I'm Getting Sued
Or Shall I say "We are getting sued".
It's about a patient I've cared for as a resident who had a bad outcome. The lawsuit is by no means a surprise. I had a feeling it would head in this direction from the beginning.
I know you don't want to hear me bitch about this. Neither would I, so I won't do any of that. I would like, however, to document a few things that I can take away from this lawsuit that may, still, make me into a better physician or, at the very least, prevent me from being sued again.
For one, when things with the family appear strained, or tense, make a strong effort to document everything. Everything that they say and all of your responses. This does, however, become difficult because it will eat up a lot of your time.
Two, when the situation is heading in the wrong direction make a strong effort to document everything. Today, the impression is that an unfavorable outcome is automatically the physician's fault.
Three, get the family involved early. In fact, a good question to a patient when admitting them is if you can discuss the situation with the family. I suggest calling the family on admission so that they understand what is really happening. Try not to commit any HIPAA violations in the process.
Never say that things are looking "great" or "good" or "wonderful". You may use words like "Better", "Improving" or "Heading in the right direction" but make sure to mention that the overall situation is still bad. This will cushion the shock if something doesn't go as planned.
Never ask about a DNR the first time when speaking to a family even if the patient is crashing. They will become paranoid that you are not doing your max to cure their loved one. People really are distrustful of doctors these days. That is real! Wait at least 24 hours before asking about a DNR.
I have to face how this makes me feel. The truth is that I have no idea what exactly went wrong. I've had a chance to look through the chart and I am still unsure. But it doesn't mean I'm a failure or that I made a mistake. And even if I made a mistake I was hoping to take some lessons away from the experience. Unfortunately, I can think of other cases where I did make a mistake but the only thing I can really learn from this case is how to prevent myself from being sued. Which won't make me into a better physician by any stretch of the imagination.
I'm mostly nervous about having someone look at all of my decisions under a microscope. Can my judgement really withstand that sort of scrutiny? We all make decisions and many times those decisions are based on instinct.
Since that case I've been a better doctor. That's the simple truth. Much more careful about every single decision I make. Many of my decisions are based on my own welfare and not necessarily the patients. They are based on what someone may say in court. They are based on my need for future employment and malpractice insurance. I do, however, feel that ultimately the patients are better cared for and that is what counts.
Residency teaches more than just medicine.