Articles Posted in Doctor-Patient Relationship

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His basic credentials would come under fire, but they were sufficient for the “doctor” to insinuate himself into major institutions, and, worse, into the lives of hundreds of girls and young women on whom he inflicted a tragic toll. His combination of enthusiasm — he was a rah-rah kind of guy— extreme controlling conduct, and horrific “treatments” never seemed to set off the red flags they should have.

Instead, Larry Nassar — an osteopath who served as an athletics and team caregiver for USA Gymnastics and Michigan State University — got away for years with abusing adolescent females put under his  sway. He purportedly provided medical services to them, many in exclusive and demanding athletic camps where young participants were cut off from their friends, family, coaches, and personal physicians. He “treated” aspiring Olympians, at all hours of the night and day, alone and without any other adults around, in their bedrooms, on their beds — not in medical offices or athletic training facilities.

He enthusiastically told his patients, many of whom excelled at their sport because of their willingness to please adults and to be coached, that he could deal with their pains and injuries with what he termed pelvic manipulations in which he digitally penetrated them in their private parts. Without medical cause or justification, he conducted repeated and invasive “exams” of girls and young women’s genitals.

massgen-300x140Canadian researchers have come up with at least 2,500  reasons why elite surgeons should reconsider their own wishes and practices to protect patients undergoing hip surgeries from significant post-operative complications. They could do so by curbing even more their dual surgeries, in which they dash between two operating rooms.

A new study has found a 90 percent increase in the risk for surgical complications at one year when doctors repair hip fractures or replace hips in so-called overlapping surgeries.

The Boston Globe, starting in 2015, has raised major issues regarding the safety and effectiveness of simultaneous operations, conducted most often at major academic medical centers (such as Massachusetts General, shown above) and by leading practitioners.

alive-300x115Nick Tullier once was a handsome, strapping sheriff’s deputy in Baton Rouge, La. Then, in a blink, he and five others were gunned down by a former Marine and black separatist who had come from Missouri to Louisiana to kill cops. Tullier was one of three deputies who survived the attack.

What happened next to him is part of a series worth reading in the Houston Chronicle, a year-long dig the newspaper has dubbed “Alive Inside.” The work asks whether doctors and hospitals across the country have stayed current with medical advances that maybe, just might, possibly offer greater glimmers of hope to patients like Tullier who suffer traumatic brain injuries.

Such individuals, the Chronicle carefully says, may too quickly be deemed too injured to survive. Doctors, in sincere acts of perceived compassion, may be too fast to urge family and loved ones to withhold or halt medical services for the brain-injured, partly out of the pragmatic reality that their recovery prospects remain poor.

womenmds-300x200The profession of medicine gets mixed reviews in rolling back the centuries of  chauvinism, arrogance, and boorish behavior of top (male) doctors.  It’s now generally if grudgingly recognized that health care, though it may be a life-and-death practice, needn’t be a rude and obnoxious one. Nurses, many of them women but many men, too, shouldn’t be bullied and demeaned by doctors. It makes for mistakes and malpractice and bad patient outcomes, for one thing.

As health care leaders look around at mighty male leaders who are falling left and right in the entertainment, news and political industries, they may wish to look closely at their own talent and its treatment. Women doctors, for example, get a bad deal on a matter as basic as pay: They earn, on average, 20 percent less than men do, even within various specialties, data from 36,000 self-reporting MDs has found. Male vascular surgeons earn $89,000 more than their female counterparts, while male pediatric rheumatologists get about $45,000 more than their female peers do.

The American Medical Association has reported that only 12 percent of internal medicine, 1 percent of surgical, and 22 percent of obstetrics and gynecology department chairs at important, prestigious academic medical centers are women—figures that also are tough to reconcile because 83 percent of obstetrics and gynecology residents are women.

clown-246x300Social media have become a “circus” for some plastic and cosmetic surgeons to clown around in unprofessional ways, including: videos in which one doctor has cradled fat removed from a tummy-tuck like an infant and put a baby face on it using a Snapchat filter. Other costumed surgeons have posted visual displays of themselves dancing before surgery and showing off on camera procedures or with tissues they have removed.

The abuses have become so bad that faculty and students from Northwestern University’s medical school, after researching incidents online, have published a prospective social media code of ethics for plastic surgeons, calling for its adoption by specialists at their next major meeting.

Robert Dorfman, one of the Northwestern students and an author of the draft ethics proposal,  has described plastic surgery’s social media landscape “like the Wild West out there, with no guidelines or rules.” Clark Schierle, senior author of the guidelines, a plastic surgeon, and a medical school faculty member, has observed that practitioners in the field are “uniquely drawn to social media because we tend to do more marketing and we are a visual specialty.”

tats-300x192Could pediatricians accomplish what many parents cannot? Can they talk to rebellious youths about the body adornments that are  all the rage now, and get kids to consider the health risks and long-term issues surrounding trendy tattoos, piercings, and body scarring?

In case you’ve fallen like Rip Van Winkle into a long doze or you’re senior enough to even understand the Washington Irving reference, tats and body jewelry worn in created openings and roughing up the skin to make interesting patterns all have become so common among the young that those who go without such au trendy beauty measures may now even be the outliers among their peers.

There isn’t good data on body scarring but the public opinion experts at the Pew Research Center found in 2010 that 38 percent of 18- to 29-year-olds had at least one tattoo, and 23 percent had “piercings in locations other than an earlobe.”

records-300x200Although patients can protect their own health by getting copies of their medical records, few consumers get them, and fewer still take advantage of the federal government’s push to make records easily  available electronically, one of Uncle Sam’s big public protection agencies reports.

The U.S. Government Accountability Office also warns that tumult in the nation’s health care system, notably in Congress’ roller-coaster deliberations to repeal and replace the Affordable Care Act, aka Obamacare, may disrupt patients’ relationships with caregivers. That makes it even more vital for consumers to have their health records.

The Association of Health Care Journalists deserves a tip of the cap for pointing to the GAO blog, where experts note that the ACA had supported a national push to get doctors and hospitals to adopt electronic health records with the aim of providing patients and caregivers more access and transparency about these crucial materials.

overdose-300x225Taken from a most favorable point of view, Big Pharma and doctors tried to address a big physical problem for patients when they pushed ahead in recent years with potent painkillers. But now, it’s those troubled Americans’ mental health woes that  officials may need to deal with to better battle what has become an epidemic of opioid drug abuse.

It’s a crisis that may worsen still and claim as many as 650,000 lives in the next decade, says the online health information site, Stat, which consulted 10 leading experts to develop its forecast.

Stat and other news organizations also have reported on newly published research showing the depths of the mental health challenges of those who abuse opioid drugs, with adults with a mental illness each year receiving more than half of the 115 million opioid prescriptions in the United States.

Diverse_doctors_3-300x201Some new research studies suggest ways to find a good doctor by focusing on demographics. Older doctors who have reduced their caseloads may not be an optimal choice, one study suggests, while another finds that, for seniors sick enough to be hospitalized, women MDs excel. And doctors who are immigrants can be solid patient choices, a third study reports.

Let’s be clear: These studies are observational, and they focus on select measures of care. But they are based on big data, analyses of hundreds of thousands and even millions of cases. Your own individual experience with a clinician counts a ton, and must never be ignored. A doctor with a brilliant resume, golden accomplishments, and a sterling reputation can still treat you badly, even blunder with your care.

Still, after examining three years of data on more than 700,000 admissions and the outcomes of 19,000 doctors, researchers from Harvard Medical School and prominent Boston-area hospitals found that as MDs aged, mortality rates of their hospitalized patients climbed. For doctors younger than 40, the rate was 10.8 percent, while for those older than 60, it hit 12 percent.

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