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Doctors delivering bad news via video link


Nice Guy Eddie

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https://www.cnn.com/2019/03/10/health/patient-dies-robot-doctor/index.html

Story about a doctor providing night rounds via a robot/video monitor telling a patient and his family there wasn't much to be done to keep him alive. Family is upset by it. Perhaps the doc could be more compassionate and improve his robotic bedside manner but I can't tell that he did something unethical or if he is liable for any damages here.

The patient and family knew he was dying, and the doc was basically telling them the end was near. As in, get everyone to the hospital to say goodbye. The grand-daughter appears to resent the doc-on-video for bluntly providing the info. 

Hospitals should take this story under advisement on whether video docs should provide all types of information since they can only take in so much from their viewpoint. Or whether they need to physically bring in someone to assist with end of life conversations. (note: it's not fully clear what previous conversations had taken place between the in-person docs and the patient but the hospital implies they had taken place.)

 

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So a human being during the day holds your grandpa’s hand and says you need to consider home hospice (good), and the night time video Dr “robot” says he isn’t making it out of the hospital (bad).  Well, he died the next day, so I would have to say well done robot.

In my experience with family members at the end, everyone wants to pussyfoot about when it comes to someone dying.  I fucking hate it as it sends false messages of hope and confuses people getting the info second hand.  We are all on our way out, act accordingly.  When my time comes, send me the no bullshit robot.

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I don't have much experience in this area but I saw one family member practically have a breakdown when someone ELSE received bad news from a doctor. She threw such a scene, she had to be asked to leave the room by the medical staff as it was upsetting nearby patients. My point being that the granddaughter is obviously upset about losing her granddad but perhaps she is overreacting to this situation that she may not have all the facts.

It also appears that at least one family member was more concerned about videoing the robot doc then taking in the news.

And the media loves a story where a "robot" is telling a person they are dying.

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32 minutes ago, TwiceHorn said:

Americans are kind of twats about death.

It seems like this is certainly a factor. I watched the video to get more context and what the doctor said to them didn't seem poorly delivered or callous... just details about  the situation and options moving forward. It seems like he would've delivered it the same way in person, and they had spoken with the same doctor earlier in the day according to the report, so it seems to me they would've been upset either way.

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I don't know what's worse with family...listening to them tell one another third-hand sensitive and complex medical information about an extended family memeber with zero training or context...or listening to them split a bill at lunch.  

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Two years ago I had an MRI for a suspected rotator cuff injury. A couple of days later I received an email notification to check the results on my BSWHealth messages. The doctor who read the MRI wrote that I had a partial tear, and that also the scan showed Stage IV Multiple Myloma in my shoulder bone and may have metasticized. 

My scheduled appointment with the orthopedic doctor wasn’t for another week, so I called my GP doc, told him the story, and he scheduled a whole body bone scan for two days later. He and the ortho doc apologized  for the premature email screwup and said it should not have been posted that way.

Anyway, the results of the whole body bone scan showed that the original diagnosis was most likely incorrect, and the “tumor” was almost certainly just bleeding into the bone because of a fracture. The doc who originally read the first scan must’ve been Dr. Magoo.

A third scan was done a month later and the so-called tumor had disappeared as my doc had predicted. So the fake cancer wreath was cancelled, much to my relief. Plus the partial rotator cuff injury had more or less healed by itself, no surgery required.

Edited by Armybrat
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When my Dad was dying a doc friend of my sister was a huge help for us.  She has crafted to some degree a specialty in "dying".  She explained the physiological changes my Dad would most likely go through, barring an acute event like heart attack or stroke, and made it clear that it would not likely be very stressful for him.  There is some level of endorphin load that apparently helps terminal patients achieve even moderate euphoria, which may be related to "white light" dreams, etc.  Of course, morphine etc. was going to be provided.

It was an immense help to all of us.  We were prepared and we made no attempt to extend his life beyond one round of steroid treatment that he wanted to try as a palliative offset to a final round of radiation.

The local hospital really had no idea what most of this was about.  It was new to them.  I'm very glad my sister's friend stepped in.

All of this was done remotely -- via cell phone (Facetime).  Not quite a "robot" but close enough.

Edited by jimmyjazz
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Dying at home with family used to be commonplace.  Not anymore.  Now it's "get that crap out of here and take it to a hospital, I've got home re-sale value to consider."  

BTW, hospice docs and staff are a Godsend.  Houston Hospice gets a donation from me every year.  Spectacular people. 

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About twenty years ago, I went to my doctor for a bad case of bronchitis. He ordered a chest x-ray, gave me some pills, and sent me home. Two days later he leaves a message on my answering machine that said the x-ray showed some spots on my lungs and I needed to come in and schedule some more tests. Of course, I didn’t get the message until I got home from work (I know you kids won’t understand any of that). I called him back the next day only to find out he went on vacation for a week.

 

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2 hours ago, Armybrat said:

Two years ago I had an MRI for a suspected rotator cuff injury. A couple of days later I received an email notification to check the results on my BSWHealth messages. The doctor who read the MRI wrote that I had a partial tear, and that also the scan showed Stage IV Multiple Myloma in my shoulder bone and may have metasticized. 

My scheduled appointment with the orthopedic doctor wasn’t for another week, so I called my GP doc, told him the story, and he scheduled a whole body bone scan for two days later. He and the ortho doc apologized  for the premature email screwup and said it should not have been posted that way.

Anyway, the results of the whole body bone scan showed that the original diagnosis was most likely incorrect, and the “tumor” was almost certainly just bleeding into the bone because of a fracture. The doc who originally read the first scan must’ve been Dr. Magoo.

A third scan was done a month later and the so-called tumor had disappeared as my doc had predicted. So the fake cancer wreath was cancelled, much to my relief. Plus the partial rotator cuff injury had more or less healed by itself, no surgery required.

I "member

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8 minutes ago, NeverMarryAStripper said:

About twenty years ago, I went to my doctor for a bad case of bronchitis. He ordered a chest x-ray, gave me some pills, and sent me home. Two days later he leaves a message on my answering machine that said the x-ray showed some spots on my lungs and I needed to come in and schedule some more tests. Of course, I didn’t get the message until I got home from work (I know you kids won’t understand any of that). I called him back the next day only to find out he went on vacation for a week.

 

A similar thing happened to me. Back in the day everyone working in pharma had to get tested for everything under the sun - drug testing, STDs, complete blood work, etc. I received a message on Friday afternoon that stated there was a problem with my HIV test and for me to call the office. I called back immediately after I received the message and everyone was gone for the weekend. On Monday, I called back and the nurse told me that they dropped the vial and that I needed to go back to have my blood drawn again. Not a good weekend.

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2 hours ago, Bevo said:

A similar thing happened to me. Back in the day everyone working in pharma had to get tested for everything under the sun - drug testing, STDs, complete blood work, etc. I received a message on Friday afternoon that stated there was a problem with my HIV test and for me to call the office. I called back immediately after I received the message and everyone was gone for the weekend. On Monday, I called back and the nurse told me that they dropped the vial and that I needed to go back to have my blood drawn again. Not a good weekend.

Well Bernard if you weren't doing anything wrong you had nothing to worry about.

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Heh -- I'm asthmatic and periodically get lung x-rays.  One time the doc came in and said "do you feel OK?"  I said I did and he took me out to the hall to look at my image.  He pointed to a spot and said "this is troublesome, it might be a tumor but probably not".  My head popped off.  Turned out it was the first bit of pneumonia and by the next day I was sick as a dog.

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