Persistent lightheadedness

[DandyDon]

I was a vet, but now an MD. I don't like to fill out profiles, as I find these open forums can be very nasty at times. There arent't very many MD DVM's with my background, and I prefer to keep my privacy.

Okay. I knew a vet that went on to become an MD once. It's your choice, but simply adding "Physician" to your profile would help when you post in medical forums...

 

[Hank49]

--- by penalizing people who were crummy at what they do. Sixty years ago, Doc Jones could deliver a baby and set a bone too...but if Doc Jones killed a baby or sentenced someone to limp for the rest of life by his amateurish orthopedics, he could get away with it. Not today.

I think this is a lot of horse manure. You're insinuating that malpractice threat has eliminated mistakes and made today's doctors more caring and competent and that there are no "crummy" doctors today? I agree that technology has moved forward and doctors are more "well armed" today but do you have data that shows less mistakes are made?
The main difference is they're covered by insurance which means the one who was "sentenced to limp due to his amateurish orthopedics" may come out a few million dollars richer, which we all pay for.

 

[shakeybrainsurgeon]

I think this is a lot of horse manure. You're insinuating that malpractice threat has eliminated mistakes and made today's doctors more caring and competent and that there are no "crummy" doctors today? I agree that technology has moved forward and doctors are more "well armed" today but do you have data that shows less mistakes are made?
The main difference is they're covered by insurance which means the one who was "sentenced to limp due to his amateurish orthopedics" may come out a few million dollars richer, which we all pay for.

I don't believe the malpractice situation is ideal, a lot of changes need to be made. But it's naive to think that the threat of litigation hasn't kept people on their toes in a number of industries, not just medicine. And I have been sued, so I have no love for the current system.

How safe do you think the airlines would be if not for fear of litigation? Or the auto industry? Do you think the amazing safety record of planes is due to an altruistic concern of airlines for your life? No chance... same with the pharmaceutical industry... in business, including the business of health care, saftey is a matter of economics. If it costs a billion dollars annually to reduce yearly fatalities by 1000, from a drug or a plane, and you lose an average of only 100,000 dollars per fatality in litigations, then it's more cost effective to let the people die, since saving them will be ten times more expensive than losing them. If you don't think such calculations go on in business, you need to return to planet earth.

That's why juries award millions for seemingly small injuries...otherwise, it will simply be more cost effective to let you die or be injured. Yes, we all pay for litigation, but no one wants to admit the up side... a degree of safety unparalleled in countries without a similar tort system.

Often, articles come out making the system sound ridiculous, like when a man got millions from BMW for being sold a used car as new. However, if he had simply been given a new car, what was the incentive for BMW to stop this fraud? The multimillion dollar award shocked the industry into behaving, something a 10,000 dollar award would not have done. It's the same situation in criminal law... a man steals 1000 dollars and pays for it with years in prison. If he were simply allowed to pay it back, there would be no disincentive for people not to steal.

Mistakes are made in medicine, as in any field, but as I posted in another thread, the issue is outcome, not the incidence of mistakes. Sherwin Nuland pointed out in a detailed article in the Wall Street Journal a few years ago that the population has grown so dependent on medical care to stay alive that the slightest human error can be disastrous.

He gave as an example a man with acute myelogenous leukemia who died from a transfusion error ten years after diagnosis. However, thirty years ago the same man would have died six months after diagnosis...he was alive due to transplant technology, but needed literally thousands of transfusions to stay alive. The need for so many transfusions made his risk of death due to error higher.

Suppose a person is asked to drive 100 miles at precisely 50 mph, not deviating from that speed by more than 1 mph...his car is wired to explode if he fails to keep this precise speed. This is a difficult task, and if he fails, it's a "mistake" but an understandable one. Physicians are increasiningly burdened with people who need more maintenance than the Space Shuttle to be alive... in the 1950s, they would not be victims of mistakes...just dead. The rising level of obesity, substance abuse, age, premature births, and so on, make the problem harder.

Doctors aren;t perfect...show me a profession that is.

 

[shakeybrainsurgeon]

I was a vet, but now an MD. I don't like to fill out profiles, as I find these open forums can be very nasty at times. There arent't very many MD DVM's with my background, and I prefer to keep my privacy.

I had a close friend, now deceased, who was a DVM but switched to human immunology...he said he got tired of spaying cats. I am not sure that treating peanut allergies was a step up...:11:

 

[cdiver2]

Sorry I could not resist.

 

[Puffer Fish]

I don't believe the malpractice situation is ideal, a lot of changes need to be made. But it's naive to think that the threat of litigation hasn't kept people on their toes in a number of industries, not just medicine. And I have been sued, so I have no love for the current system.

How safe do you think the airlines would be if not for fear of litigation? Or the auto industry? Do you think the amazing safety record of planes is due to an altruistic concern of airlines for your life? No chance... same with the pharmaceutical industry... in business, including the business of health care, saftey is a matter of economics. If it costs a billion dollars annually to reduce yearly fatalities by 1000, from a drug or a plane, and you lose an average of only 100,000 dollars per fatality in litigations, then it's more cost effective to let the people die, since saving them will be ten times more expensive than losing them. If you don't think such calculations go on in business, you need to return to planet earth.

That's why juries award millions for seemingly small injuries...otherwise, it will simply be more cost effective to let you die or be injured. Yes, we all pay for litigation, but no one wants to admit the up side... a degree of safety unparalleled in countries without a similar tort system.

Often, articles come out making the system sound ridiculous, like when a man got millions from BMW for being sold a used car as new. However, if he had simply been given a new car, what was the incentive for BMW to stop this fraud? The multimillion dollar award shocked the industry into behaving, something a 10,000 dollar award would not have done. It's the same situation in criminal law... a man steals 1000 dollars and pays for it with years in prison. If he were simply allowed to pay it back, there would be no disincentive for people not to steal.

Mistakes are made in medicine, as in any field, but as I posted in another thread, the issue is outcome, not the incidence of mistakes. Sherwin Nuland pointed out in a detailed article in the Wall Street Journal a few years ago that the population has grown so dependent on medical care to stay alive that the slightest human error can be disastrous.

He gave as an example a man with acute myelogenous leukemia who died from a transfusion error ten years after diagnosis. However, thirty years ago the same man would have died six months after diagnosis...he was alive due to transplant technology, but needed literally thousands of transfusions to stay alive. The need for so many transfusions made his risk of death due to error higher.

Suppose a person is asked to drive 100 miles at precisely 50 mph, not deviating from that speed by more than 1 mph...his car is wired to explode if he fails to keep this precise speed. This is a difficult task, and if he fails, it's a "mistake" but an understandable one. Physicians are increasiningly burdened with people who need more maintenance than the Space Shuttle to be alive... in the 1950s, they would not be victims of mistakes...just dead. The rising level of obesity, substance abuse, age, premature births, and so on, make the problem harder.

Doctors aren;t perfect...show me a profession that is.

Well written post, and very accurate description of the current situation. Overlaying all of this is the simple fact the we are all very human, and there is a tremendous variation in skills and knowledge in any profession.

 

[fisherdvm]

I was a family doctor at one time. A guy got angry that I will not remove a growth inside his mouth, and said that if I can't do that, he doesn't want me as his doctor. In our little Army health clinic, folks would come in and want me to manage their prostate cancer, prostate cancer, etc...

People expects so much from their family doctor, and yet is unwilling to forgive any mistakes or errors that they make. I realized that being a family doctor would mean I have to be a competent orthopedist, pediatrician, gynecologist, and internist all thrown into one... That's when I left FP and specialized.

The only place I would like to practice as a GP, is in a third world country, where people appreciate me, and no one will sue me.

When I graduated from medical school, a family doctor who wanted to deliver babies would have to pay about the same amount for malpractice insurance as another doctor who didn't deliver babies.... Now, a family doctor who delivered baby would be out of his mind... and his malpractice would be at least double if not triple one who did not do obstetrics...