Caporegime
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Impressive, their insurance alone can be twice what I earn.
What should the consequences be to a GP practice
- Thread starter ethan
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Soldato
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The problem is that we seem to expect them to not be human. No matter how competent anyone is they can make human errors at any time. This should not be punished. Negligence caused by laziness or wilfully, on the other hand, needs action. Unfortunately, the grey area around genuine human error and, say, laziness is only ever going to benefit lawyers.
Yet in other careers it is punished. So why should one group of people have a completely different set of laws apply to them? Or should we change the law so nobody is punished?
You've got to admit it's insane a surgeon can kill someone and not get sacked but a shelf stacker would get binned for accidentally damaging product.
Google GMC inquests
Many doctors get struck off through true negligence.
And back to the original point - I can almost guarantee it wasn't deliberate negligence. It was a system that lacked a safety protocol, which had a very unfortunate outcome, the hospital admitted fault and systems will be in place to ensure it doesn't happen again. Which is the core concept of medicine.
Many doctors get struck off through true negligence.
And back to the original point - I can almost guarantee it wasn't deliberate negligence. It was a system that lacked a safety protocol, which had a very unfortunate outcome, the hospital admitted fault and systems will be in place to ensure it doesn't happen again. Which is the core concept of medicine.
Caporegime
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Medicine is creeping very slowly past the blame game, it's very 80s. It's not the playground anymore in medicine. Individual negligence is actually very rare. When you're working in a high risk environment and things go wrong it's usually a chain of failures rather than an individual's fault.
We've done the individual blame game in years gone and buy and what happened? Everything was swept under the rug, no learning was shared, and the same errors would happen again and again. Duty of candour would have been laughed at even 10 years ago. If you could get away with a mistake you would.
Your keep saying this surgeon killed someone, but has that proven to be true? I've not seen the GMC findings but they'll look at everything. Was he trained appropriately? Were the organs screened and prepared appropriately? Was the organ donor chosen appropriately? Was the post transplant care appropriate? It's much more complex than pinning on it one guy.
At the end of the day I'm pretty sure all doctors will kill someone in their career, you'd have no doctors if everyone got struck off for their mistakes.
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Funny that you should mention lawyers.
Neither medicine nor Law are strictly technical professions. Both are more craft/art than strict science in many ways.
That is to say, despite doing everything right, Patients still die and defendents/plaintiffs still lose cases.
Like with medical professionals, It is very difficult to make claims of negligence/incompetence against a Lawyer. Indeed, prior to 2000 it couldnt be done at all since barristers had legal immunity.
So you think a surgeon failing to disclose he made an error which caused harm wasn't deliberate? He admitted he noticed the damage and didn't pass on the information at the time, what more do you need?
Of course you wilfully misunderstand me.
There is obviously a lot of science in medicine, but at the same time, unlike say Engineering, there is an awful lot of subjective analysis (Guesswork
)and indeed pure luck.The treatment that will cure 99 people will kill the 100th, and often nobody will really know why.
Peoples insides are roughly similar but they are not all the same. Even with all the sophisticated scan tools we have today. Surgeons often will have to deal with the unexpected and unpredictable and some are just better at handing surprises than others. This does not mean that the less capable have been negligent, incompetent or careless.
Nobody knows how a patient will respond to a medicine until it is tried. Nobody knows how any individual patient will respond to a combination of medicines until it is tried
It is pretty much a mathematical certainty that an I beam of known dimensions and known grade of steel will fail at a certain load. Medicine is not like that!
For all the scientific gloss, there is still far more subjectivity in medicine than in most other professions and the consequences of the need for that subjectivity have to be allowed for when people are considering legal culpability.
That's my point really.
I think we're going round in circles now.
Final example - if I cannulate someone, and miss the first try, I will try somewhere else.
I have caused 'harm' by puncturing the skin.
I will not document that I missed the first time because it isn't a done thing.
If that patient then develops a raging cellulitis from my first cannulation site and dies..
Am I in the wrong? Imade the error which caused harm but I didn't diclose it?
If i was questioned, I would have also said 'yes, on reflection, i did do this'. I would admit I noted the damage but didn't pass on the information at the time (to who?)
It doesn't always immediately equate to negligence.
Soldato
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Because we risk putting people off wanting to be a doctor. And we need doctors. We seek their help because there is nothing more we can do ourselves.
As mentioned above, medicine isn't an exact science. It isn't like IT, where problem > fix > resolution. There are innumerable variances and things to take into consideration. Personal experience plays a big part. It's an art just as much as a science.
As someone that's dealt with specialists for nearly 6 years due to an illness, I am copied in on all communications between the specialist and GP's.
I had to take a break while trying for a child and going back on proved difficult as the young GP didn't feel comfortable prescribing them without a specialist letter. Which they'd sent.
I was telling her what the dose should be, the side effects and the long drawn out procedure for getting back up to dose due to the potential for liver and kidney failure.
The patient should have been told about the incremental increase via a letter from the specialist and should have known enough to raise this themselves.
You should know what meds and doses you are putting into your body.
If there's a risk that your error could lead to further harm to the patient it should be recorded. Simple as. That might be the required bit of info that could enable another Dr to save that persons life. Information is key.
In the same context I had a guy in to carry out a required inspection on one of our shore cranes. His scope of work was only to look at the wire ropes.
He noticed a small crack to a weld and noted it in his report.
It wasn't necessary for him to do so, it wasn't his job to do so. But he did.
That allowed us to further inspect the crane where we found additional cracks. That additional bit of information he provided could well have saved the lives of several people.
All for one little note on a report. One sentence could have saved a life.
So we shouldn't hold them to any standards in case they quit?
We need teachers. We need police officers. We need fire fighters. Heck, we need cleaners. Shall we let them do whatever they want in case they quit?
It is, but you're as has been said, wilfully misunderstanding what has been said.
You can have 1000 patients presenting the same symptoms and treat them the same.
999 of them recover fully, one dies suddenly because the doctor missed something really minor and the patient didn't mention it and it turns out that it wasn't just something minor but something major that escalated rapidly.
You can deal with an issue that crops up in surgery the same way hundreds of times and it's fine, but one time it goes wrong for whatever reason.
You can prescribe a medication to thousands of people over your career and none of them have a major reaction, then one day you prescribe it and it turns out the patient is that one in 100k who has a severe reaction to it and dies is the GP at fault for not expecting that?
Medicine isn't like trying to fix an engine on a car where you know the exact state everything is meant to be in, and can pull it all apart measure it and put it back together, as there are "normal ranges" for pretty much everything in the human body and someone who is spot on the normal range for every non invasive diagnostic test you do might well still have something seriously wrong that isn't showing up because their "normal" is different to the general range (one of the reasons GP's are in theory meant to be doing routine checks on patients over certain ages* is to get the patient's specific "normal" healthy stats noted for reference if needed).
Hence the "art" involved, as the doctor has to learn to spot things that just don't fee right, or when the patient is understating a problem "i've got a bit of a belly ache" could be anything from the curry they had, to food poisoning, a minor reaction to medications, an ulcer or advanced stomach cancer, but you can't send every patient who complains of it to have a full set of x-rays and a colonoscopy (besides the number of additional facilities and costs involved, both those procedures themselves carry risks).
Even people who have extensive medicals for their jobs can suddenly fall down dead due to something none of the tests picked up on, despite them being in peak fitness (the footballer who nearly died of cardiac arrest a few years back, but was saved by a cardiologist in the crowd along with the paramedics is a good example).
*Although good luck finding a surgery that actually has the doctors and time to do the "health checks".
Caporegime
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They make up very little of what a doctor actually does.
It is of course a least harm balance Given the increasing difficulty in recruiting people such as teachers, (CRB Checks etc) Fire fighters and Police officers (And even Soldiers) these days, perhaps the balance of potential culpability has gone too far. You cannot force people to put their lives/careers on the line if easier and less contentious ways of making a living present themselves.
As i said earlier. I am sure i read somewhere that there are Hospitals in the US that will simply not admit patients with OB-GYN issues any more because it is just not worth the personal/commercial risk to do so.
Again in the US I dare say, as a consequence of BLM etc, it is becoming increasingly difficult to recruit top quality Police officers (Black OR White) to police Black majority neighbourhoods either (It probably always was really, but I imagine the situation is worse now. There will be stats available I am sure)
Hopefully we're nowhere near the ridiculous levels of litigiousness that we see in the States. I do have to highlight again though that yes, people make mistakes but there's a difference between making a mistake (surgeon slips during surgery, knicks something they shouldn't and patient dies) or dangerous/negligent actions (surgeon slips during surgery, knicks something they shouldn't, stitches patient back up, doesn't tell anyone, patient dies from preventable consequences).
Caporegime
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You realise this isn't what happened? The surgeon knicked the dead donor's stomach whilst harvesting the organs? This contaminated the organs with a very unusual stomach pathogen (candida) and they were then placed into recipients that became unwell due to the contamination.
What's important in this case is if the surgeon had reported the incident would it have made a difference? If the organs would still have been given to the donors then it's not really preventable. I don't know the answer to this but I this is what the investigation will really have been about. I suspect contamination from gastric secretions isn't normally a contraindication to transplanting organs and that candida contamination is very rare.
Usually gastric candida is a sign of advanced disease or immunodeficiency, so it may well be that the donor wasn't suitable to give organs in the first place.
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