I am all for proper care and for following the standards and expectations that are accepted by the medical/nursing community as what we call standards of care. I am also for making sure physicians and nurses use proper judgment in their care of patients. But I am not for a legislature passing a law that governs health care that does nothing but add an extra layer of bureaucracy to an already overburdened system of care just so that it can look like it tackled a problem. Especially when one doesn’t exist. And when that law serves no good purpose, but adds more potential fuel for defense attorney’s to file frivolous lawsuits, and drive up the cost of care, it’s only that much worse.
Take for example, a new law that went into effect in California. Named the Donda West Law requires a patient to receive a physical exam and written clearance from a doctor within 30 days before elective cosmetic surgery. Having a patient receive a physical examination, taking a medical history (to include family and social history) are all standard medical practice across the country as pre-op procedures. Lab tests, EKG’s and clearance from consulting physicians are also standards of care depending on the patient and his/her history prior to any surgery. The best part of the law is that it also states that violating this provision “would not constitute a crime,” so charges would not result.
So the point of this new law is?????? What purpose does it serve to pass a law that makes it mandatory to do something that is already accepted as standard of care, yet not make it criminal do fail to do so? And just what constitutes a proper “physical examination”? To put this law into effect and not specify what is the expected minimum level of care needed to reach it, puts EVERY physical examination in question………..by law. And in doing so, allows defense attorney’s to call into question a pre-op examination on ANY patient who had surgery with a less than expected outcome, and puts the onus on the medical community to justify what constitutes proper pre-op examinations for each and every surgical patient or potential surgical patient. While I empathize with families whose loved ones die from complications of surgery, I question a legislature that takes up even the discussion of such a law that does NOTHING to ensure better medical care and only serves to increase the potential liability of the health care system. Is this not one reason health care costs are spiraling out of control? Will this type of law not just serve to heap more burden, documentation, and needless testing onto an already overtaxed system only to satisfy meeting the letter of the law? And since the standard of care is already in place, and the law does not make failure to reach it a crime, what is the expected outcome of it? What reason did the legislature have for taking up this bill and making it law, if not to set a higher standard? How will this help ANYBODY except the defense attorney’s?
To meet the expectation in court, physicians will now have to justify each and every time just why they did or did not order specific tests and be “Monday morning quarterbacked” as to what tests they should have ordered for the good of the patient. And if a jury finds they should have performed MORE tests than they did, they may be found guilty of a multitude of civil crimes and given penalties and monetary sanctions that will only serve to line the pockets of defense attorneys. It will also serve to make almost any and every test possible something that might be needed prior to performing surgery on any patient……….just to make sure the letter of the law is met. This helps who? And how?
Read the linked story below from CNN on the new California law I mentioned and decide for yourself if this is the type of thing government should be spending their time and our money on doing.
CNN article on new California law
