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David J. Goldberg, M.D., J.D.
Dr. Goldberg is Director of Skin Laser & Surgery Specialists of New York and New Jersey, Director of Mohs Surgery and laser research, Mt. Sinai School of Medicine, and Adjunct Professor of Law, Fordham Law School.
When boards of nursing and boards of medical examiners disagree, who wins?
Dr. Laser, in an attempt to lower office fees, taught his nurses to use lasers for various problems such as hair removal, facial toning and acne treatment. He sent his staff to many training courses and established rigid in-office guidelines for laser treatments. Unfortunately, a patient treated by a laser nurse now has a scar on her upper lip, and she filed a complaint against the nurse and Dr. Laser with the state board of nursing.
Does involvement in a medical partnership inhibit obligations to patients?
Medical ethicists have long forewarned that the independent judgment of physicians can be compromised by private interests if left unchecked. To do so would risk interfering with the ethical obligation that a physician owes his or her patient: to provide objective and unbiased advice and treatment. Such private interests may take several forms.
How far does the intermediary doctrine hold physicians accountable?
After treatment with botulinum toxin, a patient went into anaphylactic shock and suffered permanent renal damage. The patient sued the drug manufacturer but not the physician. The manufacturer said responsibility lays with the physician because of the learned intermediary doctrine. What is the learned intermediary doctrine? Is the doctor liable?
HIPAA privacy rules become complex in dementia cases
Dr. Doe has practiced dermatology for more than three decades and has seen many of his patients become quite elderly. He is saddened by the senility of some of these patients, and he is worried about their ability to consent to various office-provided procedures. One of his patients with dementia has a brother who holds a power of attorney that becomes effective when the described patient is no longer able to make decisions for himself.
Using post-procedure photos for ads can constitute HIPAA violation
The use of patient photography, videotaping, digital imaging and other visual recordings during cosmetic filler treatment is common. Although cosmetic patient photographic documentation is common, liability issues need to be considered and federal regulations observed.
Courts say body dysmorphic disorder may impact validity of informed consent
Jane Cosmetic was injected with a dermal filler that resulted in skin necrosis. After other doctors tell her she suffers from body dysmorphic disorder, she files a lawsuit against Dr. Derm, claiming she lacks capacity to give informed consent.
Physicians have some leeway when prescribing drugs off-label
Practicing physicians are allowed to exercise their professional judgment and prescribe approved drugs for unapproved, or off-label, purposes. Physicians have been judicially accorded broad and unconstrained prescribing authority for years; "off-label" simply means that a drug is being used or prescribed in a manner inconsistent with its FDA-approved indication.
Making patients wait can prove costly
Recently, Dr. Skin saw an IT specialist who became angry when the dermatologist was late for a scheduled appointment. The IT specialist calculated his hourly wage and billed his doctor for the time he had to wait. Dr. Skin chose to pay the bill. Was this a smart move?
Physicians must ensure hearing-impaired patients understand their options
Mr. Eye, who was hearing impaired, was to be scheduled for Mohs micrographic surgery. Unfortunately, before his surgery he became ill and did not recover, nor did he return to Dr. Skin's office for six months. Unfortunately, Dr. Skin's staff had forgotten about Mr. Eye's hearing impairment. They took his lack of response as senility consistent with his age. Dr. Skin chose to use only palliative treatment while watching the carcinoma invade Mr. Eye's orbit over the next year.
What is the standard of care when taking critical information from patients?
Dr. Surgery He recently performed a large excision and failed to ask his patient about medicine intake. The patient did not take any prescription blood thinners, but he did take high daily dosages of garlic and ginkgo. Unfortunately the patient had progressive postoperative bleeding, which led to volume loss and an ultimate CVA. A lawsuit was brought against Dr. Surgery. Will he lose this case based on negligence?


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