August 25, 2008

Scrutiny May Drive Doctors Out


EXTREME public scrutiny of doctors could create a health system that punished doctors and drove them out of the profession, Otago- Southland District Health Board chief executive Brian Rousseau said.

Mr Rousseau said while he accepted there needed to be accountability, he feared excessive public scrutiny risked doctors withdrawing into practising defensive medicine.

"And in my view that would give rise to more poor outcomes." Doctors needed to be trusted and allowed to get on with the job.

"If we continue to drive hard on clinicians (doctors) as opposed to supporting the system to get better outcomes. I think we'll do ourselves a huge disservice." Mr Rousseau conceded that it was not the scrutiny that was the problem.

"But rather what happens with the results of the scrutiny that is a problem." The United States had a litigious system that punished doctors and people had been driven out of the profession for those reasons.

"If not careful, we run the same risk," he said.

"Why would you want to study medicine, if this is how we're going to treat people when things go wrong.

"There's going to be mistakes.

Humans are not machines." He said some mistakes were preventable and some were not.

Mr Rousseau's comments are in response to media coverage following the Health and Disability Commissioner's damning report, released last week, into former Southland Hospital obstetrician- gynaecologist Dr Enrique Tomeu's botched delivery of baby Ella McMillan-Meager on June 10, 2006.

Ella died in Dunedin Hospital two days after the delivery because of blood loss from the umbilical cord and a subgaleal haemorrhage (bleeding between the skull and brain).

Cuban-born Dr Tomeu was granted a New Zealand practising certificate on August 15 and began work at Southland Hospital five days later.

In his application for registration to the the New Zealand Medical Council he disclosed he was subject to four malpractice cases in the United States; two settled and two pending.

Mr Rousseau has defended employing Dr Tomeu, saying last week that the Health Board and Medical Council viewed malpractice suits as the nature of the profession in the US.

Based on US malpractice statistics, the average obstetrician- gynaecologist has 2.64 claims filed against him or her during their career nationwide.

The council and health board were satisfied Dr Tomeu met the criteria, he said. STATISTICS Malpractice statistics in the United States: Based on US malpractice statistics, the average obstetrician- gynaecologist has 2.64 claims filed against him or her during their career nationwide; Three-quarters have had claims filed against them and 41.5 percent have had three or more; 15 percent of obstetrician- gynaecologists in the US refuse to deliver babies; Half of the counties in the US lack obstetrician-gynaecologists; 40 percent of all malpractice cases against physicians are groundless; 70 percent of all physicians in the US practiced defensive medicine because they fear law suits.


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