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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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.
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.
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.
that really sets a bad precedent. The curbside consult has officially died.
Physicians can eliminate the first concern by backing independent practice for NPs.
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.
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?