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Studies Link Physician Behavior and Attitude to Patient Outcome

According to a recent article in the New York Times, studies have now linked physician behavior and attitudes to poor patient outcome.  For example, “A survey of health care workers at 102 nonprofit hospitals from 2004 to 2007 found that 67 percent of respondents said they thought there was a link between disruptive behavior and medical mistakes, and 18 percent said they knew of a mistake that occurred because of an obnoxious doctor. (The author was Dr. Alan Rosenstein, medical director for the West Coast region of VHA Inc., an alliance of nonprofit hospitals.) Another survey by the Institute for Safe Medication Practices, a nonprofit organization, found that 40 percent of hospital staff members reported having been so intimidated by a doctor that they did not share their concerns about orders for medication that appeared to be incorrect. As a result, 7 percent said they contributed to a medication error.”

The article begins by recounting how a nurse knew her patient, a child with a shunt in his brain to drain fluid, was in trouble.  She paged the on-call doctor who told her not to worry.  She paged a second time and he told her that she wasn’t a doctor and didn’t know what to look for.  The doctor ignored her third page.  The nurse then called the child’s treating physician at home who ordered the child rushed to emergency surgery.

These situations are not unfamiliar to attorneys that handle medical negligence cases.  One particular area of concern is in obstetrical care.  Generally, a labor and deliver nurse will be with the expecting mother.  The labor and deliver nurse montiors the mother and child’s vital signs.  The most important vital signs are shown on the fetal monitoring strip.  Sometimes the fetus can begin having problems in the uterus.  One example is when the cord gets wrapped around the baby’s neck.  As a result, labor and deliver nurses must monitor the fetal strips for bradycardia and tachycardia.  

When the labor and deliver nurse recognizes a problem with the baby, she must alert the obstetrician to the problem. Sometimes, the OB ignores the nurse, thinking the nurse is overreacting.  This arrogance can lead to tragic consequences including death or injury (brain damage or cerebral palsy) to the child or mother.  

We hope this study will empower nurse and other healthcare providers to be strong advocates for their patients and encourage doctors act as part of a the medical team and not mini-dictators.  The stakes are too high not to.


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