Coordinating the patient care can actually make the difference between life and death. The involvement of a number of doctors in the treatment of a patient raises the risk that some doctors might have critical information that should be communicated to the patient as well as the other physicians for necessary follow up. Without it the patient could very well go on lacking suitable and critical treatment. Many individuals believe that the doctor will inform them in case there are any adverse results from testing ordered by the physician. Generally, when people do not hear back from a physician many take that as an indication that everything is fine and that there is no need for them to follow up with the doctor. Thus if a doctor has information or reaches a diagnosis that the patient needs immediate follow up or treatment it is crucial for that physician to communicate that to the patient and possibly also at least the patient's primary care physician.
One such situation happened in the following reported case. Several doctors had a chance to diagnose the man's prostate cancer when it was still in its early stages. The individual first saw his primary care physician (PCP), a general practitioner, with complaints of urinary problems when he was fifty-six years old. The general practitioner concluded that the issues were not associated with cancer even though no testing was done to rule out cancer.
The man, on his own, went to a urologist ten months later. The urologist conducted a physical examination of the prostate and ordered a PSA blood test. As it turned out this urologist did not practice in the patient's insurance network and so the patient consulted with a different urologist.
The PSA test by the first urologist came back and that urologist advised a biopsy. Unfortunately, that recommendation evidently did not get related to the PCP or the urologist approved by the insurance company. The second urologist concluded that there were no abnormalities present with the prostate and that there was no evidence of cancer.
Therefore the cancer was not detected for 2 years by which point it had spread outside the prostate. By that point, the cancer had spread beyond the prostate and had metastasized. Had the cancer been detected at the time the patient first informed his doctors that he had urinary problems, when he saw the first urologist, or even when he saw the second urologist, it would not have yet spread and, with treatment, the patient would have had roughly 97 percent prospect of surviving the cancer. Because the cancer was by now advanced at the time of diagnosis, however, the patient was not expected to live more than five years. The law firm that helped the patient reported that the resulting medical malpractice claim settled for $2,500,000.
This claim thus illustrates two main types of failures. There was the failure on the part of the general practitioner and the second urologist to not follow the proper screening guidelines. The other error was one in communication. This occurred when there was a miscommunication of the findings, suspicions, and advice of the urologist who was not approved by the insurance company and the other physicians. If the patient had been able to stay with the unapproved urologist he would have known that he might have cancer and that a follow up biopsy was appropriate. If the other physicians would have agreed with that recommendation or would have passed this information to the patient if they had received it is unknown but then the error would have been entirely theirs.
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