Opinion: Readers comment on Medical Economics stories

September 5, 2008

Doctors hurting doctors with medical errors; a macro view of micropractice; protecting yourself from violent patients

Doctors hurting doctors

Dr. Janice Scully's article in the July 4, 2008, Medical Economics ["Doctors hurt doctors, too"] is frightening. I cannot imagine why her lawyers recommended that she not sue. I have never heard of D-Stat injections (I'm not a radiologist), but it must be rarely used for a good reason.

I was taught as a resident that you never inject anything that's not meant to be intravascular into a patient without first aspirating to make sure you're not in a blood vessel. It's an elementary precaution.

JOEL SHERMAN, MD
Waterbury, Connecticut

HEALING THROUGH SUPPORT

Dr. Scully: First, my heartfelt sympathies to you and your family for the ordeal that you went through. As another physician survivor of serious medical error, I can relate firsthand to many of the aspects of the experience you describe.

Medical errors can be devastating for anyone, but when it happens to a medical professional, the impact is compounded by feelings of betrayal by our own colleagues and a loss of faith in the very medical profession that trained us and to which we had dedicated our professional lives. I admire you for your courage publishing this article and wish you emotional healing. I have found support through the organization Medically Induced Trauma Support Services at http://www.mitss.org. You might also find it helpful.

TRICIA PIL, MD
Pittsburgh, Pennsylvania

WHEN IN DOUBT, DOUBLE-CHECK

My husband, also a physician, has suffered from many medical errors over the last 20 years. It is the reason I am very cautious about seeking any medical care for myself. It also makes me double-check when doing something I am not completely familiar with.

VICKI L. SOLONIUK, MD
Missoula, Montana

A MACRO VIEW OF MICROPRACTICE

For primary care to attract more medical students, it will need to transform the delivery of care to improve the doctor-patient relationship, as well as professional satisfaction. While I applaud the efforts of the solo practitioners who follow the micropractice model ["The one-person show," June 20, 2008], this evolution won't save our specialties of internal medicine or family medicine. Current graduates are flocking toward radiology, ophthalmology, anesthesiology, and dermatology because they offer a more predictable lifestyle with relatively good compensation.

Micropractice practitioners not only take a substantial pay cut, but also are wedded to their practice by being a sole proprietor.

Despite some erroneous assumptions, many patients find their primary care doctors in large group practices particularly satisfying and personal. These innovative groups practice the medical home touted by the AAFP and the ACP as the future for primary care.

With the use of electronic medical records, same-day access for appointments, the ability to communicate via e-mail, and improved revenue generation, patients and doctors are finding this model of delivery far superior to what has been practiced in the past.

Unless medical students and current practitioners see and join practices where primary care doctors have rewarding professional lives and are compensated well, the numbers of primary care doctors will dwindle rapidly, which will result in a complete collapse of the health-care system in the near future.

DAVIS LIU, MD
Sacramento, California