Forensics Talk

"Medical Justice" Patient Gag Contracts: Not Just Dumb, But Illegal

 Trusted.MD

by hippocrates | Mon, 06/09/2008 - 7:36am | permalink

     Asking patients to sign a contract promising to not rate their physicians could be illegal. Common sense ought to prevail.

The rise and impact of physician rating service has been a hot topic lately. In traditional media, blogosphere at large and this blog specifically.

Last year I wrote about an organization calling itself "Medical Justice". Their stated mission of "protecting physicians against frivolous lawsuits" is admirable. Unfortunately the ideas and methods are bound to sow distrust and undermine doctor patient relationship.

Anyways they are still making news, but there is a new twist:

iHealthBeat last week picked up a story from American Medical News, including an interview with Jeffrey Segal, MJ founder. There are no news in terms of how he keeps promoting his patient gag contracts, as I addressed the problems with those point by point earlier. The piece could get no quotes from any supporters other than Dr. Segal and offers no stats on how many docs bought into this idea. However the quotes from opponents (doctors and lawyers) are telling:

Alan Howard, a professor of law at St. Louis University, said there are potential problems associated with asking patients to sign the contract, especially if they are beneficiaries of publicly-funded health care programs. It is illegal to ask individuals to give up their First Amendment rights to receive goods or services paid for by the government, American Medical News reports... Read More 

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"To The Doc That Rounded On My Patient Yesterday"

  White Coat Stories:

     This is a terrific post below from White Coat Stories Blog. Oh, boy, does this bring back memories! I can't count how many times physicians would walk in to an isolation room without gowning up - and then go right on out to another patient's room!

I know you know that our patient was on isolation, because it’s very hard to miss: 1) the big red “ISOLATION” sign on his door, 2) the big cart outside of his room containing gowns, gloves, and masks, and 3) me, standing at the patient’s bedside wearing said garb. So when you come in ungowned and unmasked and I say, “Um, you do know that this patient is in isolation?” the correct response is not to hold up your gloved hands and say, “It’s okay; I’m gloved up.”

When told that this patient requires more personal protection equipment than gloves, the other correct answer is not, “I don’t have time to bother with that shit. I’m not touching him anyway.” Do you want to know how I know that this answer is incorrect? Because when you were bending over ever-so-slightly to listen to the patient’s chest using your own stethoscope instead of the dedicated isolation stethoscope, the front of your shirt poofed out just a little, and just enough to brush the side rail. The side rail that has been touched by many many gloved hands probably containing all kinds of millions of organisms that are, you know, resistant to more than quite a few antibiotics.

And the “I don’t have time to bother with that shit” comment? I did point out to you that I have to put on the gown, gloves, and mask every time I walk into the room, which was easily 1-2 times an hour, sometimes more often. For 8 hours. So you do not have to tell ME about what a pain it is to bother with it. I am well aware... Read More

Over! My! Med! Body!:Responding To The Anti-Vaccine Crowd

Check out a terrific medical blog with it's intelligent response to all the anti-vaccine hype on

Over! My! Med! Body!

Responding To The Anti-Vaccine Crowd:

A pediatric attending recently provided a great way to respond to the anti-vaccine folks, as she responded to an ad claiming a link between rates of vaccination and and rates of autism:

Just because 2 rates have risen in the same 25 year span does not mean that either causes the other. It also doesn’t imply directionality - so one could actually argue that we give more vaccines because rates of autism are rising, if you’re going to argue by this groundless line of reasoning. Please note that there are MANY other exposures that impact children that have had equally large rises in the last 25 years:

1. Mention of sex on TV
2. Computer screen exposure
3. Mean environmental temperature
4. Number of both contraceptive and fertility methods used by parents
5. Celebrity DUIs ... More

4 Hour Antibiotic Window Little Effect on Survival in Pneumonia

Emergency Medicine Doc

      "Most docs have recognized the ridiculous science behind the Quality rules requiring antibiotics in Community Aquired Pneumonia within 4 hours of arrival at the hospital. Finally, there is a study from our home NJ Medical School in Newark, NJ that reveals that giving antibiotics in the first 24 hours has little effect on survival.  The study found that despite increasing the number of patients that received the antibiotic in 4 hours over 3 years there was no change in survival.

While it intuitively makes sense that we should give antibiotics in a timely manner for pneumonia, the science behind the quality of measuring it is flawed and should no longer be measured."

Nurse Ratched's Place: How The Grinch Stole Christmas...Again!

From Nurse Ratched's Place:

Monday, November 19, 2007

How The Grinch Stole Christmas...Again!

I love Christmas stories with happy endings, but alas, this story ends with a lump of coal in everyone’s Christmas stocking. Last year at about this time I told you all about the generosity of our hospital administrator, Mr. Grinch. He sent the hospital employees a letter last year, and this is what it said: ... More

Trasylol Pulled From Market

InjuryBoard.com

   The antibleeding drug Trasylol has been pulled from the market around the world after a study has shown there may be an increased risk of death from use. The drug is used during heart bypass surgery.

The announcement came as a Canadian study comparing the safety and efficacy of Trasylol with two others was halted. Preliminary results from that trial also suggested Trasylol increased the risk of death when compared with the other drugs. The trial was to include 3,000 patients.

Trasylol, also known as aprotinin, works by blocking enzymes that dissolve blood clots.

The FDA panel had met last month to discuss the drug but was advised to keep the drug on the market. Possible side effects from Trasylol include heart attack, stroke, and kidney problems.

For more information on this subject, please refer to the section on Drugs, Medical Devices, and Implants.