Thursday, May 31, 2007
Flea
Stunning news. The Boston Globe on Flea, his trial and how his blogging ultimately led from a possible victory to settlement:As Ivy League-educated pediatrician Robert P. Lindeman sat on the stand in Suffolk Superior Court this month, defending himself in a malpractice suit involving the death of a 12-year-old patient, the opposing counsel startled him with a question.There is no anonymity on the web. If you blog under a pseudonym, people will find out who you are if they really wanted to. So with that in mind, blog as if the whole world is reading and knowing who you are.
Was Lindeman Flea?
Flea, jurors in the case didn't know, was the screen name for a blogger who had written often and at length about a trial remarkably similar to the one that was going on in the courtroom that day.
In his blog, Flea had ridiculed the plaintiff's case and the plaintiff's lawyer. He had revealed the defense strategy. He had accused members of the jury of dozing.
With the jury looking on in puzzlement, Lindeman admitted that he was, in fact, Flea.
The next morning, on May 15, he agreed to pay what members of Boston's tight-knit legal community describe as a substantial settlement -- case closed.
It's unfortunate for all concerned. For Flea obviously. But also for the medical blogosphere. The strength of blogging is its inherent openness and allowing the curtain to be "pulled back". Now, every post will be filtered through this question: "Will this ever come up in a malpractice trial against me?"
Flea, we'll miss you and sorry to see things turn out this way.
Update:
Plaintiff attorney Eric Turkewitz called it correctly and has a roundup of the ordeal:
Finally, this case was a tragedy for two parents, and a nightmare for a doctor. If the parents had lost the trial, it would have added yet another layer of extraordinary emotional trauma. If Flea lost, it would no doubt been emotionally difficult for him. A settlement allows each to move on with their lives without the additional fallout of a jury's verdict. The parents might feel they had their day in court and that the settlement was based on the merits, while Flea might feel it was based on his own carelessness with his writing and the concerns a jury might not like the way his legal team was trying to manipulate the jury. Neither won and neither lost. And sometimes that is all for the best.MetaFilter comment:
"But when I look at this case, I wonder what we've lost. Expert analysis of issues in the pediatric and medical community. Transparancy into the behind-the-scenes aspects of our legal proceedings. Eloquent and insightful content, now gone because your opinion can be a legal liability."
N=1:
"Bloggers have no real protections against the invasion of their privacy. The healthcare blogging community is the poorer for the loss of Flea’s insights, passions and wit."
Update 2 -
The Boston Globe with blogger reaction, including mine:
"'It's a little bit sad in a way. The whole purpose of blogging is to be open and pull back the curtain to talk about how it really is,' he said. 'So the question is, how realistic is that? I think that's what physicians and other health professionals are wrestling with right now. It's part of the growing pains of the medical blogosphere.'"
symtym:
"Arrogance, ignorance, or both? Dr. Lindeman’s most potent defense was his character—a character the Flea so thoroughly impeached—case over and settled. Hosea 8:7. For they sow the wind And they reap the whirlwind."
Mary Johnson:
"Anyway, a lot of people will be mulling this one over for a long time to come. The lawyers are already spinning it as a 'win-win' (I expect Flea doesn't feel that way). Doctor-bloggers are bemoaning 'the loss' of expert analysis, transparency, insight, passion, wit (it's a long list . . . for the physician known in the blogosphere as 'Flea' is a gifted writer)."
Althouse:
"Here's a tip. Don't blog anonymously unless you're ready to accept all the consequences that would come if everyone suddenly knew it was you. Congratulations to the lawyer who figured out that she should ask that question on cross. You know, I love to support bloggers, but this doctor totally deserved what he got."
Update 3 -
David Catron:
"Flea’s case wasn’t settled on the merits. It was settled because of a few intemperate posts on his blog. Now, there will be lawyers and paralegals all across the country trolling the web for blog posts by anyone connected with a medical defendant. Will they be doing so in states where tort reform has been enacted? I doubt it."
#1 Dinosaur:
"Flea -- and all of us -- have a right to blog anonymously. This also means we should have the right not to be compelled to renounce that anonymity. Anonymous blogging didn't have anything to do with the medical case at hand. What business did the attorney have bringing it up in court at all? Answer: she didn't. So I repeat, where the HELL was Flea's lawyer when that question was asked?"
OnThePharm:
"It saddens me when a case is settled not on the facts of the case, but rather on issues that are only tangentially related to the matter at hand, at best. That said, perhaps Flea was confident in his anonymity, but probably shouldn’t have been."
Ami Chopine:
"It is you and it will sadly be the general public, who do not understand the nature of Flea’s blogging. He was anonymous. We could not check. But Flea’s articles, sharp as they’d sometimes been, had always consisted of sound science. Moreso, the frustration he often expressed was a mark of his compassion for the children under his care. In the blogging world, he was a model of integrity and compassion.
If you accuse of bloggers who defended him of ’not having the whole picture’, you must accuse yourself of the same thing.
To the lawyer, Mulvey, who claims to have read his entire blog: where is your integrity? Is it truth or power that you love? Is it compassion or money?"
Update 4 -
Kinohi Nishikawa:
". . . the prosecution was able to cast doubt on the Lindeman's character -- precisely because 'Flea' and 'the real 3-D doctor' turned out to be the same person, the same 'cocky bastard.' Here Lindeman's metacommentary doesn't realize its own ironic condition of possibility: that forcefully stating the difference between Flea and the 'real' doctor only serves to underscore their inextricability. (You know the type: 'Really, I'm not like that -- in fact, I did it just to remind myself how different I really am!') This rhetorical move amounts to Lindeman denying his very real investment in Flea as both a cathartic release and an agent, however modest, of public opinion."
Eric Turkewitz:
"Saltzman informed me during our conversation yesterday that Flea's attorneys were unaware of the blog, which means of course, that Flea didn't tell them and he wasn't prepped by his attorneys on the subject on how to deal with it if it should come up."
David Harlow:
"This takes the questions about propriety of physician blogging to a whole new level."
Update 5 -
Orac:
"My bottom line on this is simple. The case of Flea is not the dire signal about the demise of the medical blogosphere that some have been making it into and that I briefly fell for. Rather, it's a wake-up call about reality. The First Amendment guarantees us freedom of speech and allows us to speak with anonymity. However, just as it does not insulate us from being offended by other people's speech, it also does not insulate us from the consequences of what we say publicly."
Notes of an Anesthesioboist:
"The discovery process can't stay the same after this - it hasn't been the norm to request blogs, myspace pages, and such, but attorneys are now clearly going to have to take various types of records into account and adapt to the Internet age."
#1 Dinosaur:
"Although a doctor's personality, appearance and demeanor on a witness stand are seen as proxies for behavior with patients, I fail to see how actions (or writings) outside the courtroom or exam room have any relevance to the questions that come up in a malpractice trial. I know that's how the world *does* work. My question is, should it? I say no."
Posted by Kevin |
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Comments:
In most settlements (be they malpractice or not), whoever is doing the paying does not generally admit "guilt". I'm not suprised this case was settled after Flea's identity was revealed. If the trial had proceeded from that point, it would have been a circus.
The Boston Globe article says nothing about the specific allegations in the case (which has always been a bit of a mystery as, to my best recollection, Flea did not discuss the medical specifics) . . . just that Flea "failed to diagnose" diabetes in a twelve year old and the child died six weeks later.
Since this cat is out of the bag (and if Flea was denied a "possible victory" on the medical merits simply because he was a prominent blogger), it's probably important now for the medical blogosphere to examine the facts of the case (if the legal theory is that the facts actually matter).
It's all public record. There should not be any privacy issues to tap dance around.
The Boston Globe article says nothing about the specific allegations in the case (which has always been a bit of a mystery as, to my best recollection, Flea did not discuss the medical specifics) . . . just that Flea "failed to diagnose" diabetes in a twelve year old and the child died six weeks later.
Since this cat is out of the bag (and if Flea was denied a "possible victory" on the medical merits simply because he was a prominent blogger), it's probably important now for the medical blogosphere to examine the facts of the case (if the legal theory is that the facts actually matter).
It's all public record. There should not be any privacy issues to tap dance around.
Flea may be book-smart but I don't think he's street-smart.
He failed to consider the worst case scenario in both situations, in caring for the patient and in blogging the trial while it was ongoing.
He failed to consider the worst case scenario in both situations, in caring for the patient and in blogging the trial while it was ongoing.
# posted by 
: 8:52 AM
: 8:52 AM
in light of flea's misfortune and the sermo-ama partnership, i've been wondering what the difference is between what sermo does and medical blogging?
after looking at sermo's site and seeing that it is filled with discussions of actual cases draped with ambiguity no different than on a medical blog, i was left wondering what the difference is between what they're doing and what medical bloggers are doing....
am i crazy?
after looking at sermo's site and seeing that it is filled with discussions of actual cases draped with ambiguity no different than on a medical blog, i was left wondering what the difference is between what they're doing and what medical bloggers are doing....
am i crazy?
I wonder if Eric negotiated a portion of the (probable policy limit) settlement for his role in the case.
(Again) Anon 8:52, I'd like to see some facts before I make judgments about what Flea "failed" to do medically.
Josh, I'd say that the answer to your question (re: the "difference") is a whole lot of nothing.
Except that sermo has the mighty AMA's blessing and the rest of us (who've been doing this for a while and have the battle scars to prove it) are fleas to stomp.
Forgive the pun.
Josh, I'd say that the answer to your question (re: the "difference") is a whole lot of nothing.
Except that sermo has the mighty AMA's blessing and the rest of us (who've been doing this for a while and have the battle scars to prove it) are fleas to stomp.
Forgive the pun.
Just curious. ive been getting bits and pieces of this one... Did his blogging Cause his LOSS of the case? or did it help to get a lower settlement? What were the circumstances of the case? All I saw was WRONGFUL DEATH. well thats pretty significant. you cant blog your way out of that i think. and blogging might be conisidered inappropriate in consideration to the patients suffering. im not so sure im impressed by this "flea" at all. but fill us in with a summary KEvin. yes blogs are great. but certainly they can get you in hot water too. its going to happen more and more.
if you think you are going to be totally anonymous think again. people can and will figure out who you are. maybe some of you know me. ;lol
if you think you are going to be totally anonymous think again. people can and will figure out who you are. maybe some of you know me. ;lol
# posted by : 9:59 AM
: 9:59 AM
I got to this from Over My Med Body, and since he has comments off, I thought I'd post here. I think what happened really really really sucks, but when in history has something you ever said, anon or not, not been able to come back and bite you in the butt? Unless you are VERY vague or change (heavily) info about semi-specifics and location, and perhaps even specialty, you're really never anonymous. Sorry Flea. We all hope you're doing ok.
Wouldn't it be great to see lawyers, judges and newsreporters subject to these same pressures that are embattling doctors? How would that work, exactly? Hmmm....
# posted by : 11:37 AM
: 11:37 AM
Additionally, in regards to HIPPA, a doctor can not respond to a newspaper article about a case unless it has already gone to trial and the patient's medical information is then considered in 'the public domain'. I think newspapers and reporters, in light of HIPPA, should refrain from publishing one sided articles on malpractice cases until the case has been settled and the physician can add a response to the article. I realize that in 'Flea's' case the article came out after the settlement, but I have certainly seen many articles in the newspaper and online that have been published at the mere mention of a lawsuit. This practice is unfair and one sided.
# posted by : 11:49 AM
: 11:49 AM
I miss Flea dearly.
I think we've all learned a lesson from tis experience, woefully at his expense. If you are involved in litigation as a doctor, patient or profession don't involve details in your blog. Strategy notes, pillow-biting thoughts and jury observations just don't read well in court.
A new, standalone uber-anonymous blog for legal details may well be in order for people who feel the need to vent their legal woes.
I hope that you com home, Flea. We all miss you. I won't expect to see you, but I'll keep the light on just the same.
I think we've all learned a lesson from tis experience, woefully at his expense. If you are involved in litigation as a doctor, patient or profession don't involve details in your blog. Strategy notes, pillow-biting thoughts and jury observations just don't read well in court.
A new, standalone uber-anonymous blog for legal details may well be in order for people who feel the need to vent their legal woes.
I hope that you com home, Flea. We all miss you. I won't expect to see you, but I'll keep the light on just the same.
I am new to the medical blogging world and as a medical student, I am forming my own voice here. Soon after I started, I created an "anon" blog with a vague identity so I could feel more open about honestly sharing my views and opinions. This event is making me think closely about this issue and others. I think I will write something about my take on all this and some important questions I have on my own "anon" blog for starters rather than taking up Kevin's valuable comment space...!
None of this should come as a surprise but the lessons to be learned here is applicable for any case. Do not give counsel representing the adverse party any additional ammunition. During the case, the only people that need convincing of your points/positions are the jury and the judge (not the general public - leave the "reporting" to the reporters). Finally, there is no guarantee of anonymity - especially if you are "reporting" about your own trial.
~Criminallopath~
~Criminallopath~
# posted by : 1:05 PM
: 1:05 PM
"Wouldn't it be great to see lawyers, judges and newsreporters subject to these same pressures that are embattling doctors? How would that work, exactly? Hmmm...."
Just as it would be great to see doctors subject to the same pressures that are embattling other professions.
Everyone has their crosses to bear.
Just as it would be great to see doctors subject to the same pressures that are embattling other professions.
Everyone has their crosses to bear.
# posted by : 1:18 PM
: 1:18 PM
This is not the end of blogging about your legal issues - just don't blog about them until the trial is over. Turkewitz is probably the only reason it wasn't worse, since he warned Flea.
# posted by : 1:19 PM
: 1:19 PM
Just as it would be great to see doctors subject to the same pressures that are embattling other professions."
You mean like the inability to pass on increases in costs of business due to no increase from third payers (ie the government)
You mean like everybody in the allied health field and insurance company's second guessing every move you make.
You mean like the essential GUARANTEE that you will be sued in your career. Probably multiple to many times.
The fact is pal you have no clue what you are talkng about.
You mean like the inability to pass on increases in costs of business due to no increase from third payers (ie the government)
You mean like everybody in the allied health field and insurance company's second guessing every move you make.
You mean like the essential GUARANTEE that you will be sued in your career. Probably multiple to many times.
The fact is pal you have no clue what you are talkng about.
# posted by : 1:58 PM
: 1:58 PM
"Just as it would be great to see doctors subject to the same pressures that are embattling other professions."
Plase give me even one example of which pressure that would be - that is, name a pressure that some kind of profession faces that doctors don't already have (or hav worse).
Let's see your list. I'd be highly surprised if you managed to come up with one.
Plase give me even one example of which pressure that would be - that is, name a pressure that some kind of profession faces that doctors don't already have (or hav worse).
Let's see your list. I'd be highly surprised if you managed to come up with one.
# posted by : 2:03 PM
: 2:03 PM
It really amazes me sometimes, how ignorant some physicians are about law, economics, computer science, ethics, etc.
They may be well-rounded going in to med school, but many fail to progress whatsoever in any other areas of thought.
Could Flea really expect his identity to remain confidential when he blabbed specifically about his case to millions of people?
Perhaps my expectations are just too high.
They may be well-rounded going in to med school, but many fail to progress whatsoever in any other areas of thought.
Could Flea really expect his identity to remain confidential when he blabbed specifically about his case to millions of people?
Perhaps my expectations are just too high.
# posted by : 2:15 PM
: 2:15 PM
How about the pressure of trying to make payroll every week?
How about the pressure of a job where you know that probably no matter how hard you work, you will probably never even sniff the average salary of a physician?
How about the pressure of a job where the people paying you aren't massive insurance companies, which for all the squeezing they may do of you, you never have to worry about them going under?
Second guessing? Every job has its second guessers, especially coaches, lawyers, and doctors - after all the latter two are on TV all the time, so how hard can it be?
Yeah, you got pressures, so what? Everyone does. And for most of them, their pressures don't come with the financial rewards yours do.
Do you guys have any concept of how the rest of the world gets by?
How about the pressure of a job where you know that probably no matter how hard you work, you will probably never even sniff the average salary of a physician?
How about the pressure of a job where the people paying you aren't massive insurance companies, which for all the squeezing they may do of you, you never have to worry about them going under?
Second guessing? Every job has its second guessers, especially coaches, lawyers, and doctors - after all the latter two are on TV all the time, so how hard can it be?
Yeah, you got pressures, so what? Everyone does. And for most of them, their pressures don't come with the financial rewards yours do.
Do you guys have any concept of how the rest of the world gets by?
# posted by : 2:15 PM
: 2:15 PM
Another lesson learned is not to post anything on your clinic's website that can be used against you in the court of law such as this statement from Dr Lindeman:
"Most Visits to the Pediatrician are Unnecessary"
Not a smart thing thing to say if you miss a diagnosis.
"Most Visits to the Pediatrician are Unnecessary"
Not a smart thing thing to say if you miss a diagnosis.
# posted by : 2:34 PM
: 2:34 PM
"Do you guys have any concept of how the rest of the world gets by?"
Completely irrelevant. And even if it were relevant, your argument is flawed.
"Most people" do not go to college for 4 years, and then on to medical school for 4 years, and accrue hundreds of thousands of dollars in debt along the way. Usually loans are deferred through residency, where one works 80-100 hours a week while making what amounts to less than minimum wage.
There might be a fellowship after that, too. So you're looking at being anywhere from 30-34 years old -- as opposed to 22 for the average college grad, white-collar worker -- before you start actually making money. (The whole time the clock is ticking on your debt, and compound interest is working against you.) Meanwhile, if you were a smart person -- you would have been maxing out your 401K and Roth IRAs the entire time, at a relatively decent rate of return, providing a nice retirement nest egg for yourself with a lot less effort.
You need to think of the cost of education and the OPPORTUNITY COST of not working for at least 8 years. There's a double whammy there.
If you want to get rich, you DON'T go into medicine.
Doctors pay their dues. Go cry a river somewhere else about how life is hard. The compensation is not commensurate with the amount of hard work required to become a physician -- compared to other fields like law and investment banking.
I'm not a doctor, and I don't intend to become one. I just get tired of all the whiny ninnies with entitlement issues.
Completely irrelevant. And even if it were relevant, your argument is flawed.
"Most people" do not go to college for 4 years, and then on to medical school for 4 years, and accrue hundreds of thousands of dollars in debt along the way. Usually loans are deferred through residency, where one works 80-100 hours a week while making what amounts to less than minimum wage.
There might be a fellowship after that, too. So you're looking at being anywhere from 30-34 years old -- as opposed to 22 for the average college grad, white-collar worker -- before you start actually making money. (The whole time the clock is ticking on your debt, and compound interest is working against you.) Meanwhile, if you were a smart person -- you would have been maxing out your 401K and Roth IRAs the entire time, at a relatively decent rate of return, providing a nice retirement nest egg for yourself with a lot less effort.
You need to think of the cost of education and the OPPORTUNITY COST of not working for at least 8 years. There's a double whammy there.
If you want to get rich, you DON'T go into medicine.
Doctors pay their dues. Go cry a river somewhere else about how life is hard. The compensation is not commensurate with the amount of hard work required to become a physician -- compared to other fields like law and investment banking.
I'm not a doctor, and I don't intend to become one. I just get tired of all the whiny ninnies with entitlement issues.
Well guys since medicine is my second career guess what I do.
Doctor's have to make payroll. You think the RN's and MA's in the office are volunteer's? And guess what guy's whenever, we have an increase in costs, we can't just pass it on to consumers like most other businesses? Try to make payroll under those circumstances jack. Yeah my salary is higher but I did not start making it until nearly 40 years of age. Add on 200K in debt. The difference between you and me is I have been in another career AND a doctor. I seen both and know both.
PS: The next time you have a 15 yo exsanguinating in front of you we will compare "pressures" OK.
Doctor's have to make payroll. You think the RN's and MA's in the office are volunteer's? And guess what guy's whenever, we have an increase in costs, we can't just pass it on to consumers like most other businesses? Try to make payroll under those circumstances jack. Yeah my salary is higher but I did not start making it until nearly 40 years of age. Add on 200K in debt. The difference between you and me is I have been in another career AND a doctor. I seen both and know both.
PS: The next time you have a 15 yo exsanguinating in front of you we will compare "pressures" OK.
# posted by : 2:44 PM
: 2:44 PM
I am a physician and:
1. I do struggle to make payroll every period,
2. As an internist, I will probably never reach the "average salary of a physician,"
3. Many of the people who pay me are individuals, small business, self-insured, and others, who, historcally, have gone out of business plenty.
It's amazing to me how many non-physicians reading/posting this physician-oriented blog keep telling the physicians that they have no idea what it's like in other professions/businesses. How is it that non-physicians have so much more insight (into businesses they are not involved with) then we do?
1. I do struggle to make payroll every period,
2. As an internist, I will probably never reach the "average salary of a physician,"
3. Many of the people who pay me are individuals, small business, self-insured, and others, who, historcally, have gone out of business plenty.
It's amazing to me how many non-physicians reading/posting this physician-oriented blog keep telling the physicians that they have no idea what it's like in other professions/businesses. How is it that non-physicians have so much more insight (into businesses they are not involved with) then we do?
# posted by : 2:51 PM
: 2:51 PM
Wait, so other people who aren't physicians have no concept what you do, but you've got the pressures and stresses of their lives all figured out? Do you even get the idiocy of that statement?
"The compensation is not commensurate with the amount of hard work required to become a physician -- compared to other fields like law and investment banking."
Tell me, what compensation would be commensurate. Since an average salary of $150K is not enough, what would be?
How much will it take to stop the perpetual freaking whining of the world's wealthiest profession?
"The compensation is not commensurate with the amount of hard work required to become a physician -- compared to other fields like law and investment banking."
Tell me, what compensation would be commensurate. Since an average salary of $150K is not enough, what would be?
How much will it take to stop the perpetual freaking whining of the world's wealthiest profession?
# posted by : 3:35 PM
: 3:35 PM
Wait, so other people who aren't physicians have no concept what you do, but you've got the pressures and stresses of their lives all figured out? Do you even get the idiocy of that statement?
Anon 3:35,
I do not know if you were referring to my comment, but if you were you misunderstood, and you actually agree with me. Non-physicians may very well know all about the stressors, pressures, and daily lives of physicians. It's just amazing the amount of hypocrisy, that in one sentence, a non-physician asserts that physicians are whiners who don't know how good they've got it, and in the next, physicians shouldn't write about other professions about which they know nothing.
Why is it that only non-physicians can understand professions in which they are not engaged?
Anon 3:35,
I do not know if you were referring to my comment, but if you were you misunderstood, and you actually agree with me. Non-physicians may very well know all about the stressors, pressures, and daily lives of physicians. It's just amazing the amount of hypocrisy, that in one sentence, a non-physician asserts that physicians are whiners who don't know how good they've got it, and in the next, physicians shouldn't write about other professions about which they know nothing.
Why is it that only non-physicians can understand professions in which they are not engaged?
# posted by : 4:24 PM
: 4:24 PM
No one has minimized the stress of being a physician. The whining just gets a little tiresome. It's a ceaseless drumbeat of complaints. If it's that bad, quit.
Just stop telling everyone else how bad you have it. Most people are tired of their jobs, most people have pressure, etc. Stop crying.
Just stop telling everyone else how bad you have it. Most people are tired of their jobs, most people have pressure, etc. Stop crying.
# posted by : 4:51 PM
: 4:51 PM
I am fairly certain that if you examine blogs focussing on other professions, the complaining is equally intense. If you don't want to read/hear physicians discuss/whine/complain about the stressors that they have in common, why read a board focussed on physician issues?
Follow your own advice:
If it's that bad, quit... Stop crying.
Follow your own advice:
If it's that bad, quit... Stop crying.
# posted by : 5:02 PM
: 5:02 PM
No, it's really not. No profession cries quite so plaintively and continuously as physicians. There never was a wealthier, more put upon group.
Why read the board? Because once in awhile one can learn something about health care in general, other than the alleged misery of your professional lives. And given that health care is, or at least should be, one of the top political topics of the next two decades, it's important to be up on it.
Whine away, but don't expect me not to point out what crybabies so many of you are.
Why read the board? Because once in awhile one can learn something about health care in general, other than the alleged misery of your professional lives. And given that health care is, or at least should be, one of the top political topics of the next two decades, it's important to be up on it.
Whine away, but don't expect me not to point out what crybabies so many of you are.
# posted by : 5:06 PM
: 5:06 PM
Oh shit. Here we go again. CJD whining about doctors whining while inciting and perpetuating more whining.
# posted by : 5:22 PM
: 5:22 PM
There are big disagreements in these comments, about what a doctor's time, work, and knowledge are worth. If someone dropped dead in front of you and you could bring them back (with your meds and oxygen and long years of training), chances are that you would feel that you are pretty special. Even treating dizziness and runny noses properly could make you feel like you can do something that - heck - even an auto mechanic might find challenging. Doctors listen to complaints all day, every day. Why can't we complain in blogs, if we choose? Why are some people allowed to complain, and not others? If you made huge sacrifices in your life and then felt that they were not worth it or that you were misunderstood or unappreciated, you might complain too. Some colleagues are not complaining but taking action. I know some who have simply stopped seeing Medicare pts, stopped accepting certain insurance plans, and/or stopped taking new patients, period. There seem to be a lot of colleagues retiring early and/or getting MBA's.
Before med school, I worked part-time as a waitress. I'm really, really glad that I'm not a waitress anymore! So I guess I'm not complaining.
Before med school, I worked part-time as a waitress. I'm really, really glad that I'm not a waitress anymore! So I guess I'm not complaining.
# posted by : 6:40 PM
: 6:40 PM
Advice to physicians: never blog again. The time you save may be used to study for another career, earn some extra money, or play with your kids. The Artic chill cast by Flea's blog should make any doctor think twice about blogging or even e-mailing anything that could be taken out of context. Even if Flea had not commented specifically about his case, his comments in general could have been used against him. You may not be running for President, or accused of any crime, yet, but what you say may and will be used against you in the future. Too bad Flea wasn't advised of his Miranda rights before he started to blog.
# posted by : 6:45 PM
: 6:45 PM
Since I am doing just that, I would support those who decide that blogging without anonymity is the best practice. At least the blogger knows that he or she is, without question, responsible for what is written. This can lead to thought out and more responsible writing. I think one can still formulate expressions of merit regarding controversial issues that won't come back to haunt you and still be open to who you are.
Nevertheless, I also have sympathy for Flea and the apparent consequences. ..Maurice.
Nevertheless, I also have sympathy for Flea and the apparent consequences. ..Maurice.
This arrogant fool "Flea" got what he deserved. Were my firm his med/mal carrier, I would likely deny coverage on the grounds that he intentionally sabotaged his defense.
# posted by : 8:21 PM
: 8:21 PM
Right. It won't be long before med-mal carriers require an agreement not to "blog" in their professional liability policies, lest you forgo your coverage.
What if Flea had live-blogged his trial but had only included statements like "I feel for the parents" and "God bless our justice system"? Would that have helped or hurt his case? Should one simply not say anything, in person or in blogs or in secret code, about a trial in progress when you are the defendant?
# posted by : 12:56 AM
: 12:56 AM
Flea should sue everybody, everyone on the internet who helped to reveal his identity, his attorney if he failed to stop the question and failed to demand a mistrial, the judge for his doctor hating bias, and his failure to declare a mistrial, for his failure to assess twice the legal expenses to the personal account of the plaintiff lawyer, the plaintiff lawyer for revealing an irrelevant private fact, for an improper purpose, to embarass, an intentional tort inside a trial, the plaintiff, everybody. Flea should try to pierce the self-dealt, unjust lawyer immunities of the plaintiff lawyer and of the judge, both mortal enemies of the doctor.
Failing that, we want names, the plaintiff family, the plaintiff lawyer, the defense attorney, the judge. These enemies of clinical care must come to account.
Flea should have stuck it out with the jury and strict instructions to ignore plaintiff shenanigans. If he felt he did nothing wrong, the blogging is irrelevant.
Where is craven organized medicine? The jive turkeys are hiding, perhaps on advice of counsel.
Failing that, we want names, the plaintiff family, the plaintiff lawyer, the defense attorney, the judge. These enemies of clinical care must come to account.
Flea should have stuck it out with the jury and strict instructions to ignore plaintiff shenanigans. If he felt he did nothing wrong, the blogging is irrelevant.
Where is craven organized medicine? The jive turkeys are hiding, perhaps on advice of counsel.
"Enemies of clinical care.."
I laughed so hard at that one that I shot pipe tobacco across the keyboard.
I could make the standard set of comments here but they have been made previously and apply rather well here.
A take home point from this is to think. Think deeply before participating in the world of PI fraud. Some attorney may line your pockets to get on the stand and parrot what a litigant told them and judges may allow such witchcraft in as "science" but think about how it would be as a defendant in the case that is getting the shaft from our broken legal system. Those that participate as profiteers have no right to complain when they find themselves in the defendant's chair. We need tort reform across the board for everybody.
Oh, and don't give opposing counsel any more ammunition then they already have. It doesn't take 10 plus years of schooling to figure that one out. It only takes a little bit of common sense.
~Criminallopath~
I laughed so hard at that one that I shot pipe tobacco across the keyboard.
I could make the standard set of comments here but they have been made previously and apply rather well here.
A take home point from this is to think. Think deeply before participating in the world of PI fraud. Some attorney may line your pockets to get on the stand and parrot what a litigant told them and judges may allow such witchcraft in as "science" but think about how it would be as a defendant in the case that is getting the shaft from our broken legal system. Those that participate as profiteers have no right to complain when they find themselves in the defendant's chair. We need tort reform across the board for everybody.
Oh, and don't give opposing counsel any more ammunition then they already have. It doesn't take 10 plus years of schooling to figure that one out. It only takes a little bit of common sense.
~Criminallopath~
# posted by : 2:50 AM
: 2:50 AM
Now it turns out that this unbelievable arrogant fool didn't even inform his attorneys of what he had done.
I hope that his med/mal carrier throws him under the bus. There certainly appears to be enough evidence to deny coverage.
This "Flea" moron should be left bankrupt and penniless as an example to others who would act so irresponsibly.
And people wonder why their med/mal premiums continue to increase. Just remember, you physicians are paying the costs of this egomaniac's behavior.
I hope that his med/mal carrier throws him under the bus. There certainly appears to be enough evidence to deny coverage.
This "Flea" moron should be left bankrupt and penniless as an example to others who would act so irresponsibly.
And people wonder why their med/mal premiums continue to increase. Just remember, you physicians are paying the costs of this egomaniac's behavior.
# posted by : 4:50 AM
: 4:50 AM
More evidence of how much insurance companies/execs/etc "care" about their policy holders.
Apparently, not at all.
Imagine if it were not liability insurance, but health insurance, and replace "blogging his trial" with cigarette smoking. I wonder how many insurance execs are wishing lung cancer on their policy holders.
Apparently, not at all.
Imagine if it were not liability insurance, but health insurance, and replace "blogging his trial" with cigarette smoking. I wonder how many insurance execs are wishing lung cancer on their policy holders.
# posted by : 10:06 AM
: 10:06 AM
" We need tort reform across the board for everybody."
Why don't we just go to no-fault insurance across the board? Or better yet, if everyone is going to have the value of their case decided by the govt., why don't we just let the govt. compensate all injuries?
CJD
Why don't we just go to no-fault insurance across the board? Or better yet, if everyone is going to have the value of their case decided by the govt., why don't we just let the govt. compensate all injuries?
CJD
# posted by : 2:18 PM
: 2:18 PM
CJD
The problem that I have with no fault is that systems that have gone to no fault (e.g. CA worker's compensation system) are rife with fraud. As far as the "government" paying out on all injury claims... the tax payers should not be the ones stuck paying the bill for an individual's negligence. I would opt for a system that actually puts the burden of proof back on the plaintiff. For PI type cases this would require more than just an advocate provider using post hoc ergo propter hoc logical fallacy as "proof" of causation. It would require not only proving general causation but specific causation in the case to a reasonable degree of scientific certainty (the particular noxious factor in question would need to be quantified as well as qualified based upon the physical evidence).
~Crminallopath~
The problem that I have with no fault is that systems that have gone to no fault (e.g. CA worker's compensation system) are rife with fraud. As far as the "government" paying out on all injury claims... the tax payers should not be the ones stuck paying the bill for an individual's negligence. I would opt for a system that actually puts the burden of proof back on the plaintiff. For PI type cases this would require more than just an advocate provider using post hoc ergo propter hoc logical fallacy as "proof" of causation. It would require not only proving general causation but specific causation in the case to a reasonable degree of scientific certainty (the particular noxious factor in question would need to be quantified as well as qualified based upon the physical evidence).
~Crminallopath~
# posted by : 4:22 PM
: 4:22 PM
"How about the pressure of a job where the people paying you aren't massive insurance companies, which for all the squeezing they may do of you, you never have to worry about them going under?"
In addition to the large, nation-wide insurance companies, there are a lot of small companies/health plans that operate in only 1 or a few small states. Sometimes these do go under.
In addition to the large, nation-wide insurance companies, there are a lot of small companies/health plans that operate in only 1 or a few small states. Sometimes these do go under.
"We need tort reform across the board for everybody"
Ahh, finally some words of wisdom, Crim.
Not to beat a dead horse, but realize that tort reform as it discussed pertaining to health care most often pertains to a larger sphere, including business owners who are adversely affected. What is your major liability in a busy medical clinic? Malpractice? Perhaps you are as likely to be sued for a slip and fall in the parking lot....but a malpractice suit is taken personally and more difficult to live with.
Small steps are needed; Rome wasn't built in a day. Many of us who own businesses have been sued; a medical practice is only one such business, but it is a start.
Ahh, finally some words of wisdom, Crim.
Not to beat a dead horse, but realize that tort reform as it discussed pertaining to health care most often pertains to a larger sphere, including business owners who are adversely affected. What is your major liability in a busy medical clinic? Malpractice? Perhaps you are as likely to be sued for a slip and fall in the parking lot....but a malpractice suit is taken personally and more difficult to live with.
Small steps are needed; Rome wasn't built in a day. Many of us who own businesses have been sued; a medical practice is only one such business, but it is a start.
# posted by : 10:54 PM
: 10:54 PM
"I laughed so hard at that one that I shot pipe tobacco across the keyboard."
BTW Crim, we really must make you laugh a bit more; laughter IS the best medicine if this is what it takes to quit smoking...
BTW Crim, we really must make you laugh a bit more; laughter IS the best medicine if this is what it takes to quit smoking...
# posted by : 11:01 PM
: 11:01 PM
So when everyone has their damages capped, I guess no one's negligence will never harm another? And when it does, they'll just be SOL?
I guess the taxpayers will pick up the tab.
I guess the taxpayers will pick up the tab.
# posted by : 11:25 PM
: 11:25 PM
No, people will still get economic damages, it is their non-economic damages that will be capped. No more jury manipulation by wiley attorneys using emotional appeals to extract excessive sums from the pockets of the public. You should appreciate this if you are a consumer or a taxpayer. Those who consider themselves "special" may not appreciate this.
# posted by : 9:08 AM
: 9:08 AM
Why should I appreciate that if I'm a consumer or a taxpayer? Perhaps if I'm a shareholder in an insurance company, it might bother me, but probably not, given how profitable they have been on a consistent basis. I've probably done quite well.
But if you're saying we must cap damages because it costs us all money, then perhaps we shouldn't stop there. Let's cap CEO salaries, let's cap the cost of fuel, let's cap the cost of clothes. It would save us all money, right?
I'm not like you - I don't think my fellow man is so ignorant as to be led around by the nose by "wiley" attorneys. After all, I think the defense gets lawyers too. And most studies say judges agree with juries the majority of the time - but maybe they've been tricked as well!
But if you're saying we must cap damages because it costs us all money, then perhaps we shouldn't stop there. Let's cap CEO salaries, let's cap the cost of fuel, let's cap the cost of clothes. It would save us all money, right?
I'm not like you - I don't think my fellow man is so ignorant as to be led around by the nose by "wiley" attorneys. After all, I think the defense gets lawyers too. And most studies say judges agree with juries the majority of the time - but maybe they've been tricked as well!
# posted by : 1:54 PM
: 1:54 PM
"And most studies say judges agree with juries the majority of the time - but maybe they've been tricked as well!"
Or bought. Are your judges elected? Ours are, and guess who funds at least some of these campaigns...well-heeled trial lawyers. This is part of the reason venue-shopping exists, the other reason is juries comprised of an undereducated populace that is favorably inclined to plaintiffs and easily influenced by emotional factors in awarding noneconomic damages. BTW, I'm sure OJ agrees with you about the wisdom of your fellow man!
Or bought. Are your judges elected? Ours are, and guess who funds at least some of these campaigns...well-heeled trial lawyers. This is part of the reason venue-shopping exists, the other reason is juries comprised of an undereducated populace that is favorably inclined to plaintiffs and easily influenced by emotional factors in awarding noneconomic damages. BTW, I'm sure OJ agrees with you about the wisdom of your fellow man!
# posted by : 7:02 PM
: 7:02 PM
So exactly why would you want judges. Nice citation of OJ - I'm sure that proves your point, just like anyone who says all doctors are negligent drunks has their point proven by this guy:
http://www.boston.com/news/globe/magazine/articles/2004/03/21/what_went_wrong/
http://www.boston.com/news/globe/magazine/articles/2004/03/21/what_went_wrong/
# posted by : 11:32 PM
: 11:32 PM
Everyone has pressures. Some of us read medical blogs for insight -- you may or may not ever hire an interior decorator but everyone needs a doctor.
Tell me something: When does losing a malpractice case ever make a dent in a doctor's license? What is it that a doctor has to do to get his license yanked? I don't mean, "Oh, he's been convicted of drug diversion, a felony, so he automatically loses the license, but tomorrow he can apply to get it back and he will." I mean, license yanked. Do not pass go, do not collect $150K a year.
I am not speaking to the merits of Flea's case, because it's clear that everyone's strayed off the subject. Let's get back to it: No one knows what impact the blog has on the case.
Flea settled the case after he was cross-examined. I take it that the attorney for the plaintiff did not stand up and ask one question -- about the blog -- and sit down again.
Procedurally, where was the case? Was that the end of all the evidence?
Everyone here -- including the Globe -- is inferring that the blog caused the settlement. We know no such thing.
Before prejudging a case, please remember that a factual nuance can mean a lot. Here is one link to the facts of the McDonald's Coffee verdict, for instance.
The point is, no one knows what the facts are in Flea's case. It is a terrible idea that he blogged about his case. It is absolutely arrogant. Ironically, one of the things that patients complain about is the extent to which doctors seem to think they know everything about everything and dismiss patient concerns. Sometimes patient concerns should be dismissed, but you know, sometimes they're real.
His lawyer, who, by the way, probably incurred significant education debt himself, would probably have preferred that he not post about the case in the blog. Had he not, I'd hazard a guess that the blog might have been a lot less useful.
Incidentally, your private e-mails could possibly be subject to discovery in certain matters as well, depending on the facts of the case.
Tell me something: When does losing a malpractice case ever make a dent in a doctor's license? What is it that a doctor has to do to get his license yanked? I don't mean, "Oh, he's been convicted of drug diversion, a felony, so he automatically loses the license, but tomorrow he can apply to get it back and he will." I mean, license yanked. Do not pass go, do not collect $150K a year.
I am not speaking to the merits of Flea's case, because it's clear that everyone's strayed off the subject. Let's get back to it: No one knows what impact the blog has on the case.
Flea settled the case after he was cross-examined. I take it that the attorney for the plaintiff did not stand up and ask one question -- about the blog -- and sit down again.
Procedurally, where was the case? Was that the end of all the evidence?
Everyone here -- including the Globe -- is inferring that the blog caused the settlement. We know no such thing.
Before prejudging a case, please remember that a factual nuance can mean a lot. Here is one link to the facts of the McDonald's Coffee verdict, for instance.
The point is, no one knows what the facts are in Flea's case. It is a terrible idea that he blogged about his case. It is absolutely arrogant. Ironically, one of the things that patients complain about is the extent to which doctors seem to think they know everything about everything and dismiss patient concerns. Sometimes patient concerns should be dismissed, but you know, sometimes they're real.
His lawyer, who, by the way, probably incurred significant education debt himself, would probably have preferred that he not post about the case in the blog. Had he not, I'd hazard a guess that the blog might have been a lot less useful.
Incidentally, your private e-mails could possibly be subject to discovery in certain matters as well, depending on the facts of the case.
If so many of you Doc's actually like Flea and you knew it was foolish, and risky to do what he did, blogging his trial, then why didn't you try to stop him? Isn't that what "friends" do? If you know someone is doing something that could cause them harm, shouldn't a friend warn them of danger? I read every one of his post about this trial and not one of you tried to make him realize what he was doing.
I guess the excitement and drama of it all was far more important than friendship? Everyone of you knew where this could lead, and quite frankly, I think you guys are gossip whores.
I guess the excitement and drama of it all was far more important than friendship? Everyone of you knew where this could lead, and quite frankly, I think you guys are gossip whores.
# posted by : 11:13 PM
: 11:13 PM
I have to disagree with Anon 11:13PM, as there WERE numerous comments on Flea's blog where readers suggested to Flea that blogging about a case in real time would probably be a bad idea. Certainly those individuals were acting as "good friends," and trying to advise what they thought was in Flea's best interest. I guess Anon 11:13 was not actually a reader of Flea's blog...
In fact, Flea never revealed on the blog whether his case was real-time vs. being reported historically, so many readers probably assumed that he was not talking about something that was happening currently.
I'm very sorry that Flea was "unmasked" without his consent. His anonymous blog was one of my favorites -- well written, with both good science and an authentic voice.
In fact, Flea never revealed on the blog whether his case was real-time vs. being reported historically, so many readers probably assumed that he was not talking about something that was happening currently.
I'm very sorry that Flea was "unmasked" without his consent. His anonymous blog was one of my favorites -- well written, with both good science and an authentic voice.
# posted by : 7:35 PM
: 7:35 PM
Yes Nicole I was most definitely a regular reader of Flea. In fact I had read him since the day he started his blog.
I stand corrected! You're right! I do recall him being warned on his blog of danger. It was Eric Turkowitz that was doing the warning. Kind of ironic isn't it, that the only person who saw fit to warn him was a N.Y. personal injury Lawyer!
Everyone knows he WAS NOT WARNED on his blog by anyone except Eric.
I stand corrected! You're right! I do recall him being warned on his blog of danger. It was Eric Turkowitz that was doing the warning. Kind of ironic isn't it, that the only person who saw fit to warn him was a N.Y. personal injury Lawyer!
Everyone knows he WAS NOT WARNED on his blog by anyone except Eric.
# posted by : 9:47 PM
: 9:47 PM
Anon 9:47 wrote-
>Everyone knows he WAS NOT WARNED
>on his blog by anyone except
>Eric.
Unfortunately, we can't go back to the comments on Flea's blog now, because then I could point out several other comments, besides Erik T's, where people mentioned things like "I hope you're not doing this in real time" and so on. From my memory, at least two of those comments were from females, and at least one was left non-anonymously.
Since comments can actually be left at any time after a post, you might consider the possibility that there were warning-type comments that *I* read that were actually left after the point in time where YOU read the comments...meaning that you could be a faithful reader of the blog and still miss some of the comments (because they were actually left after you last read the comment section of a particular post.)
Since we can't access those comments anymore, we will have to just agree that your recollections are different from my recollections.
By the way, I do regret my sarcastic comment about you not being a reader of Flea's blog. Obviously that was motivated by anger, and not very well considered before I posted it.
What puzzles me is why you feel that this perceived lack of warnings translates to readers being "gossip whores."
Did you yourself believe that Flea was doing something dangerous? If so, why didn't YOU warn him?
Speaking for myself, I didn't post a warning for several reasons. (1) I read warnings posted by others. (2) I assumed he was not posting about the event in real time, and therefore did not think there was a real threat of unmasking from his posts (perhaps this was a bit naive, in retrospect).
Here's an argument you could make that I would agree with. Some readers probably DID perceive a danger, and many of those readers apparently did not try to protect Flea by warning him. Those readers probably did Flea a disservice by not sharing their concerns.
However, I don't think you can assume anything about their motivations for remaining silent, and your conclusion that "the excitement and drama of it all was far more important than friendship" seems quite unfounded. Why would you think people that respected Flea and/or considered him a "friend" intentionally allowed him to get himself into trouble? Do you really view most people so negatively? Do you judge everyone you come in contact with this harshly?
By the way, I respect your right to comment anonymously, but practically speaking, it's easier to have a dialogue if you use some type of identifier that people can refer to. Maybe you could call yourself "John" or "PB&J" or "the commenter formerly known as Anon who thinks everyone let Flea down" or whatever. :)
>Everyone knows he WAS NOT WARNED
>on his blog by anyone except
>Eric.
Unfortunately, we can't go back to the comments on Flea's blog now, because then I could point out several other comments, besides Erik T's, where people mentioned things like "I hope you're not doing this in real time" and so on. From my memory, at least two of those comments were from females, and at least one was left non-anonymously.
Since comments can actually be left at any time after a post, you might consider the possibility that there were warning-type comments that *I* read that were actually left after the point in time where YOU read the comments...meaning that you could be a faithful reader of the blog and still miss some of the comments (because they were actually left after you last read the comment section of a particular post.)
Since we can't access those comments anymore, we will have to just agree that your recollections are different from my recollections.
By the way, I do regret my sarcastic comment about you not being a reader of Flea's blog. Obviously that was motivated by anger, and not very well considered before I posted it.
What puzzles me is why you feel that this perceived lack of warnings translates to readers being "gossip whores."
Did you yourself believe that Flea was doing something dangerous? If so, why didn't YOU warn him?
Speaking for myself, I didn't post a warning for several reasons. (1) I read warnings posted by others. (2) I assumed he was not posting about the event in real time, and therefore did not think there was a real threat of unmasking from his posts (perhaps this was a bit naive, in retrospect).
Here's an argument you could make that I would agree with. Some readers probably DID perceive a danger, and many of those readers apparently did not try to protect Flea by warning him. Those readers probably did Flea a disservice by not sharing their concerns.
However, I don't think you can assume anything about their motivations for remaining silent, and your conclusion that "the excitement and drama of it all was far more important than friendship" seems quite unfounded. Why would you think people that respected Flea and/or considered him a "friend" intentionally allowed him to get himself into trouble? Do you really view most people so negatively? Do you judge everyone you come in contact with this harshly?
By the way, I respect your right to comment anonymously, but practically speaking, it's easier to have a dialogue if you use some type of identifier that people can refer to. Maybe you could call yourself "John" or "PB&J" or "the commenter formerly known as Anon who thinks everyone let Flea down" or whatever. :)
# posted by : 10:23 AM
: 10:23 AM
"Everyone knows he WAS NOT WARNED on his blog by anyone except Eric."
I personally warned him, multiple times, nonanonymously. (Of course, I'm also a lawyer, so maybe I don't count.)
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I personally warned him, multiple times, nonanonymously. (Of course, I'm also a lawyer, so maybe I don't count.)
