Physicians doing what's right need shield from money-minded litigation

Regarding "Protect doctors so they can say no to improper requests for antibiotics" (Letters, Dec. 24/31, 2007): Mark D. Schmidt, MD, of West Carrollton, Ohio, wrote the letter we all should have. He eloquently expresses the simple facts around overuse of antibiotics -- indeed, his thoughts could be used to describe the response to the charge of "wasting medical resources." He correctly pinpoints the reasons for overuse of antibiotics: not lack of knowledge or motivation on the part of the physician, nor inadequate education; rather, the concern over litigation for the rare complications.

The public and the "justice" system refuse to acknowledge simple realities, such as a very small percentage of complications being expected. Instead, they wish to litigate those complications -- not in pursuit of perfection, but of money. I would further suggest another example: When told by a hospital's utilization person that you have to discharge a patient who no longer "meets criteria," ask that person to put that in writing and cite that as the reason for discharge (if you feel they are medically not ready). The day the hospital covers those of us in private practice for malpractice resulting from an early discharge is the day they can dictate when our patients leave the hospital.

I love the idea of linking ICD-9 codes pertaining to viral illnesses to protection from litigation from those who sue over the rare complications of bacterial illnesses. In general, as we move toward better metrics, we should incorporate protection measures for doctors who do the right thing yet face the wrath of the public, the press, and administrators for not being perfect.

Omar Khan, MD, Wilmington, Del.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2008/01/28/edlt0128.htm.