Saturday, September 8, 2007

Told ya...

Shrink Rap has posted on the recent news regarding increased suicidality rates since the black box warning was added. I had previously posted on the warning, as it was clear that this was going to become an access issue for patients.

This was not a patient safety issue. This was a CYA issue.

Is there any evil in the world that at some level can't be traced to a lawyer?

The FDA, having made a few recent snafus, is trigger happy with the black box warning, when physician education would have been more appropriate. It's a lawyer thing.

Physicians, so as not to be sued, either avoid antidepressants in patients who would otherwise benefit, or "educate" the patients so thoroughly on the risks of treatment that zoloft looks like a death sentence, and many reasonable people won't touch it.

How about a class action lawsuit against lawyers for over-lawyering?

All kidding aside, there is a lot of talk about the huge expense in US medicine as a result of CYA test ordering and other activity. There is less talk about mortality as a direct result of CYA. For me, this clearly falls in to that category. Patients are dying because of lawyers.

Tort reform would be nice for doctors. We won't pay as much for malpractice.

But tort reform is needed for patient safety as well.


The Country Doctor said...

I wrote an article for a primary care practice management magazine about a year ago which I called "Black Box Mania" describing the potential problems the exponential rise in black box warnings will cause patients and physicians. Initially it seemed well received, but then a reviewer took a disliking to it and commented that I really didn't understand the complexity of the issue. I think I understood it just fine as do you.

PalMD said...

A big "amen"!

Anonymous said...

I suspect that the snake in the garden of Eden was probalby a lawyer, too. So really that would make the the source of all the evil in the world. And the hoity-toity reviewers can go pound sand!