On Tuesday 21 Oct 2008 7:41:40 am Suresh Ramasubramanian wrote: > It is rather complex .. > > http://en.wikipedia.org/wiki/Good_Samaritan_law > > Perry E. Metzger [20/10/08 15:33 -0400]: > >> I know for a fact that even doctors sometimes delay emergency medical > >> treatment in the US until a patient with a particular emergency is > >> certified by peers as suffering from a problem that has a specific code > >> and that the treatment necessary for that code is applied. > > > >You know this for a fact, eh? I think you would have your medical > >license pulled for doing something like that. > > > >Source please? If folks wish, I can get in touch with an old friend > >that I saw over this last weekend who's now an emergency medicine > >specialist (for which read "doctor who works only in the emergency > >room at a large hospital.)
I won't say who wrote this or where, but I know the man (Edited to remove names and references to people): " in general, hospital employees are better protected since they learn to practice medicine in a manner consistent with hospital policies and not always in the way it should be done. They are also often hidden behind a wall of bureaucracy and personnel. let me give you some examples. In the most litigious area of the US, i.e. South Bronx in NY, I worked at Lincoln Hospital for a few years, first as a resident and later as an attending. It was shocking to see how things were run. A cardiologist was asked to attend urgently to a patient who had developed cardiac tamponade (vitals were stable at this point). She refused to put in a needle until a 'code' was called because in a code whatever you do you cannot be sued. A patient was declared brain dead by the neurologist but nobody had the guts to turn off the ventilator. The Chief of medicine was called who took a long time explaining to the family and after much brouhaha the vent was turned off. Nobody could be discharged from the hospital if the serum potassium level was not within normal range, so if the K was 3.7 and the normal lower limit is 3.8, the patient had to be given supplements and the K level repeated the next morning. An alcoholic walked into the urgent-care clinic intoxicated, demanding he be given food and shelter for the night. When asked to leave, he started saying he was having chest pain. Everyone knew he was lying, but he got his bed and food for the night plus a whole bunch of unnecessary tests. In private practice you are the one and only contact. The story starts and ends with you, there is no entity guarding your back. Any guidelines you follow are your own. Even in practice, there are many physicians who are so scared of doing 'something wrong' that they get paralyzed when asked to handle a difficult case. In this dog-eat-dog world, you cannot survive with such an attitude. You do as you think best, sometimes taking chances because your instinct tells you that is the way to go. If you talk to the patient and the family and keep them well informed, the likelihood of your getting into trouble is much less, never zero. There are so many times I discharge patients from the ER without admission or workup because I feel it is safe to do so, even though I know I am taking a risk. In a hospitalist setting, most people would end up admitting the guy with a small amount of blood in the stool and a normal hemoglobin." shiv
