More frustration boils over in this letter:
I can not think of a single colleague who enjoys practicing medicine due to the fear of litigation.Lawyers are only too aware that they don’t need to be correct but to have just enough information to convince a jury of laypeople. Why is there rarely a case brought against a lawyer for a frivolous lawsuit? Why isn’t it automatic for the loser to pay the legal costs of both parties?
Why do doctors treat anyone who practices malpractice law? Because physicians have a deeply rooted moral code of ethics.
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{ 61 comments }
Deeply rooted moral code of ethics? Sorry, while I wipe the coffee from my keyboard. “Moral code of ethics” indeed. Try again once the “do no harmers” stop peddling clinical causation junk science (to their financial benefit) and clogging the courtrooms with junk science PI cases and we can talk about “moral code of ethics.”
Malpractice lawyers get sick too. I have had a couple in my practice. Not always fun just because they are argumentative and cynical making it hard work, but I just shoot straight with them. Even, going toe to toe with one when he tries to bully me, and it has worked out so far.
For the first commenter… don’t even try to compare charlatan doctors and charlatan lawyers. The comparison ain’t even CLOSE!!!
If you haven’t read enough cases of doctors getting sued, EVEN when they did the right thing, just read KevinMD more often.
Mike,
It has nothing to do with charlatanism. It is called gaming the system and looking for the deep pockets. Compare the number of PI, worker’s compensation (claims and not cases in some states) and toxic tort cases to the number of med-mal cases and tell me that the former is even close. I would actually have some sympathy for the clinicians if they would stop bedding the trial lawyers (the same ones that file the junk science med-mal cases) on cases where they can act as profiteers. “They claimed that they were hurt in incident XYZ and I can find some purely subjective or non-event specific or temporally discernible findings” should never be misconstrued as a scientific basis for causation.
How do you quantify ethics? How about the trust of the public. The Harris Poll shows that physicians are the most trusted profession period, the end. More than teachers, police, fire fighters you name it. EIGHTY SIX PERCENT of people trust physicians. Nobody can talk down to physicians when it comes to ethics.
Yeah, and the other 14 percent are readers of this blog, and have learned that Doctor’s deserve no more trust than anyone else.
The trust of a credulous and generally uninformed public! What a metric to base anything upon except that the general public is want to believe in flights of fantasy. When the general public gives up its flight of fancy in believing (the operative word here), without any objective proof, in sky daddies, flying spaghetti monsters and the rest, then we can start discussing the validity of the views of the general public.
“If you haven’t read enough cases of doctors getting sued, EVEN when they did the right thing, just read KevinMD more often.”
In all the time I’ve read Kevin, he’s yet to post a link to the medical records in any of the cases he cites. So how would we know they did the right thing?
“EIGHTY SIX PERCENT of people trust physicians. Nobody can talk down to physicians when it comes to ethics.”
Just because a bunch of others in your profession may be popular, it doesn’t make you ethical.
Why wouldn’t you treat them? Do none of you know a single physician who you believe could act negligently and harm someone as a result?
Do you not know a single insurance company who might stonewall and deny a legitimate claim by that injured person?
If you do, who do you think helps that injured person? You, physician? Are you paying the mortgage for them since they can no longer work? Are you paying their future medical bills since their health insurer dropped them? How about their car payments? Buying their food?
How do you guys think that happens?
We absolutely should not treat medmal lawyers. They are the most hostile patients possible and last time I checked, you are not obligated to treat a hostile patient. Think first of the greater good. For every doc that a medmal lawyer drives out of practice, how many people are losing access to medical care? I practice in a very underserved area which has the nice benefit of a lot of appreciative patients and very little litigation. If, however, I get sued out of existence, the community will lose 50% of its medical capacity. I think the benefit to a few thousand people outweighs the risk of me turning away a lawyer if one should ever cross my door.
Please point me to all the docs who medical malpractice lawyers are driving out of practice.
So you’re saying, if one of your colleagues operated on someone high or drunk, causing them a debilitating injury, you would not treat the attorney who represented that patient?
Maybe your hometown folks aren’t so lucky to have such a compassionate guy like yourself.
“Please point me to all the docs who medical malpractice lawyers are driving out of practice.”
Funny, I haven’t checked out Kevin MD in a while. Thought I’d read these posts. Well, Here’s One!!! I QUIT!!! I have one month left in medical practice. After being sued for a patient I didn’t even see, and even if I did, it’s the most frivolous case imaginable, I quit. Who needs this shit? Did anybody see the front page of the Boston Globe today? Plaintiff’s blaming physicians for their own drug addiction? I can’t and won’t be responsible for the cocaine, heroin, and alcohol these people use. Someone else can be left holding the bag when bad outcomes occur and your name is on the chart. In one month, I will never see another patient. AND IT”S ONLY BECAUSE OF THE MEDICAL MALPRACTICE SYSTEM.
So you’re out no money, and have only been served, and you quit as a result.
You probably didn’t have what it takes mentally to handle a position with such responsibility anyway, truthfully. Which is not a negative – people in many professions would rather do something else simply to have the weight of other’s problems off of them.
Good luck in your future career. What are you going to do?
We BELIEVE you anonymous. I guit too. I will never ever sue another physician. I can’t live with myself for all the doctors I have driven out of business. It made me weep to read that Boston Globe article. I HOPE THERE’S A PSYCHIATRIST LEFT TO TREAT ME WHEN I NEED ONE SO DESPARATELY.
So you’re out no money, and have only been served, and you quit as a result.
You (probably lawyers) continue to perpetuate the myth that being served costs no money; that a case that ends in the physicians favor results in negligible loss of income, and has no effect on physicians future practice.
Here are some costs that occur after a doctor is served, and before trial or motions for dismissal:
1. Time spent (and revenue lost)reviewing complaint and records
2. Retaining personal counsel
3. Time spent and revenue lost giving depositions
4. Time spent and revenue lost attending depositions of others
5. Reviewing transcripts of depositions
6. Researching documented standards appropriate to the case
7. Deductible! (Yes, there are malpractice policies with deductibles. Mine is $10,000 per case. No limit. And no, I’ve never lost a malpractice suit.)
8. There are many studies documenting the psychological effects of malpractice suits on doctors.
Let’s have some intellectual honesty.
Being served costs you no money, that is correct. You are not out a dollar.
And none of those things you list have to be done during normal revenue producing hours, with the exception of attending and giving depositions, and your deductible. You choose a higher deductible, though.
Why would you retain personal counsel when that’s what your insurance pays for?
It’s interesting to me though, that physicians are always quick to list their own perceived costs, yet rarely want to discuss the costs to the injured patient of the negligence. Why is that?
Oh, and yes, a case that ends in a verdict for the defendant does result in a negligible actual loss of income for the physician. Perhaps if you showed us your tax returns for the years you were sued v. the ones you weren’t, a different conclusion might be reached.
I’m guessing not, though, since while physicians are quick to whine about their expenses, they’re quite reticent about their income.
I do not choose a policy with a deductible. It’s all I can get. I am denied coverage by every carrier in my state because of the claims history.
You lawyers like to blame the insurance industry for high premiums, etc., and say they are not telling us (doctors) the truth. You expect me to trust them with regards to my defense?
Every letter from insurance-provided defnse also suggests that I retain personal counsel as well. In one case I learned that the lawyer assigned was also defending the expert against me in a nother case. I had to retain personal cousel to discover this and get a new attorney.
I have been in litigation over malpractice claims since the third month in private practice, 10 yeasrs ago. There has been no intervening time during which I was not a defendant in some pending litigation. So I cannot produce control data re my income, because there has never been any.
“It’s interesting to me though, that physicians are always quick to list their own perceived costs, yet rarely want to discuss the costs to the injured patient of the negligence. Why is that?”
You are presuming that the physician bears any responsibility for the patients injuries, which is a giant leap of reasoning, since most studies show that 70% of claims are frivolous. It is not clear to me why I should discuss financial losses to the patient, if, and this is a typical case, I have nothing to do with those losses. If a patient goes out and overdoses on cocaine (a typical case, one I am currently involved in) , should I be concerned about what losses the patient incurred when I cannot resuscitate him after his lifestyle mistake? Do we incarcerate patients when they will possibly willfully do something dangerous or harmful to themselves, like Smoke Crack? According to recent court cases in the media, I have to prophylactically admit cocaine addicts for their disease, because if I don’t, they willl go out and use more cocaine, and if they die, their families will sue me for wrongful death. So I admit cocaine addicts, no matter how stupid their complaint, so my name is not the last one on their chart before they go out and use more cocaine. It’s unfortunate that a 24 year old leaves behind 4 kids when she leaves my ER and dies of an arrhythmia after doing too much cocaine. But should I be concerned about the costs to her plaintiff’s attorney when she sues me, or should It be more concerning that I now admit all substance abusers, regardless of the symptom, so when they continue to abuse, I’m not the one named in a lawsuit when they die from their addiction.
“And none of those things you list have to be done during normal revenue producing hours”
So doctors can put in that 10 hour day then take care of everything Rich MD listed after hours? Is that what you just said. That’s an idiotic statement unless you’re playing devil’s advocate with these comments.
Just because lawyers love to play legal games doesn’t mean doctors do, that’s the lawyers job remember. Claiming that doctors should get used to getting sued is simple Bullshit.
You sound like a lawyer blowing smoke with your rhetoric.
I practiced Nephrology for 10 years and I’m going on 5 years defending docs. The reasons to retain your own attorney in addition to the insurance company’s attorney are too numerous to mention. For those docs who believe that “getting sued” is not something you need to get used to, I whole-heartedly endorse Medical Justice Services (www.medicaljustice.com). We are nationwide and can help reduce frivolous suits.
Regarding Medical Justice: I wanted to retain them, and my lawyer said basically “Do you know how impossible it is to countersue in this state?” and “If you want to get the plaintiff’s attorney upset at you and never agree to drop you from the case, you’ll do this”. So I’m basically being told the Plaintiffs lawyer holds all the cards and I will only hurt myself by fighting back.
Its easy for someone to want to dismiss the general public when they are ranked near the bottom.
Good luck with the other 14 percent, you and the lot will be fighting a losing battle for the rest of your natural lives. You might as well go joust a couple of windmills while you are at it.
Anonymous:
You posted (accurately) that up to 70% of claims are frivolous, but you don’t want to fight back, instead listening to an attorney who is part of the redistribution of physician’s wealth into the hands of attorneys – plaintiff’s AND defense??
Trust me . . . I know of what I speak because I am an attorney also, but one who has only doctor’s best interests at heart. The information you have been give about Medical Justice is based on ignorance. You are forgetting that ALL med/mal comes down to a battle of the experts. Those who lie or stretch the truth are now being called out . . . and the plaintiff’s attorney can DO NOTHING ABOUT IT!! There-in lies the beauty!
…….Bob
“The redistribution of physician’s wealth into the hands of lawyers?”
What about the patients, doc? You think they matter – or did you forget about them with your focus on your redistributed wealth? You know, the people who can’t work anymore, play with their kids, etc.?
Oh, and it ain’t the physician’s wealth, it’s the insurer’s. They won’t give you any of it.
“What about the patients, doc? You think they matter – or did you forget about them with your focus on your redistributed wealth? You know, the people who can’t work anymore, play with their kids, etc.?”
I’m not sure from your perspective why they can’t “play” anymore. Are they diabetic without feet, or injured due to malpractice?? It’s quite different, eh?
As a physician, I’m dedicated to saving lives. As an attorney, I believe the system allows those patients *truly* injured to seek justice.
For many, med/mal is a lottery. The days of plaintiff’s lawyer’s medical experts lying are coming to an end, and attorney’s who file these frivolous claims are now going to have to think twice about doing it.
Not that, of course, you’ve ever been a part of that!
“So doctors can put in that 10 hour day then take care of everything Rich MD listed after hours? Is that what you just said. That’s an idiotic statement unless you’re playing devil’s advocate with these comments.”
If the doctor is in a car wreck and is at fault and gets sued, does he take work time off to review the accident report, the experts’ reports, etc.? How about if a truck driver runs you over tomorrow, should we cry tears for his lost time spent in litigation?
Contrary to physicians’ belief, they’re not the only ones who work hard. They just get paid more than just about everyone else.
“For many, med/mal is a lottery. The days of plaintiff’s lawyer’s medical experts lying are coming to an end, and attorney’s who file these frivolous claims are now going to have to think twice about doing it.”
Yeah, it’s a lottery, if instead of just buying a ticket for $1 at a chance to win a million next week, you had to suffer a debilitating injury, pile up mountains of medical bills, go deep into debt, find a lawyer who will spend thousands of dollars on your behalf before he even gets to trial, and then have 12 people decide whether you “win”, whereupon you get a prize, the bulk of which goes to pay your medical creditors, then yeah, it’s a lottery.
And that group “Medical Justice” is about actual justice, not just blackballing physicians who dare testify against negligent physicians.
Any other terms you want to completely redefine to make your misguided point?
“As a physician, I’m dedicated to saving lives. As an attorney, I believe the system allows those patients *truly* injured to seek justice.”
Would that be “truly injured” as the physicians liability carrier determines it? And “fully compensated” to whatever number that carrier feels is correct?
Yeah, you’re dedicated to justice.
“Contrary to physicians’ belief, they’re not the only ones who work hard. They just get paid more than just about everyone else.”
Which obviously makes them a target of those who want to “redistribute” their wealth, NO??
Since as you noted 70% of lawsuits against doctors are frivolous, why should doctors have to take time off for depositions, answering interrogatories, meeting with their attorney to prepare for trial, depositions and the such (not to mention that each meeting will get postponed at the last minute) when ultimately it will be shown that once again, another “lottery tossin’ Plaintiff’s Attorney” will bite the dust??
Inquiring doctors would like to know!
“Would that be “truly injured” as the physicians liability carrier determines it? And “fully compensated” to whatever number that carrier feels is correct?”
Nope.
That would be what a JURY of my “peers” (and I use that term loosely) decided.
Isn’t that what our “justice” system is about?? Or do you wish to sidetract the jury system??
Some “Justice” you are advocating!
“Since as you noted 70% of lawsuits against doctors are frivolous,”
I did not note that at all. To what are you referring?
“Which obviously makes them a target of those who want to “redistribute” their wealth, NO??”
No. Again, as anyone with a clue knows, it’s not their money anyway. Although when did paying for the harm you caused become “redistributing their wealth”?
I guess that’s your schtick, continuing to try and change the meaning of words and phrases, like “lottery”, to make your point.
To sum up:
The doctors in this discussion are saying that the ease of suing entices many patients and lawyers to file lawsuits that range from valid to completely baseless. And, although the valid lawsuits are accepted by physicians as a moral right, 70% of all lawsuits are proven frivolous, but require huge amounts of the doctor’s time and emotional strength, which the doctors feel is unfair. Also, doctors are the most trusted profession in America.
The lawyers/”patient advocates?” in the discussion are saying that doctors should be able to take care of legal problems outside of normal working hours. They also say that the ease of filing is good for patient’s who have been truly harmed. They continue that lawsuits don’t cost physicians very much money even if they lose. Also, the lawyers seem upset when anyone mentions that lawyers make money when their clients win malpractice claims (as if the lawyers aren’t in this for money, we all know that everyone works to get paid, duh). The lawyers also said that many physician’s are quacks, mountebanks, and generally just out to get people’s money by endorsing questionable products.
Other contributors have added classic themes such as:
doctor’s make lots of money so they should quit complaining.
doctor’s are all primadonnas who think that everyone else is stupid.
juries are made up of idiots, generally.
The Moral: if you’re a doctor, invent something that everyone in America wants to buy, then you can move to a 3rd world country in the tropics, find a hostel, and pay the hostel’s owner to let you kill malpractice lawyers. Until then, don’t treat malpractice lawyers and be nice to your patients.
So when the doc’s office calls and says to me….”Hey, you havent had your pap or mammo done yet this year.” “I want you to make sure that they are scheduled and done by the end of Dec.” I can assume he is worried about my health and geniunely concerned for ME? I guess if I figure out what he is truly concerned about is his bank account, and the fact he won’t get paid by the ins. if he doesn’t harass the hell out of me for tests I have no desire for, or risk factors to need, means I am in the wrong to question his morals or lose my trust in him?
you guys are making your own beds! You want the best of all worlds. You world is slowing crashing down and now you are having fits of temper over it.
No, I Think THE moral is what I have done:
I have not hurt anybody, and I am being sued for a patient I never even saw, though if I saw the patient, there isn’t much I could have done. The system is such that the lawyers can proceed with said malpractice suit. As a result of this and other threatened frivolous lawsuits, I have decided to leave medicine. There is a shortage of physicians where I work, now there is an even greater shortage. This hurts my ability to retire, but i’d rather retire poor then have to “treat” (Which these days means prevent lawsuits) patients anymore. End of story.
Regarding this argument of “patients and their injuries”, we work in healthcare. Patients get sick. We try to help them. In most cases of “med-mal”, even a medical examiner can’t figure out exactly why the patient died. Then to allow a lawyer to sue for “wrongful death”, it’s absolutely ludicrous. But it’s not my problem anymore.
This is the proverbial other shoe dropping. For any provider that has ever bought into the post hoc ergo propter hoc of “clinical causation” (i.e. rubber stamping the subjective history provided by a potential litigant), did you really think that the trial lawyers would not eventually come after you? The mentality of the dirtbag that claims MTBI, “chronic” whiplash, “disc bulges” and pure litigation diagnoses such as fibromyalgia (found any objective evidence for the existence of this garbage can) is the same as one who files junk lawsuits against providers. Think about this the next time some whining patient comes in and complains of “neck and back pain” that was “caused” by some purported MVA. By putting down the words “post traumatic” or “secondary to MVA” when you have zero ability or intent to actually analyze the history (independent evaluation of the facts) and relying on the veracity of the litigant in making, you are contributing to the problem. One way to raise the bar on these junk tort suits is to finally get some of the clinicians to admit the truth – clinical causation for non-hallmark conditions is purely speculative. Or, we could just continue with “I have to rely on what the patient tells me” and continue to watch everybody get raped by the trial lawyers.
“So when the doc’s office calls and says to me….”Hey, you havent had your pap or mammo done yet this year.” “I want you to make sure that they are scheduled and done by the end of Dec.” I can assume he is worried about my health and geniunely concerned for ME? I guess if I figure out what he is truly concerned about is his bank account, and the fact he won’t get paid by the ins. if he doesn’t harass the hell out of me for tests I have no desire for, or risk factors to need, means I am in the wrong to question his morals or lose my trust in him?”—ANON 8:59
So 1.) the doctor is doing something with only your best interest in mind or,
2.) the doctor is only doing what benefits his/her bank account.
Seems like the classic logical fallacy of black and white thinking.
Beyond this, I ask you: should doctors not be working to make money? What other profession is in business to not make money? It is in the doctor’s interest to provide the patient (you) with good health care. That’s why you’re paying him, right? If the doctor wants you to have a mammogram, he/she is hopefully following guidelines, based on the latest research, to best benefit you. If the doctor is not providing good care, he/she will lose patients, have lawsuits filed, have insurance fraud fines, etc etc. Then he/she will lose money. Wouldn’t you rather have a doctor trying to make money if the result is better health care for you?
If you believe the doctor is ordering tests you don’t need, why don’t you ask him/her about it? Obviously you haven’t done this or you would have a great story to post on this comment page. You’ve assumed the doctor has done something wrong and that’s it. I presume you don’t know which tests are necessarily indicated for your condition, and even if you are up to date on the medical literature for standard of care, perhaps you are simply following different guidelines than your doctor. Often times, more than one organization creates acceptable minimum practices for the same condition. Either way, your rant was interesting.
It was interesting because it was the absolute truth and you know it was. No, my doc does not have “my” best interest at heart when he wants to make sure I have this or that test done by a certain date. i think it is called “pay for performance”…If you’re a doctor surely you know how that works? it has NOTHING to do with me whatsoever, other than I am the one having the testing done, and everything to do with the doctor. If he were doing it for my best interest then he wouldn’t have to wait for a letter reminding him to get his patients tested for these things, would he?
10:50,
You are sooo right. The doctor should just think about you and only you. He should think about you when he wakes, eats breakfast, when he is caring for other patients, on the drive home, while helping his kid with homework, and while having sex whith his wife.
He should not rely on any type of computer reminding systems or guidelines because he should be thinking of you and only you.
No, he shouldn’t! BUT, he should sure as hell be thinking about me when he orders test that my body is going through. If he is just ordering them to line his own pockets then maybe he should put his own body through them and leave mine alone!
“Or, we could just continue with “I have to rely on what the patient tells me” and continue to watch everybody get raped by the trial lawyers.”
Who is getting “raped by the trial lawyers”? Insurers are raking in record profits, and tort claims are down and have been declining for over a decade. The average payment on all claims is around $30,000. What are you talking about?
“As a result of this and other threatened frivolous lawsuits, I have decided to leave medicine.”
So for the second time, where are you going?
1:34,
What tests do you say will line his pockets? Unless it is a procedure he is doing himself ordering tests doesn’t improve a physicians income. Pay for Performance (as far as medicare goes has not even started yet) and will be a whopping 1.5 % for reporting. The cost to do the reporting will likely be more than the 1.5% so I don’t think you have a clue what you are talking about.
Anon 8:22, get off your high horse. Of course I have a clue and you know that I do. I’m also not talking about medicare. Who are YOU trying to kid by this innocent act? Are you saying that you dont get a financial incentive to make sure pts have paps, mammo’s and colonoscopies? Weather they need one or not, or regardless of their risk factors, or lack of?
P4P recommendations, which can nominally increase pohysician reimbursement, are generally based on established guidelines for these things, such as Mammos, Colonoscopies, PAP smears. These are the very same guidelines that you and your expert witnesses will present at trial when your “greedy” doctor “neglects” to recommend them and you develop the respective disease.
“Who is getting “raped by the trial lawyers”? Insurers are raking in record profits, and tort claims are down and have been declining for over a decade. The average payment on all claims is around $30,000. What are you talking about?”
Where do we start? Individual drivers with their auto policies, businesses with their worker’s compensation (i.e. fraud) payouts, certain providers that get hit with scientifically specious causation claims. I have suggested the following in the past and will suggest it here again. If I created a study group of say 50 relatively sedentary volunteers and had half of them do some light weightlifting such that they developed some delayed onset muscle soreness involving the axial musculature and then sent them in to various providers (chirofrauders included of course) with a history of rear-end MVA… what do you think the error rate would be in terms of cause attribution. A priori, I would say 100%. The clinical causation paradigm of the “patient is infinitely reliable (unless they are claiming that a provider injured them)” is nothing but junk science. Applying the standards already present would certainly put some of the prostitutes out of business but it would also protect providers from the speculative John Edwards’ type cases.
“Individual drivers with their auto policies”
How so? Are you upset that insurers pay claims – you know, what they agree to do? The average payment is $30,000 – are you saying they’re not worth that? Are auto insurers struggling to survive?
What cases did John Edwards handle that you believe were speculative?
How so? Are you upset that insurers pay claims – you know, what they agree to do? The average payment is $30,000 – are you saying they’re not worth that? Are auto insurers struggling to survive?
What cases did John Edwards handle that you believe were speculative?
No emotion… simple statements of fact. Auto insurers do not agree to pay fraudulent claims. A system based on providers (with a financial interest in the outcome) parroting the history provided to them by litigants and potential litigants and somehow equating such
to causation to any “reasonable degree of certainty” is nothing but junk science and leaves the door open for fraud. Limiting the argument, for the moment, to the MVA environment, there can be no “reasonable degree of certainty” on any causation argument unless the particular “noxious agent” is both qualified and quantified based upon an independent evaluation of the physical evidence present in the case. Claims of “whiplash”, disc herniations, supraspinatus tendon tears, ligamentous and cartilaginous knee injuries, brain injury, etc. in clutch-stall severity collisions are generally meritless. Clinical cause analysis (aka relying on the veracity of the litigant) can not differentiate such junk claims from those that have merit. Cases of this type deserve a $0 dollar payment on clinical specials. It was a nice attempt to swerve the topic into that of “auto insurance companies” when the issue that I raised was one of unequal and almost non-existent application of the rules of evidence when it comes to “clinical causation” testimony (a point for further discussion – differential diagnosis on etiology does not even come close to meeting scientific certainty requirements).
As far as JE goes, the causation link between the actions of the providers and CP is purely speculative. Can you point to a single controlled study in which any diagnostic indicators were found that allowed for the differentiation of nascent (wrt to the time of birth) vs. iatrogenically induced CP?
anon 12:50 no he can’t but he will ask you if you know if CP was never, ever, ever related to possible birth injury. Since you can’t prove it was never, then John the slime Edwards was justified.
PS: If the dems want to ensure losing the white house again in 2008 , they should nominate John the slime.
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