I’m certainly NOT “promoting” the notion that I’m a “wack-job” or a “troll”. I’m simply repeating what people in this supposedly enlightened and “progressive” blogosphere have called me for telling the truth – and for not backing down/giving in (apparently to prove my mental health, that is what I should do).

My message IS (don’t you just love that word?) very powerful – not to mention that IT IS THE GOD’S HONEST TRUTH (why do you think I have not been sued again by the hospital/executives who did me wrong?).

Morevoer, I did what the public and (more importantly) ANY parent would have expected me to do (and probably would have sued me for not doing). What happened to me NEVER should have happend. So WHY haven’t the AMA and JCAHO and DHHS and the state Medical Societies & Boards done anything to (1) specifically address my situation and (2) generally plug the holes I feel through?

Why can’t the medical blogosphere be something besides a fricking ECHO chamber? I mean, what has the medical blogospehre really accomplished?

Yesterday, when Obama did his dance for the cameras and announced that the AMA was supporting his healthcare reform bill, I just wanted to cry. Like the AMA has EVER represented doctors like me!

On the heels of that, I got an e-mail yesterday that showed Congressmen & women playing Solitaire and checking baseball stats as one of their compatriots spoke on the House floor. These are people who might better spend their time actually reading the legislation they want to cram down our throats – and/or holding hearings to listen to people like me (as opposed to the traditional dog & pony show of healthcare “victims”). But hey, let’s mindlessly flip the cards on a computer. Those three-day work-weeks are a real bear.

It’s all a joke. Just a joke.

I have to wonder how many colleagues knew that the psychiatrist who killed/shot dozens of people at Fort Hood yesterday was a loose cannon – literally ready to blow (I’m still trying to wrap my head around the fact that this doctor was TREATING other sick minds – and was going to be deployed).

I wonder how many of his colleagues might have felt more comfortable coming forward with their concerns – saying or doing something proactive and preventative – if they knew they could rely on the law/governement to protect them from retribution?

In terms of the service obligation, my stint in the NHSC was, in many ways, not a whole lot different from a stateside assignment in the military. All any of those people had to do to see how government whistle-blowers are really treated/regarded is pop on over to Dr. J’s Housecalls.

But they don’t have to really. They already know.

I will not find peace until I get justice. But I very much appreciate the thought.

In most situations involving business transactions between equally weighted parties I would agree with you it might create some potentially great choices. Although I just don’t think it would happen, because at the end of the day many people want the right to recover if damages are caused through no fault of their own.

“And in practice, this is what we had decades ago in the friendly world before the climate change of litigation and government regulation permeated our lives.”

And I would agree with this to an extent. If you look at what has really driven the litigation “explosion” it is businesses suing businesses, not personal injury filings. Last I looked those were down.

I also think physicians have some blame to shoulder in terms of government regulation of their industry. They allow themselves to be trapped by this third party payment model where the govt. is the payor. It’s not all their fault, but they do have some responsibility. And when you take the government money, you take the government regulations. It’s nice to have a solvent party to collect from, but there’s going to be a downside.

Paul, we didn’t really discuss that, but we may well agree on the impact. Our civil justice system affects everything we do, in both good and bad ways. As would any justice system in a free society.

Now you have a tell on the adversary; the individuals involved,the system, people at large…don’t care.Knowing about that apathy, or egocentric tendency, could you redirect your resources toward a better outcome?

Please don’t promote the marginalizing label of wack-job troll. I would guess that when your fight began you had faith in truth and justice.Now you know better. Your writings are powerful and ring of truth.But, is your commentary being read, or is it effectively dismissed because ‘the adversary’ has successfully labeled you a wack-job? I think it is impossible to survive in a conflict if constantly on the defensive.

You have a hard-won knowledge about how the legal system really works. You have the attention of many people, and a powerful message to convey. I hope your administration of that message finds the right route.

And I hope you find peace for yourself.

In any cash-pay medical transaction and in other everyday nonmedical transactions, there should be an enforceable opt-out clause where two parties can agree to VOLUNTARILY waive their rights to sue. This would really create a lot of new opportunities for good mutual cooperation. And in practice, this is what we had decades ago in the friendly world before the climate change of litigation and government regulation permeated our lives.

So many lost opportunities for cooperation are lost due to fear of being sued. So much energy is wasted on “defensive transactioning”, analogous to defensive medicine.

Hypothetically, if I hire a photographer for my wedding, I would be very upset if he messed up or didn’t show up, so I would want to retain my right to sue. However, if there’s another photographer who has a good reputation and is trusted by my friends but who has decided not to “waste money” on business liability insurance and will knock $500 off the price in exchange for my waiving any right to sue, I may or may not do so, depending on how much I want to gamble. That should be my choice. Having some sort of fullly enforceable but voluntary “give up the right to sue” clause would create a lot of potentially great choices.

The re-emergence of free medical clinics would be just one obvious example, going back to the good old days when doctors would allocate a half day each month to pro bono work.

The biggest problem in terms of any kind of real tort reform, is that the medical establishment does not want to admit that there is a big underlying problem . . . i.e., physician oversight & discipline is largely an unstandardized joke – and depends on what state and what hospital one works in. Moreover, the AMA and JCAHO and DHHS and the Medical Societies/Medical Boards have been ignoring and/or white-washing the problems that medical whistle-blowers face (most specifically, the “white wall” of silence) for decades.

The careers and lives of good people have been destroyed and they did not care.

I am all for a Washington task force. But I’m even more for some of these cases (like mine) – which have legitimate unresolved criminal elements – to be agressively pursued by the US and State Attorney Generals. If they were, it might make some of the businessmen and lawyers really running the show to take notice and change their behavior.

On what planet is it okay for me to have been fired for saving a baby’s life? Or reporting what happend to peer review? On what planet is okay for me to have been sued for telling the government I served the truth?

This planet.

The public and the politicians all say they want physicians to put ethics/patients first. Well, I did. And I’ve done nothing but pay for it ever since. People who have not been there and who have not done that want me to shut up and go away. And if I don’t, I’m some kind of bitter wack-job/troll.

Well, I’m not going to just go away. And I guess I’ll just have to be a bitter, wack-job/troll.

Physicians who favor patients who agree to reasonable caps might lose out on patient volume because those patients who insist on high caps would then choose to see some other doctor instead. It sounds like a very fair system.

This would best apply to situations where there is on urgent duress, so it would not apply to Emergency medicine cases.