ER Docs Dumping On Nursing Homes --- not good for anyone
A few weeks ago we wrote about an ER contract group taking the lead with their hospitals on cases needing disclosure and apology. Too often, contract groups and independent physicians can be at odds with hospitals when adverse events happen, leaving the patient/family without information or answers, anger increases, and litigation or other acts of revenge can follow. So, it's a good thing this group of ER docs talks post-event.
However, there are instances where ER docs can talk too much. For example, a couple weeks ago I spoke at a meeting of nursing home executives and one of their gripes was a resident gets admitted to the hospital (for whatever reason), and the ER doc starts opining in front of the resident/family that the nursing home has committed malpractice. Not cool....
We have always trained clinical people not to pass judgment on other colleagues or organizations, even when pushed by patients and families. The classic case we use in trainings is two orthopods...one did a knee replacement, there were complications, so the patient goes to the second orthopod and demands that the second orthopod say the first othopod committed malpractice. Tricky situation! You can't clam up, because you will then become part of the problem, but, you also can't say the first guy screwed up because you really don't know. We remind clinical people you were not there, you don't know the whole story, including the compliance of the patient/family. To pass judgment without the facts is simply not fair to any stakeholders, including the patient/family. Once the patient or family hears the magic words like "malpractice" or "error" they will never believe otherwise, and may literally go crazy pursuing justice (that is not attainable). I've seen this my own eyes.
If a clinician has fears or concerns about the care delivered by another clinician or organization or is being pushed by a patient/family, you should encourage the patient/family to go back to the original doctor or, in this case, nursing home, to ask questions....and even suggest questions to be asked. However, do not flippantly conclude that malpractice occurred, because that may not be the truth.
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