missed soc notes for exam 2

missed soc notes for exam 2 - more on physicians...

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more on physicians 1.professional self regulation A.peer regulation fails to ensure quality of care 1.doctors respect each other's professional judgemnet 2.cant observe doctors work behind closed doors 3.belief that mistakes are a normal part of medicine doctors dont monitor eachother know all physicians are experts most doctors work behind closed doors from other doctors with nurse alone without sight of other people widespread belief that mistakes are normal 4.good manners prevent doctors from criticizing each other B.continuing education fails to ensure quality of care seminars lectures workshops to keep up it fails because the people who provide it arent regulated because its private to make money C.result medical standards of care are rules of process rather than measures of patient health some advertize luxury trips optional, credits are just as good quality of care measured by rules of process steps in treatment, tests- in patient file reported as long as doctor did what most other physicians would do the doctor is off the hook for errors informal set of rules of interacting minimizes error II.how do docs minimize errors in routine practice charles bosks study "forgive and remember: managing medical failure" 1979 he wanted to find how docs define medical error how to control/minimize how they provide social support hung out with surgeons in surgical department of pacific hospital for 18 months interviewed doctors and families. he shadowed each one for a week witnessed operations,liesure golf, went on call at night, post op visits, A.managing medical failure study details B.how surgery is done got to know what work is like 25 major ten minor five deaths per week
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attending physician is hired and in charge, but senior resident or chief resident is in charge of day to day stuff the second and third year residents are the doers and medical students then nurses go into the hierarchy the people involved in surgery enter in reverse order of the hierarchy. C.How do surgeons define error 1.technical errors if skill not goo enough its ok quickly recognized and senior is called in 2.judgemental errors not seen by peers 3.normative errors when surgeon fails to discharge 4.quasi normative errors unless you keep making the same mistake as long as you learn from them it doesnt matter when wrong treatment chosen patient dies thats how they know error stresses patient too much to stand invasive usually due to choosing too much invasive rare to not do surgery its a burden they have to get used matadors gunslingers cut at slightest opportunities violating the rule of no surprises if any change supposed to inform people higher up to prevent any surprises to his condition and surgery failure to get along with nurses huge differences in nurses often know more no surgery has to
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This note was uploaded on 04/05/2008 for the course CHEM 161, 101 taught by Professor Hansell during the Spring '08 term at Rutgers.

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missed soc notes for exam 2 - more on physicians...

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