Throughout much of the 20th century, most doctors acted as general practitioners instead of specializing in a particular area of medicine. This was considered to be a holistic approach to medicine that allowed one doctor to manage a patient's care and see them through from start to finish. Of course, this still allowed for a general practitioner to consult with a specialist if a particular issue was outside his "box," but the general practitioner was still the primary doctor and managed the overall care of the patient. In the 1970s and '80s, however, there was a shift in the medical industry where recent medical school graduates chose to pursue specializations instead of going into "general" medicine.
"Who Moved My Cheese?" was a popular business book a few years ago. It explored the idea that the constancy of change means rewards may not always continue to come from the same place.
Today, another cheese image is circulating in organizational theory. The image is that of a particular type of cheese, namely Swiss.
In simplified form, the Swiss cheese theory holds that preventing risks in complex systems is like stacking up multiple layers of Swiss cheese, one behind the other. To prevent accidents, there need to be layers of defense that aren't dependent on the other layers, so that a hazard does not get through all of the holes.
How is preventing medical malpractice like stacking up these Swiss cheese layers?
When doctors spend less time with patients, does it lead to more diagnostic errors?
It's a valid question because there are many pressures in medicine today that undercut doctors' ability to spend time actually examining a patient. The availability of so many complex tests and interventions is one factor. Burdensome compliance with new electronic medical records requirements is another. Add in heavy workloads for doctors in organizations striving to cut costs and the result is precious time taken away from doctor/patient interaction.
This is problematic because good diagnosis requires good human judgment, not merely signing off on a computer-recommended solution to someone's symptoms. Such judgment is often lacking in today's medicine, with diagnostic errors surprisingly common. We discussed this in our October 13 post.
In today's post, let's look at how the decline in status of the simple stethoscope symbolizes medicine's increasing inability to acknowledge the human factor involved in effective diagnosis.
It is a situation that happens far too often. A family member starts having chest pains. She tells her treating physician who thinks she has heartburn and he recommends taking some antacids. Some time passes and the chest pain persists. Doctors still have not identified the root cause and have instead tried to mask the pain by prescribing various painkillers. Sure, this helps mask the pain, but the underlying issue still exists. Fast-forward two months and this family member is now hospitalized. After a week of doctors in the hospital scratching their heads and pumping narcotics into her system, they finally requested a cardiology consult. The cardiologist comes in, identifies the problem, and finally places the patient on the correct cardiac medications. Unfortunately, it is to late as the damage to the heart is already done.
The prescription of opioid painkillers, such as OxyContin, Percocet, and Vicodin, is a popular way for doctors to treat chronic non-malignant medical conditions, such as lower back pain. Recently, however, the effectiveness of such treatment has been called into question. A disturbing new trend reveals that there is actually very weak evidence that opioid painkillers are safe or effective for the long-term treatment of non-malignant pain. Moreover, these drugs are highly addictive and can produce significant states of depression and anxiety.
Have you ever called a customer service number trying to find out the answer to a question only to be transferred to ten different departments and spending 2 hours on what was supposed to be a 5 minute phone call? Well, this process may become the norm for patients seeking to obtain their medical records depending on the Ohio Supreme Court's decision in Griffith v. Aultman Hospital.
Once again, the medical malpractice and personal injury lawyers at Leeseberg & Valentine have earned the distinction of being named one of the "Best Law Firms" in the country by U.S. News & World Report's 2015 Best Lawyers publication. Leeseberg & Valentine was named a Tier 1 law firm, which is the highest distinction given by the publication. This honor is especially rewarding in that the "Best Law Firms" are determined by a rigorous evaluation of a combination of client feedback and our firm's reputation among other lawyers in the legal community.
Medical providers in central Ohio are experimenting with a new method in an effort to make "going to the doctor" a little bit easier. On November 2, 2015, OhioHealth will have some of their doctors begin seeing patients for primary care visits via video and online consultations. What remains to be seen, however, is how this ease of access will affect the quality of care being provided.
If you are going in for surgery, you probably have a lot on your mind. The questions come in bunches: Will the operation be successful? Will insurance pick up the bulk of the cost? How long will the recovery period be? And so on.
It's good to know that many hospitals have been taking steps to improve safety for surgical patients. These steps include using checklists to monitor proper hand-washing hygiene and guard against wrong-site surgery.
But even when checklists are used, do you still need to be worried about medication errors during surgery? In this post, we will explore that question.
Have you ever taken the time to actually read your Verizon or Time Warner Cable contracts? Or did you, like millions of other Americans, simply sign the agreement trying to get out of the store as quickly as possible? You might be surprised how one-sided it actually is.
Many large corporations are trying to avoid having to go to court when consumers of their product have a complaint. To accomplish this, they are placing arbitration clauses into their contracts. An arbitration clause is a clause in a contract that requires the parties to resolve their disputes through an arbitration process, and they generally look like this. The main difference between the arbitration process and the court system is it strips the consumer of their right to a jury trial.