Page 22 - Hospitalists - Risks When You're the Doctor in the House (Part One)

SVMIC Hospitalists - Risks When You’re the Doctor in the House

usually viewed only the most recent progress notes. He

summarized his role in the case as merely “coordinating
a patient’s care and relying upon consultations”.

The decedent patient in this case, Mr. Jones, was

admitted with an acute spinal fracture. When asked if
assessing potential neurological injury was important

when admitting such patients, Dr. Murphy begrudgingly
acknowledged that this was “one of the considerations”,

but he added that, “Neurological consideration is not high
on my list of potential problems.”

He conceded that it is important to perform an initial
neurological exam, but that if there was a consultant

involved, he would “expect someone else to do it”. He
repeatedly emphasized he would not “go behind the back

of the consultants to see if they did their job properly”.
Dr. Murphy reluctantly acknowledged that tingling,

numbness, and weakness in the legs (as recorded in
the nursing assessment profiles) can be indications of a

spinal cord impingement. He added, however, that these
findings can be indicative of several other pathologies as

well.

On July 20th, Dr. Carter, an orthopedist, was consulted
and ordered a “CT today”. However, a CT was not

performed until July 27th. Dr. Murphy acknowledged he
never went back to speak with Dr. Carter about the CT

scan recommendation, but he noted that Dr. Carter did
not implement the CT order. Dr. Murphy again stated he

does not “go behind the backs” of his consultants.

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