[HSF] "Easier to let pts suffer than to do what is right"

Wed Feb 6 19:39:07 EST 2008

isnt surgery the failure of medical management?

-michael

On Feb 6, 2008, at 7:19 PM, Nasser F. Abou'Seada wrote:

> "Oh, by the way - what is the peer review process for "medical  
> errors" and
> how are they defined?   and by whom?"
>
> Good Question
>
> NFA
>
>
> On Feb 6, 2008 5:52 PM, Michael Firstenberg <msfirst at gmail.com> wrote:
>
>> But if the purpose of these "peer reviews" is to make sure that  
>> your re-op
>> for bleeding is not 2x the STS average, is that a bad thing?  Oh  
>> my, I am
>> starting to sound like an administator - Hal, quick, shoot me......
>>
>> Oh, by the way - what is the peer review process for "medical  
>> errors" and
>> how are they defined?   and by whom?
>>
>> -michael
>>
>>
>> On 2/6/08, John Schor <johnschor at mac.com> wrote:
>>>
>>> I have worked with people who would not admit their own errors. I  
>>> have
>>> seen many pt's "buried" due to surgeons not doing the right  
>>> thing, ie
>>> reoperating on a pt like Hal's while under close scrutiny. I no  
>>> longer
>>> work with those people.
>>>
>>> I am now alone in practice in a rural area of Northern Arizona.  
>>> When a
>>> pt has any complication, the whole medical staff immediately knows
>>> about it. If a surgeon reoperates, read "unplanned procedure", a  
>>> flag
>>> is raised on the chart and it is automatically reviewed by a  
>>> member of
>>> the "peer review committee".
>>>
>>> It's usually a primary care doc, pediatrician, radiologist, or other
>>> "peer" who has to figure out whether the Board Certified CT Surgeon
>>> knows what he's doing and has provided standard of care.
>>>
>>> I have had a couple of "unplanned procedures" because I am very
>>> conservative and will reexplore pt's if things "just don't look
>>> right". Any one on the HSF would understand and even commend such
>>> behavior, but small town medical politics are very interesting.
>>>
>>> On the other hand, I do have a monopoly for a 60 mile (100km)  
>>> radius.
>>>
>>> John
>>>
>>>
>>> John Schor, MD
>>> Verde Valley Medical Center
>>> Cottonwood, AZ 86326
>>> Tel: 928-649-2584
>>>
>>> On Feb 6, 2008, at 2:20 PM, Nasser F. Abou'Seada wrote:
>>>
>>>> "a place that keeps tabs on which pt's go back to the
>>>> OR; then secret tribunals are held in order to "educate" the  
>>>> medical
>>>> staff. It takes guts to take on cases like that. It's a lot  
>>>> easier to
>>>> let pt's suffer than to do what is right."
>>>>
>>>> Dear John
>>>> please elaborate more ....
>>>> sounds the same everywhere !!!!
>>>>
>>>> NFA
>>>>
>>>>
>>>>
>>>> On Feb 6, 2008 3:06 PM, John Schor <johnschor at mac.com> wrote:
>>>>
>>>>> Hal:
>>>>> Great job!
>>>>> You prove the point that we can only know so much without  
>>>>> operating.
>>>>> Pontificating is the worst place to be. It is clear you are a Jedi
>>>>> Master; "May the force be with you".
>>>>>
>>>>> I am currently at a place that keeps tabs on which pt's go back to
>>>>> the
>>>>> OR; then secret tribunals are held in order to "educate" the  
>>>>> medical
>>>>> staff. It takes guts to take on cases like that. It's a lot  
>>>>> easier to
>>>>> let pt's suffer than to do what is right.
>>>>> I admire your efforts.
>>>>> John
>>>>>
>>>>>
>>>>> John Schor, MD
>>>>> Verde Valley Medical Center
>>>>> Cottonwood, AZ 86326
>>>>>
>>>>>
>>>>> On Feb 6, 2008, at 10:03 AM, Hgrmd at aol.com wrote:
>>>>>
>>>>>>
>>>>>> Prasanna,
>>>>>>
>>>>>> ? Thanks.
>>>>>>
>>>>>>
>>>>>>
>>>>>> Hal
>>>>>>
>>>>>>
>>>>>> -----Original Message-----
>>>>>> From: Prasanna Simha M <prasannasimha at gmail.com>
>>>>>> To: OpenHeart-L at lists.hsforum.com
>>>>>> Sent: Wed, 6 Feb 2008 11:55 am
>>>>>> Subject: Re: [HSF] (no subject)
>>>>>>
>>>>>>
>>>>>>
>>>>>>
>>>>>> Gut instinct pays.
>>>>>> Prasanna
>>>>>>
>>>>>> On Feb 6, 2008 10:17 PM, <hgrmd at aol.com> wrote:
>>>>>>
>>>>>>>
>>>>>>> Ahmed,
>>>>>>>
>>>>>>> ? Thanks for your words.? Parenthetically, all of my partners
>>>>>>> advised me
>>>>>>> not to operate.
>>>>>>>
>>>>>>>
>>>>>>>
>>>>>>> Hal
>>>>>>>
>>>>>>>
>>>>>>> -----Original Message-----
>>>>>>> From: alsadd <alsadd at ksu.edu.sa>
>>>>>>> To: OpenHeart-L at lists.hsforum.com
>>>>>>> Sent: Wed, 6 Feb 2008 5:33 pm
>>>>>>> Subject: RE: [HSF] (no subject)
>>>>>>>
>>>>>>>
>>>>>>>
>>>>>>>
>>>>>>> Congratulations Hal a job well done. It is the thing to do  
>>>>>>> bite the
>>>>>>> bullet.
>>>>>>>
>>>>>>>
>>>>>>> Ahmed
>>>>>>>
>>>>>>> -----Original Message-----
>>>>>>> From: openheart-l-bounces at lists.hsforum.com
>>>>>>> [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of
>>>>> hgrmd at aol.com
>>>>>>> Sent: Wednesday, February 06, 2008 3:21 AM
>>>>>>> To: OpenHeart-L at lists.hsforum.com
>>>>>>> Subject: [HSF] (no subject)
>>>>>>>
>>>>>>> Dear Members,
>>>>>>> ? Two days ago, I reoperated on the gentleman with the  
>>>>>>> stenotic and
>>>>>>> thrombosed SVC.? I'm glad I did.? I femorally cannulated and  
>>>>>>> went
>>>>>>> on pump
>>>>>>> prior to splitting the chest (he was 3 weeks postop).? I only
>>>>>>> dissected
>>>>>>> the
>>>>>>> right atrium.? The adhesions were torture.? The tip of the  
>>>>>>> femoral
>>>>>>> cannula
>>>>>>> was advanced only into the IVC.? No effort was made to control
>>>>>>> either
>>>>>>> cava.?
>>>>>>> The heart stayed warm and beating.? A right atriotomy was  
>>>>>>> made and
>>>>>>> extended
>>>>>>> across the RA-SVC junction.? It was tightly stenotic.? A large
>>>>>>> amount of
>>>>>>> clot was retrieved with a 6mm Fogarty.? A large patch of bovine
>>>>>>> pericardium
>>>>>>> was placed.? The whole operation took less than 3 hours.?
>>>>>>> Yesterday, it
>>>>>>> was
>>>>>>> evident that his facial and forearm edema were markedly  
>>>>>>> improved.?
>>>>>>> He's
>>>>>>> already on Lovenox and Coumadin.
>>>>>>>
>>>>>>> Hal
>>>>>>>
>>>>>
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>>>>>>
>>>>>>
>>>>>> --
>>>>>> Prasanna Simha M
>>>>>> _______________________________________________
>>>>>> OpenHeart-L mailing list
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