No Existing Relationship Needed To Sue a Doctor

Be careful out there folks. Here is what just happened in Minnesota. You need to see this:

The Warren v. Dinter case arises out of the care provided to a woman (Susan Warren), who complained of abdominal pain, fever, chills, and other symptoms to a nurse practitioner at Essentia Health Clinic in Hibbing. After testing showed that Warren had an elevated white blood cell count, the nurse practitioner suspected infection and sought hospitalization for her at Fairview Range Medical Center. The nurse practitioner’s call was randomly assigned to a hospitalist at Fairview to discuss admission. 

After a brief conversation, during which the physician was unable to view the patient’s medical record, the physician and the nurse practitioner discussed hospitalization and whether the elevated white-cell count and blood sugar could be the result of diabetes. The physician did not recommend hospitalization during the conversation and the nurse practitioner did not seek hospitalization for the patient following the conversation. The patient subsequently died from sepsis caused by an untreated staph infection. Warren’s family sued both the nurse practitioner and the physician for medical malpractice. 

There is a lot of unpack here. I do not have all the details other than what is in this article. Therefore, I cannot debate whether the doctor really missed something obvious. The Minnesota Medical Association said this:

The Court’s decision to rely on a broader legal theory of “foreseeability” represents a troubling change that puts Minnesota in the minority of states that do not require the existence of a physician-patient relationship for a malpractice action. This change may expose physicians and other health professionals to malpractice risk in a variety of actions that were previously protected, including unbilled consultations

From the little information I have, this just shows you can be sued for anything. Examples include:

  • If you have a gaggle of NPs/PAs under you and you are not reading and correcting everything. Makes you think whether you should continue this, huh?
  • If you do a curbside consult
  • If you are a specialist and a doctor calls you for some thoughts about a case
  • If a patient calls you and you possibly miss ANYTHING and there is a bad outcome

Being a doctor is not easy. Even if we do the best we can there is always a chance for a mistake. Negligence and bad outcomes are not the same, however.

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Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  7 comments for “No Existing Relationship Needed To Sue a Doctor

  1. arf
    May 7, 2019 at 6:49 pm

    I don’t see the problem as a doctor-nurse thing. The problem is telephone medicine. Is the question whether the doctor missed something, or the nurse practitioner missed something. The only person who actually saw the patient was the nurse practitioner.

    As best as I can tell from the story, the nurse is not “under” the doctor in any administrative sense. This is not a”gaggle” of NP/PA problem, this is a “telephone medicine is bad medicine” problem. This scenario could have happened if the caller was a nurse practitioner, a PA, or a physician.

  2. CJ Ewell
    April 28, 2019 at 12:54 pm

    Hello Charles Trant. I am a nurse practitioner. Let’s walk through your response today.
    A master’s degree has been required for this title/certification for decades. Most now earn a doctorate, so the BSN argument is inaccurate.
    Physicians dont “let” others have equal status- that power resides in State Boards as well as (less formally but more powerfully) with CMS and other third party payers.
    Finally, in practice, physicians in states that require physician oversight of NPs will sometimes contract with as many as possible for the sake of increasing physician income, and then not exert the supervision/oversight implied or explicity required by that arrangement. That would be the circumstance alluded to in the original comment. My response to that specific comment is that if physicans wish to avoid that situation, then they should stop their efforts to remain as mandated overseers of NP practice.

    • Pat
      April 28, 2019 at 1:22 pm

      Excellent example of why I’d like to eliminate all state licensing of docs, NP’s, shamans, or midwives. Let the consumer be educated, let the buyer beware. NP’s want to be doctors without all that bothersome schooling, Big Insurance and Big Gov’t want cheaper solutions, and patients want doctors without paying them what they’re worth. These are all bad, corrupt influences that have diluted us to “provider” status in the public mind.

  3. April 27, 2019 at 4:59 pm

    that really sets a bad precedent. The curbside consult has officially died.

  4. CJ Ewell
    April 27, 2019 at 10:11 am

    Physicians can eliminate the first concern by backing independent practice for NPs.

    • Douglas Farrago MD
      April 27, 2019 at 10:56 am

      Let’s be clear. I won’t tolerate any militant/extremist NP stuff here. I will block any more of it if it gets out of hand. This piece wasn’t even an attack on NPs but you had to take it there. Your choice but it stops now.

    • Charles Trant
      April 28, 2019 at 8:33 am

      I don’t understand: if you are a physician, and you chose to earn the required credentials to become a physician, why are you so quick to let others have equal status based on lower standards that only apply to people like them. If you are not a physician, but you don’t think BSN’s, who are practitioners of nursing, should be declared given equal status as nurse practitioners based on lower standards that only apply to people like them, then what is your point?

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