average crowd here.
incidence of error.00021% ( i.e. the probability that an error might occur )
or
99.99979 of procedures had no errors
that's a low incidence by any standard.
Tell me when did doctors stand up and pronounce that they were perfect ?
In fact that's higher performance then almost every system you come in contact with every day.
To put this in perspective your incidence of auto accident in the US with injury is 1.68%...8000 times more likely !
Should doctors and hospitals try to avoid mistakes..YES
Should doctors who make too many mistakes face consequences..YES
BUT your comment just shows common unrealistic perspective about reality.
Is a mistake malpractice ? Even if that mistake can be fixed ? Even if that mistake has little or no effect on the outcome ? Is a surgeon or hospital that has a.00021% error rate guilty of malpractice ?
Do you want to pay a medical bill where 60% of the bill is coverage for insurance ? Even if the doctor in question has never had case of malpractice?
Medicine at the most basic level involves TWO people..thus the expectation of 100% certainty is absolutely unobtainable and unrealistic . Furthermore the cost of this level of reliability is more than anyone but the richest of the rich can afford.
No one want to have a mistake made on them , everyone wants medicine to be perfect but outside of the "bill gates" of the world no one can afford it.
Robots in medicine can help lower the incidence of mistakes . however mistakes will still exist and a mistake does not equal malpractice.
If we want to improve the medical system them we all need to have a realistic view of the possibilities.
The AMA is lobby pure and simple..now they also support research which is the past has proven them wrong and has reached conclusions they don't like...yet they still support research.
http://www.ama-assn.org/ama/pub/category/12014.h tm l
shows that the AMA has 250 K members of which not all are doctors...
Conversely there are 700K MDs and DOs in the US
Do you see the math error here ?
I don't know where you got your info but MANY doctors and MOST medical professionals are NOT members of the AMA...no doctors i know are..its optional....and i can't find any penalty for not joining....and i won't because they support political views i don't
but controlling the number of doctors? where the hell did this BS come from ?
please try and drool next to the desk not on the keyboard...
Some people here need to get a life and grow up...
Facts:
1.) FYI there already is at least one national DB that can be searched on individual practitioners ( not just doctors)
http://sra.com/services/index.asp?id=186
2.) It costs NOTHING to file a suit yet it costs thousands to defend against one
3.) Doctors are often held to an IMPOSSIBLE inhuman standard. i.e. "You may not make any mistakes"....anyone here want to held to this standard in their daily activities ? This directly contributes to high health care costs thru unnecessary tests to rule out everything to 5 nines (assuming the HMO will even let them get to 2 nines. see below)
4.) Think HMOs don't dictate to doctors ? your WRONG...HMOs dictate everything from methods of care , drugs... the list is endless and often not in the best interest of the patient.
5.) Think that HMOs keep cost down ?Ever wonder how this is done? In part its done by paying MDs irrespectively of the cost of the service they provide ! "" Doctor we know is costs you $50 to take an X-ray but we are only going to pay you $20...Oh that doesn't even cover the cost of the FILM...sorry ""
6.) I noticed people making the following assumption:
"Doctor X has been sued Y times therefore he is a bad doctor."
Bull S***...You can be sued and LOSE for anything...even in cases where you prove that you did not cause the bad result or that the case against you is anatomically impossible! Furthermore the insurance company can settle a case without the consent of the doctor in question! Furthermore consider that maybe that doctor is in a speciality or location that increases the odds...if your are the only one of five neurosurgeon who a whole city then they are going to sued...alot
7.) " why don't doctors band together to try and restore some equity in prices and compensation ?"
Because they can't ! a little thing called the RICO act has been used against doctors who do this ! Even doctors in the same practice ! But there is nothing against insurance company X calling insurance company Y and coordinating the price they pay the doctor for his services.
I am not even suggesting that all doctors are perfect in fact NONE are !! I am not suggesting there are no doctors that do bad things...they exist but no where near the level of the lawsuits out there
Look around people there is a shortage of doctors and its getting worse..doctors are retiring in their prime not only denying their skill to the public but also their knowledge and experience to future doctors...if everything was all good and this whole lawsuit/HMO thing was blown out of proportion do you really think that this would be happening?
I have been in health care for most of my life and am a 3rd year medical student. I have been to MANY malpractice trials and have never seen any case where the the case was a just one.
medicine is not an exact science. there are huge gaps in what we know and what we don't. very little is empirical.
Compare medicine with trouble shooting a flaky memory module. some times you get it on the first pass...other times its the last thing you find...now imagine you can be sued for NOT finding it in the first pass...
" But people are not memory " some whine...."if doctors get is wrong it hurts "...Look even if doctors get it right is can still hurt !
Furthermore people are more complicated then computers and have very few hot swappable parts...and can send mixed messages that make the "blue screen of death" look like a detailed sheet of what's wrong!!
Ok some of you don't use the palm..great..however understand they in some segments of the business world they are MANDATORY...
As a 3rd year medical student I can tell you that every serious doctor is getting one, pt charting systems are supporting them etc.. they are awsome reference sources.
The problems with palms action is not the lack of hot sync as I fully expect isync to fill this gap and if not mark space will fill the gap.
The problem lies in the many applications on the palm that "sync" with a central DB to update a reference. Apple needs to ensure that palm and pocket PC apps that use this fuctionality have the hooks in OS X that they need to function , without a seperate version of the palm or pocket PC app.
This kind of thing KILLS Apples market share. Apple can do what they like on their own turf but they MUST interoperate with 3rd parties SEAMLESSLY, better then windows if they expect to grow.
This is a crushing blow which means Apple will have to work hard to overcome. Futhermore dog plus world will cover the fact that palm will not support the mac but no one will cover the fact that isync can fill a significant portion of this void.
I love my mac but more Apple needs to realize that they must beat windows when it comes to 3rd party interactivity.
Apple could come out with a PDA device
BUT
1.)It must be perfectly compatible with palm or pocket PC...no exceptions
2.) when connected to my mac those palm apps must sync and be able to conenct without a single change in the developers code.
if either of the above is NOT true then the problems will ALWAYS be blamed on Apple so long as the product functions under windows XP..even if the real problem is with the palm app.
Which brings me back to my original point...this is a huge burden for Apple but its the ONLY way to make the device work.
The iPod is an excellent example. The ipod has been succesful BECAUSE it works better on BOTH mac and windows esp with itunes....any PDA will have to follow the same path which is significantly harder due to multifunctionality of a PDA
i suspect that Steve Jobs problem with PDAs have something to do with these tough issue.
I would love to hear from some people who develop for palm about the problems with syncing thru a mac for a Db driven app..(like Epocrates or PEPID)
IMHO
anyway
Andrew
Correct me if i am wrong but there is an exception in copyright law for educational use esp if no profit is involved...for example i can use footage from the latest blockbuster to point out physics flaws....i can use the latest pop hit to show how music can induce siezures....
as far as i know all these are legal uses of copyrighted material.....
this university's policy seems to ignore this fact (among others)
Slashdot Mirror
Ok 20 cases out of 1,000,000
.00002 % incidence of "wrong site/wrong pt" not exactly an epidemic , nor do we know that any of those cases involved the same doctor or even the same hospital.
... doctors in countries with socialized medcine have vast immunity.
...until people realize that suing a HMO or it's doctors is almost impossible.
Thats
While i agree that at face value " wrong site/ wrong pt " should be malpractice let's not jump to conclusions.
While "wrong pt" is harder ( but not impossible) to justify , i can think of quite a few reasons why one might operate on the wrong site.
After all the problem with assessing malpractice is that it always involves the use of 100% diagnosticly accurate HINDSIGHT.
The benifit of 100% diagnostic accuracy is something that doctors almost never have.
Completely removing doctors from responsibilty is something many propose..."lets model england or canada" they say
" we need a nationwide HMO"
As someone who has attended and testified in many medical malpractice trials i can say that the current method for dealing with medical mistakes and malpractice is dreadfully broken.
This issue i was trying to make with the earlier post was one of context . The common person hears "medical mistake" and leaps to "malpractice". That very leap is the first thing we need to change.
I would like to think that the slashdot crowd is above such base assumptions. While this may be a silly position, my last shred of optimism tells me that the best place for rational change to begin is the smarter then average crowd here.
Oh please...
.00021%
.
..YES
..YES
.00021% error rate guilty of malpractice ?
..thus the expectation of 100% certainty is absolutely unobtainable and unrealistic . Furthermore the cost of this level of reliability is more than anyone but the richest of the rich can afford.
.
in the example you cite
1,000,000 procedures annually:
20 cases - Wrong Patient, Wrong Site - Surgical
103 cases - Incorrect Procedure - Invasive
90 cases - Retained Foreign Body
incidence of error
( i.e. the probability that an error might occur )
or
99.99979 of procedures had no errors
that's a low incidence by any standard.
Tell me when did doctors stand up and pronounce that they were perfect ?
In fact that's higher performance then almost every system you come in contact with every day
To put this in perspective your incidence of auto accident in the US with injury is 1.68%...8000 times more likely !
Should doctors and hospitals try to avoid mistakes
Should doctors who make too many mistakes face consequences
BUT your comment just shows common unrealistic perspective about reality.
Is a mistake malpractice ? Even if that mistake can be fixed ? Even if that mistake has little or no effect on the outcome ? Is a surgeon or hospital that has a
Do you want to pay a medical bill where 60% of the bill is coverage for insurance ? Even if the doctor in question has never had case of malpractice?
Medicine at the most basic level involves TWO people
No one want to have a mistake made on them , everyone wants medicine to be perfect but outside of the "bill gates" of the world no one can afford it
Robots in medicine can help lower the incidence of mistakes . however mistakes will still exist and a mistake does not equal malpractice.
If we want to improve the medical system them we all need to have a realistic view of the possibilities.
LOL same here I walk with head up and eyes out...singing along...IPOD on one hip and USP var 2 9mm on the other...if you are a mugger good luck
39 + 19 +10 =68
So which media player tech controls the other 32 % ? With those numbers the media player market might just escape MS's slimy grasp.
And we care what -real- the bloated buggy crappy player does because?
I hope MLB uses those bats for something useful
Later
Andrew
ok and on what planet is this ?
..now they also support research which is the past has proven them wrong and has reached conclusions they don't like ...yet they still support research.
h tm l
..its optional ....and i can't find any penalty for not joining....and i won't because they support political views i don't
The AMA controls the supply of doctors ? Bullshit
Like the NRA controls the number of gun users?
The AMA is lobby pure and simple
http://www.ama-assn.org/ama/pub/category/12014.
shows that the AMA has 250 K members of which not all are doctors...
Conversely there are 700K MDs and DOs in the US
Do you see the math error here ?
I don't know where you got your info but MANY doctors and MOST medical professionals are NOT members of the AMA...no doctors i know are
but controlling the number of doctors? where the hell did this BS come from ?
please try and drool next to the desk not on the keyboard...
sheesh
Andrew
Some people here need to get a life and grow up ...
:
... the list is endless and often not in the best interest of the patient.
...sorry ""
...even in cases where you prove that you did not cause the bad result or that the case against you is anatomically impossible! Furthermore the insurance company can settle a case without the consent of the doctor in question! Furthermore consider that maybe that doctor is in a speciality or location that increases the odds...if your are the only one of five neurosurgeon who a whole city then they are going to sued...alot
Facts
1.) FYI there already is at least one national DB that can be searched on individual practitioners ( not just doctors)
http://sra.com/services/index.asp?id=186
2.) It costs NOTHING to file a suit yet it costs thousands to defend against one
3.) Doctors are often held to an IMPOSSIBLE inhuman standard. i.e. "You may not make any mistakes"....anyone here want to held to this standard in their daily activities ? This directly contributes to high health care costs thru unnecessary tests to rule out everything to 5 nines (assuming the HMO will even let them get to 2 nines. see below)
4.) Think HMOs don't dictate to doctors ? your WRONG...HMOs dictate everything from methods of care , drugs
5.) Think that HMOs keep cost down ?Ever wonder how this is done? In part its done by paying MDs irrespectively of the cost of the service they provide ! "" Doctor we know is costs you $50 to take an X-ray but we are only going to pay you $20...Oh that doesn't even cover the cost of the FILM
6.) I noticed people making the following assumption:
"Doctor X has been sued Y times therefore he is a bad doctor."
Bull S***...You can be sued and LOSE for anything
7.) " why don't doctors band together to try and restore some equity in prices and compensation ?"
Because they can't ! a little thing called the RICO act has been used against doctors who do this ! Even doctors in the same practice ! But there is nothing against insurance company X calling insurance company Y and coordinating the price they pay the doctor for his services.
I am not even suggesting that all doctors are perfect in fact NONE are !! I am not suggesting there are no doctors that do bad things...they exist but no where near the level of the lawsuits out there
Look around people there is a shortage of doctors and its getting worse..doctors are retiring in their prime not only denying their skill to the public but also their knowledge and experience to future doctors...if everything was all good and this whole lawsuit/HMO thing was blown out of proportion do you really think that this would be happening?
I have been in health care for most of my life and am a 3rd year medical student. I have been to MANY malpractice trials and have never seen any case where the the case was a just one.
medicine is not an exact science. there are huge gaps in what we know and what we don't. very little is empirical.
Compare medicine with trouble shooting a flaky memory module. some times you get it on the first pass...other times its the last thing you find...now imagine you can be sued for NOT finding it in the first pass...
" But people are not memory " some whine...."if doctors get is wrong it hurts "...Look even if doctors get it right is can still hurt !
Furthermore people are more complicated then computers and have very few hot swappable parts...and can send mixed messages that make the "blue screen of death" look like a detailed sheet of what's wrong!!
later
Andrew
Ok some of you don't use the palm..great..however understand they in some segments of the business world they are MANDATORY... As a 3rd year medical student I can tell you that every serious doctor is getting one, pt charting systems are supporting them etc .. they are awsome reference sources.
The problems with palms action is not the lack of hot sync as I fully expect isync to fill this gap and if not mark space will fill the gap.
The problem lies in the many applications on the palm that "sync" with a central DB to update a reference. Apple needs to ensure that palm and pocket PC apps that use this fuctionality have the hooks in OS X that they need to function , without a seperate version of the palm or pocket PC app.
This kind of thing KILLS Apples market share. Apple can do what they like on their own turf but they MUST interoperate with 3rd parties SEAMLESSLY, better then windows if they expect to grow.
This is a crushing blow which means Apple will have to work hard to overcome. Futhermore dog plus world will cover the fact that palm will not support the mac but no one will cover the fact that isync can fill a significant portion of this void.
I love my mac but more Apple needs to realize that they must beat windows when it comes to 3rd party interactivity.
Apple could come out with a PDA device
BUT
1.)It must be perfectly compatible with palm or pocket PC...no exceptions
2.) when connected to my mac those palm apps must sync and be able to conenct without a single change in the developers code.
if either of the above is NOT true then the problems will ALWAYS be blamed on Apple so long as the product functions under windows XP..even if the real problem is with the palm app.
Which brings me back to my original point...this is a huge burden for Apple but its the ONLY way to make the device work.
The iPod is an excellent example. The ipod has been succesful BECAUSE it works better on BOTH mac and windows esp with itunes....any PDA will have to follow the same path which is significantly harder due to multifunctionality of a PDA
i suspect that Steve Jobs problem with PDAs have something to do with these tough issue.
I would love to hear from some people who develop for palm about the problems with syncing thru a mac for a Db driven app..(like Epocrates or PEPID)
IMHO
anyway
Andrew
Correct me if i am wrong but there is an exception in copyright law for educational use esp if no profit is involved...for example i can use footage from the latest blockbuster to point out physics flaws....i can use the latest pop hit to show how music can induce siezures.... as far as i know all these are legal uses of copyrighted material..... this university's policy seems to ignore this fact (among others)