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A National Health Service

Arch Surg. 1990;125(5):573-574. doi:10.1001/archsurg.1990.01410170019002.
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" What did the test show that your doctor ordered last week?"

"I don't know—uh, my doctor hasn't told me, but the test must be negative since I haven't heard anything."

"That's ridiculous. Doesn't he know how concerned you are?"

"He should. I told him I really was afraid I might have cancer or something else seriously wrong with me."

Does this conversation sound unusual? Impossible? Inconceivable? It should to us as physicians, but it is all too often an unfortunate true event. Headlines scream that a young patient dies, and long working hours are blamed when the problems are one of absence of supervision, failure to heed clinical details, and poor communication. The legal profession is being called on to make medical decisions, eg, removal of nasogastric tubes or cessation of life support. Fear of litigation now justifies the performance of what may be an unnecessary and potentially harmful procedure.


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