Overreliance on subspecialty in a case of endocarditis

Conclusion

As the attending physicians of record, hospitalists carry the ultimate responsibility for the discharge decision. It is common to ask subspecialty consultants their opinion regarding stability for discharge and/or the need for ongoing hospital therapy. Yet, it is important for all hospitalists to remember that the consultant recommendations are just opinions that must be weighed against all the other evidence currently available. It is also helpful to have and document verbal discussions with consultants when discharge decisions are being made (and partially relied upon) with their subspecialty input.

The ID consultant in this case settled almost immediately with DB’s family. Dr. Hospitalist defended himself a little longer, but ultimately settled this case with the plaintiff for an undisclosed amount.

Dr. Michota is director of academic affairs in the hospital medicine department at the Cleveland Clinic and medical editor of Hospitalist News. He has been involved in peer review both within and outside the legal system.