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Primum Non Nocere

By Dr. Jay S. Grife; JD, MA

This Latin phrase is axiomatic in intent and is one of the earliest inoculations students of medicine receive.  It dovetails the Hippocratic Oath to provide both a moral and ethical foundation for physicians in furtherance of their mission to heal the sick. It asks little in objective terms but demands an immense measure of dedication and knowledge from those who practice their profession.  Yet, it is roughly estimated that one of every five practicing health care professionals will confront the enigmatic process of medical malpractice within a twelve-month span. Despite the fact that most health care practitioners will never see the inside of a courtroom, the sequelae of the event itself can scar the psyche forever after. And so, the quintessential risk-management question for all medical practitioners is: What can be done when the inevitable happens and what can you as a practicing doctor do to confront the process? 

-Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

INTRODUCTION

“Even among the sciences, [and in the managed care era], medicine still occupies a special position. Its practitioners come into direct and intimate contact with people in their daily lives; they are present at the critical transitional moments of existence. 

For many people, they are the only contact with a world that otherwise stands at a forbidding distance.  Often in pain, fearful of death, the sick have a special thirst for reassurance and vulnerability to belief.” 

Socialization of Medicine and the Litigation Prescriptive “Spark”  

When this trust is violated, whether rooted in factual substance or merely a conclusion lacking in reality, American jurisprudence offers several remedies with the core being civil litigation.

For example, I have witnessed a vast spectrum of reasons that prompts a patient to seek the counsel of an attorney.

Whether it be an untoward result of treatment or surgery, an outstanding invoice being mailed to a less than happy patient who decides that the doctor’s treatment did not measure up to expectations, a physician’s wife, employed as the office manager, charging a patient eighty-five dollars to complete a medical leave authorization form, or simply a perceived lack of concern on the part of the doctor or his personnel, patients can be motivated to seek redress outside the realm of the doctor’s office. 

Compound any of the above scenarios with well-meaning friends and family, and the proverbial initiating “spark” has been lit; and the prescription for litigation has been written.

Bilateral Communication is a Preventative Key 

Woven throughout any discussion of the topic, should be suggestions that might obviate the foregoing.

While it is not a panacea, nor a cure-all for medical negligence cases, many believe it to be the most effective methodology for resolving those differences that see the growth of a medical malpractice lawsuit; honest and bilateral communications. 

Not Trial Bound by Destiny 

In the United States, a trial is thought to be the most common manner in which disputes are resolved. Contrary to what we see on television, very few cases actually make it to trial with most be either dismissed or resolved through mediation or arbitration.

In fact, a few years ago the U.S. Department of Justice recently reported that only about three percent of all civil cases are resolved by a trial. The vast majority of civil lawsuits, and in particular medical malpractice cases, are settled or dismissed before any of the litigants see a courtroom. 

MORE: http://shrutinshetty.com/2016/10/27/primum-non-nocere/

Conclusion:

What has been your experience on this often contentious topic – settle or litigate – please comment? 

Reference: [1] Paul Starr: The Social Transformation of American Medicine, Basic Books, 1982, pgs. 4-5.

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