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Based on the article, the doctor didn't say "you're not following process", he said "send her home with some diabetes medication, and schedule a follow-up visit

Based on the article, the doctor didn't say "you're not following process", he said "send her home with some diabetes medication, and schedule a follow-up visit for next Monday". The first is not a medical opinion, the second one is. The NP can answer for not coming to the precious doctor via the right process, the doctor can answer for giving advice that led to her death.

arkades 7y ago
The sloppy, inaccurate article said that. The court ruling the article purports to be describing did not. The actual court ruling says the following: " They disagree about which diagnostic information Simon shared with Dinter. Simon says that she shared both the abnormal test results and Warren’s symptoms; Dinter says that Simon shared only some of the test results. Simon says that the conversation with Dinter took place after urinalysis results became available in the early afternoon; Dinter says that the conversation took place “in the late morning or noon,” and that Simon did not share any urinalysis results. Simon says that she specifically requested that Warren be hospitalized; Dinter says that Simon only asked him whether Warren should be hospitalized." In neither of their opposing descriptions does it sound like the hospitalist gave a specific course of treatment - they are only disagreeing as to whether he said "I don't think she needs hospitalization" vs. "No, I'm not hospitalizing her."
- JakaJancar 7y ago
  I read the whole doc. I don't know what to think anymore. Both the opinion and dissent make sense (someone once told me "when smart people come to different conclusions, usually none of the conclusions are very stupid"). I guess the debate is about whether the hospitalist a) had a duty, which if not done well, harm could be foreseen, and/or even acted as a "gatekeeper"; or b) just provided advice, one of the inputs for the decision making, and/or controlled just one of the paths to treatment, and had no expectation first doctor would rely on him exclusively. Both are argued really well. The back-and-forth between them, in the paraphrasing and footnotes, is fun to read. It's interesting to see how they use the same facts (e.g. that Dinter was assigned randomly) to draw opposite conclusions. Note that both even agree that "if Dinter breached the applicable standard of care for hospitalists, his negligence should have consequences." Huh.
- fencepost 7y ago
  Entirely circumstantial, but contacting a second physician about the same patient sounds more like something that would be done after being refused then after simply asking an opinion.

arkades 7y ago

The sloppy, inaccurate article said that. The court ruling the article purports to be describing did not. The actual court ruling says the following: " They disagree about which diagnostic information Simon shared with Dinter. Simon says that she shared both the abnormal test results and Warren’s symptoms; Dinter says that Simon shared only some of the test results. Simon says that the conversation with Dinter took place after urinalysis results became available in the early afternoon; Dinter says that the conversation took place “in the late morning or noon,” and that Simon did not share any urinalysis results. Simon says that she specifically requested that Warren be hospitalized; Dinter says that Simon only asked him whether Warren should be hospitalized." In neither of their opposing descriptions does it sound like the hospitalist gave a specific course of treatment - they are only disagreeing as to whether he said "I don't think she needs hospitalization" vs. "No, I'm not hospitalizing her."

JakaJancar 7y ago
I read the whole doc. I don't know what to think anymore. Both the opinion and dissent make sense (someone once told me "when smart people come to different conclusions, usually none of the conclusions are very stupid"). I guess the debate is about whether the hospitalist a) had a duty, which if not done well, harm could be foreseen, and/or even acted as a "gatekeeper"; or b) just provided advice, one of the inputs for the decision making, and/or controlled just one of the paths to treatment, and had no expectation first doctor would rely on him exclusively. Both are argued really well. The back-and-forth between them, in the paraphrasing and footnotes, is fun to read. It's interesting to see how they use the same facts (e.g. that Dinter was assigned randomly) to draw opposite conclusions. Note that both even agree that "if Dinter breached the applicable standard of care for hospitalists, his negligence should have consequences." Huh.
fencepost 7y ago
Entirely circumstantial, but contacting a second physician about the same patient sounds more like something that would be done after being refused then after simply asking an opinion.