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Interesting lawsuit. Thoughts??

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I posted this more on the the thought.... 

An NP recommended Admission.

A PHYSICIAN denies the admission

The Doc gets sued.......

 

Is this possibly a turf war?   Outside of all the questions and specifics - the NP contact the Doc for discussion and likely requested admission - but was denied.....  now doc is liable....  wondering if it somehow is used by NP lobby to show that NP's are correct

 

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Well...if the NP recommends admission, the doc denies it I see some liability on the Docs part but, as has been stated, why wouldn't the NP send the patient to the ER?

I know there are things about this that we don't know but it sounds like there is probably plenty of blame to go around.

maybe a deep pockets issue...

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Yikes, this thread is making me think twice about my documentation of EVERYTHING I do for the patient. My entire chart for every patient is CYA. If they have an allergy to penicillin and I am giving ceftriaxone, you'll see a note in there that states something like "reaction to penicillin is a mild rash; has had cephalosporins before" (even though we all know the low rate of crossreactivity - CYA!). If I have given a patient a narcotic, I document that they said that they had a ride home. I document reasons for delays in labs and CTs. Therefore it is obvious that I document anytime I spoke with a physician for advice and what they said, even if they didn't see the patient. Is that really bad? If I speak to my attending physician about a case and ask for advice on what to do, I will absolutely put in my chart that "I discussed this case with Dr. Bob." If I spoke to a surgeon regarding a surgical case, I will document everything he said and what his recommendations are. If I spoke to a pharmacist regarding antibiotic recommendations, his name is going in the chart as well. It is not so much about displacing responsibility (although it is nice to have my attending MD backing me up on a chart) as it is related to my habit of documenting very thoroughly, so that if anyone ever needs to pull my chart they can see exactly why I thought what I thought and acted how I acted. I was told once by a hospitalist that my documentation was "beautiful." What can I say, I am a beautiful documenter...or maybe an a-hole documenter!

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Our official hospital policy is that no curbside consults can be documented in the chart.  It has to be an official consult - and the consultant has to write a note.  I curbside all the time (sometimes to pick their brain, other times to see if this situation requires an official consult), but I don’t document it.  I think this is appropriate. 

When I get curbsided, I would hope my name isn’t in the chart either.  If they want to consult me, they can do so and I’ll document my recommendations in my own note - instead of possibly being misquoted or misunderstood in someone else’s note.  

We get warned (just a semi friendly email reminding us not to do it) and the hospital won’t back us in a lawsuit if we do stuff like that. 

Edited by EndBulbsOfMouse
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10 hours ago, EndBulbsOfMouse said:

Our official hospital policy is that no curbside consults can be documented in the chart.  It has to be an official consult - and the consultant has to write a note.  I curbside all the time (sometimes to pick their brain, other times to see if this situation requires an official consult), but I don’t document it.  I think this is appropriate. 

When I get curbsided, I would hope my name isn’t in the chart either.  If they want to consult me, they can do so and I’ll document my recommendations in my own note - instead of possibly being misquoted or misunderstood in someone else’s note.  

We get warned (just a semi friendly email reminding us not to do it) and the hospital won’t back us in a lawsuit if we do stuff like that. 

That seems like a pretty sensible policy to me, but I'm in outpatient medicine.  What would be the downsides of this sort of formality requirement?

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19 hours ago, rev ronin said:

That seems like a pretty sensible policy to me, but I'm in outpatient medicine.  What would be the downsides of this sort of formality requirement?

Having to write more consult notes, in theory.  Though I will say, anecdotally, I haven’t seen a big difference.   I just don’t feel comfortable being quoted by other people.  I’ve been completely misquoted in the chart before - and thankfully I caught that one (and I’m sure I haven’t caught many others).  If shit hit the fan, what that note said would have gotten me in hot water because what he thought I said was NOT standard of care.  Over the phone, when it’s busy and noisy, it’s easy to miss words like “not” or “but” and your recs can sound the opposite of what you mean  

  I’ve gotten pretty efficient at writing notes - I don’t give people shit for trying to consult me.  If they want my opinion, I’m pretty open about coming and seeing the patient and writing the note.  I think it’s a better way.  

Edited by EndBulbsOfMouse

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