Case Scenario Several month ago, ...

Case Scenario

Several month ago, I delivered a 36-week fetus with intrauterine demise. There had been no complications during the pregnancy, and the death was completely unexpect I conception that I had been forward good terms with my patient over her pregnancy and had been involved in all aspects of her prenatal care. Nonetheless, six weeks after the tragic result I received a letter from an attorney stating that he had been retained to investigate the death. I heard nothing more forward the matter until recently when this patient showed up for an appointment.

She is pregnant again and wants me to continue to be her physician. When I asked her if the suit was proceeding, she admitted that it was. "Then to what degree can you want me to be your physician?" I asked. "It's not me who wants the suit," she said, a little tearfully, "it's my family. I still want you to be my doctor." Because I be impressed comfortable that the intrauterine fetal demise was not related to any lapse in my care, I am inclined to be willing to continue as her physician. Needles to say, I am a little edgy about that will be adverse outcomes. Is there a conflict of interest if I recommence her obstetric care? What risk-management issues should I be aware of? Does it make reason for me to continue to care for this patient?

Commentary

The questions being asked in this case scenario can be consolidated into individual "Should I continue as this patient's physician?" An attorney's typical answer to so a query is often a cautious "It depends" In this case, a more definite answer is appropriate: "No."

Returning to the first of this physician's three questions, conflict of interest is an unlikely issue in this case. Usual conflicts of interest involve situations in which individual party is potentially advantaged at the charge of another party. An example of like a conflict would be a physician who commits a patient for an unnecessary magnetic resonance image at a facility in which the physician has an undisclosed ownership interest. A conflict exists between the doctor's interests (seeking financial gain) and the patient's interest (seeking appropriate care). In this case, however, the physician and the patient presumably have aligned and belonging to all interests--they both want the best possible medical issue for the patient and the infant. onward the other hand, if the physician's intention in continuing to care for her would be to persuade her to globule or punish her for, her lawsuit, there would indeed be a potential conflict of interest (and probably a ne for professional counseling).

The inferior question pertains to risk management and provides the chiefly compelling reasons for advising that this physician no longer obey this patient. Patients sue physicians for a variety of reasons (1); chiefly often (in 70 percent of cases) they file suit because of communication question at issues unwanted outcomes, unmet expectations, or a desire to save others from going between the sides of what they experienced. (2) If any of these was this patient's reason for a lawsuit, the physician's inability to communicate effectively with her, to understand her needinesss or to promote reasonable expectations upon her part is likely to recur

Sometimes patients petition because of economic need, flat when they do not believe the physician was negligent. An example might be the parents of a child born with a handicapping condition who face overwhelming custodial and medical care outlays But, in a case of intrauterine fetal demise, the economic require to be paid [i]or[/i] undergones are usually negligible and an remarkable motivation for a lawsuit.

Still other patients commence a suit against for their pain and suffering. If this was the patient's motive, the physician must follow to the difficult and humbling conclusion that his relationship with her was not sufficiently therapeutic to help her cope adequately with her suffering.

In all likelihood, her suit is borne of anger, do harm to and a desire to punish someone level if a patient genuinely likes and trusts a physician that she has su mostly lawyers would advise against continuing the physician-patient relationship, not because of an inadequacy forward the physician's part, but rather because the patient, having already initiated common lawsuit, will be more likely to bring an action against again in a setting similar to the the same that engendered the original suit.

The third question involves the physician's relationship with this patient. Regardless of her motives and her intimateed confidence in him, the patient has brought a lawsuit--declaring that she believes and alleges that the physician committed negligence and that the negligence caused her harm. Without those fundamental allegations, she would have no basis for filing a lawsuit. calm if she is able to reconcile the apparent contradiction between pressing a claim against the physician for negligence and continuing to entrust her care to him, the physician would have worry trusting her.

As her suit plays disclosed her attorney, expert witnesses, family, and unruffled her own testimony will challenge the physician's enough and commitment to her care. If this physician be warmeds "a little edgy" now about subsequent time adverse outcomes, just wait until her litigation is complete!