Wanting it both ways: We sued you, but we still need you
“In March 2004, dozens of patients who had films re-read joined together to file a state court lawsuit that alleged, among other things, negligence, outrage and negligent infliction of emotional distress. The lawsuit, still working its way through Hopkins County Circuit Court, requests punitive damages and injunctive relief.
After the patients filed the lawsuit, the Trover Clinic Foundation board of directors decided that its facilities could no longer provide services to those patients.
In the fall of 2004, the Trover Clinic Foundation sent letters to the plaintiffs informing them that the health system’s facilities no longer could offer nonemergency medical care to them. The letter asked the patients to arrange for new care in the next 30 days. Trover also told patients they could contact the foundation if they needed help in making any arrangements. The Trover facilities would continue to provide emergency care for the patients.
The patients then turned to the federal court system, asking a judge to make Trover take care of their nonemergency medical needs.”
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Curious JD: It was proven that the radiologist’s performance was within the standard of care. Yet he is still being sued by some greedy, unscrupulous (oh wait, that’s redundant) lawyer? Explain that one to me.
Only an egotistical, money driven (wait, that’s redundant) doctor would assume that error rate is the same as standard of care. Or that they were getting the unvarnished story from the AMA.
As far as I can tell from the article, no one has accused anyone of misreading a particular film with an identifiable bad outcome.
Some of those “misread” films may have been films read as BIRADS 1 versus BIRADS 2. Technically incorrect but of no consequence to the patient. Or misread as BIRADS 3 when it was BIRADS 2 and the patient got a repeat mammogram earlier than needed.
Nobody has written about a missed cancer. Actually, what was written about was infliction of emotional distress and all that. If true, what it means is physician review of their own quality really SHOULD be kept out of the public eye. Apparently, as evidenced by the lawsuit, they can’t take the emotional stress of knowing that their doctors are human.
The “unvarnshed” view of the AMA is the same as the stories found on the regular news feeds. Just Google the names involved. I did. They read the same as the AMA article.
Is there another story behind this? I think so. One of the radiologists involved, one who was apparently left the clinic (voluntary or involuntary?)…..had the same name as the clinic. Turns out he was the son of the founding doctor.
I bet there was a story behind that.
Nevertheless, thankfully the trial bar has not found a way to force doctors to continue to provide services to the litigous. The clinic was within their rights to tell them to go elsewhere if they find the clinic’s services bad enough to sue over.
The clinic even allowed docs who really want to see a particular patient to do so, and of course they continue emergency care.
I’d do the same thing the clinic did with those people, except I’d have extended the disinvitation to the lawyers as well.
And with this kind of legal system, patients have no chance to really know how good a doctor is, because a doctor must be insane to start publishing real numbers or real errors. So, actually, the current malpractice system encourages and perpetuates lies and mistakes.
Wow, not only is it the injured party’s fault that their doctor was negligent in treating them, it’s also their fault that the general public has no way to tell a good physician from a bad one.
I think malpractice victims may also be responsible for global warming.
As far as I can tell, from the articles (AMA and regular news feeds), no one was actually injured in the sense of missing a cancer. A complaint was filed, it was investigated, the mammography readings were acceptable. These people sued over the emotional distress that their mammograms may possibly have been incorrectly read.
Doesn’t stop them from suing, though….
I think a physician would be a fool to continue to see a patient who is suing him. At the worst, the patient could be fishing for further evidence to bring against the physician.
I terminate relationships with patients who threaten suits. I don’t deny them medical care, I deny them my medical care. Recently I had a young man who was abusing marijuana threaten to sue me because I did not prescribe him clonazepam as he requested and I recommended he see an addiction specialist. He wanted me to “treat” him, and treat him the way he wanted to be treated.
It doesn’t work like that.
To the anonymous who wrote at 10.46.
You entirely miss the point.
The issue here is that doctors are being sued even when they meet or exceed standards of care, simply because an outcome was not satisfactory to the patient.
The problem, and this is something too many people don’t realize, is that there is simply no way any doctor, any human, can avoid a bad outcome every single time. It just doesn’t happen, no matter how good you are.
Even if you are, say, a cardiologist who performs miracles in the cath lab on a regular basis, there will always be that patient who ate like a pig, smoked like a chimney, excercised like a doorstop, refused all your medical advice, and turned up one day with a massive anterior MI that all the gods in the world could not have pulled him out of. And whose wife thinks it’s all your fault that he won’t be around still eating like a pig with her for the next 50 years. And that you’d better fork over the millions that are the only thing that may somehow assuage her of the profound emotional toll she’s felt since you screwed up.
The radiologist(s) in this story, like so many others, is the victim of a bunch of pond-dwelling bottom feeders. The hospital conducted a review which although, as I understand it, it was under no obligation to make public, did make public. The review showed that the radiologist’s “errors” were well within the standard of care. Undetered, Messrs. Scum & Co used the data from the review to fish for clients and instigated them to sue the radiologists for “outrage” and “emotional distress” which, until the enlightenment conferred by Scum et al, they were quite unaware that they were supposed to be feeling. I’m sure that they’ll now also be feeling acutely the physical effects
I have no argument if these folks had launched their assault on a genuinely bad doctor, eg. someone who, say, went out for the morning coffee and crumpets while his patient lay bleeding to death in the OR. In fact, in such cases I’d wholeheartedly support action against the doctor, and will testify for the plaintiff if requested.
However, the VAST majority of malpractice cases in USA are brought by the unscruplous against the innocent. The very high success rate of doctors in med mal suits brought to trial (80%) is consistent with that idea.
Your (patently ridiculous) suggestion however does not address the problem at all. The problem is that there is a massive industry set up to assault doctors who’ve done no wrong except not being god, for stuff they simply cannot control (most of the time). How does your “solution” even address the problem?
Let us say we made it compulsory for every bit of “performance metrics” be made publicly available (we will ignore for the moment the fact that this is impossible). This will probably cause a few docs at the very top to get overwhelmed with patients wanting their services, and a few docs at the very bottom to lose it.
But how will this affect the malpractice lawsuit crisis? Do you imagine that only “bad docs” get sued now, and that your proposal will simply run them out of business? Do you imagine that the vast majority of lawsuits now are not filed against the average and best guys, but only the bad? Do you actually believe that the only time doctors are sued is when they are clearly negligient, and not when there is a bad outcome, no matter how top flight their doctoring was? Do you imagine top docs are not sued all the time? You are incredibly misinformed to suggest that your proposal will even dent the efforts of Messrs. Scum and their kind. The onslaught against doctors will simply continue unabaited. Why should it not, when the real problem is not being addressed, but, as usual, it is the victim who is being blamed?
How good a doctor is, how blameless a doctor was in a given case, has never been the criterion by which lawsuits were filed. You are simply delusional if you think it is.
ZZ
Curious JD said: The other thing he doesn’t understand is that one’s “success rate” isn’t the issue. It’s whether their actions meet the standard of care for their locality.
*Sigh*
The problem we’ve been discussing is precisely that docs are getting sued despite their practice meeting or exceeding the standards of care for their community.
Curious JD – Always wrong, but never in doubt.
Anonymous, you claim that docs are getting sued even though their acts don’t fall below the standard of care. Perhaps you can share with us how many and the names of the cases where you’ve reviewed the medical records?
Can you tell me, have the number of med mal suits increased or declined in the last few years?
Can you tell me the historical rate of return for med mal insurers? Not just 2002, but say a 20 year period?
Do you guys know any of these facts? I’ve never seen so many scientists rely so heavily on anecdotal evidence.
It appears that for Anonymous and ZZ, knowledge is not a prerequisite to having an opinion.
Curious JD, you continue to amaze.
Do you seriously think your ATLA propaganda materials, all of which look at surrogate variables, will work on this forum?
There has been no study to my knowledge that correlated the actual medical injury, degree of negligence, and the final outcome in court at the national level.
However, there have been studies geographically restricted to the state level (if I remember right). There were at least two great studies done by the Harvard School of Public Health some time ago (IIRC early 1990s) that looked at this. This type of study is very hard to do (because you have to get data from the hospitals, from the doctors, from the plaintiffs and from the courts), but the HSPH folk have been consistently awesome in research on medical error. (they are the guys who did the pioneering work in New York hospitals which first alerted everyone to the problem of medical error, and whose data were later mishandled (in my opinion) by the Institute of Medicine to produce the infamous figures for “medical” error on a national scale that continues to be misquoted and misused by folks who don’t have a clue what they are talking about).
The HSPH investigators found that the verdict in malpractice cases correlated most closely with… yeah, that’s right – how bad the outcome was as perceived by the jury. Not whether the doctor was at fault, or anything else. I’m sorry I don’t remember the citations now off the top of my head, but you can do a search and find them.
A simpler indication that a lot of doctors are being sued despite performing at or above the standard of care is a bit of data that you should actually be familiar with.
What’s the percentage of doctors who win their malpractce cases in court? It’s a ridiculously high figure – 80%. Now, that would obviously mean that 80% of the time, the jury and judge felt that the doctors involved had NOT been negligent in their care (ie. had met the standard of care).
And this is coming from juries whom we know often decide against the doctor even if they feel he was not wrong, just to “help out” the patient with insurance $$$.
For you to believe that few doctors are sued wrongfully, that must mean you hold an extrememly low opinion of the verdicts of your jurors and judges.
Cases that are tried are generally not frivolous. They’ll be tried for a couple of reasons.
1. The insurance company exposure is already so high that it’s worth it to them to take a shot. For example, even on a good case, if there is $1 million in coverage but economic damages alone are in excess of that, they’ve got nothing to lose by trying the case.
2. There is an honest disagreement about the standard of care and the parties can’t agree on a number which will make it worth it not to try it.
Do you think the cases that are tried are all the suits that exist out there? Where the negligence is clear, cases get settled. How can you say most suits are bullshit if you don’t factor in the 90% that settle?
Stop with your bullshit about how juries give money because they feel sorry for people. You’ve obviously never sat on a jury in a civil case or argued a case to one.
You’re right though, they do get it right a lot of the time. So why are we talking about caps? Are you wanting it both ways now?
For Pity’s sake, there is no book of “standard of care” to cover all of medicine. At best, there are a few guidelines here and there, like the anesthesia standards, covering certain specific procedures. The courts are not forced to recognize them. Otherwise, why have experts? I could just defend myself with some piece of paper from a national organization.
In the end, “standard of care” is what the jury is convinced is the standard of care.
You get expert “A”, the other side gets expert “B”, standard of care depends on which expert the jury chooses to believe.
Curious JD:
As usual, you’re wrong.
I have never implied that there is never a reasonable reason for the 80% of med mal cases that are decided in favor of doctors to be brought to court.
I am saying that, whether or not you or I or anyone thinks a particular case is “frivolous”, the outcomes in the overwhelming majority of cases is very revealing.
**80%** of the cases are decided in favor of the doctors.
That directly proves that your claim – that docs are only sued if they fall below standards – is the equivalent of horse manure.
You can twist and squirm all you want, but you can’t get around the fact: huge numbers of doctors are being sued despite their doing no wrong whatsoever.
Seriously, lets say that you had a scenario where 80% of prosecutions for, say, homicide ended in aquittals and conclusive proof that the people charged were innocent, would you say that the system was working?
You ask about the cases that do not go to trial. The reason I didn’t discuss that is that there is no good data about the details in such cases.
Why are they settled? Unlike the cases that go to trial (where it is clear that most of the doctors involved are innocent), the settled cases have a very heterogeneous mix of defendents. There are the clearly, horribly negligent – the “docs” who really shouldn’t be practising. There the people like Dr. Moore who Kevin has recently posted on – fine doctors who get slammed because a minor clerical mistake caused a bad outcome.
But there are also numerous cases where the doctor feels he is clearly innocent of any and all wrongdoing, but is forced to settle because the insurance company does not want to go to trial.
You are simply spewing complete garbage, as usual, when you claim that the settled cases are some sort of homogenous mass of incompetents. They are not.
This case clearly illustrates the problem.
Finally, it’s always amusing to watch your type discuss an issue. You asked if I had any evidence for my positions. I provided you with the Harvard studies, among other things. The Harvard studies convincingly showed that, in their sample, 55% of all malpractice claims did not even have evidence of any medical injury, negligent or not. Furthermore, in 40% of the cases where there was no evidence of negligence, the “victim” was nevertheless awarded an indemnity payment.
Your response to this is of course, per usual, a deafening silence, followed by a jump to a new question.
Until you are prepared to honestly discuss the issues and not merely troll out ATLA talking points, until you are prepared to honestly face the fact that the trial lawyers are doing a horrendous amount of damage to the country, don’t expect me to respond further to the drivel you market.
ZZ
(Please note the post at 2.25 was also mine).
I guess I missed your Harvard study, sunshine. Got a link? I’d be glad to discuss it with you.
Ever note how you pick some studies to believe and some not to believe? For example, there’s a study from NYU, I believe, which shows that tort reform has no effect on alleged “defensive medicine.” Do you believe that one?
How about the fact that the nation’s largest med mal insurer said that caps on noneconomic damages would affect at most 1% of their losses. Not a study, but DIRECT FROM THE HORSE’S MOUTH. You can find it by Googling GE Medical Protective and Texas and “tort reform.” What’s your opinion on that? I mean, the centerpiece of your “cure” for this “crisis” has no effect? How’s that grab you?
So basically, you’re saying that there is no standard we can or should hold physicians to? What a job. Get paid more than any other profession, never admit a mistake, never have any professional standard for your work, and if you do screw up, you’re only paying someone under 2 year’s salary for a lifetime of pain and suffering.
Good work if you can get it.
Curious JD
This is rude of me, and I don’t wish to say it, but you are being truly – incredibly – dense. It’s a little scary to think that you might be a practising lawyer.
1. Once more, you repeat your pattern of never responding intelligently to an argument, but flit from one issue to another after being defeated at each.
In your latest post, you again fail to acknowledge that you were wrong to deny that large numbers of doctors get indiscriminately sued when they are completely and totally innocent of wrongdoing. Or, if despite the overwhelming factual evidence you still feel you are correct, to offer any sort of defense for your position.
2. Lets see where little JD has traipsed to now, shall we? He’s now flitted on to yammer incoherently about
a. tort reform and its perceived weaknesses,
b. why we should never critique studies but accept all of them
c. an astonishingly naive fantasy of how physicians perceive themselves.
In responding, I’d note the following:
1. Nowhere in this thread, not once, have I made claims about the desirability or otherwise of tort reform. Yet we have the following tirade from Ms.Panties-in-a-bunch:
How about the fact that the nation’s largest med mal insurer said that caps on noneconomic damages would affect at most 1% of their losses. Not a study, but DIRECT FROM THE HORSE’S MOUTH… What’s your opinion on that? I mean, the centerpiece of your “cure” for this “crisis” has no effect? How’s that grab you?
Well, for starters, it leads me to believe I’m wasting my time arguing with a particularly dull fellow – I never said anything like what you ascribe to me. Secondly, since you’ve now asked what I think of it, I do not think tort reform is a perfect solution to the med mal crisis. The crisis faced by doctors, and the larger problem of errors in health care delivery, is exceptionally complex and multifactorial such that any one measure (particularly one that is meant to provide symptomatic relief) will not completely obliterate the problems.
However, I do believe that tort reform can definitely be part of the solution, and the available data clearly show, on balance, that it can work. The actual data from capped states is pretty conclusive. By the way, your naivete is charming: data counts for infinitely more than claims, whoever’s mouth it came from. Folks in medicine have learnt to respect that rule.
The thing I do not like about the type of tort reforms frequently proposed is that there is a small number of plaintiffs who might be paid less than they should be paid.
A large part of that problem of course is that trial lawyers demand such an exorbitant portion of the indemnity payment. (It’s really quite shocking when you look at what they charge – I don’t think there is a single profession on earth that is as greedy. The tired excuse trotted out is that they only get paid when they win, but as a principle that’s pretty disgusting since they are basically garnishing all their money from the very people who actually may have been genuinely harmed, and secondly even then there is no justification for the exorbitant percentages – up to 50%!!)
But the system we currently have is even worse than a tort-reformed scenario – it harms a lot more people in terrible ways. Leave alone the doctors, huge numbers of whom are 100% completely blameless. A bigger problem is the shocking effect the current system has had on the practice of medicine and the health care system in general. There is huge wastage, loss of life, loss of health. Where we are at now is the worst possible scenario, and even tort reform, imperfect as it is, will be better.
Finally, in your last paragraph you go completely bonkers. I never said any of those things. I understand you must feel bad at being repeatedly owned, as the kids say, but really, you can’t expect people to take you seriously in a discussion when you behave like a raving lunatic.
Anonymous, do you write for the Onion? You must. I can only assume you’re being facetious.
It’s like you never read what I’ve written, merely what you want it to be. Which I guess is the preferred method for winning arguments when you don’t know what you’re talking about.
Of course, there’s no telling what you’ve said in any of the previous posts, because you’re too cowardly to even give a pseudonym.
Let me introduce myself – I am one of the patients that has filed suit in this case. I trusted Trover Foundation to employ the highest calibur of persons in the medical field – as had always been my prior experience – with them.
After reading this thread, I realize those of you posting here truly know very little of the “facts” as they exist. The KY Medical Association found that this doctor “proved an immediate threat to his patients” and revolked his license. Granted he has since regained them but only with certain qualifying conditions.
Missed cancers? You bet. Death due to misreadings? Yes Sir. Emotional trauma to those of us affected? Absolutely. My entire life has changed. As has the life of many others in this suit. I have gotten to know several of them through the course of this ordeal.
Are you aware there was a peer review prior to his dismissal. Amazing what was brought to their attention by his peers.
An ambulance chasing attorney? I’m sure those do exist. But that is not the case in this matter.
Lives have been destroyed. Not just patients lives – but our families lives.
Compensation is not of issue here. In fact – when initially discussing my situation with the attorney – he knew it wasn’t about money for me. No amount of money can ever replace what was taken from me and my family. It’s about putting a stop to this doctor (I use that term only because I must) before he wrecks more lives.
Curious JD,
I am looking forward to the situation when a client sues you because he got, surprisingly, the death penalty instead of life imprisonment, in a case where the “standard of care” is the latter.
Would you be so arrogant in a situation like that? Would you condemn so easily the imperfections of any imprecise science, such as medicine or justice?
Most lawsuits we call frivolous are the equivalent of a client suing an attorney because he got 12 months instead of the 9 he expected, based on his idea of justice.
How about when a radiologist grabs the wrong two x-rays from the jacket and compares two x-rays taken 20 minutes apart instead of the proper comparison of x-rays taken six days apart. Then he writes his report saying there is no change (of course) when if he had read the correct x-rays, it would have shown a raging change and severe pneumonia. Is that just a bad outcome? Then the pulmonologist says he agrees with the radiologist and says he too read the x-rays and sends the elderly patient home with severe pneumonia. The patient dies a horrible death on a respirator and the patient’s family sues. Now the pulmonologist refuses to treat the attorney’s father and has threatened to have the entire family thrown out of the clinic. He says the attorney is a criminal and the patient’s family is crazy. Well, I say hoorah because the doctor is a flaming incompetent ass who should not be allowed to treat anything. I say, patients and fellow doctors need to weed these crummy doctors out and instead of them saying they won’t treat us, we need to tell them that they are not fit to treat us. There are too many substandard doctors out there that are protected by their fellow docs and defended to the hilt by the insurance companies.They just need to clean house! If you put garbage in… you’re going to get a bad outcome!!!!
Why kill the goose. If they win the suit, they win. If they loose the suit, they can sue because they received substandard care because of the suit. Nice.
Imprecise science / art or whatever, there are standards of care that we must follow in treating patients. If we, as health professionals, did a better job of weeding out incompetents the “litigation crisis” would not exist. Some are better off in academic health professions, some are better in practice, some should not be in the health professions at all. I’ve seen some ridiculously frivolous claims by patients who were sure they had a claim, but I’ve also seen the cases in which the standard of care was not followed and as a direct result a patient was injured or died. I look at it similarly to a speeding ticket. If I don’t follow the speed limit (standard of care), regardless of the reason or excuse, I’ll get fined. I may “get away with it” 9 times out of 10, but that 10th time I’ll have a big fine. If our colleagues don’t “play by the rules,” and we don’t take them to task about it, then we all get “hit” with the increased insurance rates – just like we all are when too many people in our area are getting too many speeding tickets and having too many wrecks. That’s just the way insurance companies work. If we want lower insurance rates, we need to “police” ourselves **and** our colleagues who contribute to those rates. That includes raising heck at hospital board meetings when there is substandard care or management in any hospital department – nursing, radiology, medicine, whathaveyou. If we don’t take hold of the situation from within, we deserve what we get.
According to public records Tyler Hammond sued his physicians at St. Louis Children’s Hospital claiming negligent care when, during teh course of his liver transplantation, an IV tube leaked some fluid under his skin, causing a small chemical burn. This later was treated with a skin graft leaving a 2 cm area visible where the accident happened.
Tyler, then age 2 now 10, through his lawyer asked for more than 6 million dollars in compensation for this injury. All the while this litigation was going on he continued to recieve his care from the very physicians named in his lawsuit. We continued to provide his care because we felt that ultimately were this to go to trial that showing that Tyler and his mother continuing to choose us over all others was in stark contrast to the inflammatory language of the lawsuit documents. Eventually his lawyer dropped the case after costing us thousands of dollars and dozens of hours in deposition.
Tyler continues to receive his care from the same hospital and physicians he (his mother) believe greivously injured him.
In reading again the original post that led to this discussion – the heading was “Wanting it both ways: We sued you, but we still need you” is a bit misleading as is the previous posting.
Yes, we sued the radiologist and the Foundation. Yes we still need you. But you must consider the reasons.
The radiologist was sued because … well that issue speaks for itself. The Foundation was sued because of the cover up that followed. Eventually the minutes of the (inhouse) medical review were obtained and the disclosures prove the Foundation knew the problem yet ignored it for a long time.
We need you … yes. We do need you. We need local care in a rural area. We need you because the old saying is so true – “one bad apple does not spoil the whole bunch”. There are many excellent physicans practicing in the walls of this Foundation. And they deserve our respect, our patronage, and our dollars. They, like many of you, are the essence of the oath. The *other* one doctor in particular deserves none of that.
I agree too that you must stand up for what is right. I applaud those of you that do. YOU are the best of your chosen profession.
Thank you.
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