The obvious answer is no, the tough part is we are expected to be both socially and legally. So does this paradigm create any problems for you the patient? In my many years working in many areas of healthcare from the office to the ER, I can safely tell you that in most cases it absolutely does. The threat of lawsuits can actually change the way doctors care for their patients. The big question is whether or not these changes either benefit or harms patients. I propose it has led to significant overall harm coupled with huge waste of valuable medical resources.
Here’s the deal: Doctors are NOT perfect, they are humans. Medical diagnosis is not always a simple, logical, criteria-based calculation; it is a complex “art”. Good for us docs, you will never be able to simply input symptoms and lab values into a computer and expect a better overall diagnoses than an experienced doctor. There are too many subtle “non-scientific” factors that come into play in some diagnoses. Unfortunately for all of you, the legal system has tried to boil down the criteria for malpractice in as “resulting in a bad outcome” or “being wrong”. Are we allowed to be wrong? I understand many would say no, but again, we are human and we will get it wrong at times. In efforts to reduce the chance of being wrong or missing even the most rare disease or condition doctors are now pressured to run more tests than were necessary 30 years ago, with the same outcomes.
When you have a headache or hit your head and wind up in the ER, your doc used to be able to examine you and based on your explanation of the event, assess whether a cat scan of your brain was warranted no questions asked. Nowadays that assessment is followed up by the patient demanding that a cat scan or x-ray be ordered, without having the knowledge of radiation exposure and long term risks involved. Just one of MANY examples. Patients seem to take ques from TV legal ads and argue more with their diagnosing physicians than their car mechanics. Somehow the average Joe now feels he can grasp the vast arena of medical knowledge more easily than reading a car manual! As you can tell, I don’t blame the patients, I blame the legal system and the environment it has created.
I spent 4 years in medical school and then approximately 25,000 hours of supervised training, (at minimum wage) before I could practice medicine by myself. When doctors are assessing your illness they are using that knowledge and experience, PLUS integrating the many years of job experience they accumulate over the years to calculate what is best for you. I do believe there has to be open dialogue and many time lengthy explanations about how we come to our conclusions, but in the end you still should trust your doctor. I’m also here to tell you that with all that skill and training, we will sometimes get it wrong. Just like other professions, we should be monitored and held to very high standards but as long as we have the option of ordering a needless test versus losing our career patients will suffer from over-diagnosis, over-medication, and frivolous testing. Support legal tort reform and limit lawyer’s motivation to sue merely to win cash settlements that can be career-ending. There will always be a place for criminal prosecution of ill-intentioned doctors but it doesn’t have to be a billion dollar industry. Being a physician is a huge blessing and responsibility and the motivation to do right by our patients should come from within, not based on fear.