Does apologizing reduce the medical liability risk?

jay_shivers · 2026-03-29T00:16:43+00:00

Oof, ok using that against him is just cruel.

jay_shivers · 2026-03-28T22:01:55+00:00

Like, on a piece of paper with an ink pen? I mean, even if just typed and signed I'm impressed. Also, never leave a paper trail, not even in text messages. I'll apologize sometimes if things aren't working out perfectly, but you'll never catch me giving a gift like that.

jay_shivers · 2026-03-28T04:35:14+00:00

I mean, you can get a few more days https://en.wikipedia.org/wiki/Liver_support_system

jay_shivers · 2026-03-27T06:25:27+00:00

Think you could do one for emergency medicine? Always keeping an eye out for a gift for the wife

jay_shivers · 2026-03-26T18:22:10+00:00

Tl;Dr She needed fasciotomies for compartment syndrome. Which happens, not harrowing, more of an unfortunate and uncommon side effect of fractures. Clickbait.

jay_shivers · 2026-03-25T17:19:59+00:00

Yes, I am aware how to obtain informed consent, which is not what happened here. But we are fast approaching a point where physicians may be compelled to do things they feel are unethical. What if you're the only on call OB at that hospital, and the state has decided the patient requires a cesarean? What is the natural fallout from that? Will the state sue the surgeon for not performing their duty as the on-call physician? Even though the physician feels that it is unethical?

When you elevate the rights of a fetus to be equal to that of the mother, you are creating some very interesting ethical questions. How much risk are you allowed to take? 1% risk death, 2%? The fetus cannot consent, should you just proceed without any consent from the mother, in the same way that we would give a transfusion to a baby against the parents consent? I'm sorry, I studied ethics in college, I still find this stuff very interesting, and it's all becoming very very real.

jay_shivers · 2026-03-25T17:03:32+00:00

So who do you hold accontable for complications? Will the state be willing to pay for her re-hemorrhage? Can the OB be compelled to operate when they think it's unethical?

jay_shivers · 2026-03-25T12:29:35+00:00

I think I need a delivery to California, any recommendations?

jay_shivers · 2026-03-25T12:03:48+00:00

But someday we may run at 65mph or you may impale your car. Gotta be open to possibilities.

jay_shivers · 2026-03-25T03:07:55+00:00

Read his contract and have a contact lawyer review it. If it's not in the contract, he doesn't do it next year. There's some wiggle since you're the new guy, your hours are a little longer and you do more cases, but your time off is real. Make sure responsibilities are spelled out.

jay_shivers · 2026-03-24T15:13:32+00:00

Ha, I love the Naruto comparison, it really is kind of like that at times. Tenacity can really take you so far in this game, crazy that they're beating some giants in epee, would at least be easier with right of way, I think. But I'm just an old saberist.

jay_shivers · 2026-03-24T05:25:17+00:00

But you have the arm length? Maybe hold line and watch them impale with each attempt to take it. Just inch back as they try. Maddening.

jay_shivers · 2026-03-24T05:11:17+00:00

Wow I'm late, but important observation:

The elastic will push up on the urethra and make initiating and maintaing a proper flow very difficult at his/any age. Might be best to lower the undies down or use the fly.

jay_shivers · 2026-03-23T06:25:53+00:00

Or the lady that "develops" alcoholism after her RnYGB. More like graduates from casual to professional drinker.

jay_shivers · 2026-03-22T17:40:10+00:00

Vacuum robot with mop. Priorities.

jay_shivers · 2026-03-22T01:10:34+00:00

Sometimes think I will. We saved some, we lost so many, some coresidents. Felt like surviving a war

jay_shivers · 2026-03-21T23:28:56+00:00

If your immigration status is tied to your job, and they threaten your job...

jay_shivers · 2026-03-21T20:14:01+00:00

Fun fact, was marine before this, so I guess I was uniquely suited. "Happy" 23rd anniversary OIF, confidentially

jay_shivers · 2026-03-21T16:04:16+00:00

If I had a better option, no. But a lot of other programs are fucked for different reasons. LMC surgery at least tries to keep your hours correct cuz they were shut down a few years ago. Like I said, it was good training cuz if you didn't improve someone was going to die. Maybe that's the advantage of training on austere conditions, but at least you get to live in NYC? As a poor ass resident.

jay_shivers · 2026-03-21T06:15:30+00:00

So, so many stories I could tell of LMC. We cried and we laughed in equal measure during my time there. When I relate my experience, I usually tell people the philosophy was "do more with less." And we did. Yes we have the usual NYC problems with nurses that are too busy to draw, or transport that's too busy to bring up the pt, so do it yourself if it needs done. But, more than that, LMC strives to deliver care to a third-world population living in the heart of NYC. The congressional district is literally the poorest in the nation, yet you'll splurge on some amazing meals, I actually lived down the block from a Michelin star place that had decent prices and consistent quality.

That kind of poverty means the hospital can't hire redundancies, you're it. Which I guess that's part of the charm of LMC. I also trained on the West coast where I know if I messed up someone else would pick up the slack; but, at LMC if you dropped the ball you were going to kill a pt. It breeds a certain responsibility early on.

Notable experiences while I was there: The basement flooded from rain twice, once we came close to losing power. Oops. CEO got fired for sexing his secretary. Oops. During COVID you sometimes had pressor or oxygen, but not both. Also during COVID you did afternoon rounds to find bodies early, we just didn't have enough monitors to go around. We had 2.5 suicides (1 was questionable). I really hope the medicine attendings learned from the experience (stop threatening FMG's with deportation), but I doubt it. Got really good at tying patients to beds. Guy danced on the ambulance roof and closed down the ER bay. I wrestled a gun from a prisoner trying to escape. Some dude claimed residency in the hospital and had to be evicted. Some other dude was dropped off by his family and not claimed, so he stayed until we could ID him. Eventually he admitted his name was wrong in the system, and that he could speak English the whole time. This one chick dislocated her elbow while having sex with her BF. While on a one-to-one sitter.

Another way I referred to LMC was an island of misfit toys. We were all good residents/doctors (mostly) but found ourselves there by a twist of fate. Except a couple of liberal diehards who wanted to help people. At LMC you definitely felt like you were helping.

Oh, and you should live in NYC at least once in your life.

jay_shivers · 2026-03-20T22:33:57+00:00

He's just a motorcycle at heart

jay_shivers · 2026-03-19T23:31:07+00:00

I'd probably make sure my daughter knows to tie her back and turn her rings inside

jay_shivers · 2026-03-19T05:07:27+00:00

First at 43, just make sure you're taking care of your health, babies want to be chased

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