If this post were solely about bad reporting, the linked story would keep a journalism class busy for a week. An incomplete narrative, with hearsay, and little illumination for the lay reader on standard hospital physician interaction make for compelling reading…if you enjoy fiction.
Unfortunately, this story is real. Painfully so, and as I read it, my mood soured. Not because I suspect malfeasance—that will take a day in court and hours of depositions, but because the public is refereeing the participants and prematurely rendering verdicts before the facts are unearthed and judged in the appropriate forum. Shame on them!
However, what is principal are the issues that this case will raise, mainly, the “risk zones” that hospitalists venture into when engaging with specialists and community based doctors.
Allen Kachalia MD, JD runs the Legal Consultation: Risk and Mitigation Strategies session at SHM Annual (which I never miss, and is exceptionally good), and without fail, participants ask these questions every meeting:
- Where does my responsibility begin and end via the PCP?
- Who is responsible for carrying out orders, the consultant or me?
- Must I address every suggestion a physician places in the chart?
- As compared to ambulists, i.e., as a “hospital specialist,” do the courts hold us to a different standard of care?
- Can my employer base compensation on LOS reduction?
If these resonate with your experience, read on and render your own judgment. This case touches upon them all, and reflects a reality we must accustom to as our specialty matures. It will also leave you with an unsettled reaction, and not of the warm and fuzzy kind.