Medico-legal education at Penn

First, some comments on music of the East Coast. The Captain and Tenille as well as the BeeGees are big and it drives me crazy. This is one thing that I don't miss about the East Coast. The same lovely music plagues other cities in this quadrant of the U.S. I thought the Kenny Gland of Overlake Hospital was bad but this music is worse...I think I need music desensitization therapy.

Also, I must say, the best news and stories often come from cabbies. Yesterday I took a cab to classes on bioethics at the UPenn Medical School. I got talking with the cabbie about baseball since all of us are ready for Spring. He told me a story of his son growing up. For years he took his family of four to opening day of the Phillies. They usually play the Pittsburgh Pirates and this was a family ritual. But one year recently his fifteen year old son told him that he didn't want to see the Pirates anymore. His son didn't want to go, instead he went skateboarding with his friends. The rest of the family didn't go either, because of the son's unwillingness, and the cabbie was sad because he sensed his son growing up and not wanting to be with him, his wife and his little sister. He told me that he still has those four tickets saved and sometimes looks at them with lament. I hope his son comes back and I think he will. In baseball and religion children may stray but they always come back, in some way, to the game.

Now about medico-legal stuff. This week I have been going to the medical school to sit in on the classes that University of Pennsylvania gives to their fourth year students on medical ethics. Today prosectuting attorneys spoke in the morning and defense attorneys, and the University of Penn Hospital attorney spoke in the afternoon. Here are some salient points:

As physicians and nurses all know, document. But some recommendations include, try not to document opinion if one expects bad outcome. That is, don't speculate, just write the facts, M'am. Speculation is bad for everybody.

Electronic documentation not helpful to doctors if there is no narrative involved. Templates and drop down point-and-click software can be more detrimental for legal issues even though it may fit reimbursement criteria. Always add summary narrative.

Encouraging information for nurses, there have been no lawsuits against nurses (alone) that the chief counsel for UPenn Hospitals, defense and plaintiff attoroneys of Philadelphia knew of. Of the lawsuits that come against doctors, about 10% included nurses and plaintiff attorneys don't like to bring nurses into lawsuits because juries are very sympathetic to nurses, no matter what the circumstances.

It's snowing again in Philadelphia, ugh.