Comments on: Straight talk in medical reports

By: B. RAD

B. RAD — Tue, 22 Sep 2009 02:15:09 +0000

Dr. T:
My reports sound similar to yours.

Also, if there’s anything published by the legal staff of the study you cited, I’d like to see it.

By: Dr. T

Dr. T — Mon, 21 Sep 2009 22:39:52 +0000

I’m a pathologist. I’ve seen this type of non-diagnosis among pathologists, radiologists, and specialists writing consultant reports. Studies by the legal staff at the College of American Pathologists indicate that the likelihood of being sued for medical malpractice INCREASES when you use weaselly phrasing. Therefore, it is not defensive medicine, it is pseudo-defensive medicine. It is often recommended by lawyers, but it is a stupid practice.

I use much simpler phrases: these findings are diagnostic of X, these findings are consistent with Y, these findings are suggestive of Z, or these findings are inconclusive, recommend tests A and B.

By: B.RAD

B.RAD — Mon, 21 Sep 2009 20:57:00 +0000

Throckmorton, you are right, it is defensive medicine. It also might be the fact of being in a dark room all day might have one see imaginary things. Welcome to Radiology. The reason the reports are like this is often the same reason the exam is ordered– shotgun approach. Often times with little or no clinical information or direction provided, radiologists must comment on all findings, real or not, because they may be real and significant. And how about when a slegdehammer to used to kill a knat; when the CT scan is obtained to look for something a plain xray would be perfectly fine-as you know, this fishing expedition will uncover incidental findings that radiologist must report as they may be a problem for the patient. Lawyers don’t understand xray artifacts, funny shadows, differential diagnoses or disease probability. Disclaimers and hedges appear on reports just like it says “contents hot” on a to go coffee cup. In residency, a professor said to write your findings as if a plaintiff’s attorney will be reading them–sad but often true. So when the onus is put on a radiologist to clear a belly or spine in a trauma case, hope you don’t take it personally when sometimes, the buck is passed back.

By: Doc99

Doc99 — Mon, 21 Sep 2009 20:34:37 +0000

The solution is obvious. Getting legislation passed to enact the solution is the problem.