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Tue Jan 5 18:16:06 GMT 2010

I work in a big traumatology service in southern Brazil, where this legal 
issue is not (yet) a big problem like in the US.

Since august 2008 our service changed and now patients are admitted not 
anymore on the name of one doctor, but in the name of the service. Even in 
the electronic registry there is "Responsible Physician: Trauma Service". 
Residents see admitted patients daily and there are daily rounds with the 
staff of the given day. Decisions are made in a group, and post-operative 
care is not done by only one doctor.

Advantages: cases are more "visible" to everybody, residents learn even more 
because they see more cases and decision making every day, everybody knows 
about all patients, and multiple opinions about management lead to better 
decisions.

Disadvantages: some patients have complained about not knowing "their 
doctor", what I understand completely. also, some cases that become 
complicated lack a leader taking the difficult decisions. protocols are 
needed more than ever for the routine cases.

About lawsuits (the few times we had them since august 2008) with this new 
system, patients sue the hospital, not the physician.

Cheers

Felix

----- Original Message ----- 
From: <nappio at aol.com>
To: "Trauma-List [TRAUMA.ORG]" <trauma-list at trauma.org>
Sent: Tuesday, January 05, 2010 3:56 PM
Subject: Re: kids FRAUD

> That's not an advantage.. They'll sue all your butts off.dn
> ------Original Message------
> From: Mohammed al Malik
> Sender: trauma-list-bounces at trauma.org
> To: trauma-list at trauma.org
> ReplyTo: Trauma-List [TRAUMA.ORG]
> Subject: RE: kids FRAUD
> Sent: Jan 5, 2010 12:44
>
>
> We practice as a team, just as your trauma service surgeons cover each 
> other for take back operations and rather than just one doctor being in 
> charge, a lot of doctors assume the broad risk.   This way if there is a 
> law suit, it is difficult to determine just who is responsible.    That is 
> one advantage of collaborative practice.
>
>
>
> Mohamed
>
>> From: Krin135 at aol.com
>> Date: Tue, 5 Jan 2010 12:20:14 -0500
>> Subject: Re: kids FRAUD
>> To: trauma-list at trauma.org
>>
>> no, Sir. in a true collaborative practice, there would still be *one*
>> primary physician, and each consultant would take the time to read and 
>> evaluate
>> what the primary has done and planned, and what each of the other
>> consultants had done and planned, so as to *reduce* duplication and 
>> eliminate
>> conflict.
>>
>> the primary physician (team leader in a teaching hospital, or 'admit to'
>> physician in a non teaching hospital) has the responsibility to ride herd 
>> on
>> the consultants and make sure that they are being used properly.
>>
>> This is something that many folks who trained as 'true specialists' have
>> forgotten...
>>
>> ck
>>
>>
>> In a message dated 1/5/2010 11:12:40 Central Standard Time,
>> traumawon at hotmail.com writes:
>>
>> I must say that all of our patients are consultant rich and sometimes the
>> orders and treatments are duplicative and conflicting. But that is the 
>> way
>> it works in a collaborative practice.
>>
>>
>>
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