Legal Reference Blog by Renee C. Walsh, Esq.

30/05: Medical Malpractice - Who is Treating You?

Do you know who is treating you? Patients are often unaware that the professional treating them is not a physician. For example, a patient goes into a routine outpatient procedure under which they are sedated with anesthesia. The anesthesiologist M.D. greets the patient briefly and asks some history and may perform a short examination. This takes place after another professional, likely a C.R.N.A. certified nurse anesthetist and/or a nurse has taken a history from the patient. The M.D. doesn't do a real thorough job taking the history or performing an examination because he assumes this has been done by the nurse and/or C.R.N.A. He is present to sedate the patient and once sedated, leaves the operating room giving control and supervision over to the C.R.N.A. The patient has no idea that this is taking place and that they are not being cared for by the M.D. If something goes wrong during the surgery with the anesthesia, the C.R.N.A. is allowed to use discretion to take care of the patient and may give more anesthesia without asking permission of the M.D. They don't have as much education and are not allowed by law (at least in Michigan) to practice in this manner, prescribing medication without the supervision of the M.D.; but "supervision" is a loose term. What sometimes


happens? The non-M.D. practitioner makes big mistakes which should not have been made and which injure the patient forever.

Another example are physician assistants who routinely treat patients in the E.R. The patient makes assumptions that the person giving the orders and treatment is a physician and does not know to inquire further. He is not aware that he is not being treated by a physician assistant and if he is, he is not aware of what that means. Specifically, he is not aware that the physician assistant is again loosely supervised by the physician in charge who may or may not look at the patient's chart until after, and in some cases, well after, the patient has been discharged. Then, it may be too late as for example, in a hypothetical case in which the patient presents to the E.R. for back pain, gets examined, treated, and ultimately discharged by a physician assistant who diagnoses back strain. Turns out, the back pain was a symptom of a heart attack and the patient goes home and dies of another massive heart attack. At deposition, the physician will testify that he did nothing wrong and it was no breach to allow the physician assistant to make the decisions he did and for the physician to sign off on the chart days later, having never been aware of the patient or the treatment prior to his death!
(See MCL 333.16215, MCL 333.17049)

"BUYER" BEWARE!