Don't become a doctor #5 - Thou shalt not opine

One of my colleagues asked me to write him a script for Augmentin a while back, which I did without a second thought. A week later, I found out he was in the hospital with a serious infection, and that the Amox/Clav I wrote was pissing on a forest fire. I was kicking myself all day.

Once you're a doctor, you'll find that people will continually ask for your professional opinion, which is fine when they're your patients and you've examined them and can best determine their plan of care. But it's very dangerous if that opinion is given out casually. The danger is that you could completely miss the mark, like I did with my Augmentin, or risk being completely wrong, like good old Dr Frist on the subject of Terri Schiavo.

Senator Frist had proclaimed her not to be in a persistent vegetative state, based on the 1 minute video we have all seen. Now, Senator Hatch or Biden or Kennedy or Clinton or any other senator could have said the same thing, but with Frist, he's a doctor. That's his professional opinion. That's not rhetoric. That's diagnosis. I don't know how he can still call himself a doctor, because he should've known better.

Most of the time, it's not such an overt display. We will make an offhand comment or some remark, and that carries amazing weight. It determines what shampoo someone will buy or whether to eat more broccoli, or most notably, whether to sue another doctor.

The numbers show that one of the most powerful factors in patients bringing malpractice litigation forward is doctor B telling the patient that doctor A was wrong. This is simply irresponsible. People think that when we say that we should refrain from these comments, we are trying to protect our own (which is a legitimate reason in and of itself, but certainly morally questionable). I disagree. The simple fact of the matter is that you weren't there. You didn't see what doctor A saw. You can't put yourself in his shoes.

Honestly, I think that a lot of people go into medicine because they have this vision of the rabbi rather than the healer. What I mean is that in the Jewish community, a rabbi is a teacher and a scholar. People come to him and ask his advice or knowledge. He offers a piece of scriptural wisdom to support his point.

The same cannot be done in medicine because it's dangerous. We don't have the authority of God to fall back on when we have bad outcomes. I seldom if ever give out free medical advice, even to family, because I am professionally liable for that advice, and my conclusions bear serious weight, but are based on limited data. Your professional opinion is not something to just throw around or wear on your sleeve. Unless you want to sell your soul to some foot cream company.

So if you want to go into medicine for the admiration and having people seek your opinion, please reconsider. It's a dangerous game.

BTW - I'm still on vacation.

1 comment:

Anonymous said...

You're back! :-) well, sorta.