24 April 2004

Can We Heal Without Damocles' Sword On Our Heads?

Photo clip from the BBC

A Rehabilitation Medicine specialist friend of mine had coffee the other day and she told me an interesting case she recently saw. It involved a 37-year old woman who consulted her because of right foot paralysis after a myomectomy (obstetric operation that surgically removes myomas or uterine fibroids). The woman had an infertilty work-up and was diagnosed to have multiple myomas that had to be removed in order for her to conceive. Her operation lasted for 5 hours and was practically uneventful except for the right foot paralysis that developed. Asked why she had foot paralysis after the operation, the woman was told by her On-Gyn doctor that the paralysis while unfortunate, is one of the complications of the operation. She was referred to a Rehab Med specialist friend of the Ob-Gyn doctor, and was diagnosed to have partial peroneal nerve paralysis. She was assured full recovery after 1 month of physical therapy and daily taking of B-complex vitamins.

The said woman, a feisty mathematics teacher, consulted my Rehab Med friend in turn, for a 2nd opinion. My friend told her that recovery will take 3-6 months, and recovery might not be 100% anymore. The woman cried and wanted to know why she now had a foot paralysis when what she just wanted was to have her myomas removed so she can conceive. My friend, while sympathetic to the sad plight of the anxious patient, was also feeling uneasy because she felt that this might be a budding case of medical malpractice.

Physicians have an unspoken rule of protecting one another, when things go wrong. It does not matter if that doctor is from another school or hospital, or from the other side of the world; we tend to protect one another, or to play it safe, we tend not to get involved. Often this contributes more to the misery of the patient(s) involved.

Two years ago, there was much talk about House Bill 4955 and Senate Bills 2298 and 2303 which aimed to pass into law the Philippines' first Medical Malpractice Bill. I do not know what happened to this bill or if it had been passed into law. Maybe Sassy can help me on this.

What I know is that was a cannonade of position papers like this one that rained left and right from medical associations and other organizations opposed to the bill. They argued that there was no need anymore for a medical malpractice bill because Article 2176 of the Civil Code and Article 365 of the Penal Code adequately covers both the civil and criminal aspects of a negligent doctor doing wrong.

The photo above shows an X-ray film with surgical scissors noted in the patient's abdomen. I think this is really an obvious case(!!!) of medical and surgical negligence. Read the whole story here. There are other cases of medical negligence here and here. Lately in Australia, even hospitals are under fire.

My own 2-cents here is that physicians should police their own ranks, improve the quality of medical education, make continuing medical education mandatory for all doctors with periodical examinations to gauge performance, strict hospital policies on surgical operations, and some occasional lessons on empathy, for those doctors who need it the most.

0 reactions: