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Tag: Medical Malpractice

How to Find a Good Doctor (in Virginia)

April 10, 2018

I am sometimes amazed how people find and choose their doctors.  You do want a good and competent doctor don’t you?  Sometimes you have no options…you are admitted to the hospital with stomach pain, diagnosed with appendicitis and need emergency surgery.  In those cases you agree to take whichever general surgeon is offered by the hospital.  But what about those cases where you have time to consider and select a doctor?  How do you go about finding the surgeon to fix your hiatal hernia…perform elective back surgery…or replace your hip or knee?

This article will provide information sources and comments which will help you become an informed patient and find a “good doctor.”

     1.  Search for your doctor on the Virginia Department of Health Professions.  This site provides a wealth of information.  First, it tells you whether your doctor is licensed to practice in Virginia.  Second, it discloses where your potential doctor went to medical school, post-medical school residency, and fellowships. If your American born doctor went to medical school in Aruba, Grenada, or Belize, I suggest they were unsuccessful in gaining admission to any medical school in the United States…not impressive.  As a general rule, do not select those doctors.  Third, this site discloses whether the physician you are considering has ever had an adverse action taken against his/her medical license by the Commonwealth of Virginia.  Adverse actions can be anything between failing to keep accurate patient records to situations where the doctor has an alcohol or drug addiction which negatively impacted patient care.  Finally, this site may tell you if the doctor you are considering has ever been successfully sued for medical malpractice.  However, this section of the site contains information “self- reported” by the physician so it is not always accurate…more on lawsuits against your potential doctor later.

     2.  Age and Experience.  The older we get the younger all of the healthcare professionals look.  This truism aside, age matters…on both ends of the spectrum of life and a medical career.  You don’t want a doctor who graduated medical school 5 years ago if you can help it because that doctor doesn’t have the necessary “on-the-job” experience to deal with complicated medical issues.  Likewise, you don’t want a 70 year old doctor fusing the vertebrae in your low back as it is unlikely that doctor has kept up with modern surgical techniques.  General medical experience is important but so is experience with the specific surgery or condition for which you are searching for a doctor.  If I need a doctor who is removing a brain tumor or a mass pressing on my spinal cord, I want a doctor who has performed that same procedure many, many, many times.  I also want to know the success rate my potential doctor has had with the surgery…not what the national averages are for the success of the surgery but my potential doctor’s success rate.  If he/she will not answer that question I suggest moving to another doctor.

     3.  Membership in professional organizations for their specialty.  In short, you want to select a doctor who keeps up on the literature and developments in his/her area of practice.  Here is a list of medical associations based in the United States.  Many of these associations have a web site listing their members by name and location of practice.  Also, many doctors will gladly provide you with a list of the professional associations for which they are members.

     4.  Lawsuits.  I promised (above) to provide more information on previous medical malpractice lawsuits against doctors you may be considering to be your doctor.  Just because a doctor has been sued (successfully or unsuccessfully) does not necessarily mean they are incompetent or bad doctors.  There are certain “high risk” medical specialties which simply leads to lawsuits. The high risk specialties include neurosurgery, general surgery, orthopedic surgery, obstetrics and gynecology, among others.  With my concession that a previous lawsuit against the doctor you are considering should not rule out the doctor, there are easy ways to check on whether the doctor has been sued and, if so, how many times.  Almost all of the Circuit Courts in Virginia are online and can be searched by the public to see if the doctor you are considering has been sued.  Here are the easy and fast steps to follow:         

           a.)    Go to the Virginia Judicial System web site

          b.)    Click on Case Status and Information

          c.)    Under Circuit Court, click on case information

         d.)    Hit the drop down key and pick which jurisdiction (court) you would like to search & hit begin.  You want the city or        town where the doctor’s office is located or the location of the hospital at which the doctor has privileges.

         e.)    You will be at the main menu.  Check Civil and type in the doctor’s name (last name, first name) and hit search by name

          f.)    You will just need to scroll through the names (names are in alphabetical order).

My TakeDo your research and find a good competent doctor…your life just might depend on it.

What could go wrong – orthopedic surgery in Virginia

August 23, 2017

With over 5 million orthopedic surgeries in the United States each year and Americans getting older thanks to advances in modern medicine, it is important to know what should happen after an orthopedic surgery, and where mistakes are often made. 

Likely, if you or a loved one needs an orthopedic surgery because of an acute (sudden) injury such as a hip, leg, ankle fracture, or chronic condition (long term) that leads to a knee or hip replacement, the following healthcare providers will be involved:

  • Orthopedic Surgeon
  • Physician Assistant to Orthopedic Surgeon
  • Office staff of orthopedic surgeon
  • Anesthesiologist
  • Cardiologist for surgery clearance
  • Post Op PACU staff
  • Hospitalist if surgery occurs inpatient 
  • Physical Therapists
  • Occupational Therapists
  • Wound care nurses
  • Home Health or Rehab Staff

The list goes on. And when you have numerous providers each handling one aspect of care, mistakes in communication are bound to happen. And with 5 million surgeries a year, it is likely you or your loved one is just one of many patients being operated on at your surgical site in a day, and receiving post operative care. 

So, what could go wrong? The following is a list of the more typical mistakes that are made before, during or after an orthopedic surgery: 

  • Negligence that causes fracture – such as fall or improper transfer in a nursing home or hospital
  • Wrong site surgery (yes – this still happens)
  • Improper anesthesia (Not all orthopedic surgeries require general anesthesia and many can/should be handled with regional blocks)
  • Negligent pre-op evaluation which could include failing to appreciate a heart condition or other condition which would place the patient at risk during surgery
  • Failing to stop blood thinning medication pre-operatively
  • Incorrect orthopedic device (wrong size rod, screw, etc)
  • Nerve damage during placement of device (yes, there are nerves in your lower limbs that need to be protected during surgery)
  • Inadequate DVT prevention post op (failing to order medication or use foot pumps)
  • Excessive DVT medication that could cause internal bleeding (Xarelto, Coumadin and Lovenox are often used post operatively and all three come with significant risk and complications)
  • Failure of therapists to follow physician orders re: weight bearing, non-weight bearing
  • Failure of therapists to quickly initiate proper therapy
  • Transfer mistakes leading to patient falls, additional orthopedic injuries
  • Infection of surgical sites
  • Failure to diagnose or treat infections post operatively
  • Foreign bodies left in patient (gauze, sponges) 
  • Medication errors post operatively (mistakes in writing orders or administering medication)

hip

Sadly – when you are dealing with so many providers, the list of possible mistakes could go on. 

While not all mistakes are preventable, and not all are negligence under Virginia law, our office can quickly help your family determine if the complications you experienced before, during or after an orthopedic surgery rise to the level of malpractice under Virginia law. 

No surgery is risk free – but one thing we advise all families to do is be your own best advocate. Take notes while speaking to doctors. Write down orders to make sure you understand the plan and question when it changes. 

This week I am helping a loved one after a hip fracture and repair, and have already needed to clarify physician orders on three separate issues (who is doing wound dressing changes, when is the patient to receive rehab, and who is to remove wound staples). The MD orders state one thing, yet home health claims another. When in doubt – call. Be an advocate. Ask questions. And call our office if you have further concerns about orthopedic surgery in Virginia – 540-520-4582.