Malpractice News

June 8, 2013

Doctors avoid admitting uncertainty

Doctors aren’t infallible, much as they’d like to be. Dr. Danielle Ofri, associate professor of medicine at NYU School of Medicine, said that as a doctor, she understands that feeling. “As a group, doctors dislike ambiguity,” she explained. “We are most comfortable when we are dispensing medical care to our patients that comes from a double-blind clinical trial, that fits into a validated clinica-prediction rule, that derives from an accepted algorithm.”

A patient’s predicament

However, solutions to health problems are rarely black and white. Though modern medicine has brought with it a plethora of new discoveries, improved treatments, and stronger medications, many of these treatments have not been studied sufficiently or, as Dr. Ofri explained, “large swaths of the population are woefully underrepresented in clinical trials.”

Case in point, Dr. Ofri consulted with a patient who had been recommended by his cardiologist to undergo surgery to have an I.C.D., a type of automatic defibrillator, implanted in his heart. The patient had risk factors for abnormal heart rhythms, though he hadn’t at the time suffered any such rhythms. After discussing benefits and risks of the surgery with Ofri and in the end, she said, “We decided [the surgery] was worth it, since he still had many good years ahead of him.”

Low-risk procedures can have consequences

Unfortunately, though the surgery went well, the I.C.D. didn’t function correctly and would shock his heart randomly. He took more and more medicine with more and more side effects until the side effects associated with the wife outnumbered the benefits. Finally, he had the I.C.D. disabled and Ofri said for her it was “an object lesson that every decision has risks and consequences, and that nothing can be taken for granted, even ‘low-risk’ procedures.”


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