Picture this scenario: your spouse is complaining of terrible abdominal pain, so bad that you know a trip to the emergency room is in your future. Sure enough, you find yourself driving to the ER, where your spouse is triaged, and eventually, moved to an examination area. You hear the triage nurse saying that you're being sent to the "Fast Track" area, and that sounds like a good thing.
In Fast Track, you meet someone who looks and acts like a doctor, and whom you assume is a doctor. They examine your spouse, order some tests, find nothing seriously wrong. Since your spouse's pain has abated, you're sent home. Hours later, in the middle of the night, you're back, with your spouse in worse agony than ever. Somehow, the ER missed an acute illness, which worsened after your spouse was discharged.
You may think your spouse saw a doctor, but in many parts of the country, including Oregon, it's increasingly likely that they were seen by a physician assistant, or PA. PAs are being utilized in many medical practices and emergency rooms as "physician extenders." Well-trained PAs can be a boon in the ER, cutting patient wait times and freeing up physicians to focus on the most obviously urgent cases. But when they miss a serious health issue and the patient suffers, who is to blame?
Physician assistants are supposed to operate under the supervision of a doctor. However, the form this supervision takes varies. When you think of supervision, you probably envision someone literally overseeing the work of someone else. But in fact, a physician may not ever enter the room of a patient being treated by the PA the physician is supervising.
That's not so bad, so long as the PA is consulting with the physician about symptoms, diagnosis, and treatment, right? Maybe—but in many cases, the "supervision" consists of the physician simply reviewing and signing off on the treatment chart, frequently after the patient has been discharged and left the hospital.
A PA is often dressed in scrubs or a white coat like a doctor. If they do not tell you that they are not a doctor, you might not recognize that they are not. You have the right to know who is treating you. When you are in pain and vulnerable in the emergency room, you might feel uncomfortable asking the person treating you if they are a doctor. If you have a friend or family member with you, encourage them to ask on your behalf. If you are being treated by a physician's assistant, your next question might be what involvement the ER doctor will have in your case. If you're told that the doctor is "overseeing" the case, you or your companion may want to get clarity on exactly what that means.
If you were seen in an ER and misdiagnosed, or discharged as if nothing was wrong, only to suffer even more later because your diagnosis was delayed, it is possible you were a victim of medical malpractice. You may have recourse against the person who treated you, their supervising physician, and the hospital itself.
The doctor and hospital may be held liable if they were negligent in hiring or supervising a PA. They also may be held liable under the theory of vicarious liability. A Latin phrase for this is respondeat superior, which means "let the master answer." According to this principle, the master (or physician) is responsible for the negligence of the employee.
Often, it can be difficult to know exactly who is responsible for the harm that you suffered in the emergency room, and the fault may lie with multiple parties. The wisest course of action is to speak with an experienced Oregon medical malpractice attorney. An attorney who handles a significant number of medical malpractice cases will be able to help determine if medical malpractice was committed, and if so, by whom. If you truly were the victim of malpractice, it is in your best interests to take legal action against all of the parties who were to blame. Just because a medical professional didn't put their hands on you does not mean they do not bear responsibility for your injury.
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