LO>GS> Actually, I think that the quote is, "If it wasn't written, it
LO>GS> wasn't done", and it is not CYA, it is a matter of good practice.
LO> 
LO>    And you're correct. It was my typo.
 
I didn't want to make a big deal of it, but I wanted to be sure that we 
were talking about the same thing. I've always wondered though, is the 
corollary to that "If you wrote it, you did it" even if you didn't 
really do it?  With some doctors I have to wonder. 
 
LO>GS> Part of treating the patient is documenting what you found, what
LO>GS> you did, and the effect that it had on the patient. CYA, is
LO>GS> putting a collar on a patient that was in an accident, has no
LO>GS> complaint of injury, doesn't particularly want to go to the
LO>GS> hospital, and has no sufficient mechanism of injury. As for
LO>GS> protocols, if you deviate from them, you had better have a good
LO>GS> reason, and it better be documented, but again, that is not CYA,
LO>GS> it is good practice. 
 
LO> 
LO>    Thus, it seems that we agree. Good practice and CYA go
LO>hand-in-hand.
 
Not always. I had related to me a story of a system that routinely puts 
CHF patients on boards with collars. The rationale? They found the 
patient on the floor and the person may have fallen and suffered a C-
Spine injury! Now, they have CYAed themselves as far as the theoretical 
C-Spine injury goes, but have they really helped the patient? BTW, I am 
not making this up. 
 
Excellence is what we all aim for in our practice; along the way, the 
individual professional needs to cover him/herself.  
 
I agree, but I think that the best way to do that is to provide the 
appropriate treatment for the patient's needs, not the insurance 
companies.
 
Gary 
 
* CMPQwk 1.42 129 *Genius is perseverence in disguise.
--- GEcho1.20/Pro/TriBBS
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