September 8, 2005

Doctors vs lawyers in Washington State

Voters will decide the battle over dueling malpractice initiatives in November. Both sides are trying to outspend the other: “No question facing voters this November has drawn political powerhouses the likes of those waging the battle over dueling medical malpractice measures.

The only common ground in the contest, which has shattered fund-raising records, is this: The stakes are highest for patients.

Combined, the two sides have raised more than $8 million for their competing Initiatives 330 and 336, which offer dramatically different takes on overhauling the state’s malpractice laws.”



Related posts:

  1. Mississippi: What happened after tort reform
  2. "Searching for a snowman in a blizzard"
  3. 11 electronic medical record posts you may have missed
  4. My take: Funding geriatrics, electronic records, CT-cardiac scans
  5. The Texas stampede of physicians
  6. Hedge fund managers vs doctors
  7. Universal health care = political suicide?


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{ 58 comments }

1 Curious JD September 8, 2005 at 8:13 am

I wonder if the members of the Wash. State Medical Association, who have had $780,000 spent on this, realize that over the last 4 years, the nations 15 largest malpractice insurers have tripled premiums while claims remained flat, and have 3x the amount in reserves that they did in 2000?

2 Anonymous September 8, 2005 at 8:22 am

I wonder if the members of the Wash. State Medical Association realize that when we advise new graduates of our Emergency Medicine residency program we strongly urge them to avoid Washington State due to it’s malpractice climate. This is difficult since Seattle is such an attractive place to live.

3 Curious JD September 8, 2005 at 9:14 am

What a dumb thing to do. I would imagine you have no idea of the amount of claims filed or paid in Washington state as compared to other states.

Perhaps your residency program should stick to teaching medicine, where the instructors know what they are talking about.

4 Anonymous September 8, 2005 at 1:39 pm

Look I hate to say it but the ‘right or wrong’ aspect of the malpractice situation is moot.

The fact is doctors believe that there is a malpractice crisis and it affects them. It affects where they practice and it affects how they treat patients. Which without a doubt hurts patients. From a utilitarian viewpoint the physician’s response to this precieved malpractice crisis is hurting the collective patient body more than say, a cap on their ability to collect punitive damages.

Take an area that will see a half dozen malpractice claims filed over a year, but will see hundreds of head and spine injuries over that same period. There neurosurgeon has left because of a percieved medical malpractice crisis in the area. I’m making up numbers, but that’s not an important, because people like Curious JD have run around making a point of how view malpractice claims are actually filed. The hundreds of people affected by the lack of a brain surgeon in the area far outweigh the damage done to the plantiffs.

It doesn’t matter really if there’s a crisis or not, only that that brain surgeon believes there is and the only way to get him back is for the people of Washington state to represent their own interests (cause, the point I’ve tried to make is their interest really is their health over their ability to collect damages) and vote for some sort of cap on malpractice suits.

5 Anonymous September 8, 2005 at 2:53 pm

And to make it even simpler, whether realistic or not, you’re not truly my patients anymore. There’s a built-in antagonism. You’re out to sue me and take away my assets. That makes you no better than the mugger who held a knife to my neck when I was 15 years old to get my gold chain. That’s how I view lawyers. That’s how I view the belligerence in the health care system. I see no difference between Curious JD & the dude who stood behind me and held the blade of the knife to my neck. You’re both out for the same thing. How can I be expected to put the patient first? No, I have to put defense first.

6 Curious JD September 8, 2005 at 3:06 pm

Putting aside Anonymous 3:53’s Chicken Little complex, let me address 2:39.

Are you really advocating that we cap liability based on any irrational fear? If physicians were all told that driving on pavement increased their fear of lawsuits, should we all drive dirt roads? After all, access to health care is more important than access to asphalt isn’t it? Or because the media reported shark attacks in Florida one year that must mean there is an outbreak and all sharks must be killed?

What an odd argument. You don’t want to know how much your insurers have historically paid in claims, you don’t want to know how much they’ve collected, what their rate of return is, what they spend their money on. It’s simply enough that you think it’s bad and hate lawyers. That’s hardly a utilitarian argument. It’s a hysteria argument.

And of course, the claims of physicians leaving can’t even be directly tied to malpractice, and in most cases have been debunked.

Thank goodness for the Constitution.

7 Rich, MD September 8, 2005 at 3:24 pm

No, we shouldn’t do anything based on irrational fear.

Like chest x-rays to detect lung cancer, or CA-125 to detect ovarian cancer, or routine urinalyses to detect bladder cancer, or treat viral infections with antibiotics. Or offer a reasoned rational approach to prostate cancer screening and allow the patient the option to opt out. Or create media campaigns about the evils of statins. Or find against Merck for $253 M because their drug has some bad side effects, none of which occured in the plaintiff. Or order CT scans for everyone who comes to the ER with abdominal pain. Or CTs of the head for every nursing home patient who arrives by ambulance. Or MRI for every patient with a headache.

8 Curious JD September 8, 2005 at 4:21 pm

“Or find against Merck for $253 M because their drug has some bad side effects, none of which occured in the plaintiff.”

Rich, I assume you heard the testimony of the Plaintiff’s expert, Dr. Isaac Weiner of UCLA? Or you reviewed the deceased’s medical records? Or the studies on Vioxx?

By the way, I read a lot of doctor’s reports. You guys are ordering a lot more tests than your colleagues who treat my clients. Not too many MRIs because of a single reported headache. Or you are all Chicken Littles.

9 Rich, MD September 8, 2005 at 4:51 pm

I assume you heard the testimony of the Plaintiff’s expert, Dr. Isaac Weiner of UCLA? Or you reviewed the deceased’s medical records? Or the studies on Vioxx?

Some but not all. But the jury has admitted that it ignored the medical/scientific evidence anyway, so what’s the difference? And the “expert” is entitled to his opinion – doesn’t mean that what he said is true (argumentum ad verecundiam – to follow the thread of our friend who likes to poiint out genetic fallacies).

BTW, it’s amazing how many patients leave angry that I won’t order the MRI. One day one of them will have a tumor. Expect a call.

10 Curious JD September 8, 2005 at 6:00 pm

” But the jury has admitted that it ignored the medical/scientific evidence anyway, so what’s the difference?”

Actually, the “jury” admitted no such thing.

The reason I mention him is because I was wondering how you ended up disagreeing with his opinion since you hadn’t reviewed the evidence?

11 Curious JD September 8, 2005 at 6:13 pm

By the way Rich, Dr. Weiner is a graduate of Harvard Medical School, and now teaches at UCLA. He is board certified in internal medicine, cardiology, and cardiac physiology.

He DID review Mr. Ernst’s records and concluded that Vioxx was the cause.

12 Rich, MD September 8, 2005 at 6:41 pm

So what? His opinion is his opinion, even if he is an authority. There are other opinions that differ. Is there an objective means by which we can select between two equally qualified positions that differ?

Are you sure that there has never been a medical conclusion by Dr. Weiner that has ever been refuted? No one ever disagrees with Dr. Weiner’s opinions about his patients? Wow.

BTW, what do you call the person who graduates last in his class from Harvard Medical School?

13 Anonymous September 8, 2005 at 7:31 pm

“I would imagine you have no idea of the amount of claims filed or paid in Washington state as compared to other states.”

Just as you had no idea how much was paid in claims in Texas since 1997 until I pointed it out to you.

14 Anonymous September 8, 2005 at 7:33 pm

“What an odd argument. You don’t want to know how much your insurers have historically paid in claims, you don’t want to know how much they’ve collected, what their rate of return is, what they spend their money on.”

You don’t either, at least not in Texas.

15 Curious JD September 8, 2005 at 8:33 pm

“Is there an objective means by which we can select between two equally qualified positions that differ?”

Sure, we could review the testimony and evidence. Once we’ve done that, then we might have the knowledge to criticize the people who did.

“You don’t either, at least not in Texas.”

What I do know about Texas though, is that the nation’s largest insurer told them that their noneconomic caps would affect at most 1% of their losses, and that’s why they were requesting a rate increase. Bummer for your argument, eh? Or are you the guy who is still excited that your increase in premiums was only 95%

16 Anonymous September 8, 2005 at 8:40 pm

“By the way, I read a lot of doctor’s reports. You guys are ordering a lot more tests than your colleagues who treat my clients. Not too many MRIs because of a single reported headache. Or you are all Chicken Littles.”

This goes to show you. To hell with the radiation. To hell with health care dollars. If we CT Scan and irradiate every little bugger who walks into the ED, order blood tests till patients are anemic, bankrupt the economy by admitting every patient that walks into the ED, we protect ourselves against sharks like Curious JD. Just remember these people are out for your personal assets, like a downtown mugger, so test away.

17 Anonymous September 8, 2005 at 8:43 pm

“Not too many MRIs because of a single reported headache.”

MRI is not the evaluation tool for a benign headache. CT, then Spinal Tap. They usually end up with a post-lumbar puncture headache worse than the headache that brought them in initially, but that’s their problem (I consent them and explain this risk) the poor buggers came to me with their benign headaches, and there are a–holes like CJD just waiting for me to miss one and take away what I do for a living.

18 Curious JD September 8, 2005 at 9:18 pm

The sky is continuing to fall, I see.

You poor, poor, Anonymice.

19 Samson Isberg September 9, 2005 at 9:49 am

What it all comes down to is this: If you wish to keep a population of a certain species, like (e.g.) bald eagle or bottlenose dolphins, you restrict the hunting season on them or ban hunting them altogether.
- So if the (e.g.) state of Pennsylvania finds the local population of obstetricians on the brink of extinction, the first logical step would be to ban hunting them, right? Instead you keep open season until they’re all gone. Doesn’t sound like a wise policy to me.

20 Anonymous September 9, 2005 at 10:01 am

Thanks got I don’t bother going to the doctor for a headache or colds, do my own research. I really wish I didn’t have to as it takes too much of my time.
curious jd, you might not realize it but there are some patients who want honest information about real probability of benefit (absolute not relative) as well as probability of harm and want a right to decide for themselves without being pressured or lectured. But in the current climate there is no chance of that.

One other thing. Rich D, I understand why a fear of malpractice would make a doctor send a smoker for a lung X-ray, but what I don’t understand is why a doctor would go on TV and tell millions of people how every smoker should have this test. (no, I don’t smoke, it’s just an example) This is what was said a couple of weeks ago on Foxnews Sunday Housecall. How can this be justified? The doctor on TV is not going to be sued – he doesn’t have to talk about the subject at all or he can make usual “talk to your own doctor” disclaimer. Patients haven’t gotten ideas “earlier is always better”, “there is no downside to screening” out of thin air – they were conditioned to do so by doctors adn the media (who gets the idea from the doctors). Also, look at many clinics’ websites, even including Mayo clinic’s: they all glorify the benefits of many tests without ever mentioning the single biggest harm – overdiagnosis and overtreatment. Actually I wrote to Mayo clinic website once asking why they never mention overdiagnosis as one of the harms of a particular test. They sent back their usual disclaimer “we don’t offer medical advice talk to your doctor”. The thing is – I haven’t asked for a medical advice; I didn’t even give enough details of myself – beyond sex and age. I made a generic comment about website content, and I got a brush-off. I think if more doctors websites and more TV programs start giving open and honest information, the mindset might change. I think Welch’s “Should I be tested for cancer” should be a required reading for both doctors and lawyers.

21 Samson Isberg September 9, 2005 at 10:30 am

The thing is, almost on a weekly basis the media reports (with big headlines) a doctor recommending this or that test as being “life-saving”. More often than not, what the particular doctor wants is for the taxpayer to chip in so that the test can be made on everyone, bringing more government funding to the said doctor’s pet project,thereby increasing his prestige as well as his bank account. What the media want are headlines.
When these doctors are confronted with the headlines in a collegial forum (by disgusted colleagues like myself who have to fend off the nervous public feeling their lives can’t go on without this new test), they always hide behind the same mantra: “the journalists made up that story; I didn’t mean for it to come out that way”.
That argument must be hollow by now. It’s time to actually make these “taking heads”-doctors responsible for the headlines they make. If a scientific discovery is so useless that the scientist has to use the tabloid media for publishing, he ought to be banned from the scientific media – for ever.

22 Rich, MD September 9, 2005 at 11:23 am

One other thing. Rich D, I understand why a fear of malpractice would make a doctor send a smoker for a lung X-ray, but what I don’t understand is why a doctor would go on TV and tell millions of people how every smoker should have this test…

I think Dr. Isberg has proposed one likely explanation. Certainly “everyone should do this test” is sexier than “this test might be useful to some people.”

But the fact of the matter is that Dr. So-and-So on TV really is “just playing a doctor on TV.” He is not giving medical advice, which you can tell when they conclude with “check with your doctor.” These media docs’ motives may be that if they have nothing newsworthy to report, they have no job on the news.

What’s equally frustrating and incomprehensible is that these media docs are given more credibility by the public than their personal physicians that they have known for years. It’s sort of like “he must know something special or he would not be on TV.” The fact is likely that he does not know anything special, but he knows some special people who are in a position to get him or her on TV. That a patient would look askance at their personal physician of years when s/he disagrees with the TV doc is also questionable behavior.

The Mayo web site is an ad – trying to sell their services to the public. Why would they tell you the downside if they don’t have to? Even if you respond to the the ad, and seek out their services, and are told of the downside, you are now a customer, and there is a world of other services they can offer you as well.

23 Curious JD September 9, 2005 at 12:04 pm

You know, Rich, it’s kind of funny you say that, because I deal with that in my own practice. I don’t know how often I hear that “So and so in the paper got millions so why is the insurer offering so little on my case?”

Half of my job is countering the media to instill realistic expectations in my clients.

24 Curious JD September 9, 2005 at 12:06 pm

“So if the (e.g.) state of Pennsylvania finds the local population of obstetricians on the brink of extinction, the first logical step would be to ban hunting them, right? Instead you keep open season until they’re all gone. Doesn’t sound like a wise policy to me.”

Cute analogy, Sam, if not particularly applicable. See, PA lost two insurers two what the Dept. of Insurance claimed was gross financial mismanagement and one was simply looted. The other insurers, and the taxpayers, had to pick up the tab.

So how will screwing some really hurt people over help PA insurance executives do their jobs better?

25 TXMed September 9, 2005 at 2:59 pm

I’m sorry, I don’t want to get into hate speech, but I’m trying to judge people’s critical thinking skills in this debate and I was Curious JD, what you got on the LSAT, if you remember?

That standard test in particular seems a pretty good measurement of your reasoning ability.

I know you get a lot of slack here :) But it is a doctor’s board so you must find some pleasure in the arguments if you keep coming back.

In any case, I’m a little put off by this analogy,

“Are you really advocating that we cap liability based on any irrational fear? If physicians were all told that driving on pavement increased their fear of lawsuits, should we all drive dirt roads?”

It lacks almost all the characteristics of a reasonable analogy. I understand your use of hyperbole but, I’m not sure this is the place for it. Let’s put this to a ‘reasonable person’ test. Reasonable people can disagree on malpractice caps…no reasonable person thinks driving on asphalt causes increased malpractice premiums.

Using this as an analogy seems like poor rhetoric and would’ve gotten me kicked off my debate team (just kidding).

You follow it with another analogy,

“Or because the media reported shark attacks in Florida one year that must mean there is an outbreak and all sharks must be killed?”

So the doctor’s are like the media in this case? I would think the media is like the media. A better analogy would be that if the Coast Guard, an authority on the issue, reported people were getting eaten by sharks and then called for all the sharks to be killed…hey, I’d personally think that was reasonable. But I can certainly see differing opinions here.

“That’s hardly a utilitarian argument. It’s a hysteria argument.”

No, IF, and a big that’s a big if, you take the original ‘points’ made at their value, it is a utilitarian argument. Whether it’s right or not, the most utilitarian act for patient health is to cap malpractice awards. Because, the care lost by doctor’s FEAR of non-capped awards (whether valid or not) is far more costly to a far larger number of patients than the loss of some monies to be paid upon physician negligence to a small number of people. If the voters in Washington are the actors in this debate then from their viewpoint it is entirely sound to say that voting for the caps is a utilitarian action.

“And of course, the claims of physicians leaving can’t even be directly tied to malpractice, and in most cases have been debunked.”

There’s a legit debate on the cause of malpractice premium increases. There’s a debate on the COST of defensive medicine. But there’s no arguments that doctor’s aren’t the best represenatives of their own motives. If the last neurosurgeon in southern Illinois reports moving out of state because of higher malpractice premiums or because there’s no cap, then that’s why he moved out of state. I don’t see the ifs, ands, or buts here.

I think there are legitimate arguments against the post. For one, it seems to me most physicians report leaving areas because of malpractice premiums not because they’re upset about a lack of caps. If that’s the case then the argument must assume that malpractice caps will lower premiums to bring physicians back to the area. If it has to assume that then there’s really no argument at all.

26 Elliott September 9, 2005 at 6:34 pm

Come on, txmed, why would I assume that doctors are objective reporters of their motives? In fact, I know it to be otherwise. At least three doctor blogs cited an article that credited the Texas tort reform in 2003 with increasing physician services over the last two years. None of these three retracted their comment or updated their entry when I pointed out that the increase in Texas in the previous two years had been greater in absolute and percentage terms. This held true for the specialties cited and for the counties cited. This was based on the same information that the original article used except the original article only cited the information from 2003 to 2005. Were these doctors uninterested observers in their reporting of the original article or did they have an agenda?

I can think of plenty of reasons doctors report leaving because of malpractice rather than the fact that maybe they don’t like the rural environment, maybe the money is better somewhere else, maybe they perceive their colleagues as lower quality, maybe they don’t like the poverty of their patients. All of those reasons might be more embarassing to state than to blame malpractice. The truth is the problems with underserved rural areas is uniform across the malpractice “crisis” states and the non-crisis states.

27 Curious JD September 9, 2005 at 6:41 pm

TXMed,

I will admit to imperfect analogies. It’s the perils of multitasking.

But you seem to be arguing, and correct me if I’m wrong, that it doesn’t matter what the real cause of high premiums is – what matters is what physicians THINK it is. Therefore, we should change policy based on their perception, regardless of reality.

Assuming one can do that with a straight face, what do we do when the premiums don’t fall?

28 Anonymous September 9, 2005 at 7:12 pm

Dr. Elliot lectures:

“I can think of plenty of reasons doctors report leaving because of malpractice rather than the fact that maybe they don’t like the rural environment, maybe the money is better somewhere else, maybe they perceive their colleagues as lower quality, maybe they don’t like the poverty of their patients.”

Or maybe some, like me left at age 46 precisely because of the malpractice crisis. It’s too bad for the public because I was quite good at what I did and there is a severe shortage of practicing docs in my field (radiology). I might’ve practiced 10-12 more years but since I had enough money to quit I figured why risk losing it to some jerkoff lawyer trying to hit the lotto at my expense.

29 Anonymous September 9, 2005 at 7:15 pm

“But you seem to be arguing, and correct me if I’m wrong, that it doesn’t matter what the real cause of high premiums is”

If you poll most physicians, even if the Lottery system has no effect on Malpractice premiums, they would still oppose it. It sucks that a whole profession gets a free ride because no matter what we do, young people have bad outcomes. If a young person dies, someones gotta pay.

30 Anonymous September 9, 2005 at 10:30 pm

Ohh, the injustice of having to retire at 46. How do you cope with the misery that has befallen you?

31 Anonymous September 10, 2005 at 6:31 am

Maybe the above retiree made good investments. Maybe he worked his ass off 16 hours a day, 7 days a week. Maybe he had old money. Maybe he lived way way under his means.

Myself, I am 44. I just paid off my medical school loans a few years ago. I was not making money really until finishing residency at age 33. My friends who became policeman, fireman right after high school, now have enough time in to retire with a pension. I have no pension, other than what I can save. It is not a sob story by any means, but it is not a way to become rich.

32 Anonymous September 10, 2005 at 12:48 pm

I too am a physician who avoids medicine because I don’t want a lawyer to rape my assets. I can’t afford to retire, but I work half-time, as minimal as possible but enough to eat and pay bills. The rest of the time I have a business, which isn’t very profitable but I don’t risk my assets doing it, like medicine. Every dollar I earn makes medicine less attractive as it becomes another dollar that can be stolen by a lawyer. I don’t see it as retiring, I see it as escaping with the shirt on my back. I never thought I would be terrified to go to work every day, and sign charts, like I am. I’m not whining, I’m stating a fact.

33 Anonymous September 10, 2005 at 12:50 pm

“Ohh, the injustice of having to retire at 46. How do you cope with the misery that has befallen you?”
It actually befalls you. Don’t cut your hand today and go to an ER expecting to see a Hand Surgeon. The ER won’t have one on-call, because they have deserted medicine, due to the liability.

34 Anonymous September 10, 2005 at 4:53 pm

“Maybe the above retiree made good investments. Maybe he worked his ass off 16 hours a day, 7 days a week. Maybe he had old money. Maybe he lived way way under his means.”

Dead on right. As a matter of fact, I had all of those things going for me. I’m 51 now and am in the best shape of my life. I’ve lost 20 lbs and I’m normotensive again. I’ll be doing a triathlon next month. I feel like I’m 20 years old whereas I always felt like I was 70 when I practiced. I only wish that more of my colleagues could get out of medicine and start enjoying life again. My ex-partners are very jealous of me. :)

35 Anonymous September 11, 2005 at 11:18 am

“It actually befalls you. Don’t cut your hand today and go to an ER expecting to see a Hand Surgeon. The ER won’t have one on-call, because they have deserted medicine, due to the liability.”

Except for the fact that all of these claims have been thoroughly debunked, that would be true.

Oh, the miserable plight of the physician. How do you guys cope?

36 Anonymous September 11, 2005 at 11:21 am

Good luck in your triathlon.

I (anon 7:31) have been sued 5 times in last 3 years. They are all bogus. I have gotten dropped by two and fully expect to win or get dropped from the remaining. But it is such an expensive, time consuming pain in the ass. I have cut back on my hours and dabbled in triathlon and marathons as a method to manage the stress. It takes about 10 freaking miles before I am too tired to worry about it.

37 Anonymous September 11, 2005 at 12:01 pm

“Except for the fact that all of these claims have been thoroughly debunked, that would be true.”

Debunked? How? What fairy tale place do you live in?

From 1990-2000 about 500 hospitals have closed. From 1997-2000 over 1100 emergency departments have closed despite 10% increase per year in the number of visits. (sources – American Hospital Association, Lewin Group Workforce Study, American college of Emergency Physicians)

At my hospital you will not find a hand surgeon, plastic surgeon, ENT surgeon, neurologist, intensivist, vascular surgeon, oral surgeon, gastroenterologist that is on call to treat emergencies. The best insurance in the world wont necessarily get you any of those specialists either. We aren’t a podunk little hospital in rural america, we are a trauma center in a major metropolitan area.

My advice: don’t get injured or sick. Or if you do, know how to treat your own stroke, fix your own jaw, cauterize your own GI bleed, repair your own triple AAA, repair your own daughters dog bitten face, repair the tendons in your hand, etc…. Or expect delayed care, transfered care, nonspecialist care. And of course, you can always sue somebody if you don’t like your outcome which is exactly why this problem exists.

38 Curious JD September 11, 2005 at 12:56 pm

“From 1990-2000 about 500 hospitals have closed. From 1997-2000 over 1100 emergency departments have closed despite 10% increase per year in the number of visits. (sources – American Hospital Association, Lewin Group Workforce Study, American college of Emergency Physicians)”

Why did these hospitals close? Do you have any clue beyond your unsupported opinion?

Seriously, as a physician, is this how you reached conclusions? You had an answer you wanted anyway, so you did no further investigation into the facts? If you’re the retired anonymous, thank goodness you are retired if that’s how you diagnosed problems.

Here’s an article you might find of interest. It describes the number of closings in California. Interestingly, despite draconian caps AND insurance reform, hospitals are still closing there. And they don’t seem to be blaming it on malpractice. Maybe they don’t have your impressive ability to reach conclusions without knowledge?

http://www.larouchepub.com/other/2004/3138cal_hosp_cuts.html

39 Curious JD September 11, 2005 at 12:59 pm

You might also enjoy this one from California – from BEFORE the alleged liability crisis started:

http://www.nurseweek.com/features/99-5/hospital.html

And here’s another article which might help you:

http://www.rwjf.org/reports/grr/028054.htm

40 Anonymous September 11, 2005 at 1:44 pm

“Do you have any clue beyond your unsupported opinion? ”
What do you think those of us in the healthcare field do at work. Do we show up, find a bathroom, and spend the day masturbating? No, we are living this crisis you created. If I have a patient whose airway is closing off and needs a tracheotomy, I have to put him in an ambulance and transfer him 10 miles to another hospital. Why? Because our ENT surgeon quit after the most bogus bullshit lawsuit imaginable. If a pregnant woman shows up, and she’s bleeding, I have a choice: deliver the baby myself in the ER, or put her in an ambulance and hope she makes it to a hospital with OB-GYN. Why? Our hospital got rid of Obstetrics. Again, I work in an Urban Hospital too. I don’t know why we argue with you. You argue for a career, and our facts and the fact that we are in crisis because of what you do never seems to get in the way of your “arguments” At least admit you’re full of it, but your parasitizing makes for a good living.

41 Curious JD September 11, 2005 at 2:03 pm

Instead of all your fear mongering, why don’t you share what hospital it is so we can look at the facts ourselves. Your credibility is lacking, to say the least.

Perhaps you didn’t read all (or any for that matter) of the links, but it’s pretty clear liability fears aren’t why hospitals are closing. Oh, and the GAO looked into your claims of all these physicians leaving, quitting, etc. It turns out they were “unsubstantiated” or occured in places which had always had trouble recruiting physicians.

Urban hospitals all over are closing, moron. Why? Because they aren’t being reimbursed for care. Again, read the links.

I realize you have a bogeyman to hunt, but at least do a LITTLE research.

42 Anonymous September 11, 2005 at 5:43 pm

If you hadn’t failed out of pre-med, like most of your parasite brethren, you would have learned in Med school that most problems, like urban hospitals closing, is multifactorial. Lack of reimbursements is one problem. It doesn’t help that they have to waste so much money protecting themselves from parasites like you. I’ll tell you what hospital if you tell me where you work. Oh wait, I forgot, I can’t trust you, Law is the least trusted profession in America; never mind.

43 Anonymous September 11, 2005 at 6:17 pm

By the way JD, you changed the subject tro one that suits yourself (Wow a lawyer would never do that would he?) If you go back some slimeball mocked the lucky radiologist who saved enough money to get out of this horrible profession, so “some lawyer won’t win lotto off me”. The slimeball said:
“Ohh, the injustice of having to retire at 46. How do you cope with the misery that has befallen you?” And I answered that the patients are the victims now, because specialists refuse to take Hospital Call because of the medico-legal risk (why my hospital has no OB-GYN or Hand surgery) Suddenly you start talking about hospitals closing due to financial problems. What the hell does that have to do with the fact that I can’t get a hand surgeon to come to my hospital? That works in your “hood” but not here.

44 Anonymous September 11, 2005 at 6:46 pm

Anonymous #2,

I didn’t change the subject – you did. You posted about X number of hospitals closing and were saying it was all the lawyers’ fault (again, it’s never the victim who gets mentioned). So I exposed the ignorance of that statement.

Since no one has any way of verifying your claims, why should anyone believe you? You won’t even say what hospital you work at. And your deductive reasoning is always horrible. You make claims with no proof whatsoever on a routine basis. Back this one up and maybe we can discuss it. For now, it’s just your statement. Nothing more.

And the guy crying about retiring at 46 should be mocked. Tell you what, since he and you have it so miserable, why don’t you trade places with one of those “lottery winners” who had an injury bad enough to get a million dollar non-economic verdict? After all, they’re the ones with all the money they don’t deserve, right?

CJD.

45 Anonymous September 11, 2005 at 7:14 pm

cjd

You are moron. Go ahead, make some long bag of wind post about insults.

You don’t need the name of my hospital or any hospital in particular. Except for teaching institutions, call just about any hospital you want and there will be specialty deficits in emergency department back up panels — but not because those doctors aren’t around. Liability is the reason. Most docs used to do it for free and enjoy, now they loathe it even if they get paid. We all know it. You don’t. Write another post about doctor hysteria, or how a jury of Jr. college drop outs can thoroughly understand a medmal case, but doctors are too dumb to understand insurance concepts. We will all ignore you.

46 Anonymous September 11, 2005 at 7:15 pm

“And the guy crying about retiring at 46 should be mocked.”

Hey Einstein, if you’d learn to read then you’d see I’m not crying about it, I was just rebutting Dr. Elliots’s faulty premise that docs don’t retire early to avoid losing money in the lawsuit lottery that you and him love so much. In fact I’m thrilled about my retirement and am greatful that I was able to retire early so leeches like you won’t be able to take my hard earned dough.

I’m loving my life away from medicine and very much enjoy tormenting know-it-all, condescending a**holes like you and Dr. Elliot on this blog. :)

47 Anonymous September 11, 2005 at 7:18 pm

For someone who enjoys it so much, you sure seem awfully bitter. You’re even cussing at people on a Internet message board, for goodness sake. If I was retired, I think I’d be a lot happier.

Good luck with that.

Anonymous 8:14, how come there are specialty shortages in states with the most restrictive liability limits? I’ll continue making you look silly until you realize that you have no clue how insurance rates work and do some actual research. Good luck to you, too.

CJD

48 Anonymous September 11, 2005 at 7:25 pm

Mr. Einstein/CJD,

LOL – looks like it’s working – it took you all of two minutes to respond to my comments. Do you do anything other than constantly monitor this blog? Get a life, dude.

49 Anonymous September 11, 2005 at 7:38 pm

Yes, I’d rather get the million bucks you can pillage for me when a cousin I didn’t give a shit about or ever visit suddenly dies and some unlucky doc had just seen him, then have to work in what you’ve turned into a shithole profession.

50 Anonymous September 11, 2005 at 7:39 pm

CJD, what are you going to do when they finally catch on and stop letting you molest the healthcare system with your lottery bullshit? You seem to worry alot about insurance, maybe you can clean up after the AFLAC duck. AFLAC!!

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