This case highlights the problems of practicing what is termed “defensive medicine” – trying to protect yourself from a lawsuit by aggressively testing or treating a patient. It’s ironic that lawsuits for delayed or missed diagnoses are what led to the practice of defensive medicine in the first place, but now we are starting to see new lawsuits as a result of this practice.
Clearly, Dr. M should have run blood tests before jumping to suggest surgery, and one wonders why he didn’t. He also should not have discounted (and should have listened to) what his patient was saying to him – what seems like trivial conversation can often hold hints, as it did here.
Dr. M thought he was being cautious by removing and biopsying the lymph node, but actually caution would have dictated waiting a few days and running some less invasive tests, before concluding that the biopsy was necessary.
Fear of lawsuits is normal. No one wants to be a party to one. However, letting that fear affect how you treat a patient can be equally disastrous.