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Nov 19
2009

Unanticipated unfavorable Outcomes: Communicating Errors

Posted by Prashant Bhatt in Practice , Health Policy , Ethics

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Prashant Bhatt
Patients report wanting to be told about all harmful errors
in their care, and consider disclosures an important part
of a trusting relationship with their physicians (1)

How will you disclose unanticipated unfavorable outcomes? To whom will you disclose? How much will you tell?

Mammogram Errors
In “Disclosing Harmful Mammography Errors to Patients” Thomas H. Gallagher et al(2) tried to assess the attitudes about disclosing errors to patients by using a survey with a vignette involving an error interpreting a patient’s mammogram leading to a delayed diagnosis. This study was based on a survey which included items on demographics, practice characteristics, and experience in radiology and breast imaging. A copy of the survey is available online (http://breastscreening.cancer.gov)

To assess radiologists’ attitudes about disclosing errors to patients, the survey contained a vignette involving an error interpreting a patient’s mammogram, leading to a delayed cancer diagnosis:

A diagnostic mammogram for a new palpable lump shows an obvious malignant lesion. You realize a mistake was made in your prior interpretation of this woman’s last screening mammogram. Prior films had apparently been put up in reverse order, and you mistakenly concluded that the calcifications were decreasing in number when they were actually increasing. Your prior incorrect interpretation has resulted in a delayed diagnosis”(2)
May 14
2009

Preparing for Ramadan

Posted by Prashant Bhatt in Practice , Faith , Career

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Prashant Bhatt
Is there hope left for humanity?

Patients have become consumers. Doctors are service providers. If we blind ourselves to the business aspects of healthcare, then it is only at our own peril. When the insurance companies come, they need certain criteria to be met before your hospital is given the contract. When the maintenance contracts are signed, there are cold blooded calculations to be made by large transnational companies on the other side.

 

No effective modern Radiology manager can be blind to these realities. No idealism, only social and production material relations seem to be left.

 

May 07
2009

Pals Forever

Posted by Prashant Bhatt in Practice , Philosophy , Faith

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Prashant Bhatt

Let us practice in a way which enhances communications so that the personality of the person who is interacting comes through.

 

As radiologists, we use Imaging sciences to come to certain truths about the processes going inside a patient.

 

But there are some other truths, which help us grow as humans.

 

The patient should get a sense of the person as a human being and not just as a business-like transaction.

 

While keeping an appropriate balance to maintain professional boundaries, we can try to make patients feel like they have been related on a personal level.

Apr 30
2009

In the Face of Adversity

Posted by Prashant Bhatt in Working people , Practice , Philosophy , Faith , Career

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Prashant Bhatt
I am a believer

Does having a photograph on the form change the way you report?

That set me thinking. Over the years, I have had some beautiful relations with patients who have changed my approach, to radiology, medicine and life.

Usually we have transactional relations-business like dealings. A transformational relationship is something which changes your nature.

As a radiologist, I have tried to live by the Credo that any possible diagnosis should be open to you. It is our duty to look beyond the obvious, establish or refute alternative diagnosis, and also look for possible changes due to metabolism, medicines or therapy.