Sunday, September 27, 2009

Witnessing an accident first hand and musing on defensive medicine

Being a healthcare personnel has its shares of ups and downs, perks and quirks, joy and sorrow. We are often silent witnesses to some of the most tumultous events in a person's life. Trauma, birth, death, cancer, severe illness, recovery..these are all parts of the circle of life that we encounter daily.

For example, we were travelling for dinner while oncall during the Raya period. You can say that we are having a very good call if we are able to go out for makan at normal times. Anyway, we were following an old Roadways bus near an intersection in the Greentown area when a blue Viva shoot out of the intersection. BANG! I heard a loud sound and there was a collision right in front of us.

We immediately parked our car near Dave's Diner, jumped down the parking lot (I was glad I was wearing trousers and could run around anywhere!) and checked on the passengers of the small car. Apparently, a young girl was the 'unlucky' driver with her boyfriend sitting next to her. We checked on her briefly and although the car was totally wrecked (it looked bad), the direct impact was on the back seat behind the girl thus she was spared from any bodily harms. We let the paramedics do their work and continued on with our dinner.

Anyway, the incident made me wonder about emergency services. Although all 3 of us in the car was fully trained for emergency procedures as we are surgical registrars and medical officers, we would not be able to do anything if there were serious injuries outside the hospital. We do not have any medical supplies, oxygen tanks, splints or even bandages in the car. In fact, I don't even carry any resuscitation tools with me at all times.

On the other hand, I have recently heard of the Good Samaritan principles in the practice of medicine. Basically, if a doctor decide to help a person in need outside the hospital (let's say in a medical emergency on an airplane, in a boat, by the roadside, etc), we are equally liable to any untowards event in case of death, permanent disability, etc happening to the injured person. In short, we could be sued for malpractice despite the lack of diagnostic and treatment tools. Moreover, medical malpractice insurance may or may not cover the doctor, as the person in need did not deliberately seek our help in the first place; i.e. the person in need is technically not a patient as he/she did not solicit us.

Now this puts a lot of us in a dilemma isn't it? As a fellow human being, we would normally offer help and being medically-trained, everyone would expect that a doctor is the best person to assist a person in distress. However, there is this hand-tying, law-suit happy society nowadays that would not hesitate to persecute anyone that could be blamed in the event of an unhappy ending. I guess this will again reinforce on the practice of defensive medicine....

How about me? Would I help a person in need? I guess I need to be wise in offering help as the ultimate tenet is : FIRST, DO NO HARM. Whatever it is, we must remove ourselves and the person in need from danger and then, intelligently & calmly assess the situation. After all, we cannot be a 'hero' and try to perform some 'miracles' without back-up personnel and the proper tools and facilities!!

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