Malpractice in Mexico: arbitration not litigation.
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Liability, Legal↗
Biomedical subjects
Carlos Tena-Tamayo
Publications and source records attributed to Carlos Tena-Tamayo.
Preventing medical errors in pediatric emergency medicine.
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Humans↗
[Recommendations to improve quality of obstetrics care].
The maternal care represents 50 percent of surgical and medical interventions in México. Around 80% of the maternal deaths are foreseeable with actions as risk-managed prenatal care. Prevention of these complications are difficult and require of a competent obstetrician to handle them appropriate. Some assays calculate about 46.4% of maternal deaths, as related to professional responsibility, and 9.7% with hospital responsibility. In México, obstetric malpractice complaints are the most frequent, and reached 14.5% of total matters received by the National Commission of Medical Arbitration (CONAMED) between 1996 and 2001. We analyzed 121 cases concluded, specifically obstetrics-related, requested to the Commission between 1996 and 2001, to identify moments and factors of the medical attention, linked to obstetric claims. Most prominent finds were: high risk pregnancies in 57%, prior cesarean section 22%, hospital income by labor in 28%. Complications were fetal death 25%, obstetric trauma and perinatal asphyxia 12% each one. Births ocurred by cesarean in 37%. Perinatal mortality was 39% and maternal mortality in 33%. The principal deviation was deficient care of labor. They were observed medical patient communication deficiencies in 76%, incomplete expedients in 45%, ethics deviations in 30%, and malpractice in 55%. Whole this information was presented to gynaecologist leaders of opinion: speciality Council, medical associations, public and private hospitals representatives. The conclusion were Nine recommendations to improve the patients care during the pregnancy, labor and postpartum: 1) Pregnancy, labor and postpartum should be attended by personnel qualified and properly authorized; 2) Value integrally each case during the prenatal care and identify high risk patients; 3) Tighten the prenatal care during the third quarter of the gestation; 4) Provide the best obstetric care; 5) Establish best way for each birth; 6) Reduce unnecessary risks; 7) Watch narrowly all patients during the immediate postpartum; 8) Document all the process of attention; 9) Promote and facilitate health education to pregnant patients and their relatives on the gestation inherent risks.
Female↗
[An exploratory approach on teaching for prevention of medical error].
INTRODUCTION: Medical error is prevalent in the contemporary practice of medicine. Prevention and solution of the majority of medical errors can be focused upon from the early stages of physician formation by improving knowledge and abilities with regard to human communication. Despite its importance, information systematized with empirical bases on the teaching of human communication in Mexico is non-existent. PURPOSE: Our purpose was to highlight the experience of an exploratory nature on the educative intervention on human communication in medicine in medical residents of different medical specialties. METHODS: A study of educational intervention was presented 216 medical residents of the National Institutes of Health in Mexico City on the topic of human communication in medical practice. Chi square distribution was employed to find associations among variables. RESULTS: Eighty percent of students presented deficiencies in knowledge and thinking abilities for clinical communication. As a result of the educational intervention, 70 percent of medical resident students reached acceptable significant learning on the topic. There were no appreciable differences between the men and women in response patterns. Data indicated necessity of incorporating this topic pre-and postgraduate studies, to achieve improvement of quality of medical care and prevention of conflicts in medicine.
Communication↗
[Clinical guides in Mexico, emission of the Academia Mexicana de Cirugia].
Today, these exist worldwide organizations related with the practice of medicine that are interested in marking recommendations and in formulating guidelines for better performance of physicians and health professionals. These organizations are headed by universities, associations, colleges, research center, and work groups and are made up of well-known physicians with academic prestige from the private and public sectors. This report presents a brief overview concerning the development of three clinical guides related with illnesses frequently observed in the physician's office: rhinosinusitis gastroesophageal reflux diseases (GERD), and prostate benign hyperplasia. These guides are issued by one of the most important academic institutions in the country. In the above-mentioned works, the efforts of specialist who are opinion leaders in these topics form different states of the country converge. Likewise, critical points to consider for producing clinical guides are provided mechanisms of diffusion, consultation, feedback and updating of these documents, have already been provided and focus on national medical practice quality of services, and the manner in which to carry out diagnosis and therapy at the different levels of medical care, with emphasis on preventing complications.
Gastroesophageal Reflux↗
[Defensive medicine in Mexico: an explorative survey of its characteristics].
INTRODUCTION: defensive medicine, has been recognized as a problem for health services in several countries of the world. It is defined as the application of treatments, tests and procedures with the main intention to defend the doctor of critic's and to avoid controversies, regarding diagnosis or patient's treatment. There are multiple causes of the defensive medicine: the fundamental is patient doctor relationship without the necessary trust. MATERIAL AND METHODS: the present reports it is a observational, cross-sectional and descriptive study of exploratory nature, with the objective to consider the dimension of the defensive medicine (MD) in Mexico. A survey was designed to pilot an application with Likert scale in a representative sample. 613 doctors participated to national level, with index of confidence of 95% and maximum error of 5% (p < 0.05). The questions explore the level in agreement or disagreement with perceptions, specific attitudes and conducts that are related to the MD practice. RESULTS: categories and degrees in the defensive practices of the interviewed doctors settled down, 38,7% were nondefensive, whereas 61,3% presented association with some MD degree (p < 0.05). CONCLUSIONS: The defensive attitude of the participant doctors is high, it emphasizes the importance of establishing measures that stimulate their containment and fights, which will allow to improve the quality of the medical practice and the doctor-patient relationship. The instrument maintained a degree of confidence and sensitivity (p < 0.05), that its future use allows.
Adult↗