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Re: Doctor visit or Deposition?
Old 07-22-2006, 12:21 PM   #21
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Re: Doctor visit or Deposition?

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Originally Posted by LL
Perhaps if the problem is that other family members are unable to attend the doctor appointment and miss out what was said then maybe a phone consultation between the doctor and family member could be arranged. If patient confidentialty is an issue then permission to discuss matters before hand could be handled prior to phone appointment.
As you can imagine, we do this quite regularly. Most of the time it is not a problem but there are more than a few families where you have to recycle the whole, long thing 3, 4 or more times. That can take a lot of time which takes away from other patients or self. Normally we request that such families appoint a spokesperson who can help in that regard, but that's not always feasible.

I enjoy relating to families most of the time.
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Re: Doctor visit or Deposition?
Old 07-24-2006, 08:05 PM   #22
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Re: Doctor visit or Deposition?

Rich, this is a difficult situation. While probably well motivated, there is a significant possibility that the recording is being done "just in case" something goes wrong, to have as evidence. There are also privacy issues for you and the way I see it, they need your consent. If there is no existing policy, I suggest you check with your friendly hospital lawyer on how to handle this situation in the future. It might be wise to begin the recording by having a short discussion about its purpose and getting an agreement not to use the tape in any litigation. Better still, get the patient to sign a waiver of liability that you can keep on file. Then relax.

I once led a family meeting that included 30 relatives and a lawyer. Their relative was critical following care at St. Elsewhere's, and they were not happy. It was most uncomfortable and changed the focus from the patient to "can we sue?" Our family meetings are often held to discuss life or death issues and our practice is to have a team member take notes and document the dialogue and decision making in the chart. Now we always ask who's coming.

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Re: Doctor visit or Deposition?
Old 07-24-2006, 08:16 PM   #23
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Re: Doctor visit or Deposition?

Thanks, all, for the insightful feedback.

I'll check to see if any policies are in existence.

I think in the future I'll decline to have the entire visit recorded in the interest of open communication and everyone's comfort including mine. But I'll offer a recordable few minutes at the end where specific questions can be asked and recorded to help them remember the information. During that phase I'll be cautious in my remarks, and open with a statement that we have all agreed to this recorded session solely to help the patient recall the advice we agreed on today, and I'll summarize what was recorded in my note.

Any other suggestions are always welcome.
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Re: Doctor visit or Deposition?
Old 07-24-2006, 09:17 PM   #24
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Re: Doctor visit or Deposition?

Rich,
- Not to drag this out, but I think the suggestion to make your own recording is a good one as well. Let everyone know, and you could even state at the outset words to the effect that you are making your own recording in order to have a reference of the discussion in case the family does have questions. Ultimate reason--to have something to prep the legal folks in case it is ever needed .
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Re: Doctor visit or Deposition?
Old 07-24-2006, 10:40 PM   #25
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Re: Doctor visit or Deposition?

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Originally Posted by Rich_in_Tampa
Thanks, all, for the insightful feedback.

I'll check to see if any policies are in existence.

I think in the future I'll decline to have the entire visit recorded in the interest of open communication and everyone's comfort including mine. But I'll offer a recordable few minutes at the end where specific questions can be asked and recorded to help them remember the information. During that phase I'll be cautious in my remarks, and open with a statement that we have all agreed to this recorded session solely to help the patient recall the advice we agreed on today, and I'll summarize what was recorded in my note.

Any other suggestions are always welcome.
Rich I hate to say it, but I think even your well reasoned approach may be putting yourself into legal jeopardy. I would check with the hospital's counsel, as another poster mentioned. Imagine that one time you forget to re-cover some ground on the recorded tape. In court, it turns into you never having covered the information at all. And the recording makes filing of a suit more likely, and makes it more likely to be found non-frivilous.

Is the kind of recording you propose in the best interest of the patients? Absolutely. Is there a way to do it under the current rules, without putting the physician in serious legal jeopardy? Unfortunately, I don't think so.
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Re: Doctor visit or Deposition?
Old 07-26-2006, 12:28 PM   #26
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Re: Doctor visit or Deposition?

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I wonder how you all feel about this
Sounds like they are preparing for a future trial.
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Re: Doctor visit or Deposition?
Old 07-26-2006, 12:29 PM   #27
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Re: Doctor visit or Deposition?

You guys are too paranoid.
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Re: Doctor visit or Deposition?
Old 07-26-2006, 12:43 PM   #28
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Re: Doctor visit or Deposition?

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You guys are too paranoid.
I agree with you, Martha. We live with the "malpractice" shadow all the time, but rarely does it surface. And when it does, it is usually the patient you haven't heard from for 6 months, not the squeaky wheels.

Best protection is to listen to your patients and practice good medicine. Most patients just want to know they are being genuinely heard. I've never practiced defensive medicine (i.e. more tests, referrals and over-treatment without scientific reason), though I do practice defensive charting (recording even trivial phone exchanges, detailed recounts of what risks were discussed etc.).

This recording question is more about impeding the relationship. Since I'd never seen the patient before, I can feel confident I was not being targeted for malpractice claims.
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Re: Doctor visit or Deposition?
Old 07-26-2006, 12:59 PM   #29
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Re: Doctor visit or Deposition?

I agree.

The same goes for lawyers.

When I was in management, if a small mistake was made (we didn't have any big mistakes), I said fess up, apologize and make it right at no cost to the client.
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Re: Doctor visit or Deposition?
Old 07-26-2006, 01:04 PM   #30
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Re: Doctor visit or Deposition?

If you're going to work, work hard and do good work is surely the right advice. If you get caught up in trying to anticipate how to avoid potential problems of possible antagonists . . . well, work just turns to sh#t.

Good work does not always guarantee success and satisfaction, but the alternatives almost certainly guarantee misery.
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