Doctors don't report colleagues, errors: Study finds practices at odds with beliefs

[AnotherGreenWorld]

Link...

Nearly half of doctors surveyed say they have failed to report an impaired or incompetent colleague or a serious medical error, and more than one-third say they would order an unneeded MRI scan for an insistent patient - though these actions conflict with what the physicians consider the heart of their professional obligations.

...

"Given all of the work that has been put into patient safety, the fact that half of doctors don't report impaired colleagues, I find absolutely astonishing," said Eric Campbell, of the Massachusetts General Hospital Institute for Health Policy and the lead author of the study.

...

Dr. David Blumenthal, director of the health policy institute and an author of the study, said he did not expect doctors to always live up to their beliefs. But he was surprised that 25 percent said they would refer patients to an imaging facility in which the doctor had a financial interest, because doing so is usually illegal.

[no_hypocrisy]

1. I knew a doctor who covered for a colleague who had lost his sight to diabetes

retinitis. The blind doctor was a general practitioner who worked in the same unit as the other physician. This is a different situation from a doctor who was originally blind who was trained to incorporate his disability into his practice.

And the blind doctor's patients were not informed of this change.

The blind doctor would greet the patients in his office, do a history and physical by dictating it onto a tape. The patient would be escorted into the examining room where the second doctor would do the exam (gratis, albeit), and the results and treatment were again dictated.

Without the assistance of his friend, the blind doctor would have had no choice but to retire in his late 50's.

While no patient was in jeopardy at any time, over the years I have wondered whether it was ethical or appropriate for the blind doctor to have practiced as he did not have the capacity to observe for himself the manifestations of his patients and thus his diagnosis was dependent upon that of a third party, plus the patients were not informed and allowed to consent to such an arrangement. I cannot be certain I would have accepted were I a patient.

[flashl]

7. Doctor's white shield? Law enforcement have their blue shield.

[AnotherGreenWorld]

9. I think that's disgusting.

Putting the well-being of the doctor over hundreds of patients.

That would happen in no other profession.

[LaurenG]

2. Insurance companies and Malpractice law suits now dictate

how a physician must practice. In most cases an impaired colleague would be consulted on the side and most physicians have to carefully weigh the reasons not to order tests for an insistent patient. They have to play the cards that are dealt.

Working in medicine can be a challenge but then add in the other two factors and your damned if you do and damned if you don't. :shrug:

[AnotherGreenWorld]

11. Doctors simply don't care about their patients.

If they did, they would report incompetent colleagues.

[fasttense]

3. Have you noticed how doctors are also protected from globalization?

Their jobs are not outsourced or in-sourced, though most of what American doctors do can be done easily and more cheaply by foreign doctors on HB1 visas.

All those anti-free trade state laws controlling how and when a doctor can be licensed and practice in a state are never challenged by big corporations. Corporations have challenged pollution restrictions and privatization state laws but they just have not got around to challenging the laws restricting doctors. I wonder why?

A foreign doctor also doesn't have the handicap of huge loans for their schooling that they must repay like most American doctors do. Most foreign doctors get their education for free and they are willing to work for less because they don't need to make those huge loan payments.

I think doctors are being paid off so that they don't complain. True, every now and then you find a foreign born doctor working in a hospital or private practice but they are not swamping the field like they are in the IT industry, hotel maintenance, restaurants, construction and harvesting. Their jobs are being protected so they go along with this idiotic insurance backed medical care system we have in the US.

I wonder if the Bill Gates of medical insurance will be petitioning congress to allow more HB1 Visa foreign doctors?

[TZ]

5. Not quite true

I have met quite a few foreign born doctors who are underemployed because they can't get medical licenses in this country. Its a question of the education requirements for doctors in these other countries in many cases not being considered the equal of the Med Schools here. And I can tell you, in a few cases, thats truly the case. This country still has one of the better higher educational systems in the world. Otherwise why do you think so many international students come here to be educated?

[flashl]

6. Not exactly ....

Most doctors on J-1 visas come to the U.S. for “graduate medical education or training”. Such doctors are subject to a requirement that they return to their home countries for two years prior to obtaining an H visa or permanent residence status. From the hospital’s point of view, the J-1 visa has advantages over the H-1B visa, including:

No employer sponsorship;
No employer recordkeeping;
No institutional liability;
No prevailing wage requirement;
No employee notice requirement;

Substantial fees affiliated with H-1B visas do not have to be paid.

---

Additionally, I have read about parts of the country where concerted efforts to bring foreign doctors to U.S. is the norm because U.S. doctors can not afford to live in their areas.

[Mayberry Machiavelli]

10. This is not true. While there are significant barriers to entry for foreign doctors in that they

must pass the same USMLE licensure exam as U.S. medical grads, but there are plenty of graduates of foreign medical schools, born in foreign countries, practicing in the U.S., and new ones can come also as long as they meet the licensure requirements.

[Thothmes]

12. Last few times I visited local Military Clinic

Saw three different foreign national physicians working under contract. Two were from Australia and one from India.

[Wiregrass Willie]

4. The Golden Rule of Medicine lives on ..

"Do unto other doctors the way you would have them do unto you".
In other words --- money comes first.

[AnotherGreenWorld]

8. Too true.

[raccoon]

13. I'd rec this if I could! nt