An Advice from a Retired Doctor

Malpractice is a sad reality. lt occurs all over the world. The Philippines is not an exception. The local situation is aggravated by the lack of a comprehensive set of malpractice laws.

The local med mafia has so far been quite successful in blocking even the tamest legislative move to correct the situation. This, along with the absence of any in-hospital quality assurance protocol leaves a patient quite literally at the mercy of the attending physician. This is a subject worthy of a week long seminar, so l wont get into it. But....

There are a few items, your friend should clarify. Foremost is the diagnosis of acute appendicitis and then "sending the patient home". NOBODY IS THAT DUMB. Even a 3rd year med STUDENT should know, that acute appendicitis equals surgery. lt is possible, that appendicitis was NOT the initial diagnosis? This could also explain the need for the CT study (appendicitis is one of the easiest disease to diagnose and very (very) rarely need a CT study). Then, the physician should be made to explain WHY, he did NOT think of appendicitis. lf he indeed thought of this then why did he try to send the patient home - lt doesn't really compute - there is misinformation here.

Re: the reaction to the X-ray contrast - a first or second year resident SHOULD be able to handle that. By and large, this is simple allergy. A very small percentage will get an anaphylactoid reaction and may die. lt doesnt constitute malpractice, per se, - the question is what kind of treatment was given, when, and how appropriate was this. (l assume, the patient did not eat a few hours prior to the exam - if he did, then that would make matters worse - regurgitation-aspiration).

Lessons -

A good hospital doesn't mean good doctors. Do not be shy in contradicting, getting a second opinion, even transfering to another facility. Do not ever think of any doctor as a GOD. Remember, God doesn't need to earn!

There are problems inherent to big hospitals. Primary is SCHEDULING and all ramifications connected to scheduling problems. If its an elective procedure, by all means REFUSE any study that can be done in the daytime from Monday to Friday. ALL hospitals are understaffed at night, during weekends and holidays but any self-respecting hospital administration will deny this.

If you need an Xray study that requires contrast injection and if you have money (it is quite expensive) and you have a strong history of allergy then by all means ask for a non-ionic contrast or even a hypo-ionic one. (The problem is l dont know if the Philippines has this).