[HSF] Standard of care for lawyers {OT}

Fri Apr 11 20:03:38 EDT 2008

Like Hals partners i am always available unless I am busy, drinking, or out of town or a combination of those. Naturally it is always best to be doing at least one of these when stuff hits the fan...

btw michael how many times do you change lines on a CABG? Valve? Just checking.

We surgeons have a pretty skewed view of reality and priority. Let's test it out. 

Next time that you make big boy rounds, those of you that do such activities for learning and enjoyment, ask the chief what the lab and details of each patient are if it is so important to know off the top of ones head at that moment as a doctor. Let me know how it goes particularly whether you get a reasoned opinion as to the value of such and each data or if you get more of a relational (power) discussion. 

Ask me sometimes for some stories from my training years, I heard this message often, but never internalized it. 

tea

----- Original Message ----
From: "hgrmd at aol.com" <hgrmd at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Friday, April 11, 2008 8:04:48 PM
Subject: Re: [HSF] Standard of care for lawyers {OT}

Michael,
  One of my partners is nearly always available, just like we are always available to take a case from cath lab.

Hal
Sent from my Verizon Wireless BlackBerry

-----Original Message-----
From: "Michael Firstenberg" <msfirst at gmail.com>

Date: Fri, 11 Apr 2008 18:10:29 
To:OpenHeart-L at lists.hsforum.com
Subject: Re: [HSF] Standard of care for lawyers {OT}

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> > > > >
> *************Planning your summer road trip? Check out AOL Travel Guides. >
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