Doctors Using Defensive
Medicine to Avoid Suit
Daily Observer
The malpractice imbroglio perks on apace. Judgments against physicians provide a flood
of monies awarded by juries to plaintiffs, and through them a tidy sum goes to
their lawyers.
There is, as a result, considerable talk of doctors practicing defensive
medicine. This means that doctors will
order unnecessary tests from a medical point of view, in order to insure that
no stone has been left unturned, to uncover the worm of malpractice in the eyes
of a curious lawyer. The bill for defensive medicine to this country, now so conscious of
the costs of real medical care, is incalculable, but possibly more than double
what the normal bill would be.
Lawyers might take pride in the fact that they are spurring the doctors
on to better practice procedures.
Let us take a hypothetical case.
A man is mangled in an automobile collision. He ends up in the emergency room, his jaw
splintered, an eye avulsed, his chest crushed.
Whatever doctors happen to be in the vicinity drop what they are doing
to help out. The man is rescued from
immediate death by emergency measures.
His chest is supported so that he can breathe. Blood flow is stanched. He is finally put back together enough to get
him to the operating room. The avulsed
eye is removed. The mangled arm is
pinned, tendons sutured, blood vessels bypassed and anastamosed
so that there is finally some circulation in the hand. Miraculously, the patient survives.
Unfortunately, however, an infection develops in his mending arm. X-rays demonstrate that the infection is due
to a gas-forming bacillus. The patient
is transferred to a facility containing a hyperbaric chamber. Despite this, and the extensive use of
antibiotics, and repeated surgical attempts to clear the infection, the
infection worsens, and ultimately, to save the patient’s life a second time,
the arm is amputated.
The patient, however, survives to sue.
He sues the doctors caring for him and anyone who touched him during the
long course of his illness. He sues for
the loss of his arm.
The doctors are pursued through the courts. Their reputations are tarnished. They suffer loss of income because of drawn
out days in court. They lose the
case. The insurance company pays the
damages.
This brings defensive medicine to another dimension. It occurs to the doctors, after five years of
travail in the courts and adverse newspaper publicity culminating the headlines
about the judgment that is brought against them, that they have made the wrong
decision.
They made the error of putting the patient’s welfare first. They recall that no attempt was made to save
the avulsed eye, and they were not sued on this account.
Possibly the next time they are faced with a similar situation, and
certainly they will be, they will decide that the
patient’s welfare, as well as their own, hangs in the balance. Perhaps a decision will be made not to save
the arm.
Defensive medicine can be carried to a more amoral and grisly
conclusion. For it is true that, if they
failed to save the patient altogether, there would be no possibility of a
malpractice suit. People do, after all,
die as a result of automobile accidents.
The term defensive medicine should not be taken lightly by the public.