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Detroit Medical Malpractice Law Blog

What is the relationship between clinical practice guidelines and standard of care?

In recent posts, we’ve been discussing cancer screening guidelines in the context of medical malpractice litigation. One important point to highlight in this discussion is that cancer screening guidelines do not, in and of themselves, constitute a standard of care.

Cancer screening falls within what could generally be termed clinical practice guidelines. There is, to be sure, a difference between clinical practice guidelines and the legal standard of care. The latter is determined by how a reasonable practitioner would act in given set of circumstances, and is the proper subject of medical malpractice litigation. Clinical practice guidelines, on the other hand, are intended to synthesize the evidence and guide physicians in making evidence-based decisions in caring for patients. 

Study highlights family physicians’ knowledge gap regarding lung cancer screening, P.2

In our last post, we looked briefly at a recent study which highlighted, at least to a small extent, the concern that family physicians may not have adequate knowledge of cancer screening guidelines, at least in the context of recommending effective screening for lung cancer.

This is concerning, of course, because many patients rely on their family physician to not only be knowledgeable about available cancer screening methods, but also to recommend appropriate cancer screening when the time is right for it. While no physician is perfect, a patient should be able to expect a physician both appreciates the effectiveness of cancer screening and follows accepted cancer screening guidelines when advising patients. 

Study highlights family physicians’ knowledge gap regarding lung cancer screening

We have previously written on this blog about failure to properly diagnose cancer, and the duty of physicians recommend appropriate screening tests and track a patient’s conditions, noticing potential warning signs of cancer and referring to specialists when necessary.

Part of what is required for doing this effectively is to keep up with current practice guidelines regarding cancer screening, and recognizing the importance of cancer screening in the first place. Surprisingly, many physicians are simply unaware of the effectiveness of cancer screening and aren’t familiar with screening guidelines. 

Study: error-tracking makes for more effective surgical resident training

An important task for any surgical residency program is how to evaluate the skills of its surgeons in training. Thorough and effective training, of course, ensures surgeons are equipped to succeed in their work and that patients entrusted to their case will receive competent care.

A recently published study from Johns Hopkins looks at the issue of how to effective assess the operating skills of orthopedic surgeons. What the study found was that the common method of using step-by-step checklists and measures to assess general surgical skills is effective as far as it goes, but that it is more effective when combined with a rigorous system for detecting and tracking errors. 

Did your physician fail to recommend cancer screening?

Last time, we looked briefly at new lung cancer screening technology and noted that physicians have the duty to take appropriate action with regard to cancer screening, whether this means referring a patient to a specialist or ordering appropriate tests for the patient.

Cancer screening is a bit tricky, because there are different screening guidelines for different types of cancer and these rules change over time. In addition, different organizations have slightly different screening recommendations. That being said, there is a great deal of agreement in these recommendations, and patients should not suppose that their physicians are without clear guidelines when it comes to medical recommendations. 

Lung cancer breath test could be effective screening tool

When it comes to treating cancer, early detection and treatment are critical to success. Screening guidelines exist for a wide variety of cancers, with breast, colon, and skin cancer being among the more well known and performed screenings. Some forms of cancer are harder to diagnose than others.

As our knowledge and technology continues to develop, we will hopefully have more and more screening options available to for a variety of cancers. A recent example of such a development is a straightforward breath test which apparently can help identify chemical compounds indicating the presence of lung cancer. The test used in the study is not approved by the FDA, but it may be someday. The cost is reportedly quite low, which would make it accessible to the public. 

Federal program shares similarities with Michigan Model on med mal dispute resolution, P.2

In our last post, we looked briefly at a federal program known as CANDOR which aims to help federally funded hospitals adopt dispute resolution programs which increase hospital and provider transparency in dealing with patients. The program is being promoted

As beneficial as the program and similar approaches may be to patients, open communication and transparency is all too often lacking for patients attempting to secure answers about failed medical or surgical care. The first step, whenever a patient has questions or confusion about their situation, of course, is to communicate with their doctor, the medical staff, and the hospital. When this proves unproductive, it is time to talk to an experienced medical malpractice attorney. 

Federal program shares similarities with Michigan Model on med mal dispute resolution

A federal program being promoted by the federal Agency for Healthcare Research and Quality is now seeking to implement in federally funded hospitals some of the same principles that have made the dispute resolution model used at the University of Michigan Health System so successful.

The program, known as Communication and Optimal Resolution (CANDOR) was introduced last month after being tested at a number of hospitals and health systems. Through the CANDOR Toolkit, hospitals are given resources to assist them in adopting an approach to medical incidents that will keep patients more in the loop about medical errors and help prevent medical malpractice litigation. 

Recovering from a home birth gone bad: work with experienced advocate, P.2

In recent posts, we’ve been looking at the topic of home birth, the regulation and discipline of midwives in Michigan, and seeking compensation when a midwife acts negligently and something goes wrong. As we mentioned last time, licensed midwives can face both professional discipline and charges of negligence.

Taken together, there are several options available to a patient who has been harmed by a negligent midwife, depending on the status of the midwife. For certified nurse midwives, a complaint can be filed with the state to determine whether disciplinary action through the Board of Nursing is appropriate. Civil litigation for malpractice or negligence may also be a possibility, as we’ve noted, though this is more likely to be a productive course of action when the midwife carries malpractice insurance. 

Recovering from a home birth gone bad: work with experienced advocate

We’ve been looking in recent posts at the topic of home birth safety and the regulation of midwives. As we noted last time, there is only one type of midwife that is regulated in Michigan, and that is certified nurse midwives.

According to Safer Midwifery for Michigan, the exact rules governing a midwife’s practice depend on the specific practice setting. As we noted, the rules governing midwives are not specific to midwives and don’t specifically address out-of-hospital births. Different CNMs will, therefore, have different philosophies and scopes of practice. Midwives who practice in hospitals and in clinical settings may have rules and procedures they must follow, while those who practice in the home set their own rules.