A patient is sent home at the end of a long day, but you gave him a medication he is allergic to. Your supervising physician says not to worry and that he’ll be fine. What do you do?
This question is evaluated if you can perceive and anticipate many different consequences that can occur from your decisions. PAs are not independent practitioners and practice under an MD who has final responsibility for patient care. While you may practice under an MD you still have your independent responsibility to provide the best care you can and to do no harm.
"I would talk to the supervising physician again and emphasize my concerns about the case and the need to contact the patient. Although the patient is discharged and not under my or the supervising physician's direct care, or I may have repercussions from my mistakes, I as a medical professional, am still responsible for what happens to the patient after they leave my care. If I fail to persuade the supervising physician to take action, I would take action myself and contact the patient."
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Anonymous Answer
If I was in the situation where a patient was sent home with a medication they were allergic to, I would have a discussion with the supervising physician. I would inform them of my concern and let them know what I would like to do, including contacting the patient to change their medication. If they are still telling me not to worry about it after this discussion, I would have to let them know that I would be personally contacting the patient to change the medication or at least inform them of the mistake.
Stephanie's Feedback
That's a tricky situation to be in! You do a good job of walking us through this complex challenge, sharing the various steps that you'd take to ensure the safety of your patient. The only piece that I would add is perhaps looping in another physician for a second opinion if your supervising physician has just given you poor advice. That way, you have covered your bases in ensuring that a healthcare provider is aware of the situation and is able to support you with your decision-making.
Anonymous Answer
I would go to the attending physician and explain my concerns. Personally, I would call a patient, apologize for the wrong medication, and prescribe a different medication. As a PA, I am responsible for my actions.
Marcie's Feedback
You're right that it's crucial that you fix your mistake, especially in a situation like this where someone might be harmed. Discuss how you would go up the chain of command until you found a manager who was willing to listen and help you remedy this. Stress to the interviewer that you want to be held accountable for any mistakes you make and always strive to quickly find and implement solutions. If there's an example you can cite of a time when you fixed an error in a timely manner, consider mentioning this as well. Good job!
Anonymous Answer
I would review the patient's chart to see what type of reaction he had. I would then clarify with my supervising physician on why they thought the patient would be fine to be sure of any possible knowledge deficit I had. I would then call the patient about my mistake and discuss the treatment plan further. If I wasn’t able to reach the patient, then I would contact the pharmacy to have them hold the prescription until the patient contacts me.
Marcie's Feedback
Your response is thorough and logical. Initiating a talk with your supervising physician is a great first step, and the interviewer will be happy to hear that you would also follow up directly with both the patient and their pharmacy if necessary. Would you also try to determine why you gave the patient the wrong medication in the first place? Emphasize to the interviewer how seriously you would take this situation - remedying the problem and ensuring both that the patient will be fine and that you won't make this same mistake again in the future. Good job!
Anonymous Answer
I would make every effort within my power to get in contact with the patient and ensure that they do not take something they are allergic to. If they have already taken it I would give follow-up medical advice. I would also get them a new treatment that they can better tolerate.
Marcie's Feedback
Good! It's great that you would do everything you can to contact and warn the patient, in addition to providing follow-up advice and a new treatment. Also, don't forget to tell the interviewer that you would evaluate why this happened in the first place and explain how you will ensure that it doesn't happen again.
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