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The earnings on assets—generally loans—may not respond as rapidly as the cost of funds—deposits—leading to declining profits.

Members of the medical profession may be asked to testify sometime during their career. It is in the best interest of the legal and medical professions if this testimony, in either a civil or criminal case, is scientifically sound and provided by an unbiased expert witness. Medical professionals, as members of the medical community, patient advocates, and private citizens, have a professional and ethical responsibility to assist with the civil and criminal judicial processes. Evidence-based and experience-based opinions from medical professionals in legal cases have become increasingly important and common. Many professional medical societies (American College of Obstetrics and Gynecology, American College of Emergency Physicians, American Academy of Pediatrics, American Society of General Surgeons, American Association of Neurologic Surgeons,  American Academy of Orthopedic Surgeons, American Academy of Ophthalmology, American College of Cardiology, and American College of Radiology) have addressed the issue with recommendations or guidelines. Legal Concepts Medical Malpractice Medical malpractice law is based on tort and contract law, and it is commonly understood as liabilities that arise from the delivery of medical care.  These liabilities may be based on negligence, insufficiently informed consent, intentional misconduct, breach of a contract, defamation, divulgence of confidential information, or failure to prevent foreseeable injuries to third parties. Of all of the potential liabilities in medical malpractice, medical negligence is the most common.  Medical negligence requires that the plaintiff establish the following elements: 1. The existence of the physician’s duty to the plaintive, usually based on the existence of a physician-patient relationship. 2. The applicable standard of care and its violation. 3. Damages, a compensable injury. 4. A causal connection between the violation of the standard of care in the injury. Standard of Care In medical malpractice cases, the defendant’s behavior is compared to the standard of care for that specific situation. The standard of care is most commonly defined as, “that reasonable and ordinary care, skill, and diligence as physicians and surgeons in good standing in the same neighborhood, the same general line of practice, ordinarily have been exercising in like cases.” Nowadays, with the establishment of national boards and greater standardization of practice, there is less local variability. The exception is access to care and health care facilities in underserved or rural areas. The question of whether there was a deviation from the standard of care, is often the most crucial decision of the expert witness in medical liability cases. If it is determined that a deviation from the standard of care has occurred, a secondary role for the expert witness may be to provide an opinion regarding whether the deviation of the standard of care could have been the cause of the patient’s alleged injury. Medical Errors Compared to Medical Negligence There are several possible outcomes from a medical intervention; the condition improves, the condition worsens, and the condition remains unchanged. A deterioration in the patient’s condition does not necessarily indicate medical negligence. The three above outcomes are possible with appropriate care and treatment. Medical negligence cannot be determined solely from an unexpected result, an unacceptable result, a failure to cure, a failure to recover or any other situation which might indicate a lack of success of the intervention or care. Burden of Proof The burden of proof is different in civil cases than in criminal cases.  In civil cases, the plaintiff must convince the jury of its position with a preponderance of the evidence. A preponderance of the evidence means at least 51%. Therefore, the jurors in a medical negligence case must be convinced that the argument and evidence provided by the plaintiff are more plausible as the proximate cause of the alleged injury than the argument and evidence provided by the defendant., (Copyright © 2022, StatPearls Publishing LLC.)

Colchicine has FDA approval for gout prophylaxis and treatment of acute gouty flares. It also has approval for the treatment of familial Mediterranean fever. Colchicine has been used off-label to treat several other conditions, including hepatic cirrhosis, primary biliary cirrhosis, and pseudogout. Colchicine has primarily anti-inflammatory properties. This activity reviews the mechanism of action, adverse event profile, toxicity, dosing, pharmacodynamics, and monitoring of colchicine for gout and other indications for interprofessional team members., (Copyright © 2022, StatPearls Publishing LLC.)

Palpitations are one of the more common complaints of patients who presented to emergency departments, primary care providers, or cardiologists. In one study, it was estimated that 16% of patients presenting to their primary care provider reported palpitations. The word palpitation is defined as a rapid pulsation, an abnormally rapid or irregular beating of the heart. Palpitations are a sensory symptom and are often described as a skipped beat, rapid fluttering in the chest, pounding sensation in the chest or neck, or a flip-flopping in the chest.  Palpitations are nonspecific and can be a symptom or a diagnosis.  While the cause of palpitations is most commonly benign, they may be a sign of a life-threatening condition., (Copyright © 2022, StatPearls Publishing LLC.)