The physician/patient relationship is one of the most important in our lives.  We place our lives and our trust in the hands of the physicians who provide medical treatment to us and our families.  We want to believe that they are well-trained, honest, ethical, and have our best interests at heart when they make medical decisions and provide care.  As much as we want to believe these things, it is important to remember that physicians are human beings and, as human beings, are flawed.  Sometimes, their human nature means that they betray our trust.  Somehow we need to balance our…
Continue Reading Be Careful

A diagnosis of melanoma was often a death sentence.  It was and remains today one of the most dangerous of the skin cancers.  However, as science has marched on, there have been a number of developments in prevention, diagnosis and treatment, which make this disease a lot less lethal.

We know a lot more about how melanoma develops than we did even 10 years ago.  If you are of a certain age group (looking at you, Boomers), you grew up without sunscreens.  No summer was complete without at least one or two sunburns so bad your skin peeled off.  We…
Continue Reading Advances in Diagnosis and Treatment of Melanoma

Over the past two weeks, I have written about the first two required elements of a medical malpractice case:  Standard of Care and Causation.  There is a final requirement.  It is that the breach of the standard of care must cause damages.  Damages is another area in which the Arizona legislature, prohibited by the Arizona Constitution from capping damages, has used workarounds to limit what negligent healthcare providers must pay.

Damages come in two basic flavors.  The first is special damages.  These are amounts which can be the subject of actual computation.  Some obvious examples in medical malpractice cases are…
Continue Reading Damages: The Third and Final Element of a Medical Malpractice Case

Last week I wrote about the standard of care.  Standard of care is the first element a patient must prove to win a medical malpractice case.  The second element of proof is that the breach of the standard of care “caused” an injury.  Causation requires, not only that the breach of the standard of care cause the injury, but that the injury would not have occurred in the absence of the breach.

Causation in medical malpractice cases is a difficult element of proof.  One of the reasons it is difficult is complexity involved in medicine.  Things are not always crystal…
Continue Reading The Role of Causation in Medical Malpractice Cases

Everybody talks about medical malpractice but when you ask them about it, you find people have different ideas about what it really is.  Given its legal definition, this difference of opinion is not surprising.  Depending on whom you ask, you will get different definitions of medical malpractice.

If you ask a lay person what they think malpractice is, you will likely hear that it occurs when a doctor or nurse makes a mistake.  Allthough that is a good answer, it has a number of problems.  In the first place, it doesn’t take into account whether the mistake causes an injury…
Continue Reading What Exactly Is Medical Malpractice?

Recently, my daughter, who teaches high school art, asked me why, if malpractice cases are so hard to win, do doctors continue to complain about high malpractice insurance rates.  I thought that was a good question that deserved to be discussed on this blog.  The answer, as with so many things, is that they don’t know what they are talking about.

This is not a criticism of doctors alone.  Everyone believes things that are not true.  We have heard them so often and believed them for so long that we just assume they must be true and never stop to…
Continue Reading Medical Malpractice Insurance Rates And Entitled Doctors

Last week I wrote about some of the dangers of overuse and misuse of antibiotics: they create resistance among the disease causing bacteria and make antibiotics less effective in saving lives.  There is an equally important second reason, however.  The overuse and misuse of antibiotics kill and damage the good bacteria upon which we depend for our health.

Not all bacteria are bad for us.  We have evolved over millions of years alongside bacteria.  Some of them have taken up residence inside us.  We benefit from them and we have given them a home.  We have literally billions of bacteria…
Continue Reading The Good Bacteria

We are surrounded by life forms that are constantly mutating and changing.  This is particularly true of bacteria.  Because they have such short life spans, they can evolve quickly to meet threats.  That is exactly what they have done to meet one of their biggest threats: the antibiotics we use to try and kill them.

Most of the people alive today never lived in a world without powerful antibiotics.  Penicillin was discovered in 1928 and its use ushered in what came to be known as the antibiotic revolution.  Before the development of antibiotics, people died in the millions from bacterial…
Continue Reading The Danger of Antibiotic Resistant Bacteria

USA!  USA!  We’re Number –  Eleven?
The Commonwealth Fund was founded in 1918 to create better, more accessible health care systems.  Since 2004, it has been conducting studies of the health care systems of the richest eleven countries in the world and ranking them on various measures such as access to health care, outcomes, administrative efficiency, and care process, which includes things such as preventative care and patient engagement.  In every one of the seven studies the Fund has conducted since 2004, the United States has finished dead last overall among the eleven countries surveyed.  This has been consistently so…
Continue Reading We Are At The Bottom. Again. Still.

In 2001, the concept of “never events” was introduced.  The idea was that a never event was one which was identifiable, caused serious injury or death and was almost always preventable.  The original list has grown and there are now 29 recognized never events.

Never events are grouped into seven categories.

• Surgical or procedural events
• Product or device events
• Patient protection events
• Care management events
• Environmental events
• Radiologic events
• Criminal events

Examples of surgical events are operations on the wrong patient, on the wrong body part, right patient but wrong surgery or leaving a surgical instrument or foreign object behind…
Continue Reading The Never Event.

I came across an interesting story recently that resonated with me because I have seen this in my practice.  A Kentucky woman who noticed a lump in her breast went to have it checked out at a local hospital.  The hospital performed a mammogram and then sent her a letter.  The letter stated that there was “no evidence of cancer” seen on the mammogram.  The woman, whose mother had died of breast cancer, was greatly relieved.  She should not have been.

When the lump in her breast continued to grow, her concern returned.  After 10 months of pain, during which…
Continue Reading The Dishonest Hospital

The Arizona legislature does not like you, if you have been a victim of medical malpractice.  They have enacted several laws which apply only to victims of medical malpractice and which are intended to make it more difficult for you to be compensated for the harm you experienced.

Arizona began its life as a state as a bastion of progressive populism.  We had three provisions in our territorial constitution which gave power to the people:  Recall, referendum and initiative.  These provisions were so anathema to the moneyed interests that even then ran the United States that Arizona was prohibited from…
Continue Reading The Arizona Legislature Does Not Like You.

Medicine is an art, not a science.  There is far more that we do not understand about the human body than we do understand.  When you receive medical treatment or undergo a surgical procedure, no one makes you any guarantees.  Doctors hope for a good result when they treat you but everyone understands that the actual result may be far less than what the doctors were hoping for.  This has a definite application in medical malpractice cases.

There are two main elements of proof in a medical malpractice case.  The first is that the health care provider did something wrong. …
Continue Reading The Bad Result.