The daily burden of risk

in Uncategorized | 22 responses

Take a walk in our shoes: “I signed up for this job, and I continue to do it. I still don’t want to quit. But that does not mean that the daily burden of risk does not take its toll. That toll is fatigue and chronic anxiety for many. That toll becomes bitterness when coupled with a system that keeps lowering what they pay us while raising our exposure to risk.”

Comments

Anonymous
Part of the solution is to order your life to minimize risk. That’s why the surgeons stop doing emergency work, the neurosurgeons stop doing intracranial, no one wants to do obstetrics anymore, on and on.
At one time I used to feel guilty. When I saw tort reform voted down, and our courts overturning tort reform legislation, I no longer feel guilty at all. They’d rather sue doctors than have doctors. They got their wish.
Anonymous
Fine. Now YOU look at it from the other side. I didn’t sue ANYBODY. A surgeon apparently decided that after seven surgeries I might pose such a risk and therefore, quite cowardly, stuck a termination letter in my permanent record endng my care “due to past interactions”.
Past interactions? Thanks a bunch. Now anybody can interpret that any way they wish, and most will probably assume I didn’t pay my bills or was abusive to staff. Never mind that I paid every dime, contributed charitable donations on top of that, and sent the staff flowers!
So excuse me for not having a helluva lot of sympathy for your “risk”. Some of you risk absolutely nothing. Some burden.
Anonymous
5:25,
It is hard to imagine how you could have been terminated.
Medical care costs in this country will not be contained until society will allow for some risk taking. Otherwise I am going to continue to spend millions of dollars a year with the stroke of a pen to uncover the last 1% of disease that can’t be discovered by H&P. I will no longer take ER call.
Anonymous
5:25 – The surgeon chose to minimize his/her risk. You don’t care about the surgeon’s risk. Fine. I would imagine the feeling was mutual.
Your surgeon chose not to do high-risk work, and YOU were the high-risk work. And 6:30 chooses not to take ER call.
Sue doctors or have doctors.
Anonymous
The above comments are sad, sad, sad,..Its us vs them…so much hostility!
For my part any weekend complaints for other pcp’s patients go to the er…I need to manage my risk exposure- having no relationship to them…I feel the patiemnts pain….but my pain would be far harder to bear.
Anonymous
It’s us versus them all right, but who started the fight?
How many doctors have sued their patients?
Anonymous
If the physicians actually had any idea wwhat exactly their risk is, this argument would have more weight.
Buut almost all of them don’t. They have no idea how likely any of their fears are, nor do they care to learn what exactly will minimize the relatively limited risks they already face. They just complain. Nonstop.
“Sue doctors or have doctors.”
Nonsense. Why should doctors be immune from their errors? And spare us the great disappearing doctor cry. It’s so tiresome and has been proven wrong so often.
Anonymous
“How many doctors have sued their patients?
# posted by Anonymous : 11:55 AM”
Doctors don’t ever sue their patients because the physician is insulated from the part of the process the patient brings – the money. The people who do collect the money on their behalf DO sue the patient. They also harass them with collection calls, ding their credit, etc. if the patient doesn’t live up to their end of the bargain.
And physicians DO sue the health insurers that pay them. Funny how they never want to “reform” their ability for nearly a million physicians to file class actions which net hundreds of millions for the physicians. And if I use physician logic, that only drives up health care costs for the patients.
Guess it all depends on whose ox it is, eh?
Anonymous
Nonsense?
I saw the empty trauma rooms in Vegas.
I see the docs turning away high-risk work. I know why they turn away the work. We see them returning in the states that passed tort reform.
But if you think it’s nonsense, fine. Just don’t complain when the doc isn’t there.
And nobody’s trying to insulate doctors from mistakes. Just the lawyer jackpot. Noneconomic damages limited to a predictable amount. As evidenced from the McDonald’s coffee, the 52 million ruined pants, it is clear the Bar can’t control itself. It’s your greed.
Anonymous
“And spare us the great disappearing doctor cry. It’s so tiresome and has been proven wrong so often.”
Right, so we won’t quit. What we will do is simply not offer the treatments that are high risk, the list of which will grow longer and longer as you continue to sue. So the doctors are still there, but the treatments are not. Is that what you wanted? “Your wife needs a C-section because she has pre-ecclampsia? Well, we’re sorry, we don’t do that anymore. Too risky, the hospital doesn’t like it. As you’re a lawyer, I’m sure you understand.”
This is the world you are making. We live in it, even if you don’t.
Anonymous
My area, a group of neurosurgeons moved nearly all their practice out of the trauma hospital, went to a nearby hospital to do spine surgery, and some elective intracranial neurosurgery.
So on paper, the doc is at the trauma center. Still on staff and all that. But in reality, when you want the doc, he’s not available. He’s at the smaller hospital doing spines.
So you get the usual arguments that there’s been no change in physician numbers. Yet despite having the same number of neurosurgeons, you can’t get head trauma done in the town.
Anonymous
However, like in all industries, someone will eventually assess the amount of risk and fill the hole you guys claim to be leaving, and be compensated better than you for doing it.
“We see them returning in the states that passed tort reform.”
No you don’t. Your great state of Texas hasn’t got anyone returning. They went on a hospital building boom in the “crisis” years in Texas, and as soon as they were all built they started hiring. Texas still doesn’t even keep up with the per capita growth. You went where there were people, and thus jobs. You can pass all the “reform” you want in Detroit, if people aren’t there, there will be doctors leaving. I know you want to attribute everything rosy in the world to your “reform” that screws elderly and kids, and I guess what that’s what statistics are for, but don’t think you’re fooling anyone but yourself.
“Noneconomic damages limited to a predictable amount.”
Why should your lobbyists get to decide what is “predictable”? Why is the out of shape couch potatoes loss of quality of life worth the same as the college athlete? So your insurer can save some money?
Again, spare us all the disappearing docs cries. If you’re in an out of the way rural place, you’ll have trouble getting docs.
Tell you what, we’ll give you tort “reform” when you physicians agree to give us a certain number of you, and in certain specialties, per capita. Until you do that, you’re getting something for nothing. At least until the insurers declare a “crisis” again. The early part of this decade was only the third “crisis” in 30 years. All oddly timed with economic downturns. Hmmmm. Guess you missed that little fact in your rigorous analysis.
Anonymous
CJD,
Welcome back. Whats’ up?
Anonymous
“However, like in all industries, someone will eventually assess the amount of risk and fill the hole you guys claim to be leaving, and be compensated better than you for doing it.”
Um, ok, who do you want doing your head trauma? Your PA? And compensated better… That really is too funny. 9:18, for humor value, your post simply can’t be beat. Thanks for the laugh!
Anonymous
Must be a slow week for ambulance chasing.
Notice how he gets madder and madder as the evidence piles up against him.
Anonymous
“5:25 – The surgeon chose to minimize his/her risk. You don’t care about the surgeon’s risk. Fine. I would imagine the feeling was mutual.”
My point was, if you cared to see it, that there WAS NO RISK to the surgeon. If I wasn’t OK with his plans for treatment I wouldn’t have agreed to them. By contributing money to his charity and being nice to his staff, I was trying to demonstrate that even though the treatment wasn’t resolving the problem ASAP, I still had faith. And if he had simply said, “You should get a second opinion,” I’d have done that. But he didn’t. He dropped the axe. That is not justifiable. It left me without insurance-covered access to care in his specialty unless I change carriers. No reason I should have to put up with that.
So sure, after he decided to dump me and throw vague BS into my records to cover his backside, then yes, I did begin to care a bit less about the fellow. Simple cause and effect. Stab me in the back and I’m not going to like you.
I can appreciate that you folks don’t like to be sued, but I don’t like to be on the receiving end of such action either. Don’t suggest that it’s OK for the patient to suffer while you’re objecting to the very same conduct. That’s hypocrisy, and it doesn’t help your argument.
Anonymous
Sheesh, you’re laying it on awful thick. You contributed to his charity? Gave flowers and gifts.
Hoooookay…….
You assume I care? Assuming I believe your story……you’re starting to sound like the psych cases who praise the new doctor to heaven and damn the old doctor to hell. We know not to trust such patients, they will be cursing you very soon, and suing later.
But, specifically about the doctor taking NO RISK.
Unless you signed some sort of agreement to indemnify the doctor, your word is worthless. The doctor had whatever risk he perceived, and chose to avoid it. And you were the risk. Period. The doctor is the one taking the lawsuit risk, he’s within his rights to avoid it if he perceives it as such.
Sue doctors or have doctors. Whether CJD cares to believe it or not is irrelevant. That’s the way it is.
Anonymous
Assuming that you’re a doctor…if so, you’re not one I’d care to trust…let me restate:
He could have referred me elsewhere if he was not willing to accept the risk. Instead, he blocked my access to every physician in his group and increased both the cost and inconvenience of my care.
Not necessary. Not humane. Not intelligent. And not honorable.
Doubt those are qualities you value, but I’d like to believe there are a few doctors out there who still do.
Anonymous
So you say.
Dismiss from practice = dismiss from group is usually a group policy. I doubt very much he personally stood up and barred the door against the wishes of the physicians he works with. Blame him if you wish I honestly don’t care. And everybody seems to want big corporate medical practices, that’s what you get with the big groups. In my area, you get dismissed by the big group, there’s a couple small fish like me still solo, but mostly it means you have to go a couple counties away. I’d say about a hundred miles or so.
My sympathy evaporated with the repeated failure of tort reform, and judicial overturn of what little tort reform we had.
You wanted a referral. Even referral carries risk. Blame the lawyers. That’s why I don’t make specific referrals. If I send a patient away I tell them to call the usual medical society and hospital referral lines.
>>Not necessary. Not humane. Not intelligent. And not honorable.
(so you say)
Nope. It’s business. And self-protection in the days where John Edwards and his ilk make tens of millions off junk science and junk lawsuits.
Sue doctors or have doctors. You reap what you sow.
Anonymous
“Sue doctors or have doctors. You reap what you sow.”
We have more doctors than ever. And what would we sow? When you screw up you deny responsibility and say they would have died or had that happen anyway, medicine is not perfect blah blah blah. Yet somehow you always seem to take credit when things go right.
You keep crying about the fact that you’ll be held responsible for your negligence. So how many times has your care been negligent, in your oh so humble opinion?
Anonymous
When you screw up you deny responsibility and say they would have died or had that happen anyway, medicine is not perfect blah blah blah. Yet somehow you always seem to take credit when things go right.
“medicus curat deus servat” is on my wall. The saying is as old as medicine.
If there’s anything I’m “afraid” of, or more to the point, have contempt for, is the manufactured “negligence” ginned up by junk science and greedy lawyers channeling babies in front of juries.
Glad to see your real attitude is breaking through. Yeah, I bet you sent flowers and contributed to the doctor’s charity.
You might notice I’m not the one crying. You are. You’re the one crying you can’t find a doctor willing to do high-risk work, which is exactly my point. Thank you for proving it.
cjd
“If there’s anything I’m “afraid” of, or more to the point, have contempt for, is the manufactured “negligence” ginned up by junk science and greedy lawyers channeling babies in front of juries.”
Do you ever get “afraid” of pontificating on cases and patients that you’ve never seen the records on? Or do you have that Fristian ability to diagnose without those things?
People in rural areas can’t find doctors period. We’ll give you your “reform” when you’ll guarantee us something. So far you haven’t, so why should we do anything for you?
Besides, even if you would do it and you screwed it up, you’d never admit you were wrong. You’d point to the sign on your wall.