August has been a month for disasters with the sudden, unexpected, wildfires of Maui, Hawaii. This was one of the largest natural disasters in the United States, the greatest natural disaster in one hundred years, and with more than 130 souls dead in the fire and almost one thousand more family members missing. All disasters are tragic, whether they be caused by nature, or people’s carelessness, terrorism, or war. Our hearts go out to the families of the victims. Who could not be empathetic to mothers, fathers, sons and daughters, grandparents and grandchildren? When we are called to look at the word, empathy, I am reminded of the words of Alfred Adler who said, “Empathy is seeing with the eyes of another, hearing with the ears of another, and feeling with the heart of another.” How many of us dare to apply these things to catastrophes and disasters that we have seen or been informed about?
One of the not-so-surprising scenarios that surfaced shortly after this loss of life and property was that the media, journalists, started to make assertions before tears could fall to the ground. There was an almost spontaneous pronouncement of who may have been guilty, the lack of a disaster plan, an ineffective state government, faulty communication, a lack of a disaster plan, all effectively taking the eyes of society from the grieving of the families. There was a fire in an area a mile from this city twelve hours before. It was attended by the local fire department and was labeled “extinguished” when they left the site of the fire. Unfortunately, a 60-80 mph wind settled over Maui. It created a blowtorch-like effect on whatever embers were remaining, set the nearby grass on fire, and roared down toward the ocean, destroying almost everything in its path. Today they are accusations, but tomorrow will be followed by intensive investigations to create blame, to create guilt. For some reason, our society looks for a scapegoat in the multitude of disasters, in the ineffectiveness of government and in the ability of the professionals involved. Americans love Monopoly, Clue, many other board games but seem to have a greater appreciation for vindictiveness, “The Blame Game.”
Let us segue this situation into a medical catastrophe, disaster, or general medical error. Medicine is not an exact science and there may always be missing information, changes in anatomy or the general condition of the patient that will lend itself to a poor outcome. These things, unfortunately, happen and are painful to the family as well as to the medical professionals involved. Bishop W.C. Magee once stated, “The person who makes no mistakes does not usually make anything.” It is human to make an error and it is a natural tendency to blame others for our acts of omission or commission. What triggers medical malpractice action? It could be an attitude of a poor response to the error, or no response when asked by the family. Another springboard for litigation is the HCP that points his/her finger at everyone else. Some will blame the nurses, NPs and PAs, technicians, even the housekeeping staff. But they fail to recognize the old axiom, “When you point your fingers at others, there are three fingers pointing back to you.”
Another factor is the scuttlebutt that seems to travel throughout the institution. This is not Las Vegas where anything that happens in Vegas stays in Vegas. There are always M&M conferences where explanations are sought, and a better treatment plan devised. There are clinical review cases that have documented the chart. There is the EMR which cannot be changed or modified in the manner that paper charts could three decades before. There are the comments of other personnel in the room, involved in the care of the patient, who share their interpretations; there are others who may appreciate vicious comments, recklessly thrown to the wind and eventually documented. These all send out the scent of a wrongful action creating an occurrence and the scent will be picked up by a malpractice attorney who is privy to this information.
Suddenly, like the unwanted winds of Maui, a subpoena arrives at our door. We are named defendants and need the services of our malpractice company. And here is the rub: some discover they lack the policy or are uncovered in this situation or are woefully underinsured, in what may become a major settlement. There are some that advocate that a professional go “bareback,” meaning without insurance. This is a recipe for personal disaster. If found guilty, someone will always pay, whether it be an institution, a malpractice carrier, or the clinician. You do not want to be a target for a malpractice action without securing the best insurance available as your future is dependent upon it.
How can we expand our knowledge of this subject and of injuries or deaths caused while practicing medicine and the need for excellent malpractice coverage? I would suggest reading books, listening to podcasts that continually surface, attending medical meetings and conventions and your state society meetings, Why this suggestion? Because by utilizing these sources you will be current, you will have absorbed the knowledge, wisdom and experience of your peers without needing to walk in their shoes; you are able to condense their experiences into the allotted time of the conference. Remember the famous quote, “Destiny is not a matter of chance, it is a matter of choice.”
Written For CM&F By: Robert M. Blumm, PA, DFAAPA, PA-C Emeritus
CM&F Clinical Advisor
