Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Are physicians still responsible for mistakes in health care?

James C. Salwitz, MD
Physician
July 14, 2013
Share
Tweet
Share

Who is responsible for mistakes in health care?  Who should take credit for success or blame for failure?   Most families, patients and obviously the courts, hold the doctor responsible.  It seems to me this is reasonable; it is the obligation physicians assume and which society returns with empowerment and respect.  However, is this changing because of the Internet and big data?

In 2013, most patients have spent hours on the Internet investigating their medical complaints, before they walk in a doctor’s front door.  Rather than having sole faith in their doctor’s advice and knowledge, they work to become minor experts in their illness.  Patients frequently have tests, diagnosis and treatment in mind (or printed in hand), before the physician even opens their chart.  Does this mean that the balance of responsibility for medical care is shifting toward the patient?  In the future when a mistake happens will we say, “well, she deserved that, she didn’t take the time to look it up on WebMD?”

Both players in this relationship have strengths and weaknesses.  The doctor has years of experience, which can help predict medical futures. They have formal training, the ability to incorporate myriad unrelated conditions, cultivated medical judgment to detect subtle change and the emotional objectivity to make tough recommendations while communicating in a compassionate manner.  Yet physicians have limited time for each case, carry a tendency toward tunnel vision based on preconceived notions which can corrupt differential diagnoses, may have finite “patience” for each patient’s peculiarities and of course in the end are simply human, with all that creature’s colorful flaws.

Relative to the needs of an individual or family, the Internet is a source of massive information, which is infinite in quality, quantity and patience.  It can connect with experts from anywhere giving up-to-date answers at any moment.  It has no single bias and as a whole is immune to tunnel vision.  On the other hand, the Internet has no ability to focus or tune answers for a specific individual, but must rely on searches from patients who are biased, medically naïve, frightened and ill.  Patient online investigations often yield bad data, either because the website is unreliable or because the patient does not ask the correct questions.  Hundreds of patients have come to my office having done exhaustive research on the wrong disease. Finally, the Internet has no built in screen to identify high quality sites verses snake oil salesman, who simply had a good web designer.

As a generalization, doctors are likely to produce the correct diagnosis and treatment, but are often incomplete in their communication, teaching and offer too little choice.  While physicians usually take into consideration medical variation in the patient regarding how the treatment of one condition affects another, they may underestimate the individual patient’s emotional need. The failure to adjust for individual desires and cultural norms can produce poor compliance.

On the other hand, patient generated computer searches result in reams of data which may include the individual illness, but are broad and unfocused even though producing extensive choice.  This kind of Internet research may empower one patient, but for another the intellectual burden and anxiety may result in the patient making lousy decisions or confuse them to the point of inertia.

So, how does the data revolution affect the doctor-patient relationship and does it change responsibility?  If both parties are open to opportunity, having a patient prepare in this way can improve the quality of discussion.  Even if the patient’s Internet prep is not quite focused on the particular medical problem, it at least makes the patient familiar with the broad issues and language, which helps the doctor, with the limited time available, more clearly communicate.  With this being the goal, both patient and doctor need to bend, a little.  The doctor needs to welcome the data and the better basic education that online investigation gives the patient, and the patient needs to be aware that the doctor’s decades of experience cannot be replaced by a Google search.  By finding a balance, better health is possible.

Who is responsible for the quality of medical care?  I would suggest both the doctor and the patient and I do not believe this changed at all. Both must demand full commitment and responsibility from themselves, as well as the other.  The data revolution underlines, more than ever, that medical care is a team sport. Only together, do we heal.

James C. Salwitz is an oncologist who blogs at Sunrise Rounds.

Prev

How to know whether alternative medicine is safe

July 14, 2013 Kevin 33
…
Next

Judiciously order CT scans to protect our children

July 15, 2013 Kevin 1
…

Tagged as: Health IT, Malpractice, Patients

Post navigation

< Previous Post
How to know whether alternative medicine is safe
Next Post >
Judiciously order CT scans to protect our children

ADVERTISEMENT

More by James C. Salwitz, MD

  • Each line on the radiology list is a patient’s line in the sand

    James C. Salwitz, MD
  • The broader mission for hospice care

    James C. Salwitz, MD
  • Is the medical profession at its end?

    James C. Salwitz, MD

More in Physician

  • Why heart and brain must work together for love

    Felicia Cummings, MD
  • How pain clinics contribute to societal safety

    Olumuyiwa Bamgbade, MD
  • Why frivolous malpractice lawsuits are costing Americans billions

    Howard Smith, MD
  • How AI helped a veteran feel seen in the U.S. health care system

    David Bittleman, MD
  • Why physician strikes are a form of hospice

    Patrick Hudson, MD
  • How a doctor defied a hurricane to save a life

    Dharam Persaud-Sharma, MD, PhD
  • Most Popular

  • Past Week

    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Love, birds, and fries: a story of innocence and connection

      Dr. Damane Zehra | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why physician strikes are a form of hospice

      Patrick Hudson, MD | Physician
    • The overlooked power of billing in primary care

      Jerina Gani, MD, MPH | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • AI in health care is moving too fast for the human heart

      Tiffiny Black, DM, MPA, MBA | Tech
    • How physicians can reclaim resilience through better sleep, nutrition, and exercise

      Kim Downey, PT & Shirish Sachdeva, PT, DPT & Ziya Altug, PT, DPT | Conditions
    • This isn’t burnout, it’s moral injury [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why heart and brain must work together for love

      Felicia Cummings, MD | Physician
    • Who are you outside of the white coat?

      Annia Raja, PhD | Conditions
    • How hospitals can prepare for CMS’s new patient safety rule

      Kim Adelman, PhD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Love, birds, and fries: a story of innocence and connection

      Dr. Damane Zehra | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why physician strikes are a form of hospice

      Patrick Hudson, MD | Physician
    • The overlooked power of billing in primary care

      Jerina Gani, MD, MPH | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • AI in health care is moving too fast for the human heart

      Tiffiny Black, DM, MPA, MBA | Tech
    • How physicians can reclaim resilience through better sleep, nutrition, and exercise

      Kim Downey, PT & Shirish Sachdeva, PT, DPT & Ziya Altug, PT, DPT | Conditions
    • This isn’t burnout, it’s moral injury [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why heart and brain must work together for love

      Felicia Cummings, MD | Physician
    • Who are you outside of the white coat?

      Annia Raja, PhD | Conditions
    • How hospitals can prepare for CMS’s new patient safety rule

      Kim Adelman, PhD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Are physicians still responsible for mistakes in health care?
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...