This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
To the Editor.—
The special communication by Dr W. E. Mitchell entitled "How to Deal With Poor Medical Care" (236:2875, 1976) describes two examples of poor medical care. Dr A performs too many unnecessary appendectomies. Dr B performs unrecognized or inappropriate procedures.The diagnosis of acute appendicitis is sometimes difficult to make because many other conditions can mimic it. Frequently, a patient with all the signs and symptoms of appendicitis will have a normal appendix with perhaps a few enlarged mesenteric lymph nodes. Again, the appendix may be normal, but a foreign body (such as a toothpick) may have perforated the cecum. Patients are usually referred for surgery by a well-qualified physician. It takes a brave man to dispute the diagnosis. Dr A may have missed the diagnosis and not operated, only to see peritonitis develop, with its morbidity and sometimes mortality.Dr B, who probably continues to use obsolete
Beyer MC. Quality of Medical Care. JAMA. 1977;237(19):2036–2037. doi:10.1001/jama.1977.03270460022008
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: