Re: Question about "Medical Protocol"


"Robert" <Robertitsme@xxxxxxxxxxx> wrote in message
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>
> <Hawki63@xxxxxxxxxxxxx> wrote in message
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>>
>> "Jason" <jason@xxxxxxxxxx> wrote in message
>> news:jason-1806051047060001@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
>> >
>> > I am NOT a doctor and I don't currently work in the medical profession.
>> > "Medical protocal" related to statins were discussed in a recent post.
>> > I
>> > I would like to know which organization establishes the official
> protocal
>> > related to statins.
>>
>> actually there are NO official protocols for most anything medical...
>
> Not quite. There are protocols per institution as needed. Check UCLA
> protocal for ruling out acute myocardial infarct. This is an official
> protocol by the cardiology department. These are recommendations or
> position
> papers on how to do or rule out things.

aactually these are called "algorithms"....and surely do help the providers
to approach diagnosis in an organized fashion....."recommendations" is the
better term...
remember also that UCLA is a teaching hospital..lots of interns and
residents around..."they" need such algorithms and "protocols" as they do
not yet have enough practice experience to go right to the appropriate
action and diagnosis..

Kaiser (my employer for many years as an NP) also had EXCELLENT protocols
and algorithms...but take my word for it...far more likely for the NON MD
providers to follow these word for word...
> www.med.ucla.edu/champ/CLOT%20Team%20Protocol.PDF
>
>>
>> yes some professional orgs to publish "suggested protocols"...but
>> licensed
>> providers are NOT obligated to follow them...and many do not
>>
>> medicine is not the IRS .....lists and books of what is "required" is not
>> part of the practice of medicine..
>
> Not required but if you don't follow national guidelines or protocols then
> you can be subjugated to lack of providing the standard of care per
> region.
> Medicine is a profession which means no one can make you do anything but
> if
> you don't follow accepted medical practices then you are asking for big
> trouble.
>
actually the lawyerly term is "standard of care in the community".....so I
agree that most providers do follow some accepted guideline ...esp national
standards...but they are NOT obligated by law to follow a "cookbook"
approach


> Institutions publish protocols and so do individual institutions as there
> is
> variants per region.
> The suggested protocols are official and institutional.
>>
>> suggestions based upon current studies and data are just
>> that...suggestions..
> Which are valid in a court of law as are published papers and
> institutional
> recommendations.
> Medical practice guidelines are exactly that. If you don't follow those
> then
> be ready to defend yourself.
>
>>
>> so your doctor was NOT obligated to rush in and run a CK....tho changing
> to
>> a different statin without a trial of seeing if your muscle aches went
>> away...would have been wise...and common sense..
> That is a judgement call and if there would have been any permanent damage
> then they can hang her for not doing so.
>
>>
>> my hubby..for instance ...got all over achyness after Lipitor...his doc
>> stopped it...the pains went away...but his lipids shot up....he started
> him
>> on another statin and after 4 years...lipids are terrific..and never an
> ache
>> or pain
> He got that idea from following the protocol and if something would have
> happened his defense would be that he followed accepted medical practice
> in
> the field and would be held innocent of malpractice. The doctor would not
> be
> blamed but the drug manufacturer would.

sorry this was a doc in private practice ...he had NO protocols to
follow...I would hope his actions were based on years of experience...and
certainly I would expect that he reads journals and studies...so no "he did
not get the idea from following a cookbook approach"...he got it from his
brain by extrapolating many sources and experience

"standard of care" does not automatically mean protocols exist and were not
followed to the letter....mainly it means "what would doctor A in the same
area do for a patient such as my hubby"....answer ...obviously...stop the
statin...see what happens..then measure lipids,,and try another statin...

in certain HMO settings..such as Kaiser..."recommendations on those decision
trees" ARE made based upon what DRUGS the HMO stocks....this still falls
under "standard of care " in the community...

Kaiser docs...BTW....do NOT HAVE to follow the protocols!!! many use
whatever has worked in their experience in the past....


> If the protocol had stated that once one person reacts to one statin then
> they should not be put on another then that would be the accepted medical
> standard and if something would have happened on the second one then the
> doctor would be held liable.
> Does the doctor have to follow any protocol? Yes, he must follow accepted
> medical practices in his region and provide "the standard of care" for
> that
> region. The standard of care is derived from what? Writtien protocols from
> national institutions or local institutions, written articles, books and
> anything else.

actually this is true...somewhat...huge HMO's like Kaiser..(in my
experience)...spend a lot of time and money evaluating and re evaluating the
literature,,,etc...actually...even from NIH..what they provide are called
"guidelines"...


>
> Keep in mind protocols are usually written by specialist in the field
> based
> on consensus to be given out to the general medical staff who are not
> specialists.

yes I would agree here...in large HMO's it is usually the specialists..ie
the cardiology or orthopedic depts that get together and establish these
"algorithms" which are basically "decision trees".....their intent,,,not a
bad one..is to assist the primary care providers "in the field" in making
decisions,,and to know WHEN to call the specialists....

just my h.o.


based on years of working as an NP

obviously many many places depend totally on algorithms and do not use their
brains to help them out!!
>
>


.

Relevant Pages

  • Re: Question about "Medical Protocol"
    ... >> I am NOT a doctor and I don't currently work in the medical profession. ... There are protocols per institution as needed. ... you don't follow accepted medical practices then you are asking for big ... Institutions publish protocols and so do individual institutions as there is ...
    (sci.med.cardiology)
  • Re: Question about "Medical Protocol"
    ... >>> they were promised that the patients would sue if the doctor did not ... > All sentinel events occuring in hospitals are reportable and the FDA is ... > The topic was following protocols and consequences of not doing so. ... > So what you are saying is that if a patient reports an adverse event to ...
    (sci.med.cardiology)
  • Re: Question about "Medical Protocol"
    ... >> they were promised that the patients would sue if the doctor did not ... >>> Such errors as you know are FDA reportable. ... The topic was following protocols and consequences of not doing so. ... So what you are saying is that if a patient reports an adverse event to his ...
    (sci.med.cardiology)