[HSF] Standard of care for lawyers {OT}

Fri Apr 11 19:10:29 EDT 2008

hal.
on the rare chance that you are in the OR and a case from earlier in
the days has a problem (bleeds arrests or something weird )- who deals
with it particularly when a doctor needs to be at the bedside.

On 4/11/08, hgrmd at aol.com <hgrmd at aol.com> wrote:
> Ani,
>   I'm satisfied with the results of my caseload.
>
> Hal
> Sent from my Verizon Wireless BlackBerry
>
> -----Original Message-----
> From: Ani Anyanwu <anianyanwu at hotmail.com>
>
> Date: Fri, 11 Apr 2008 22:19:10
> To:<openheart-l at lists.hsforum.com>
> Subject: RE: [HSF] Standard of care for lawyers {OT}
>
>
> So Hal, the patients do not know then that on the first night after surgery
> all they have in house is an ER doctor... I was raising this not as a
> question as regards your practice but as we are discussing standards about
> another profession (lawyers) whether it is acceptable standard of care and
> information that we do not inform patients of these deficiencies in ICU
> coverage that exist in different surgical units.
>
> Should patients have a choice or should they just accept what they are
> dealt? I certainly know for sure that regardless of who was doing the
> operation, I would not have my surgery in a hospital manned by nurses and ER
> doctors on first post-operative night as I do not think that meets a minimum
> acceptable standard of post-surgical patient care. I suspect some of Hals
> patients with the information might say same.
>
> Answer to Michael's question about my unit is we have a surgical physicians
> assistant (PA) most nights (some nights a CT fellow) and five nights a week
> an inhouse intensivist. We know that is not perfect and are moving towards a
> model of 24 PA and 24h intensivist inhouse cover (not sure that is perfect
> either though).
>
> Ani
>
>
>
> > To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] Standard of care for
> lawyers {OT}> Date: Fri, 11 Apr 2008 17:07:38 -0400> From: hgrmd at aol.com>
> CC: > > Ani,>   I guess the upside for the patient is that I'm the one
> actually doing the surgery, not some resident who was shucking gallbladders
> 3 months previously.  Look, it's not a perfect system, and I'm working to
> improve it.  In fact, I was talking with the CEO earlier today about my plan
> to get intensivists for the hospital.  I will say that the vast majority of
> the CVICU nurses recognize when one of the docs needs to come in.> > Hal> >
> > -----Original Message-----> From: Ani Anyanwu <anianyanwu at hotmail.com>>
> To: openheart-l at lists.hsforum.com> Sent: Fri, 11 Apr 2008 10:36 am> Subject:
> RE: [HSF] Standard of care for lawyers {OT}> > > > > Frankly, I'm amazed
> that I'm able to > get my case load through with good > esults considering
> it's only the nurses > and the ER docs in the house at > ight.> > Hal> > al>
> > re the patients you operate on in this hospital aware that not of your
> team are > vailable at night of their surgery and that they will be looked
> after only by > R doctors and nurses? With this knowledge do some ever (or
> would you expect > ome to) opt to have surgery in another hospital you
> operate?> > ni> > > > From: Hgrmd at aol.com> Date: Fri, 11 Apr 2008 06:49:05
> -0400> Subject: Re: [HSF] > tandard of care for lawyers {OT}> To:
> OpenHeart-L at lists.hsforum.com> CC: > > > ichael,> Our current approach of
> postop management is a delicate balance > etween > the cardiac surgeons,
> P.A.'s, cardiologists, pulmonologists, as well > s any > other consultants
> who might be on the case. It generally works, but > t's far > from perfect.
> In fact, I'm currently pushing for 24/7 intensivists > or one of > my
> hospitals. You really need a doctor in the house at all times if > ou're >
> going to provide the best postop care. Frankly, I'm amazed that I'm > ble to
> > get my case load through with good results considering it's only the >
> urses > and the ER docs in the house at night.> > Hal> > > > >
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