Sometimes the little things matter just as much as the big ones. They can create downstream problems that were never anticipated.
We recently heard from a surgeon in Ohio. He was performing an office-based procedure. An employee was looking for the doctor. She quickly opened the door to the room where the surgeon was working. In a high-decibel, shrill voice she said something like “There you are!”
The surgeon was not expecting the intrusion of the cacophony. His hand moved. An extra unintended snip. Now this outcome will require additional treatment / repair.
The first webinar I presented from my office, I was ten minutes into the discussion when someone barged into my office. An unexpected interruption. Now I put a sign on the door before any webinar putting everyone on notice that quiet is the order of the day.
At a later webinar, I was in a heated discussion with a co-presenter. My phone went off. Multiple times. It was spam marketing. Yes, it was a distraction for me. Even more of a distraction for the people listening. Now I turn my phone off before getting started.
None of these details are earth shattering. They require no effort. But, we don’t think about them unless and until something bad happens. Or unless someone else tells us to think about X, Y, or Z.
So, help out your colleagues. Please give us some pearls of wisdom in your routines. Pearls that are obvious in retrospect. But pearls we really don’t think about until something hits the fan.
What do you think?
About the Author
Jeffrey Segal, MD, JD
Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.
Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.
If you have a medico-legal question, write to Medical Justice at infonews@medicaljustice-staging.shfpvdx8-liquidwebsites.com.
When doing an anesthetic induction or nerve block, insist on turning off the music in the OR. If there is a problem, you don’t want to be shouting over the music for help.
Turn down the music before the crisis
Look thru your spouses phone every once in a while. You might catch a cheater !
Keep Junior Mints out of the Operating Room
Always important
This may be a terrible example because I’m not sure it would have been preventable. A very calm and deliberate friend, who is also a mother, was examining a child in her ED. This child was one of those that had been undisciplined all his life, something one can easily tell by the attitude adopted towards his primary caretaker. When my colleague pressed on the body part that was the basis for the visit, the child BIT her without any warning, causing an involuntary reaction where she seemingly swatted the child. The mother and child then proceeded to announce to the entire department “this doctor hit me!” and subsequently complained to the state licensure board, which, along with the hospital put her through a lengthy investigation before acknowledging that the entire incident was a fluke and an accident. I really don’t know what she could have done differently, except possibly to have asked for a nurse to chaperone the exam, just on the basis that the family dyad was unbalanced. But this type of patient is not uncommon in an ED. I see them not infrequently in public places, and they do tend to get into accidents as a result of their unbridled behavior. I wonder whether most ED nurses would take the time to do this for an exam that was not particularly sensitive.
One more likely scenario that comes to mind relates to my practice of telemedicine, but also to any time a physician is talking to a patient by phone. Such conversations always need to be held in private spaces to avoid potential HIPAA violations.
I am interested in learning more about safety procedures you are taking for the telemedicine practice. Can we talk?
True, preventive measures are not needing exorbitant effort. One has to think the workflow through and along with that incorporate protective measures which have to be respected.
Take 20 seconds to review the chart before walking into the exam room.
It would seem wise to me to always have a “chaperone” in the room with you when examining any patient of the opposite gender, or any juvenile patient of any gender – and not just the parent in the juvenile’s case. In dentistry, we always have to worry about a patient jerking their head because they “feel” something, like the water or air spray. A rubber dam helps somewhat. Expecting the unexpected helps more.
If the door is closed, always knock. Regardless if a procedure is being performed, or if the doctor is in the room. If the patient is in the room and the door is closed, the patient is afforded the privacy and respect of a knock as if she was in her own home.