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Detroit Medical Malpractice Law Blog

Study suggests change in standard surgical practice may be appropriate

We have written before on this blog on the topic of medical standard of care. As we’ve noted, the medical standard of care can vary from one state to another and even from one community to another, depending on state law.

Standard of care can come from a variety of different sources. They can be based not only on federal and state laws governing the delivery of health care, but also by commonly accepted clinical practice. Clinical practices can change over time based on new research, though, and so standards of care based on them can also change. 

Study suggests inverse relationship between pro-plaintiff med mal laws, quality of care

A recent study from Northwestern University’s Feinberg School of Medicine in Chicago confirmed what has come to be increasingly obvious to many in the medical field: the threat of litigation doesn’t necessarily motivate physicians to do better work. The lead author of the study says, rather, that it is more likely to lead to the practice of defensive medicine.

Defensive medicine commonly includes ordering unnecessary or inadvisable tests out of a fear or potentially being sued, but it can also include a lack of transparency in communicating with a patient. Fearful physicians may think that the less they communicate to a patient, the less ammunition the patient will have to hurl at them if something goes wrong. Neither patients nor physicians benefit from such a relationship.

When routine medical, surgical procedures result in serious harm to patients, P.2

Previously, we began looking at the issue of medical mishaps which occur in the context of routine medical procedures. As we noted, routine medical procedures, such as tonsillectomies, are by and large successful and occur without serious incident. In some cases, though, something unexpected occurs and the outcome is not a good one.

Whenever an unexpected outcome occurs with a routine medical procedure, patients want answers to their questions. What happened? Is the patient going to be alright? What long-term consequences will there be, if any? Patients also want an answer to the question, who is at fault?  

When routine medical, surgical procedures result in serious harm to patients, P.1

One important point that every patient needs to be aware of is that every medical and surgical procedure presents risks to the patient. The nature and seriousness of the risks depends, of course, on various factors, including the patient’s condition, the proposed treatment, the overall health condition of the patient, the resources of the medical facility where treatment is being offered, the skill of the doctor and other staff, and so on.


Research shows potential connection between brain functioning and preterm delivery, P.2

Previously, we began looking at a recent study which found a potential connection between preterm delivery and lack of neural connectivity in a specific region of the brain. As we noted, it isn’t known yet exactly what the connection is, if any, between preterm delivery and lack of neural connectivity, nor is it known what causative factors are at play in these observations.

From a scientific standpoint, of course, more research needs to be done on the issue. This research very possibly could impact the way obstetricians do their work. One of the particularly important ways the research could affect obstetrics is by giving physicians a possible way to identify another risk factor for preterm delivery. Identify lack of neural connectivity as a risk factor for preterm delivery could help physicians better address the risks associated with preterm delivery. 

Research shows potential connection between brain functioning and preterm delivery, P.1

Something like 10 percent of births in the United States every year is premature.

Premature delivery can present serious risks for both mothers and their children, and medical professionals are expected to follow accepted standards of care in handling pregnancy-related care to minimize these risks. Both before and after childbirth, physicians are expected to pay attention to signs of risk and take appropriate steps to manage those risks.

Study highlights potential risks of mammograms in early screening, P.2

In our last post, we commented briefly on the variation between clinical guidelines for breast cancer screening and the importance of physicians using discretion in applying these guidelines. We also noted that the application of screening guidelines should take into account research, and can even change on account of research.

Part of the reason there is disagreement about clinical guidelines at all is that there are risks associated with screening. One important risk is that screening will return a false positive result and the patient will end up being treated unnecessarily. This risk was highlighted in a study recently published in the journal, Annals of Internal Medicine

Study highlights potential risks of mammograms in early screening, P.1

Medical professionals use a wide variety of tests to screen and diagnose cancer, and make use of a variety of clinical guidelines to determine when diagnostic testing is appropriate and when it is unnecessary. These guidelines vary depending not only on the research that is taken into consideration, but also on the organization.

One area where this variation is seen is with mammograms for the detection of breast cancer. According to the American College of Radiology, women should begin receiving annual mammograms at the age of 40 in order to detect tumors that are small and easier to treat. The U.S. Preventive Services Task Force, however, recommends biannual mammograms beginning at the age 50, since the risk of breast cancer increases with age and there is a higher likelihood of detecting benign growth before 50. 

Pediatric physicians increasingly taking on risk of treating mental health conditions

For counseling professionals, particularly those who prescribe medications and/or monitor their use by patients, the ability to manage medication-related risks is critical to ensuring the safety of patients and avoiding liability. This is important not only for professionals in the field of mental health, but increasingly also for pediatric physicians.

In recent years, a shortage of adolescent psychiatrists and an increase in pediatric mental illness has resulted in an increasing number of pediatricians stepping up to take on the role psychiatrists ordinarily take. This is positive in that the need for such care is being met in places and at times when it otherwise would not, but it also raises concerns about whether many pediatricians are capable of handling mental health issues.

Identifying the standard of care in malpractice cases involving counseling professionals, P.2

In any healthcare-related liability case, it is not enough for a plaintiff to provide evidence of a poor outcome and to blame that poor outcome on the health professional. Not every poor health outcome is attributable to professional error, and not every professional error rises to the level of malpractice.

What must be done to build a meritorious malpractice case is to establish the standard of care, the course of action that would have been expected of the professional, and to show that the professional’s failure to follow the legal standard was a sufficiently significant cause of the harm suffered by the patient.