Once multiple doctors become involved in the care a patient it can be very important for them to communicate urgent diagnostic results as well as follow-up and treatment suggestions to the patient and other doctors. The need for such communication is not necessarily negated just because the patient does no return to one of the doctors. Hence once a doctor has information or reaches a conclusion that the patient should have immediate follow up or treatment it is important for that physician to communicate that to the patient and possibly also at least the patient's primary care physician.
Consider the following reported medical malpractice claim. A number of doctors had a chance to detect the male patient's prostate cancer The individual first went to his primary care physician, a general practitioner, with urinary problems when he was fifty-six years old. The PCP decided that the problems were not associated with cancer even though no testing was done to rule out cancer.
Ten months later the individual consulted with a urologist who performed a digital examination on the prostate gland and did a PSA blood test. As it turned out this urologist was not an approved provider under the patient's insurance and so the patient went to a different urologist.
The PSA test ordered by the first urologist came back and that urologist advised a biopsy. Unfortunately, that recommendation apparently was not communicated to the PCP or the urologist approved by the insurance company. The authorized urologist did not order a PSA blood test. The approved urologist also carried out a physical examination of the prostate but found no abnormalities and so concluded that the patient did not have cancer.
Therefore the cancer was not detected for two years by which point it had spread beyond the prostate. The physicians treating the patient's cancer came to the conclusion that he likely had only 1 to 5 years to live because of the cancer's spread. The law firm that handled this matter documented that they were able to obtain a settlement during jury selection at trial for $2,500,000 on behalf of the patient.
As the case described above demonstrates, having several doctors for the same issue may end up in multiple errors. The first error was not following the screening guidelines. This was an error committed by both the primary care physician and the second urologist. The other error was one in communication. This happened when there was a miscommunication of the findings, suspicions, and advice of the urologist who was outside the insurance network and the other doctors. Although it is impossible to know whether the general practitioner or the second urologist would have followed up on results of the PSA test from the first urologist or on that urologist's suspicion and recommendation they at a minimum would have had information and perspective they were missing.
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