[jdoliner]

Are there any similar prior cases where similar things have happened? Consults like this seem incredibly common, so it's hard to believe that this is the first one where the consult was wrong and it had consequences, maybe this is the first one where they thought to file a malpractice suit?

It seems like this suit may have a chilling effect where Doctors won't even be willing to get on the phone for consults, given that they're taking on extra liability by doing so. Do you think that's a risk here?

[bilbo0s]

Mmmm, I'm gonna play Devil's Advocate here and ask what would be necessarily wrong with a physician actually examining patients prior to making an admit decision? (Particularly given the fact that said physician really is acting more like he/she got a referral than a consult request.)

You can do consults, but they have to be consults. I think what happened here is that these two organizations are playing fast and loose with the essential distinction between a consult and a referral. The decision to admit has to come from this physician, so really, it was not a consult. Because the original physician had little to no power. (I'm almost ready to argue that the original physician had essentially no power over the decision, but I'd need a bit more information to make that call.)

EDIT:

Friend just pointed out that some people may not understand the difference between a consult and a referral. Basically, in laymen's terms, a referral is a request that you assume care of the patient. Whereas a consult is a really just a request for, let's call it, "advice", for lack of a better term. Kind of like, "Hey man, can you give me a second opinion on this?" But the patient is still under your care. You still make the final calls on things. As opposed to, "Woah, dude... you're gonna have to handle this one, I'm no cardiologist, so I'm not even gonna try to do a cath, much less a PCI."

[merpnderp]

This wasn’t really a consult. This was the admitting doc at the hospital overriding a doc who wanted to admit.

He made a decision, contrary to the examining doc’s opinion, that was final and without some crazy new information, asinine.

[aladoc99]

Not a risk, a certainty. Until this ruling, not having a physician-patient relationship was an absolute safe harbor against professional liability. It was understood that the clinician seeing the patient had the ultimate responsibility. Now we can program Alexa to say "Send the patient to the ER" and save ourselves a great deal of time.

[olliej]

The ruling is that when you make a medical decision about a patient you have a physician/patient relationship. You no longer get to say “I was not present so that fact that I provided incorrect treatment instructions is irrelevant”.

If the doctors involved weren’t the ones responsible for allowing a patient to be transferred to the hospital maybe you could more reasonably claim you were giving advice.

But by denying the transfer to the hospital and misdiagnosing them, they were making (and effectively enforcing) those decisions.

[merpnderp]

If the doc had merely advised, instead of overriding the examine docs opinion, there wouldn’t even be a case because this woman would still be alive. Looks like doctors are free to consult, but are on the hook when they make an overriding decision.

[girvo]

> Now we can program Alexa to say...

I don't really understand your point here I'm afraid. The courts won't give a shit about the Alexa bit, no?

[aladoc99]

Sorry for being obtuse. The point is that it doesn't take a physician to tell EVERY clinician calling with a patient for possible admission to send them to the ER. If the hospitalist is going to be liable for advice given on patients never seen, he can only err on the side of maximum treatment, since he hasn't had the benefit of seeing the patient and can't necessarily rely on the referring clinician's assessment.