Georgia Malpractice Law does not guarantee optimal care for patients
Physicians are required to meet the “Standard of Care”, (“SOC”). In Georgia, that means that degree of care and skill which, under similar circumstances, is ordinarily employed by the medical profession. In other words, the physician must perform services in a manner consistent with the prevailing medical standards. One question that crops up regularly is what standards apply; in other words, which group of doctors should performance be measured against. Unfortunately, this definition can allow doctors to provide less than optimal care.
By way of example, doctors receive their training in residency. The length of such residency varies from specialty to specialty. For example, general surgeons do a five year residency while Obstetrics and Gynecology (OB/GYN) is a four year residency. The general surgical resident focuses exclusively on performing surgery while the OB/GYN resident does obstetrics and non-surgical gynecology in addition to surgical procedures. Simply stated the general surgeon has significantly more surgical training than the typical OB/GYN, and there is no reason that OB/GYNs should not receive adequate surgical training. In fairness, it should be noted that there are OB/GYNs, in particular doctors who specialize in gynecologic cancer, who do post-resident fellowships and obtain additional surgical training.
This difference in training can means that undertrained gynecologists may not employ the safest method of performing surgery. By way of example, a gynecologist’s training for performing a laparoscopic hysterectomy may not include identifying and protecting the ureter, which is the tube that connects the kidney to the bladder. As a result, there are numerous cases in which the ureter is cut.
If you ask a gynecologic oncologist, who has additional surgical training how to perform the surgery, they will tell you that it is essential that the ureter be identified and protected. That is the way the operation should be done. Yet, if you ask gynecologists who lack additional training, they will tell you that the surgeon who doesn’t identify and protect the ureter is still within the standard of care because that is the way the typical gynecologist does the surgery.
What does this mean for the patient? First, the patient of the undertrained gynecologist is not getting the best available care. That patient has an increased risk for a urethral injury and, more likely than not, would not be successful in a medical malpractice case, at least in Georgia, because the undertrained surgeon did the procedure the same way that all of the other undertrained gynecologists do the procedure.
What needs to be done is to better train the gynecologists who do these procedures. The same holds true for other physicians who perform surgery for which their training is less than optimal. Better training, using established procedures, will go much farther in protecting patients than any medical malpractice lawsuit.