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Pressured medical residents produce faulty death certificates

NEWS IN BRIEF — Posted June 3, 2013

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Nearly half — 48.6% — of medical residents training in New York City knowingly entered the wrong cause-of-death information on a death certificate, said a study published May 9 in the Centers for Disease Control and Prevention journal Preventing Chronic Disease.

The 521 internal medicine, emergency medicine and general surgery residents surveyed for the study said they lied about the cause of death 30% of the time. A big part of the problem is that the system used to report causes of death in New York City does not allow physicians to enter diagnoses such as septic shock and acute respiratory distress syndrome, said the study (link).

More than three-quarters of residents who gave the wrong cause of death agreed with the statement, “The system would not accept what I felt was the correct cause of death.”

Many residents said admitting personnel, medical examiners and senior residents told them to “put something else” if the true cause of death was not listed. Poor training and communication also contributed to inaccurate death reporting, the study said. About 20% of residents said they did not know the patient well enough to determine the cause of death, and 18% said, “I took my best guess.”

“Reform is needed both in the training and education of residents and in the system itself,” the study’s authors wrote.

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