1. Attachments are working again! Check out this thread for more details and to report any other bugs.

Secret Doctor Conferences...

Discussion in 'Fred's House of Pancakes' started by Mystery Squid, Jan 12, 2006.

  1. Mystery Squid

    Mystery Squid Junior Member

    Joined:
    May 18, 2005
    2
    3
    0
    So, I've been told, by a good friend of mine, that, periodically, Doctors get together (behind closed doors), and discuss various mistakes they've all made. Since we have several Doctors on board, I wanted to see if I could verify this "hearsay"....

    Is it true? Do Doctors periodically sit around and discuss all the mistakes they've made?

    :ph34r:
     
  2. Salsawonder

    Salsawonder New Member

    Joined:
    Nov 28, 2005
    1,897
    47
    0
    Location:
    La Mesa California
    Vehicle:
    2010 Prius
    Model:
    IV
    As a nurse of 20+years I can guarantee you that Doc's discuss their mistakes, so do the nurses (probably more than the Doc's cause sometimes they don't even know they've made a mistake!)

    No one is perfect, it is just worse for some folks to be wrong. The best we can do is learn from our mistakes and be good listeners, because if you listen, you learn.
     
  3. Mystery Squid

    Mystery Squid Junior Member

    Joined:
    May 18, 2005
    2
    3
    0
    True, true....

    I wonder though, at what point must a mistake be revealed? Like for example, if a "mistake" was made, and let's say, as a resultant, if the "mistake" was not revealed in a short period of time, someone would ultimately end up with a scar somewhere barely noticable, do you think most Doctors would keep their mouth shut to avoid being hit with some sort of malpractice suit? OR, would they attempt to position it as something other than a "mistake", thereby ultimately correcting the resultant, thus, no scar, while at the same time, lowering the risk of any malpractice suit? OR, would they simply confess to the "mistake", ultimately correcting the resultant, thus, no scar, and take the chance?
     
  4. efusco

    efusco Moderator Emeritus
    Staff Member

    Joined:
    Nov 26, 2003
    19,891
    1,193
    9
    Location:
    Nixa, MO
    Vehicle:
    2004 Prius
    Model:
    N/A
    They're not secret, but they are protected. We call them M&M--morbidity and mortality. And it's not just to discuss mistakes, but to discuss interesting or complex cases in an open forum to learn from and to improve patient care.

    It's similar to the FAA's way of reducing the pilots liability if they self-report an error.

    The only way M&M can work to improve patient care is if everyone can speak openly...the physician in question can be honest about his mistake and others can be honest in their criticism and critique.

    Nothing discussed is discoverable in court.
     
  5. skruse

    skruse Senior Member

    Joined:
    Apr 6, 2004
    1,454
    97
    0
    Location:
    Coloma CA - Sierra Nevada
    Vehicle:
    2007 Prius
    Model:
    II
    Most medical practices have a "Quality Review" panel (hospital, clinic, county medical association) that meets monthly and reviews individual cases. Cases are referred to the panel or some cases are obvious and beg for review.

    The objective of a Quality Review panel is to identifiy mistakes, errors and omissions, identify protocols and practices that should be followed, and share findings with other physicians. Hence, every physician has an opportunity to learn from the mistakes of others. Related medical disciplines often come together with physicians to learn from QR panels (dentists, nurses, pharmacists, attorneys).

    The goal is preventative medicine to better serve the public, not hide mistakes and conduct business in secret. We all benefit from QR panels. A physician, nurse or technician will be criticized for not paying attention to QR panel findings. Information frequently is dispersed to others - paramedics, laboratory technologists, fire fighters, educators, police officers.
     
  6. Mystery Squid

    Mystery Squid Junior Member

    Joined:
    May 18, 2005
    2
    3
    0
    Then who decides/judges the ethics behind various situations? Something amongst the lines of my example above.

    I most certainly agree there should be an open, yet protected, forum for these discussions, but I would imagine, there's also some sort of governing ethical concept behind it whereas there must be SOME level of disclosure if there is some sort of impact to the patient right? Or is it much like a church confession?

    Being totally crude to illustrate the point more effectively, if a Doctor within one of these sessions raises his or her hand and says, "Hey, I made this mistake, and as a result, if I don't go back and fix it, this will be the result". What then? Does the ethical responsibility fall upon the individual, or otherwise?

    If you're wondering "why" I'm bringing this up, simply for no other reason than I think it's interesting discussion that probably isn't discussed too often, and most people probably have no idea this sort of thing goes on. :ph34r:
     
  7. mdmikemd

    mdmikemd Member

    Joined:
    Dec 3, 2005
    436
    13
    0
    Location:
    Minneapolis
    Vehicle:
    2017 Prius
    Model:
    Two
    As I do surgery every week, I have to go through a process of "Informed Consent" with the patient prior to every surgery. One of the things I tell them is that surgeons make mistakes at sometime in their life and it's not a matter of if, but when it happens to one of us. I tell them that we might accidentally injure their bladder, intestines etc, and the surgery may even lead to death. If after that they consent to the surgery, at least they understand the risks.

    I can honestly say that I've never made a "mistake" as far as I know. But I'm young...it will happen to me one day.
     
  8. efusco

    efusco Moderator Emeritus
    Staff Member

    Joined:
    Nov 26, 2003
    19,891
    1,193
    9
    Location:
    Nixa, MO
    Vehicle:
    2004 Prius
    Model:
    N/A
    I guess the thing you have to keep in mind is that the physicians who participate in M&M are interested in giving the best possible care. Those who habitually do not or who do not correct their mistakes or who intentionally allow patients to be harmed are dealt with via our legal system and through the state licensing boards.

    Generally cases are resolved already when discussed...the M&Ms are usually 'after the fact' meetings. In those cases where a physician is still involved in a patient's care it is at that physician's discretion if he's going to follow the recommendations of the group, but I have never encountered a situation where solid advice wasn't heeded. It's a chance to reduce one's liability by correcting the problem, failure to do so increases the liability.
     
  9. Mystery Squid

    Mystery Squid Junior Member

    Joined:
    May 18, 2005
    2
    3
    0

    That's right! I totally forgot about the consent form just prior to some sort of procedure. Of course, that brings up another thought, given this consent, how much liability does it exclude? Obviously, if the consent was "all encompassing" there would be no need for malpractice insurance... except, I would imagine, for very gross circumstances...
     
  10. Mystery Squid

    Mystery Squid Junior Member

    Joined:
    May 18, 2005
    2
    3
    0
    Ah, usually "after the fact".... Thanks for the clarification... I guess between, personal ethical behavior, the "informed consent", and these M&M-type meetings, there's a decent cross-check "net".

    You have to understand, I'm rather paranoid, and don't believe anything anyone tells me, so I have to explore these issues... :lol: :) Plus, I've come across some "curious" situations when taking various family members to see Doctors. No offense to the medical professionals, but too many people are simply willing to believe what a Doctor tells them simply because they are Doctors. Of course, this applies to almost any field, not just medical, but when it comes to personal health issues, you tend to take them a wee bit more seriously.... (at least I would lol) I will, of course, digest this info. and ponder it further....
     
  11. mdmikemd

    mdmikemd Member

    Joined:
    Dec 3, 2005
    436
    13
    0
    Location:
    Minneapolis
    Vehicle:
    2017 Prius
    Model:
    Two
    Short answer is none...but if there is no documentation of a discussion of the risks of surgery, then as far as the lawyers are concerned, the discussion never happened.

    However, it gives you a legal leg to stand on. The plaintiff can't argue that, "If I had known xxxx was possible, I never would have had the surgery." It was actually a lawyer who recommended we include "death" in every consent. He said that if someone understood they could die as a result of the surgery and consented, how could they claim that the scar through a tatoo would have been unacceptable.
     
  12. hdrygas

    hdrygas New Member

    Joined:
    May 22, 2004
    3,650
    6
    0
    Location:
    Olympia Wa
    Vehicle:
    2004 Prius
    I have to say that we are constantly trying to improve in the hospital, the clinic and everywhere. Yes many of these are privileged, or protected. The purpose is to improve and take it from me some of this is brutal. A M&M conference can be a turn over coals. Most of us try to do better and better. Are there bad eggs. Yes but they no longer last very long if they have privileges at a hospital. I would ask two questions of a doctor. First are they Board Certified in their specialities? Second do they have privileges in the local hospital? Docs in groups check up on others, Docs alone are well alone. That is not to say they are bad, but if they are not in any group no one is looking over their shoulders. We are not very tolerant of Docs who are not towing the line.
     
  13. DocVijay

    DocVijay Active Member

    Joined:
    Sep 15, 2005
    1,455
    2
    0
    Location:
    Tampa, FL
    Well this has been pretty well covered. Since I have now moved from medicine to the wonderful field of law (school), I'll be able to fill in the other side in a couple of years.
     
  14. tripp

    tripp Which it's a 'ybrid, ain't it?

    Joined:
    Oct 23, 2005
    4,717
    79
    0
    Location:
    Denver, CO
    Vehicle:
    2005 Prius
    Squid does rate himself 83% paranoid. :p
     
  15. Jack 06

    Jack 06 New Member

    Joined:
    Oct 13, 2005
    2,556
    0
    0
    Location:
    Winters, CA: Prius capital of US. 30 miles W of S
    I don't worry about the ethics of doctors in relation to their medical care. (If I were a woman I'd worry more, especially about cosmetic surgery, after all the evidence you see on TV and the 'net about all the botched breast enhancements and other cosmetic procedures, but that's a branch of medicine I have no use for.)

    The ethics I do worry about is the prodigious fraud engaged in, I suppose mostly by group practices, in ripping off Medicare, Medicaid and insurance companies. All of us, as taxpayers and insured people, pay for these "white-collar crimes" through higher taxes and premiums. The perpetrators seldom lose their licenses. Is it possible to have a "high sense of medical purpose" and still engage in massive overbilling and billing for services never rendered, sometimes to nonexistent patients?
    I'm sure docs don't admit these "mistakes" in their private sessions. We have to spend even more taxpayer money to catch and prosecute them.
     
  16. DocVijay

    DocVijay Active Member

    Joined:
    Sep 15, 2005
    1,455
    2
    0
    Location:
    Tampa, FL
    Those are not medical errors, and would not be covered in a M&M meeting. That is called insurance fraud, and can be committed by anyone in the office, not just the doctor.
     
  17. Mystery Squid

    Mystery Squid Junior Member

    Joined:
    May 18, 2005
    2
    3
    0
    Now THAT'S one of those "darkly" brilliant concepts...
     
  18. Mystery Squid

    Mystery Squid Junior Member

    Joined:
    May 18, 2005
    2
    3
    0
    I hear you. There are bad apples in EVERY field, thankfully though, your chances are decent that you won't run into any. Even I have to say the bar is set pretty high, so to speak...

    Funny how a stupid admin job when I was really young actually paid off. The questions you mentioned, are basically what I used to do for a summer job: making sure Dr's were board certified and had appropriate hospital privileges for an HMO...

    Anyway, I guess where I'm also going with this (here come the groans!), is the tremendous cost of healthcare these days. IMO, it's flat out wrong, and highly unethical to have to "drain" all your assets to simply acquire various amounts of healthcare. I know Dr.'s have to carry certain minimums of malpractice/liability insurance, and the premiums are insane (I'm sure you'll all agree?). Then again, multi-million dollar settlements seem all too common these days, which in turn drives up the costs of care, blah, blah, blah, you all know the hash...

    The whole thing about draining assets just pisses me off. :angry: It's one of those things seems to require some sort of planning for, even though I'm technically 32. Obviously, the best thing to do is not get sick, but well, obviously that's a crapshoot...
     
  19. Mystery Squid

    Mystery Squid Junior Member

    Joined:
    May 18, 2005
    2
    3
    0
    Jack man, you've got it upside down...

    I'd worry about the ethics first, as that has the ultimate impact: potentially on your life.

    All else is secondary...
     
  20. Mystery Squid

    Mystery Squid Junior Member

    Joined:
    May 18, 2005
    2
    3
    0
    Now this is interesting...

    Why would one do that? If you don't mind?