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Is it fair that the pot has to be carried by the doctor?
Source: Yimaitong Author: Rushing Emergency Lao Liu This article is authorized by the author to be published by Yimaitong, please do not reprint without authorization.
An ordinary accident, a normal medical visit, caused heated discussions due to the examination items prescribed by the doctor and the dissatisfaction of the driver of the accident car.
Event recap
On April 9, a driver posted a video saying that his car was parked on the side of the road, and an elderly man riding an electric car hit his car.
Although the driver of the sedan was not responsible for this accident, for safety reasons, he immediately ran over to ask the old man if he was wrong, and the driver saw that the old man was a little old, so he offered to take the old man to the county hospital to take a picture of his leg, so that he could rest assured.
When the old man went to the doctor, he told the doctor that his leg was a little painful, and it was okay to take a leg film, but the attending doctor had to ask the old man to do a full-body CT examination, if not, he had to ask the old man to sign and inform the other party that if there were any follow-up problems, the doctor was not responsible.
The doctor's action instantly aroused the driver's doubts and dissatisfaction, thinking that the doctor was over-examining, and immediately picked up his mobile phone to record a video and quarreled with the doctor.
In the video, the driver shouted at the doctor: "The patient has to do a leg examination by himself, and you ask someone to do a full-body CT scan, right? You ask her if she is dizzy, and they say she is not dizzy! You ask her if her hands are numb, and they say that she is not numb! You are now asking people to do any examination, this is your doctor's medical ethics?!"
The doctor replied, "There is nothing wrong with my treatment." ”
In the end, after the two argued, the driver took the old man to find a doctor in another clinic in a fit of anger, and after a brief examination, no physical problems were found for the old man.
After this incident was exposed, it quickly aroused heated discussions among many netizens.
What tests do I need to do for car accident injuries?
The author, Lao Liu, looked at the examples in the comment area and remembered a sentence on the Internet: Car accident injuries should not be underestimated.
Some people asked on the Internet, what kind of full body tests should be done after being hit by a car?
The Guidelines for Clinical Diagnosis and Treatment of Persons Injured in Road Traffic Accidents (Wei Yi Fa [2007] No. 175) points out:
Trauma is divided into two broad categories: open and closed. In general, open trauma is easy to diagnose and is prone to secondary infection due to wound contamination, while closed trauma is sometimes difficult to diagnose (eg, some visceral injuries) and often requires a period of close clinical observation or examination to rule out or confirm the diagnosis.
The examination of the wound should be carried out on the principle of "observing the vital signs of the casualty first, and then checking the location of the injury and other changes".
It is difficult to define which tests are needed and which are excessive, depending on the doctor's judgment.
In today's healthcare environment, protective care is difficult to avoid in order to avoid risks. In judicial practice, it is common for examinations to be imperfect and inadequate, while excessive medical treatment is not common.
Is there any problem with the doctor's treatment?
Returning to the accident, is there any problem with the doctor's handling of the accident? Lao Liu expressed some personal opinions.
First, closure damage due to such impact is often difficult to estimate with complete accuracy.
The evaluation of a car accident injury begins with a history of the injured person, followed by a detailed physical examination to initially assess the location and severity of the injury, but the reliability of the history is often worth considering. The site and severity of the impact are often inaccurately expressed, and physical examination is important for the evaluation of open injuries, but for closed injuries, it is usually not accurate and requires the aid of imaging.
Secondly, the injury of the elderly is more complex and needs to be treated with caution.
Does a leg hit only hurt your leg? It might flash to your waist. For older people with underlying diseases, they may also be "scared" out of cerebral hemorrhage, heart disease, or even emphysema to pneumothorax in seconds. Also, some older people are not sensitive to pain, and early onset may be mild and there may be no abnormal signs. Therefore, it may take a lot of thought and examination when dealing with elderly injured people.
Finally, car accident injuries are always accompanied by medical disputes, and it is important to leave evidence.
In today's medical environment, doctors need to be cautious about the diagnosis and treatment process, do a good job of communication, medical record writing, improve examinations, and actively deal with them. Among them, it is difficult to improve the inspection, and once there is an "accident", it is usually accused of "not checking in place and failing to fulfill the duty of care".
So, is there a fault in the doctor's insistence on a "full body examination" in this case? After an older person has been hit or frightened, a complete examination may be necessary. As for whether there is a fall and whether the injury is limited, it is not something that a doctor can judge correctly based on subjective feelings.
However, the fact that the doctor who visited the injured later and prescribed a small number of examinations does not negate the first doctor. It can only be said that in the face of a thunderous driver, the practice of calming things down may also be a way to deal with it.
Why is it so hard to get a patient to sign off an examination?
Many times patients or family members will not agree with the doctor's judgment, especially when faced with expensive tests.
After an ultrasound examination of a part is done, the doctor also asks for a CT examination, and the CT scan should be enhanced after the CT scan, and the CT may be done after the X-ray, and the MRI may be required after the CT is completed, which is particularly common in clinical practice. In this regard, patients or family members are often mistaken for excessive examination, because they feel that "black-hearted doctors want to generate income, and hospitals need to make money from patients".
But they don't know that the necessity of the examination is determined by the doctor, and each doctor has his or her own judgment of the condition and experience of the disease, so the examination prescribed is usually different. Overtesting is also often difficult to define, and cannot be inferred solely by the question of whether it is ultimately positive.
Doctors sometimes have protective medical behavior, but most doctors will communicate with the patient, if the patient is unwilling to check (willing to bear the consequences of not checking), then the doctor will accept the signature refusal and agree not to test, after all, the doctor has the obligation to diagnose and inform the obligation, and the patient has the right to informed consent.
The first doctor in this case believes that the examination is necessary to ensure safety and fully reduce the risk to the elderly, and the car owner is not willing to bear the cost of the examination, so it is good to sign and refuse. If you don't sign and refuse, and you don't agree to the examination, you just know that the doctor is really right?
If the patient refuses to be tested and it is not absolutely necessary, the doctor usually agrees not to do it. Why does the patient always not sign, forcing the doctor not to check, and saying all kinds of high-sounding reasons, but not willing to take any risks himself?
Is it fair that the pot has to be carried by the doctor?
Column Counsel Lawyer:
Lawyer Liang Yu and lawyer Xiang Haiman of Beijing Gordon Law Firm. Mr. Gordon focuses on civil and commercial legal litigation, corporate legal counsel and medical litigation, and has long been engaged in medical law research and practice, and has rich experience in medical law.
The incident in this article comes from the Internet.
Editor-in-charge|Yonko
Cover picture source: Yimaitong
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