Anatomy of a blunder

Some folks were offended when told, before they had the chance to see the movie, that the Titanic sank. If you're like that, skip this post. I'll continue my sorry fake-but-accurate shipwreck of a tale later in the week.

For everyone else, this is how the story ends: I didn't perform the colonoscopy demanded by the patient, and he turned out to have colon cancer, and I got my butt sued off.

How could something like this happen? For many of you this will be a once-in-a-lifetime experience to listen to a doctor admit to anything less than perfection.

These are the factors I've identified:

Over-reliance on technology. We have the finest diagnostics in the world, but we sometimes forget that all tests have their limitations. Sadly, we've let our physical examination skills and, to some extent, our clinical accumen atrophy. It's easier just to order a CT scan.

A misplaced sense of fiduciary responsibility. Healthcare costs are skyrocketing. The national debt grows every day. It would be wonderful if we docs cut back on all the tests we order. We'd save a lot of money.

Well forget it. Unless a physician participates in a capitated insurance plan (which I don't), there is little to be gained and a lot to lose by even thinking about being careful with your healthcare dollars.

Information overload. There are a lot of things vying for our attention. Sometimes the urgent crowds out the important.

Arrogance. I pride myself on my sense of humility, but there are times I make up my mind and don't want any additional facts to confuse me.

Guardian angel vacations. Evangelical lingo would sound like this: sometimes God, for whatever reason, removes His protective hand from us. Or like this: the Good Lord let Satan take a chain saw to my hedge of protection.

Relying on the work of other doctors. I never dreamed that the Best GI Guy In Town, Maybe Even The State would miss such a serious lesion.

Stupidity. Just what on earth was I thinking? Do the flipping test. Collect your fees. Don't worry about it. Hope the patient doesn't get a complication from yet another "unnecessary" test.

Now if you'll excuse me, I'm going to curl up in the fetal position and hide under my desk for awhile.