As a pharmacist, I have a couple ways to tell whether a doctor is good or under average. Patients talk about their doctor, I can see the prescriptions (and on occasion have to call back a doctor if something isn't safe), I check whether the required follow up labs are ordered, I see whether the doctors go to continuous training programs that I attend, and I know how often they see their vulnerable patients, and what infrastructure and procedures they have to guarantee that their patients can consult in a time efficient manner. In my experience, the best care is provided by doctors that are not close to retirement, and work in a clinic with several other clinicians that is staffed with nurses and consultant medical professionals. In fact, half of the advantage of having a doctor from a larger clinic is that you can see a different doctor by showing up to the unscheduled-checkup, in case your family doctor failed to address your problem effectively the first time.
what are the options you have as a pharmacist to report a doctor about you have concerns, is there a database you can "flag" a dr such that after a few flags an investigation might occur? ( i will note that there is such a database between most animal shelters to flag persons who repeatedly adopt and then return animals so it seems one should exist for doctors)
If I had sufficient concerns I could report a doctor to the "Collège des médecins" which is their professional board in Québec, but the truth is even the least effective doctors are better than losing your GP and having no entryway into the health system at all. I work pretty far in the north were there is a waiting list to even have a doctor, and the less ... evidence based ones are typically less than 5 years from retiring. Not that all older doctors are problematic. Some of our best are / were above 60. We also have professional back-and-forth relationships with the doctors so I wouldn't see myself reporting one unless they did something extraordinary such as prescribing themselves narcotics, or completely and consistently failing to make any effort to follow up their population. Malpractice is probably fairly rare. In a town with 12-20 doctors, it's unlikely I ever encounter a real case. Typically we get payed by the healthcare system to send the doctor "pharmaceutical advice", so they'll eventually stop prescribing terbinafine without doing hepatic checkups... one day.
On that last point, in the UK at least, there have been individual Doctors charged for incidents where the blame really should be put on understaffing and the managers/heads of departments who let safe staffing levels slip
Its difficult for a layperson to spot malpractice unless its very serious. On the other hand, being understaffed and having long shifts should also be as spoken about as malpractice.
You can check them for donation from big pharma for a start. I dont have a link on me right now, but im fairly sure I got it from one of John Oliver med-related videos. Look them up :)
Best way is to see where they went to school, and especially where they went to residency. Many hospitals proudly publish this information. Most doctors (or their office staff) will tell you over the phone. You can easily find out how their schools rank from places like US News.
This is what countries with unified health systems deal with better. A national board means that to make a solo practice or work someone else, someone needs to check if they are licensed. They should not be allowed to practice in the country at all if they are highly negligent in their duty of care. Being struck off a license registry should have real consequences. A lawsuit can help a patient recuperate costs, but a board of peers need air deal with the fallout for the physician who failed.
Being "struck off" in the US is a much bigger deal than in the UK. A US physician is likely $250k in debt, and that debt cannot be eliminated through bankruptcy. In fact, such a punishment would be greater than that which the UK metes out for murder. As such, it is not utilized unless there is a frankly criminal action.
The Hospital in my area made it close to impossible to file a complaint I literally ended up calling about 6 different numbers getting the run around for hours and was only given the rite number after threatening to get the police involved and just file for sexual harrasment it was ridiculous
I was wondering: you always cite studies but dont link them. Could you include your sources in the video description like most science focused channels do? In this case i just wanted to look up the methods that were used. But i think in general it is a good practice to include the sources in the video description where anyone can check them.
There is always an accompanying post at my blog (The Incidental Economist). And in that post, there is always a link to where you can find the sources.
@@aaecarro I went to your blog, there is a link there leading me to the nytimes where sadly i was greeted by a paywall. I am glad the sources are there somewhere, but wouldnt it be easier for everyone to just have them (or a link to them) in the video description?
Yep I don't trust people who don't put sources. Makes you realize 90% of youtube is people speaking out of their asses. So sources would be great to establish some credibility (esp for new viewers), in the meantime I won't treat this as information.
@@MrTomtomtest My point is not about the sources not being there, but about providing an easy way to check them. healthcare triage still has high standards and dont "speak out of their asses" as you say.
Just read your piece in the Indianapolis Business Journal. I had know idea you worked at IU! I'm a sophomore in SPEA. I've been subscribed for over two years now! Good work with the channel
Healthcare still understands little about quality control and doesn't seem to want to learn from industrial practices. Don't Punish! is a well known rule. Penalising errors only creates a culture of secrecy and hiding or if that fails pointing and blaming. This distracts from any serious investigation into the real causes let alone structural improvements. So nothing changes. The simple fact is that humans are gonna human (Doctors are still somewhat human...) and humans make mistakes. Only a commitment to changing procedures, tools, and training to prevent mistakes will really improve anything.
You are very right on that, but the legal profession has eliminated any chance of that. Theoretically, Quality Assurance is not discoverable in a law suit. But that applies only to specific cases, not to corrective actions. Furthermore, any corrective action has to be reported to the National Data Bank. So, no corrective actions.
The system doesn't really do much to correct malpractice among physicians. I was treated at a hospital by a psychiatrist who had his license suspended for giving a child an overdose of medication because he was on cocaine. He was the worst doctor of any kind I ever had. He was medical director of the hospital. They managed to do a lot of damage to me and then stole my stuff. It took me a while to recover from what happened to me. It was psychiatric hospital which later mysteriously closed down probably to avoid charges of malpractice and medicare fraud. All the staff including him moved to a newly opened psychiatric hospital. This was not the first time they did that. If doctors do messed up things in a smaller town there's often so few options that they'll still get business if they're awful. If doctor behaves like that they should just have their license taken away but that rarely happens. By the way, that doctor is still practicing.
I wonder how many claims are against surgeons who take on jobs that have a minamal chance of success. An elderly gentleman I knew was put forward for some very invasive heart surgery, apparently, the doctor was relieved when he decided not to have the operation after all.
The fact that A small percentage of doctors accounts for a large percentage of claims does not mean anything nefarious. This is a very misleading statistic that relies on the listener jumping to the incorrect conclusion that these two percentages represent similarly sized populations. Let’s say 5% of doctors account for all the malpractice claims. And Of those 2% account for 39% as you said. Well, so what? A small percentage of doctors accounting for the majority of the malpractice claims simply means that not many doctors commit malpractice!
@Yevhenii Diomidov A more charged view that this research would like readers to assume would be that there are a handful of doctors just doing malpractice out the wazoo while twisting their handlebar mustache and laughing. I had questions regarding the statistic just like Matt. If you have 100 doctors and 10 paid claims *all by different doctors* it's still only 10% of doctors paying out 100% of the claims. VERY MISLEADING haha
I work as a CNA at a hospital so I only hear this through the grapevine but my hospital's focus on reducing malpractice claims is better bedside interaction and transparency(as I work nights and rarely see the doctors, it's very likely I don't see the medical safeguards). The theory being even when mistakes happen, people are less willing to sue open and likable doctors. The hospital does not want a Dr. House situation.
Hey, could you guys do another healthcare system video, but this time do a country in a region that you haven’t done before like Latin America, the Middle East or Africa
The malpractice system scares away good doctors and makes them run extra tests that aren’t needed, to CYA. The best doctors get more selective about patients, so the healthiest end up getting the best doctors - which is opposite what should be happening. And people try to nitpick to sue. That scares even more good people from practicing medicine.
There should be a national database of malpractice cases. It should list how many times a doctor has lost a case. No details mind. HIPAA should not be violated. But the public should know how many times a doctor has lost a case. We can look up data on used cars, why not doctors?
There is obviously, such a database. But it can only be accessed by hospitals or prospective employers because they know to ignore it. Malpractice data have little to do with malpractice.
if only 2 % are "mal practice ing" has anyone sought to find what these 2% may have in common. is it more likely after false accusations, patient loss, personal tragedy, etc... Has anyone looked into the prevalence of nursing complaints compared to patient complaints against doctors. what about complaints against them by colleagues. or assessments out of medical school. It seems there may be some truth to the idea that the system is unfair to doctors on this issues if there are so few actual malpracticing out there, is there a way doctors can help with more peer reviews and interventions prior to the malpractice occuring.
Be careful of that data. There are few who are paying out money, but it is the rare doctor who has been practicing for more than 15 years who has not been sued.
Unfortunately this video implies that a claim is equal to truthful wrongdoing or that a claim is proof of poor care or a violation of the “standard of care”, a moving target. It’s interesting how the narrator seems to imply also that the malpractice system is failing patients. The malpractice system is based on tort law, it has nothing to do with patient outcomes and to pretend to imply otherwise is hubris. What is sad about this is how a medical board, a political body that is not uniform from state to state and with legislative and budgetary constraints, fails to work on “process improvements” that can lead to claims to be filed to begin with. Imagine being a lawyer working for the state board: it’s a thankless job and you get no leadership, no direction and you make sure you keep your job based on how many professionals you “punish”. If you think our criminal justice system needs reform, look at the prosecutorial over reach from the state medical boards. These attorneys have no oversight and have no idea what it takes to become a physician, let alone practice medicine. By the way, in many states, physicians can get sued without even having an expert on their specialty review the case. In addition, physician discipline is a broad concept: not everyone disciplined is because they are an alleged “bad doctor”. In some states if you fall behind child support obligations or paying taxes or even your mortgage if you are going through a hard time (yes, physicians do fall into hard personal and financial times! Surprise! Surprise! ) the state board will send an “order of consent” in which the physician agrees to unilateral terms of discipline formulated by administrative personnel.
This malpractice loophole in US is the reason why all Asian parents all of a sudden want their kids to become lawyers or doctors as soon as they set foot on US soil.
As a pharmacist, I have a couple ways to tell whether a doctor is good or under average. Patients talk about their doctor, I can see the prescriptions (and on occasion have to call back a doctor if something isn't safe), I check whether the required follow up labs are ordered, I see whether the doctors go to continuous training programs that I attend, and I know how often they see their vulnerable patients, and what infrastructure and procedures they have to guarantee that their patients can consult in a time efficient manner.
In my experience, the best care is provided by doctors that are not close to retirement, and work in a clinic with several other clinicians that is staffed with nurses and consultant medical professionals.
In fact, half of the advantage of having a doctor from a larger clinic is that you can see a different doctor by showing up to the unscheduled-checkup, in case your family doctor failed to address your problem effectively the first time.
what are the options you have as a pharmacist to report a doctor about you have concerns, is there a database you can "flag" a dr such that after a few flags an investigation might occur? ( i will note that there is such a database between most animal shelters to flag persons who repeatedly adopt and then return animals so it seems one should exist for doctors)
If I had sufficient concerns I could report a doctor to the "Collège des médecins" which is their professional board in Québec, but the truth is even the least effective doctors are better than losing your GP and having no entryway into the health system at all.
I work pretty far in the north were there is a waiting list to even have a doctor, and the less ... evidence based ones are typically less than 5 years from retiring. Not that all older doctors are problematic. Some of our best are / were above 60.
We also have professional back-and-forth relationships with the doctors so I wouldn't see myself reporting one unless they did something extraordinary such as prescribing themselves narcotics, or completely and consistently failing to make any effort to follow up their population. Malpractice is probably fairly rare. In a town with 12-20 doctors, it's unlikely I ever encounter a real case.
Typically we get payed by the healthcare system to send the doctor "pharmaceutical advice", so they'll eventually stop prescribing terbinafine without doing hepatic checkups... one day.
On that last point, in the UK at least, there have been individual Doctors charged for incidents where the blame really should be put on understaffing and the managers/heads of departments who let safe staffing levels slip
Its difficult for a layperson to spot malpractice unless its very serious. On the other hand, being understaffed and having long shifts should also be as spoken about as malpractice.
As a US patient, I wouldn’t even know how to begin researching my doctor
Same! That really bothers me!
You can check them for donation from big pharma for a start. I dont have a link on me right now, but im fairly sure I got it from one of John Oliver med-related videos. Look them up :)
Best way is to see where they went to school, and especially where they went to residency. Many hospitals proudly publish this information. Most doctors (or their office staff) will tell you over the phone. You can easily find out how their schools rank from places like US News.
This is what countries with unified health systems deal with better. A national board means that to make a solo practice or work someone else, someone needs to check if they are licensed.
They should not be allowed to practice in the country at all if they are highly negligent in their duty of care.
Being struck off a license registry should have real consequences. A lawsuit can help a patient recuperate costs, but a board of peers need air deal with the fallout for the physician who failed.
Being "struck off" in the US is a much bigger deal than in the UK. A US physician is likely $250k in debt, and that debt cannot be eliminated through bankruptcy. In fact, such a punishment would be greater than that which the UK metes out for murder. As such, it is not utilized unless there is a frankly criminal action.
The Hospital in my area made it close to impossible to file a complaint I literally ended up calling about 6 different numbers getting the run around for hours and was only given the rite number after threatening to get the police involved and just file for sexual harrasment it was ridiculous
If it is for sexual harassment, skip the hospital. Go to the state licensing board.
I was wondering: you always cite studies but dont link them. Could you include your sources in the video description like most science focused channels do? In this case i just wanted to look up the methods that were used. But i think in general it is a good practice to include the sources in the video description where anyone can check them.
There is always an accompanying post at my blog (The Incidental Economist). And in that post, there is always a link to where you can find the sources.
@@aaecarro I went to your blog, there is a link there leading me to the nytimes where sadly i was greeted by a paywall.
I am glad the sources are there somewhere, but wouldnt it be easier for everyone to just have them (or a link to them) in the video description?
Yep I don't trust people who don't put sources. Makes you realize 90% of youtube is people speaking out of their asses. So sources would be great to establish some credibility (esp for new viewers), in the meantime I won't treat this as information.
Iamtop the sources are all in the video. The names of the papers and the journals.
@@MrTomtomtest My point is not about the sources not being there, but about providing an easy way to check them. healthcare triage still has high standards and dont "speak out of their asses" as you say.
My question is, when you're choosing a new doctor, is there anywhere the average patient can go to do that research on previous malpractice suits?
No.
Just read your piece in the Indianapolis Business Journal. I had know idea you worked at IU! I'm a sophomore in SPEA. I've been subscribed for over two years now! Good work with the channel
Healthcare still understands little about quality control and doesn't seem to want to learn from industrial practices.
Don't Punish! is a well known rule. Penalising errors only creates a culture of secrecy and hiding or if that fails pointing and blaming. This distracts from any serious investigation into the real causes let alone structural improvements. So nothing changes.
The simple fact is that humans are gonna human (Doctors are still somewhat human...) and humans make mistakes. Only a commitment to changing procedures, tools, and training to prevent mistakes will really improve anything.
The NHS is quite good with quality improvement and striking physicians from practice when they willingly endanger or assault patients.
You are very right on that, but the legal profession has eliminated any chance of that. Theoretically, Quality Assurance is not discoverable in a law suit. But that applies only to specific cases, not to corrective actions. Furthermore, any corrective action has to be reported to the National Data Bank. So, no corrective actions.
The system doesn't really do much to correct malpractice among physicians. I was treated at a hospital by a psychiatrist who had his license suspended for giving a child an overdose of medication because he was on cocaine. He was the worst doctor of any kind I ever had. He was medical director of the hospital. They managed to do a lot of damage to me and then stole my stuff. It took me a while to recover from what happened to me. It was psychiatric hospital which later mysteriously closed down probably to avoid charges of malpractice and medicare fraud. All the staff including him moved to a newly opened psychiatric hospital. This was not the first time they did that. If doctors do messed up things in a smaller town there's often so few options that they'll still get business if they're awful. If doctor behaves like that they should just have their license taken away but that rarely happens. By the way, that doctor is still practicing.
Love the cover screen "Where do the malpracticing doctors go",....😂to the "other" hospital 😂😂😂😂😂😂
Please tell about the MOC controversy
I wonder how many claims are against surgeons who take on jobs that have a minamal chance of success. An elderly gentleman I knew was put forward for some very invasive heart surgery, apparently, the doctor was relieved when he decided not to have the operation after all.
The fact that A small percentage of doctors accounts for a large percentage of claims does not mean anything nefarious. This is a very misleading statistic that relies on the listener jumping to the incorrect conclusion that these two percentages represent similarly sized populations. Let’s say 5% of doctors account for all the malpractice claims. And Of those 2% account for 39% as you said. Well, so what? A small percentage of doctors accounting for the majority of the malpractice claims simply means that not many doctors commit malpractice!
@Yevhenii Diomidov A more charged view that this research would like readers to assume would be that there are a handful of doctors just doing malpractice out the wazoo while twisting their handlebar mustache and laughing. I had questions regarding the statistic just like Matt. If you have 100 doctors and 10 paid claims *all by different doctors* it's still only 10% of doctors paying out 100% of the claims. VERY MISLEADING haha
So stop them practicing medicine in the country then.....
For the stats that show a small number of patients account for most claims, is that referring to claim count or claim dollar value?
I'm 99% sure it's claim count. Claim dollar value is meaningless and varies too much.
I work as a CNA at a hospital so I only hear this through the grapevine but my hospital's focus on reducing malpractice claims is better bedside interaction and transparency(as I work nights and rarely see the doctors, it's very likely I don't see the medical safeguards). The theory being even when mistakes happen, people are less willing to sue open and likable doctors. The hospital does not want a Dr. House situation.
Hey, could you guys do another healthcare system video, but this time do a country in a region that you haven’t done before like Latin America, the Middle East or Africa
In India, there was a study which claimed that Drs (Medical Boards) always tend to protect fellow Drs during an investigation.
The malpractice system scares away good doctors and makes them run extra tests that aren’t needed, to CYA. The best doctors get more selective about patients, so the healthiest end up getting the best doctors - which is opposite what should be happening.
And people try to nitpick to sue. That scares even more good people from practicing medicine.
Do ever plan to collaborate with other youtubers into the medical profession...doctors and nurses? How about zdoggmd ?
There should be a national database of malpractice cases. It should list how many times a doctor has lost a case. No details mind. HIPAA should not be violated. But the public should know how many times a doctor has lost a case. We can look up data on used cars, why not doctors?
There is obviously, such a database. But it can only be accessed by hospitals or prospective employers because they know to ignore it. Malpractice data have little to do with malpractice.
Is there a difference between errors and malpractice? If so, does this data differentiate?
I know where they go... to the VA clinics!
if only 2 % are "mal practice ing" has anyone sought to find what these 2% may have in common. is it more likely after false accusations, patient loss, personal tragedy, etc... Has anyone looked into the prevalence of nursing complaints compared to patient complaints against doctors. what about complaints against them by colleagues. or assessments out of medical school. It seems there may be some truth to the idea that the system is unfair to doctors on this issues if there are so few actual malpracticing out there, is there a way doctors can help with more peer reviews and interventions prior to the malpractice occuring.
Be careful of that data. There are few who are paying out money, but it is the rare doctor who has been practicing for more than 15 years who has not been sued.
Unfortunately this video implies that a claim is equal to truthful wrongdoing or that a claim is proof of poor care or a violation of the “standard of care”, a moving target. It’s interesting how the narrator seems to imply also that the malpractice system is failing patients. The malpractice system is based on tort law, it has nothing to do with patient outcomes and to pretend to imply otherwise is hubris. What is sad about this is how a medical board, a political body that is not uniform from state to state and with legislative and budgetary constraints, fails to work on “process improvements” that can lead to claims to be filed to begin with. Imagine being a lawyer working for the state board: it’s a thankless job and you get no leadership, no direction and you make sure you keep your job based on how many professionals you “punish”. If you think our criminal justice system needs reform, look at the prosecutorial over reach from the state medical boards. These attorneys have no oversight and have no idea what it takes to become a physician, let alone practice medicine. By the way, in many states, physicians can get sued without even having an expert on their specialty review the case. In addition, physician discipline is a broad concept: not everyone disciplined is because they are an alleged “bad doctor”. In some states if you fall behind child support obligations or paying taxes or even your mortgage if you are going through a hard time (yes, physicians do fall into hard personal and financial times! Surprise! Surprise! ) the state board will send an “order of consent” in which the physician agrees to unilateral terms of discipline formulated by administrative personnel.
Who here thought the truck in the thumbnail said HENTAI
this is of course to say nothing about the obgyn who gets sued for making a joke / 'finger blasting' a karen
To jail and hell, I hope!
This was a very weak video with confusing stats. Please, and I mean this respectfully, try again.
This malpractice loophole in US is the reason why all Asian parents all of a sudden want their kids to become lawyers or doctors as soon as they set foot on US soil.