April 10, 2005
Dethrone the Doctors
My sister is about to undergo surgery for lymphatic and lung cancer. She is 43. Therefore, I was drawn to two stories in the news yesterday about doctors. Political focus should also be drawn onto these two stories. They are, Medical Boards Let Physicians Practice Despite Drug Abuse and After Stealing Drugs, Doctor Goes to Rehab. It is high time to dethrone these kings of life and death.
Who wants their name associated with bad mouthing doctors? Let's face it, we are all going to need one eventually. Would any of us feel secure being grudged by the medical community at a time of need for medical attention? Regardless, the royal occupation of physician has too long enjoyed the double standards of law and policy. The laws of the United States are constitutionally to apply to all persons equally. When Doctors steal drugs for their personal use and are caught and reported to the Medical review boards, it is criminal that those peer review boards would respond by telling the thief they must enter rehabilitation to avoid other penalties.
This is illegal for a couple reasons. First, failure by the review boards to report this conduct to police, constitutes aiding and abetting a criminal in evasion of justice. Second, it is illegal because its is unequal application of the law. If a waitress is caught stealing drugs, she will go to jail. But if a doctor is caught for the same crime, they get help and assistance and never appear before the justice system. Finally, it should be a crime to permit an illegal drug using doctor to continue to carry the responsibility for life and death over their patients without their patients knowing the facts.
But there is an even darker side. Insurance premiums, tort reform and spiraling health care costs are all affected by these news stories. As Congress reviewed the causes for medical malpractice, they uncovered an interesting phenomena. A large number of malpractice suits were brought again and again against the same doctors. Could that phenomena be explained by drug and alcohol abusing doctors, in fact, guilty of malpractice? Oh no, say the conservatives who need malpractice costs to be the result of fraudulent claims in order to get their reform passed. Thus, they sweep the actual malpractice, perpetrated upon the innocent public, under the rug for political reasons. And finally, if these alcohol and drug abusing physicians were held accountable and removed from practice, would not malpractice suits drop and the adherent costs also drop? Why this cover-up continues is readily apparent.
It is plain to see that once again, putting doctors in charge of peer review for physician malfeasance is an idea that just does not work. And Americans are asked to give up their rights to sue these criminal doctors in class actions in the name of controlling health care costs. Congress did not investigate the legitimacy of the large number of medical law suits filed each year, nor did they investigate why it is the same doctors name reappear in suit after suit. So, not only are the peer review boards failing to represent the consumer's interests, but, Congress is complicit in this action as well.
They cover for each other like a secret brotherhood, and we the consumers of medical care in America get to play the lottery as to whether we will live or die at the hands of competent or incompetent Royalty called physicians. Doctors are not priests, kings, or saints. And somebody needs to start holding them to account to the same laws and punishments that the rest of us are subjected to. To allow doctors to have a favored status in the eyes of the law subverts our Constitution and breeds contempt amongst the population for experts and expertise. This cannot be healthy for our nation's future nor our own inevitable dependence upon a doctor at some point in our lives.
Posted by David R. Remer at April 10, 2005 09:36 AMExcellent points David. 5% of doctors are responsible for more than 50% of all malpractice payouts. The kicker is, the AMA successfully lobbied the GOP congress to make a doctor’s malpractice suits confidential. We have no way of knowing which 5% are the serial screwups.
This is an area where Republicans are inhibiting free market forces. If patients knew their doctor was a serial malpracticer, they’d go to someone else and the number of malpractice cases would decline dramatically.
Right, AP, just another example of how the two major parties heed money far more than principle.
I am very encouraged to see polls on Bush’s overall performance and Congress’ tanking into the 40% range. The public is becoming more disaffected as more and more Americans turn to the internet for news and information.
There may be an anti-incumbency movement swelling up that just hasn’t hit the radars yet. One can only hope.
Posted by: David R. Remer at April 10, 2005 10:37 AMMalpractice reform is an important part of tort reform. It should be harder to sue, but easier to recover damages, but damages need to be commensurate with the injury. I think we can all agree on this.
Records of court cases should be more open. Some doctors are constantly making mistakes. We should know their success and failure ratios. Some plaintiffs are always suing. We should know the repeaters.
In the medical field, like everywhere else, mistakes are inevitable. Sad as it is, people die and sometimes they die as a result of a mistake or misjudgment. It doesn’t help to criminalize that. Rather, we should study the process and eliminate bad procedures and bad performers. One stupid relic of the past is the horrendous hours put in by hospital staff. The longer you go without sleep, the more mistakes you make. That would be a good place to start.
David,
I lost my sister to breast cancer a few years ago, I will say a prayer for your’s to be cured.
There are just as many stupid doctors out there as there is auto mechanics, just trying a bunch of crap on you/your car because the dont know what they are doing.
I think the medical review boards actions should be made public, and if the board wishes to let one of their peers of the hook, they should sign a form saying that they would have done the exact same thing!
The new tort reform law was about much more than medical malpratice, in fact that was a small part of the abuse that led to that bill.
Posted by: Beagle at April 10, 2005 12:03 PMJack, I agree with most of your assessment. Two exceptions are “harder to sue” and “mistakes are inevitable. Sad as it is, people die and sometimes they die as a result of a mistake or misjudgment.”
Why should it be harder to sue if one has been negligently or willfully harmed by another? I think we need a screening process for suits where the fact set of the plaintiff is reviewed for potential credibility. If potential credibility is lacking, the suit should not be allowed to proceed.
But, making suits more difficult will only discriminate against those who can’t afford overcoming the more stringent green light standards for suit which you imply should be set.
In the second quote above, my exception is simply to my interpretation that you minimize the negligence taking place in the medical community. If I recall correctly, nearly a quarter million people each year are harmed by physicians and hosptitals. This is not a small problem. In a 10 year period that amounts to 2.5 million patients dying, maimed, disfigured or misdiagnosed negligently. And almost all of them will be unique patients with very few repeat occurances to the same patient.
A much higher level of scrutiny is required, and there is no room in the medical field for alcoholics, drug abusers, mentally or educationally incompetent individuals. Politicians have the power to bring forth that increased scrutiny and it is up to the voters whether they attend this issue or not.
Posted by: David R. Remer at April 10, 2005 12:37 PMBeagle, thank you for your best wishes.
I agree entirely with your comments. Though medical malpractice was a small part of tort reform, it was the poster child for moving the legislation forward, and that makes it significant. The other aspects don’t touch voters as directly as medical malfeasance and unwarranted medical lawsuits do. To pass tort reform without increasing scrutiny over medical performance will do much harm to the public. The primary vehicle for bring medical malfeasance to the public eye was through lawsuits. Tort reform will diminish public view of the amount and kind of medical malpractice actually taking place. This is not a good thing.
If Congress will ramp up standards and investigations into medical malpractice, then doing away with class action medical lawsuits at least makes some sense. But, Congress is not taking this balanced approach. Voters should be very concerned at this one sided approach that enhances protections of medical professionals without also enhancing the safety for the consuming public of medical services.
Posted by: David R. Remer at April 10, 2005 12:44 PMDavid,
I think the tort reform bill still allows for class-action-suits, it mostly limits “judge shopping” and non economic damages doesn’t it?
I agree with most of what you want in reform, I don’t agree with lawyers advertising nation wide for a group of morons that dont understand that gravity can hurt you, to sue a ladder mfg., and then file that case in an area with the most liberal they can find.
Posted by: Beagle at April 10, 2005 01:20 PMI hope all goes well for your sister…
I have had both ‘problems’.
A doctor that performed an unnecessary surgery and one who had a pain killer addiction.
I did sue the first one. I found out that the problem in our city includes the lawyers.
Our state will let you know how many times a doctor has been sued but not the outcome.
My lawyer dropped me when she found out there wasn’t enough money it for her. ( I found out later the firm has ties with the hospital.)
I finished the case myself because I could not get another lawyer to take it - claimed it was too late to take over.
I got what I wanted, not to pay anymore money than we already did for something that shouldn’t have been done. (no insurance and the doctor knew it)
I had to have the c-section repaired. The doctor who did it was reluctant to help me because he knew I was sueing the other doctor. He asked if I’d sue him. I told him that was a different issue - it wasn’t the sewing - it was that it shouldn’t have been there to begin with. He did my repair and it was fine.
My other doctor, who delivered our second child, came out and admitted his drug problem on his own and stopped practicing until he is better. Of course it was a front page story. Too bad. I actually liked AND trusted him.
That woman’s clinic also knew of my previous problem and did everything they could to make sure my second went well. (the first kept poor records of my surgery also) Apparently the bad reputation of the first doctor is well known amongst the medical people - he isn’t even allowed to practice at the second hospital.
I did find out that one should not go to a doctor who is in practice by theirself if you are having a baby.
Posted by: dawn at April 10, 2005 01:29 PMActually the new laws are there to protect the HMOs more than the Doctors. Some Hospitals are forced to give privileges to a known incompetent because they will lose HMO business otherwise.
Posted by: Aldous at April 10, 2005 02:28 PMDavid,
In my mind those doctors that are multiple offenders with malpractice should also face criminal charges as well. They should also forfit their licence.
I realize that medicine is not an exact science, but that is no excuse for a doctor to make the same mistakes over and over.
David:
First of all I wish your family well, especially our sister. My mom has cancer so I know a few of the emotions.
I think we should hand “evil doers” where ever we find them. If they be trial lawyers, then fry ‘em, if it’s the doctors through malpractice or through Medicare fraud, it is all a rip of of the system that hurts us all.
I don’t have a problem with tort reform and reform of how doctors are reviewed at the same time. In the end we need to improve how medicine is practiced in this country. So bring it all on!!
“Take all the rope in Texas, and find and old oak tree, ,,,,
“Give me beer for my horses and wiskey for my friends”
The sooner we clean house the sooner we can have more confidence in the system.
Actually isn’t Medicare fraud, and medicaid fraud where the big waste in the sytem is??
Craig
Posted by: Craig Holmes at April 10, 2005 11:05 PMTruly very sorry to hear of your sister’s illness, David.
I agree completely with this article — as I have with the others you’ve written regarding their sham concept of “tort reform” designed to benefit the corporations only.
Thanks to everyone for the kind wishes for my sister. Whether she survives or not is not as great a concern for her as whether she will suffer or not. She is in Michigan where Kevorkian offered such patients a choice if suffering became intolerable. She is very aware Kevorkian options are no longer available.
The real issue I wanted to raise however is that, as most of you expressed, regulation, oversight and investigation are needed to deal with those 5% of doctors creating 50% of the malpractice claims. And it will not happen if we, the voters and consumers do not make it an issue for our representatives.
Dawn, I am very sorry you had to go through what you did.
I contemplated becoming a doctor at one time in college, and decided against it because I am not the kind of person who tolerates routine and repitition very well, which at the time I thought would not make me a very good doctor. To this day, I think it was a good decision; I am reluctant to approach a problem the same way twice, even if it worked the last time. This is one of the reasons my house has taken 6 years instead of 4 to build. Electrical had to be done exactly the same way each time; I hated it, it was the most boring and unrewarding aspect of building this place.
Posted by: David R. Remer at April 11, 2005 11:59 AMDavid,
If you buy a house, or have one built for you, you wind up with a house.
However, If you build it you will wind up with a home, boring electrical and all.
Someday you may look back and feel just as good about that as not becoming a doctor.
Posted by: Beagle at April 11, 2005 12:30 PMBeagle, that is so true. I have so much of myself invested in this 5 acres now, that no amount of money could be offered to induce me to sell it. It still looks like a construction site, but, it really is home to me, where I raised my daughter and where my wife and daughter and I all sacrificed and worked to make this place uniquely ours. I am even tempted to never take a mortgage out on it either, just as a safety measure to insure it remains ours regardless of what happens to the economy.
It is amazing to me how many obstacles our society puts in the way of anyone building their own home. Our society very much frowns on anyone exercising such indendence from trades groups and government regulations. In the end however, we won the right to build our own without a single contractor (save drilling the well). Unfortunately it was necessary to make a few enemies along the way of those who said we couldn’t do that. At the end of the year, we will even have the ability to service our own well.
We have no mortgage, no homeowners insurance, no PMI insurance. Self insuring is not a popular option, but one still available to those who build themselves on a paygo basis. We built safeguards in such that the only real risk we face is tornado. What are the odds? In our favor to say the least.
So while we dethrone the doctors, we should also dethrone a host of other professionals like well drillers and contractors (who never come in on or under their original estimates) and rip off the public on a routine basis for no more reason than they have the public in a completely submissive and dependent position. How many Americans can build or maintain anything they own anymore. With that kind of dependency, there are a fair number of contractors who see the rip off value of their position of being able to dictate, pay what we ask or do without - a position not unlike that which doctors enjoy.
Posted by: David R. Remer at April 11, 2005 01:59 PMDavid:
“Whether she survives or not is not as great a concern for her as whether she will suffer or not.”
Does Michigan have medicinal marijuana laws?
Because her cancer is in her lungs, and because consumption can be very harsh for some people, you might want to make or recommend her to MJ tincture — something a friend of mine came up with years ago, and a recipe that I’ve since shared with people who have need of it.
A dry ounce (the higher quality the better) completely broken up along with some sugar to taste and large sprigs of fresh peppermint (well chopped) or an equivalent amount of peppermint oil (tastes great and always good for a nauseous stomach), submerged, then stirred and mashed down daily in everclear or vodka for at least two weeks or longer at room temp, then strained through fine mesh until clear, and chilled in the fridge.
A small shot of this is often very quick and easy to take, is not addictive and better for the body than lots of pain meds (but of course, always be careful about reactions between drugs and alcohol), and also very easy to hide in a small flask.
Call it a homemade schnapps aperitif for before meals! :^)
David,
If you own it free and clear now, taking out a morgage now would only offer someone else to profit from what you already sacraficed to do yourself.
Unless you feel you you could profit more by investing the “instant cash”, I personally wouldn’t.
As far as ins. goes, take the $600-$1200 ? a year for Ins. Take that and put that into an interist bearing account that is “available” if you need it.
Think about it, if doing that didn’t work would ANY Ins. co’s be in business or able to operate ?
If the average person, ( in your case above average, I.Q.) would look at the facts that any business is based on, they could get farther ahead in life.
Just as in “Jacks” article, people that can take a risk and make a decision will likely come out ahead in the long run.
” The sheep will always be subject to the wolves, but the smart shepard can control both”.
Just my opinion.
Posted by: Beagle at April 11, 2005 03:53 PMYes, best wishes to you and your family …as well as all good people who may have illness in their family.
Have paid a price for being v. smart and thinking this country is far off course from what is best for American citizens interests. Had I decided to be a med. malpractice att.as family members, I could be limo driven, etc.
I maintain any group of five citizens can decide most cases rather than use of court cases for civil cases in the King’s courts. (generally should be only coporations v each other in courts)
Government/governing and court use/influence should be largely no higher than County level for citizens.
Adrienne, I have passed this information you provided on. Thank you.
Posted by: David R. Remer at April 13, 2005 11:42 AM