Medical malpractice stress syndrome: The ignored side of litigation

Medical malpractice stress syndrome: The ignored side of litigation

In March 2008, prominent Denver business owner Leslie Fishbein suffered cardiac arrest and died after receiving trigger point injections with bupivacaine for chronic neck pain.  Ms. Fishbein owned a chain of high-end furniture stores.  She was well known within the community because of her starring role in television commercials promoting her business.  Her death drew tremendous media attention and heavy scrutiny for the physician who treated her.

Dr. Daniel Brookoff was her doctor.  He was sued for wrongful death.  Even though we worked in the same city, I never knew him.  But we have two things in common – the same law firm sued us both, and our lives were both tragically affected by allegations of medical malpractice.  Sadly, Dr. Brookoff paid the ultimate price for the pain of his lawsuit.  On April 14, 2001, Dr. Brookoff was found dead inside his car in a parking lot in Memphis, Tennessee.  He had a self-inflicted gunshot wound to the head.  The day he killed himself was the very day that the lawsuit filed against him settled out of court.

When a physician is sued, regardless of whether or not the allegations have merit, it is a personal assault on his or her honor.  Unfortunately, the odds of facing litigation are against us.  A study conducted by the New England Journal of Medicine in 2011 shows that by the age of 45, 36% of doctors in low-risk specialties and 88% of those in high-risk specialties have been subjected to a malpractice claim.  By the age of 65, when most of us retire, those numbers jump to a staggering 75% for low-risk and 99% for high-risk specialties.  The fact that being sued is nearly guaranteed and often described as the “price of practicing medicine” does little, if anything, to soften the blow when it occurs.

Medical malpractice stress syndrome (MMSS) is being recognized as a real entity.  It bears a striking similarity to post-traumatic stress disorder.  Sadly, emerging victorious in litigation does not protect a physician from being traumatized.  One reason for this is that physicians are inherently likely to blame themselves for bad outcomes.  Legal claims magnify feelings of self-reproach.  Further exacerbating the situation is the physician’s inevitable concerns over loss of livelihood, loss of control, damage to reputation, loss of assets, and lack of knowledge regarding legal proceedings.

MMSS can manifest in both psychological and physical forms.  Following a lawsuit, physicians report feelings of isolation, negative self-image, anxiety, depression, self-doubt, anger, and inability to concentrate.  Physical symptoms can include either the development of a new medical illness or the exacerbation of a pre-existing medical condition, such as hypertension, coronary artery disease, or diabetes.

Treatment of the disorder depends upon the severity of the symptoms.  In the case of severe or prolonged anxiety or depression, especially if there are thoughts of suicide, the physician should not hesitate to seek psychiatric help.  Anti-anxiety and antidepressant medications may help stabilize a physician’s mood, thereby helping them to better cope with the litigation process.  Beyond this, knowledge is key.  Physicians should strive to educate themselves about the unknown.  This includes seeking guidance from colleagues and attorneys, reading literature about litigation stress, and attending support groups.

Another useful tactic for coping requires the physician to change how they view the process.  Being sued does not make one a bad doctor.  Unfortunately, many good doctors will find themselves involved in a medical malpractice case.  In many ways, it is more a factor of luck than competency.  The physician should also realize that the goal of the patient and the patient’s attorney is to obtain money.  In light of that, to the extent possible, the physician should ignore what the plaintiff’s side says or does.

Dr. Brookoff’s suicide should serve as a shocking reminder to us all that when we are publicly accused of harming a patient, the stakes are personal and extremely high.  For me, the process was the most devastating and stressful event of my life.  However, time has brought clarity.  I realize that I have something to offer to others.  By openly talking about my experience and bringing MMSS into the forefront, other physicians may be helped.  At least, I hope so.

Sherry Gorman is an anesthesiologist.  In 2009, she was sued for medical malpractice after a drug-addicted scrub technician diverted fentanyl and allegedly replaced stolen syringes with contaminated ones refilled with saline.  The scrub tech’s crimes are blamed for infecting over two dozen patients with hepatitis C.  One of those patients was under the care of Dr. Gorman.  Her case settled out of court in January 2012.  Since that time, she has slowly started to heal.  Part of that process involved writing a book under the pen name Kate O’Reilley.  Dr. Gorman hopes that through her book and speaking out to other physicians, she can bring something good out of a situation that nearly destroyed her. 

Image credit: Shutterstock.com

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  • http://twitter.com/drtwillett TheresaWillett MDPhD

    Thank you for this post. We are all practicing under the threat of legal assault, and we need to be more open about the consequences. The burden affects how we practice before and after the experience.

  • karen3

    Eyeroll. Try the stress of being the victim of medical malpractice. A life time of disability of death is immeasurably worse than being embarrassed, especially if the physician did something to deserve it.And maybe you should have paid a bit more attention to your scrubs…

    • Mika

      Eyeroll indeed. If you or I stuffed up at work, and fronted up to Sherry here asking for the same anti-anxiety & sleeping tablets which helped HER cope with the aftermath of HER stuff-up, do you think WE’d be so indulged? “Hey, my incompetence at work caused someone’s lifelong disability, and peole are being JUDGMENTAL to me over it. Gimme some nice drugs to make me feel better about it!” I don’t think so. As long as doctors treat us commoners like scum, and themselves & each other like royalty, I couldn’t give a flying f…….ish.

      • themedstudent

        Don’t you have some commoner duties to attend to? Probably not. Just another lazy American with no job and looking for a handout/free healthcare/obamaphone/whatever…

        • http://twitter.com/medmalpatient Patients First

          If you are a med student, I would guess you are going into surgery.

    • Suzi Q 38

      I dare told the surgeon I felt weakness in my inner thighs after my hysterectomy.
      that made him panic that it could have been a “poor outcome.”
      He did not push for treatment for me, instead asked that we wait and see if it “went away.” It did not, and eventually he referred me to a neuro, who tried, but slow to order any tests or get to the bottom of my leg weakness. I begged for more tests. When I told the PT person that I was thinking of going to get a second opinion from another teaching hospital, I was told that my condition was serious, but they could handle it. Also, I was better off at their facility since the teaching hospital was so large. He said I would get “lost” there.
      Now I have lost at least 30% of my walking function. I finally bailed and went to another teaching hospital and they told me that there was not much more they could do for me except the surgery for the spinal stenosis that I should have had done over a year ago. The surgeon said the other hospital waited to long, and now it may be permanent.

      So now, do you think that I should just “suck it up” in silence?

      I am not sure I am going to sue, as negligence is hard to prove, but there is a long story that I have with a lot of medical mistakes.

      i have decided to at least report it, but I will be fair.

      I am not sure that the author would accept my paralysis that was needless so readily. Some days I feel like shooting myself with all of these doctors acting as if I was a hypochondriac and playing “hot potato” with me for so long. You ever want to know what it feels like to be on the receiving end of your human errors or fears and cover-ups that result in physical decline?

      I think I will have to go all the way to the top. Patient advocacy, medical board, or Joint commission.

      I am concerned about the cost of litigation; I have a family friend that successfully sued a pharmaceutical company and won. So no lack of lawyers in my neighborhood. It is just that there is so much stress that I am afraid to even call him. I know he would get all angry and make everyone’s life miserable, but I need to see what my options are, if any.

      I keep putting it off, hoping that my surgery will make it all better so no one will have to get in trouble.

    • http://twitter.com/AnikaSchaedler Anika Schaedler

      And suppose the patient who sues is someone who had a bad outcome at no fault of the physician? A lawyer will take his/her case and drag the physician through the mud costing the physician thousands of dollars, hundreds of uncompensated man hours and tremendous psychological stress. There is a reason most malpractice litigation results in verdicts in favor of the physician. There are a LOT of inappropriate lawsuits out there and these take their toll on PEOPLE (yes, doctors are people just like you) who go to work everyday trying to do their best. A bit of compassion would suit you.

      • http://twitter.com/medmalpatient Patients First

        Compassion for destroying my life! You will never know how medical negligence affects lives. What a shame!

        • http://twitter.com/AnikaSchaedler Anika Schaedler

          Yes, I do know, more than you think. You are angry and you are hurt, and I don’t blame you. I don’t think you’re fully capable of relating to what the author was trying to share here, but that’s ok. She’s not dismissing patient suffering. She’s shedding light on the other side of things.

        • http://twitter.com/ZansD94 Dana

          Yes they do destroy lives and then they expect the Hollywood treatment where they don’t end up having to pay for what they did because they are “special”

      • Suzi Q 38

        You make a good point. This is why I haven’t jumped to get to a lawyers office yet, and to get one, all I have to think of is which friend or neighbor to call.
        In my case, I suspected a bad outcome, but the surgeon got so defensive and annoyed that he stalled my care.
        He thought he was doing us all a favor, but instead, my paralysis was getting worse. The PT thought it was serious, but didn’t want to ruffle the feathers of the neuro, who did not think it was serious. I asked the neuro for more diagnostic tests, but he did not tink it was all that bad. He thought it was more muscle related. Also the surgeon was his dorm roommate from Berkeley. I think he hesitated to go full boar for me given that his friend had done the surgery. To add to this confusion, my pain came and went. The tingling and weakness was always there, though…just in varying degrees. In retrospect the PT really needed to advocate for me and get into the face of the neuro, but he was a bit of a wimp. I ordered all of the medical records, and in my chart, the PT person wrote: “Possible Cauida Equina”
        which is not what is was, but something equally serious with devastating consequences. Certainly a condition that warranted further testing.
        One thing I am going to point out in my grievance is this:
        A little over a year ago, PT thought I had CA. Was the neuro notified on my behalf? If so, why wasn’t I given the diagnostic tests that I asked for (more MRI’s and nerve tests).
        If not, why not? Certainly, if you suspect cauda Equina, a “red flag” should have gone out.

        I think the that neuro had the most responsibility here. I do not have the skills that he does and he was in charge of my care.

        I notice now on my last evaluation he wrote that my spinal stenosis was congenital. I wonder how it showed up right after my surgery, also, why didn’t he mention congenital when he first discovered it , too little too late? Also, none of the 2 or 3 radiologists mentioned the stenosis being congenital in their radiology reports. One of the reports came from a neuroradiologist…no mention of the blockage being congenital. How convenient and somewhat desperate.
        No matter the reason, even the second teaching hospital politely and calmly told me that it was unusual that the first hospital kept me so long with out the definitive tests.
        They would have ordered the tests much sooner, to avoid what happened to me. The surgeon and neurologist at the second hospital do a lot of work with the first teaching hospital. They said that I should have been referred a lot sooner. I told them that I was discouraged from leaving.
        I also do not think that the doctors thought I was going to lose function in my legs and possibly paralyze. Even when they first hospital found the stenosis (after 1 1/2 years), they refused my request for a referral to a different teaching hospital for another opinion. I had to go out alone and start all over again’
        I feel that the least they could have done for me when they screwed me up with sub par treatment was to to what was best for me and help me get another opinion from a teaching hospital that specialized in neurology.

        I am trying to avoid an inappropriate lawsuit, and I am hoping I can still avoid it if I get some concrete answers and no B.S.

        Of course my story is so long, even I would fall asleep.

      • http://twitter.com/medmalpatient Patients First

        Cry me a river!

      • http://twitter.com/StopMicra Stop MICRA!

        Why would someone sue if it’s of no fault to the physician???!!!

        • Noni

          Are you really asking this question? Why do you think?

        • Glenn

          “John Edwards was not available for comment.”

      • http://twitter.com/ZansD94 Dana

        Sorry not all doctors go to work trying to do their best a bit of compassion would suit some of your doctor friends you seem to passionately defending

  • Mika

    My sister suffered true PTSD after an assault & rape. She wasn’t able to get the anti-anxiety drugs and sleeping tablets which this doctor charged with malpractice recommends that doctors charged with malpractice be given. My sister was treated like scum, like a drug-seeker, and basically left to tough it out on her own. I guess it’s true, “some animals are more equal than others”.

    • http://twitter.com/VivaVallyvivA Heidi ~*

      Clearly a doctor shopper if the first thing she did was then bring a lawsuit rather than find another provider who could meet her needs… AGAIN – JUST SAYIN’!

      • Payne Hertz

        Where did she say her sister brought a lawsuit and how is that evidence of being a doctor-shopper?

        This is the kind of perverse, fact-free moralizing that results in patients being demonized and abused by the medical profession for the “crime” of wanting relief from their emotional or physical pain.

        • http://twitter.com/ZansD94 Dana

          Yeah no kidding Heidi, I hope you aren’t a doctor you can’t even comprehend what you read. Nowhere does it say she filed a lawsuit

      • Anon

        You scare me because not only do you have no sympathy for those who have had bad experiences but because you can’t (…….or won’t…….) READ.

    • http://twitter.com/medmalpatient Patients First

      That is unfortunate and I hate that for your sister. I also have PTSD, but it was due to medication error for a spinal. Your sister should seek counseling for the emotional aspect and then see a psychiatrist for help with her meds. I was always a skeptic when it came to mental conditions. Not anymore, because PTSD is a beast. I’ll never have the old me back, so I am trying to deal with the new me.

  • 2EyesWideOpen2

    Lawsuit happy clients in the USA is as routine as gum chewing. No so here in Canada. Doctors earn less but have a better quality of life knowing that they are not going to be sued for every error or bad result they make.

    • http://twitter.com/medmalpatient Patients First

      Well then God Bless America! Physicians are held to a higher standard for a reason. They placed themselves in positions of treating people. We are not major appliances and do not have warranties. If your mother was the patient who suffered or died because of an error, would you be so flippant about a healthcare providers making errors? I’ll put it another way. If your newborn baby were accidentally given the wrong medication due to an error, oversight, or oops just picked up the wrong syringe and then suffered a massive brain hemorrhage due to that med being given, but she will be buried in a wheelchair and unresponsive for the rest of her life would you just let it slide. If your answer is forgive and forget, PLEASE stay in Canada and away from American patients!

      • http://twitter.com/AnikaSchaedler Anika Schaedler

        Good thing you are not a Canadian then. Apparently there you just have to accept that the medical system is not perfect and errors occur. In the good ol U S of A you can get money for other people’s mistakes and drive them to suicide! Good for you!

        • http://twitter.com/medmalpatient Patients First

          You are simply a fool! I never mentioned that physicians name. We do not knw what issues he was dealing with other than settling a medical malpratice lawsuit. Suicide is the easy way out. My family is from Canada.

          • http://twitter.com/AnikaSchaedler Anika Schaedler

            You have no clue about the toll malpractice litigation takes on physicians. Yes, being a patient who’s suffered a bad outcome is terrible, but this is not routinely the physician’s fault and this is not something money will fix. Yet, money grubbing lawyers will take a case and drag a physician through the mud. To say that suicide is an “easy way out” for a professional who has devoted their life to the care of others is repulsive and disrespectful.

          • http://twitter.com/medmalpatient Patients First

            That is one case! Would you give a crap about me, my three children and husband if I blew my brains out because of what I suffered through. Don’t you dare preach to me!

          • N N

            You truly need to seek psychiatric help.

          • http://twitter.com/medmalpatient Patients First

            This will be the last comment/reply I make on this article. It is simply a waste of time. I never once dismissed the fact that physician took his own life. I made a valid criticism of an article and now you want to attack me when you clearly have not read the entire thread. Many of my physician friends have a fantastic head on their shoulders and then I come across ones who cannot see past their egos and cannot knock the enormous chip off their shoulder. You are a class act and I am sure one hell of doc.

          • Payne Hertz

            Whatever the toll is, I am sure it is nowhere near as terrible as the price paid by the victims who are killed or left to suffer a lifetime of pain and disability.

            Given the staggering indifference shown to the huge numbers of patients killed or injured in this system every year, you’ll forgive me if most doctors and their organizations don’t appear to be as concerned with patient safety as they are with being sued for screwing up.

            If doctors are so traumatized by the injuries they cause then one has to wonder why they resist taking responsibility for their actions and not forcing the victims to go through the ordeal of a long, drawn-out litigation process to receive compensation.

            If doctors feel so bad about injuring patients, you have to wonder why they are not on the front lines of the battle to improve hospital safety, rather than trying to rob the victims of medical negligence of their legal right to seek redress in the courts. Quite the contrary malpractice victims barely warrant a mention other than to demonize them as rent-seeking villains looking to “win the lottery” with the help of “ruthless” and “greedy” lawyers.

          • http://twitter.com/AnikaSchaedler Anika Schaedler

            You make excellent points here. The system in place to deal with bad outcomes or negligence here in the US is so dysfunctional that we end up with the current situation: suffering patients, cowering, secretive doctors and hospitals, and a judicial system set in place to maximize profit rather than obtain a speedy and appropriate resolution. There is no real justice for anyone and there are no winners, only losers.

            I think there are clinicians who DO own up to mistakes only to get sued. This affects their future practices as well as the practices of those around them. Clinicians see that being open and honest will result in a lawsuit, so why tell patients the truth? Often hospitals do not want clinicians to admit wrongdoing as this will end up with the hospital being sued (i.e. – big money lost). Clinicians who are sued are expected to keep quiet and bear the stress, guilt and suffering on their own.

            Again, I don’t think the point of the author’s post was to minimize the trauma and suffering of victims of med mal but rather shed light on the other side of it. It’s not fully surprising that her story gets little sympathy from those outside of medicine.

          • http://twitter.com/sherrygmd Sherry Gorman, MD

            Hi Anika,
            Thank you for your post. You are right. My post was not intended to minimize the patient’s suffering. But, in any malpractice suit, there is another person who suffers greatly — the doctor. I’m glad you appreciated that.

            I’m sure that there are plenty of people out there that have been legitimately harmed by clinical error. I wish it never happened, but I know it does. My post, however, was focused on one issue only — what it does to the doctor.

            Sincerely,

            Sherry Gorman, MD

          • karen3

            Sherry, I have never seen a doctor have a moment’s worth of conscience over patient care. It does not happen. As far as I can see, you all are pithed of a conscience in med school (and the research actually shows that people become less moral as they go through med school). Whatever unhappiness there is, it is a result of being caught and the consequences of being caught. Which is no different than the reaction of your neighborhood drug dealer, rapist or other thief when they get arrested and go t jail. Your conduct seems to show you as having little remorse or sensitivity towards your victim. If you were a poor black kid in Chicago, you’d get the book thrown at you. and I have to say, I’d have more compassion for the kid gone wrong in than you.

        • advocate

          Yep, over there, apparently if you go in for a simple boob job and come out with doctor-inflicted Hep C or AIDS, you just just keep quiet and meekly thank the doc for not outright killing you instead. PATIENTS, KNOW YOUR PLACE!

          • Noni

            Yes, that boob job should have been risk free with a 100% money back guarantee that NOTHING will go wrong and if it does, I’ll sue. Plastic surgery patients are the biggest head cases . If there’s a a complication or you picked a bad surgeon, hey, presumably you did your research and found the best, right? Plastic surgery is removed from the rest of medicine in that it’s largely a cash pay system where patients can shop around and choose a surgeon based on price and quality of work (which is all over the inter webs). No other area of medicine operates in the same fashion. Not the best example to choose to discuss medical malpractice!

          • advocate

            “Yes, that boob job should have been risk free with a 100% money back guarantee that NOTHING will go wrong”

            Regardless of what you think of people who get plastic surgery (i.e. “head cases”), does someone who gets a boob job “deserve” to end up with Hep C for life? If that were a listed risk (“One possible complication may be that your anesthesiologist will inject you with a dirty syringe and give you Hep C or AIDS”), then no, probably no-one would get plastic surgery. Or if they did, and ended up with a potentially fatally-infected liver, they wouldn’t really have grounds to sue.

            I used the boob job/Hep C example because that is exactly what happened in the author’s case which she ended up settling out of court. She demonized the victim something awful in her book, TOTALLY dehumanized her, it was just disgusting. Now her victim STILL has Hep C for life, and we’re asked to pity the Xanax-popping self-styled “REAL victim” doc who injected her with it. GAAAAH.

            Doctors who hate their patients should just refuse to operate on them, not go ahead and operate on them so they can get the money, then go and trash them as head cases or dumb sluts afterwards.

          • Guest

            Her victim was C. Joshua Kraft, a former Marine who was working at the local fire department and studying to be an EMT. He was there to get a benign thyroid cyst removed, and they sent him home with Hep C.

            The author changed him into a low-life stripper getting a boob job in her “novel” because a low-life stripper getting a boob job is a less sympathetic victim than a former Marine working at the local fire department having a thyroid cyst taken out.

            Google “Doctor Accused of Infecting Patients With Hepatitis C Breaks Silence” in The Daily Beast, and “Colorado anesthesiologist being sued defends practices that defy guidelines” in The Denver Post.

          • Diane Cotugno

            Listen—-ultimately, the anesthesiologist or nurse anesthetist is responsible for keeping the narcotics secure. Even though you think you may “know” your OR staff, you still can’t trust them, as horrible as that is to say. NOTHING can be taken for granted anymore. If you always keep your syringes full of narcotics in your pocket, there is no risk of anybody else getting their hands on them, period. Healthcare has turned into an atmosphere of “defensive” practice in every way. It’s sad, really. Because this anesthesiologist trusted the OR staff, she is being crucified. There is always the other side of the coin too, where on could say she was being lazy by pre-drawing up synringes & leaving them in the OR. I don’t know—-don’t know the facrs of the case.

          • karen3

            Ask Naples Community Hospital about how well the “narcotics in my pocket” deal works with Medicare. Twice nearly lost their medicare contract. Fail.

          • http://twitter.com/AneekaSchaedler Anika Schaedler

            Was the anesthesiologist at fault though? There are no guidelines for securing narcotics in the OR and it was the actions of a criminal that led to the patient being infected with Hep C. I can’t help but wonder what the patient hopes to accomplish by suing the anesthesiologist, especially after the hospital has already settled.

          • Diane Cotugno

            I don’t think I’ve ever seen a cosmetic surgery case with any merit. Sure–I’ve come across tons of people who want to sue because their boobs didn’t come out as nice as they wanted them to, or because their nose didn’t come out like their favorite celebrity’s nose, or because their lipo came out lumpy—but any lawyer with half a brain knows that those are not good cases. In my humble opinon, anybody that has an “elective” surgery that doesn’t fix some kind of physical malfunction is out of their mind. Becoming a vegetable from a lack of oxygen is certainly not a risk I’d be willing to take for a lovely set of perky DD’s.

          • Diane Cotugno

            “Boob jobs” are 100% elective procedures—-nobody is going to die without a perky set of DD’s. If you don’t want to risk having something happen, live with your God-given B’s.

      • N N

        Your last statement about Canada shows you know NOTHING about the Canadian healthcare system. You’ve destroyed what little credibility you ever had.

        • http://twitter.com/medmalpatient Patients First

          Did not appear as if I was being received as credible on this thread. I am JUST a patient. Why don’t you come over and beat me up on my blog. Over and out!

    • Payne Hertz

      Over 250,000 Americans die every year and millions more are injured as a result of medical careless in the the US. Numerous studies confirm the appalling rate of death and injury in American hospitals.

      Most of these patients receive no compensation for their losses and indeed are usually made to pay for the careless that resulted in their injury or death.

      Only a small minority of these patients and their families ever sue despite all the propaganda, and as I mentioned above, “death was by far the most frequent type of injury among successful medical malpractice plaintiffs, accounting for 22 percent of med mal victims who prevailed at trial.”

      Even Victor Schwartz, the General Council for the American Tort Reform Association, acknowledges that “It is ‘rare or unusual’ for a plaintiff lawyer to bring a frivolous malpractice suit because they are too expensive to bring.”

  • http://twitter.com/VivaVallyvivA Heidi ~*

    >>> ” I wonder if a diagnosis of MMSS would require the licensing board to have you psychologically evaluated as stable before returning to your duties as a physician.” << I'm pretty sure practicing Doctors are psychologically stable–and if there is a question about this stability, evaluations are conducted prior to any possibility of returning to practice. Physicians are humans, too. I find your response to be somewhat contradictory. You even ASK that one diagnosed with MMSS can recover 100%, but then go on to state one with PTSD has that to suffer FOREVER [I disagree, but likely your professional standpoint does not].

    There are reasons for such things as 'medical malpractice insurance.' A doctor does not just lose their reputation, but money, possibly their entire 'fortune' so to speak-their house, retirement, college funding for children; which brings up their marriage and personal life. The stress it brings can take a toll on personal relationships they have with others, leading to loss of friends. Innocent Dr.'s could go to prison. And not only [in some states] are they charged with Medical Malpractice, but they are charged with the CRIME as a CRIMINAL matter on it's own! Talk about insult to injury! They could of course lose their license! They then lose their lives! At least something they have worked very hard to build up.

    And the hospital staff is not going to admit to a Dr. being negligent, for that affects their own licensing, funding, etc. So the plaintiff has to prove that the Dr. was negligent to begin with.

    "Those professionals accused with medical malpractice are sometimes weighed based on their professionalism and level of competency in those similar circumstances. What does it mean? It means that if a brain surgeon is charged with malpractice, he will be held according the standards of other brain surgeons. The same thing is true if a general practitioner tries to perform a procedure that is done by a specialist, he will be tried or judged according to standards of the procedure he tried to perform."

    Article Source: http://EzineArticles.com/4693319

    Moreover:

    Diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, with text revision (APA 2000) (DSM-IV-TR) for Acute Stress Disorder (DSM-IV-TR 308.3) and Post-Traumatic Stress Disorder (DSM-IV-TR 309.81) other than Criterion A (the stressor), describe the signs and symptoms suffered by physicians who suffer MMSS.

    And REALLY? Your SOURCE is from, not only something UN-PEER REVIEWED; but biased BY FAR!? A blog of all things-by a PATIENT?! Come on, get out of here. Who are you anyway? Bet your life you yourself are married to one of these said professionals; and until something like this occurs [heaven forbid] to you; I would think twice before I am quick to sue the sixty year old half blind man who left a minor dent in your car in the parking lot.

    JUST SAYIN'

    Valley, MSCJ

    • http://twitter.com/medmalpatient Patients First

      Just wanted to let you know that I will respond in more detail in a bit. I need to let it soak in a bit, because right now I might get a little too mouthy. You have zero clue who I am, but I will give you a history lesson later. Yes, I am a PATIENT! I am a mere mortal among gods daring to give an opinion.
      My 3 children and husband just walked in the door. I’ll get them tucked away, grab my bottle of Pinot Noir and I will give you the scoop. Are YOU an MD? If so, I would love to take your post with me to Capitol Hill. It helps prove my point.

      • themedstudent

        I’m sure she is just quivering in fear of your completely anonymous wine-fueled ignorance to grace the comment section of a simple health blog….

        Yawn.

        Don’t take yourself so seriously. Nobody else is, that’s a promise.

        Oh, and you can take this post to capitol hill too if that makes you feel better.

        • http://twitter.com/medmalpatient Patients First

          Thanks I will. Wine-fuled ignorance! I like that one. I forgot how much I missed you guys! Your egos are simply gargantuan on this simple health blog. Until later…

          • themedstudent

            Get a job.

          • http://twitter.com/medmalpatient Patients First

            Are you a medical student?

          • http://twitter.com/medmalpatient Patients First

            Are you a medical student?

        • Payne Hertz

          It take her thoughtful responses a helluva lot more seriously than your snide and arrogant attacks.

          Don’t take yourself so seriously. Your ego may be huge and your empathy small but you’re still a god in training and not a madonna yet, just a pre-madonna.

    • http://twitter.com/medmalpatient Patients First

      Ugh…simply not worth my time . Follow my blog and you might get a clue.

  • David1234

    This is a good essay and I appreciate you sharing your perspective, doctor. The issue I’d like to have fleshed out is this: We take it as a given that it’s appropriate for a doctor to say (this is a quote from the article):

    “When a physician is sued, regardless of whether or not the allegations
    have merit, it is a personal assault on his or her honor. ”

    Why do we just accept that as an appropriate response? If an accountant were sued for accounting malpractice, would we call it an attack on their honor? What if a truck driver were sued for a car accident? Has their “honor” been attacked because their care for a given act or error in their chosen profession has been challenged?

    I’m interested in your thoughts on why doctors – who rightfully occupy an important position in our society – are entitled to hold this perspective when facing the litigation system. Do you think it’s right or wrong? If so, why?

    • http://twitter.com/medmalpatient Patients First

      Thank you!

    • http://twitter.com/sherrygmd Sherry Gorman, MD

      Hello David,

      First of all, thank you for your time and your very well articulated comment.

      I think there are two main factors that separate doctors from other professions. First of all, doctors are much more likely to face litigation than any other profession. Certainly, there are instances of accountants, truck drivers, etc. being sued, but these are rare compared to malpractice litigation. Like I stated in the article, by the age of 65, most doctors have been sued. I don’t think any other profession faces such oppressive chances of litigation. Also, as a physician, we are trained to save lives and do no harm. We spend upwards of twelve years or more living, breathing, and eating this doctrine. We take that responsibility to heart. Accountants may be accused of messing up your taxes, but they aren’t accused of inflicting bodily harm. Just as if you were involved in a motor vehicle accident where someone was hurt or killed, whether it was your fault or not, it would most likely haunt you for life. Now consider how you would feel if someone blamed you. It’s awful.

      For the record, I have the utmost respect for accountants and truck drivers :)

      • Suzi Q 38

        There is nothing so important or personal than you or your loved ones health or life. If the patient feels that you did not take their illness seriously, we get angry.
        I asked my surgeon what his wife’s ability to walk was worth to him? What about his own ability to walk? why was I told that I was O.K., when I wasn’t?
        He is a physician and can say, “Well, I would have done this or that..” but I am not, and trusted all of them. Stupid me.
        when my condition got so bad that my urinary function was affected, the urologist was annoyed that I was asking so many questions. I had to tell him: “Oh, you are the newest and probably last doctor that I will have at this place. If you take a couple of hours and read about what I have experienced at the hands of some of your inept colleagues, you would not be even asking me why I am asking so many questions. I have learned.”

        Do no harm? My doctors did harm by not ordering enough diagnostic tests to reveal spinal stenosis with signal changes on my cord. They let me go on with weird symptoms for more than a year and allowed the signal changes to become permanent, thereby causing paralysis.

      • karen3

        the reason that accountants, truck drivers, engineers and architects don’t get sued so often is that there are strict professional standards and real accountability. Having read your story, you did not appear to take that “do no harm” part very seriously, and given your response to the whole thing, I think you are darn lucky to have your license,

        Seems to me that we need better standards for doctors.

    • Diane Cotugno

      My opinion is this: First of all, I don’t think all physicians consider it as an attack on their “honor” so much as an attack on their wallet. That’s what the legal system & the government have allowed it to come down to. There are lots of lawyers out there who would take a bulls*** case just to roll the dice because they payday for them is potentially huge. An accountant & truck driver don’t have to face public ridicule like health care providers do. Do you know that the government now has a central database that keeps track of licensed health care providers? That’s right—so any hospital, health care facility, medical malpractice insurance company can access this database & check out their past before they give them privileges to practice or before they insure them. It is not in a doctor’s best interest to admit when they’ve done something wrong because then they face threats to their job & the possibility of not being able to even get malpractice insurance anymore. Some health care providers settle because they’re afraid to go through a trial—then that stays with them forever. In that database, it doesn’t state what a physician’s incentive was to settle. There is no incentive for a physician to admit his mistakes—-having that splattered all over a database where so many people have access to it certainly isn’t one. Both doctors & patients have to realize that doctors are not gods, & that he health care system has changed in ways that the doctors had no control over. Having been a nurse for over 25 years, & also as a legal nurse consultant who has seen numerous medical malpractice lawsuits, I can see things from both sides of the fence. Needless to say, neither side is pretty. Instead of beating up the doctors, perhaps some attention should be paid to the sleazebag lawyers that run their commercials on television, leading the public to think that just because they have a certaqin type of hip implant they’re “entitled to compensation”???? Nobody is “entitled” to anything unless they have sustained injuries that have severely affected the rest of their lives. Nobody wants to consent to a surgical procedure & end up in a wheelchair, but sometimes it happens & that person should be compensated. The rub there is that SOMEBODY did something to cause that person to end up in the wheelchair, and instead of beating a lawsuit around for 10 years, the person responsible should come forward & accept the consequences. But our system is not built for that. The system that exists now is one in which everybody denies everything until they are confronted with something they can’t deny, and then MAYBE they’ll admit their mistake. Maybe not. The whole system is broken.

  • http://twitter.com/normanblake1 norman blake

    The best way to reduce the cost of health care is for congress to pass meaningful tort reform. Such as a ‘loser pays’ rule. Frivolous suits would disappear over night.

    • http://twitter.com/medmalpatient Patients First

      Are you a US citizen?

    • http://twitter.com/medmalpatient Patients First

      You are nuts!

    • karen3

      Loser pay prolongs litigation

    • Diane Cotugno

      Bull****. The way to reduce healthcare costs is to: 1. Get the government out of health care, 2. Start regulating insurance companies, i.e. how much they’re receiving in premiums, how much they’re paying health care providers & how much the upper level adminstration is making and what “rewards” they’re getting for not paying for things, 3. Open up interstate commerce for insurance so people can go where they want get the best price, 4. Create more “Standards” for the treatment of certain disease states so that a protocol is followed that was created by evidence-based medicine, 5. Stop letting the FDA, big pharmaceutical companies & other big medical companies manipulate the market prices, 6. Get rid of the “You can’t be refused treatment in an emergency room just because you can’t pay” rule—there is no entitlement to free health care in this country, especially if you’re not an American citizen. Either buy health insurance, get Medicaid or pay for it out of your own pocket. What I do happen to believe with medical malpractice litigation is that it should not be tried in front of a “regular” jury—-have med mal cases put in front of a panel of medical people, i.e. doctors, nurses, etc., that know the medical theories. You’d see med mal litigation drop dramatically because no smooth talking expert witness that was paid $15,000 to testify for the day is going to sway a panel that knows about medicine & health care. A doctor that was negligent isn’t going to want to testify in front of that panel, and neither will a plaintiff that is trying to “have their day in court” whether their case has any merit or not. Lawyers would think twice about filing a lawsuit, and insurance companies would think twice about defending a lawsuit.

  • http://twitter.com/AnikaSchaedler Anika Schaedler

    Wow, what an offensive post. To minimize the effect lawsuits have on physicians is incredibly hypocritical as a pt who suffers from PTSD yourself. How many times have you been dismissed or undertreated? Now you want to dismiss people who ARE suffering just because you don’t like them or have a personal beef against them. Shame on you.

  • Payne Hertz

    As this article amply demonstrates, the “ignored side of litigation” is the effect malpractice has on the victims who are injured and killed by negligent doctors. We read of nothing else BUT the stress doctors are said to suffer in these wholly one-sided anti-litigation jeremiads. The ordeal of malpractice victims who are left disabled and in pain while being stigmatized as “drug-seeking scumbags” for the crime of seeking treatment for that pain or blacklisted and denied treatment for the crime of being a malpractice victim is ignored.

    The facts in this case have also been ignored, but easily found with a Google search. These are:

    1. Dr Brookoff was an oncologist with no formal accreditation in pain management, which is typical of many “shot jockeys” who go into doing injections with little to no training because the money is outstanding.
    2. He is said to have given Ms Fishbein 30 trigger point injections in the space of just 5 minutes, each containing Marcaine and presumably some kind of steroid as well. That is one shot every 10 seconds. If this is true than he was not merely “negligent,” but a dangerous and incompetent quack.
    3. Ms Fishbein had previously had a severe adverse reaction to 15 of these shots.
    4. He was already being sued by at least 3 other patients who were severely injured and nearly killed in remarkably similar circumstances when he killed Ms Fishbein.
    5. According to the lawyer for the Fishbein family, it is practically unheard of for a patient to have a heart attack as the result of trigger point injections.

    All these facts together make it clear Dr Brookoff is not the victim here. Everything he went through was entirely the consequence of his own choices. It was his choice not to receive proper training in pain management. It was his choice to subject his patients to a dangerous and excessive regimen of injections. It was his choice to end his own life when the case went public. Ms Fishbein and the other victims didn’t get to choose their fate.

    Unfortunately for Dr Brookoff he killed a high profile VIP, so the insurance company had to settle rather than engage in their usual sleazy and underhanded tactics. That hasn’t stopped the media from portraying Brookoff as some sort of poor victim of a greedy and vindictive family and their evil lawyer.

    It would have been nice if you had contacted the Fishbein family and gotten their side of the story, and maybe said something about the stress and pain they endured.

    • http://twitter.com/medmalpatient Patients First

      Very well written.

    • advocate

      Yup. Thank you for taking the time to put a “reality-check” on the table here.

    • http://twitter.com/StopMicra Stop MICRA!

      I’ve tried to post my sister’s story twice here, and it’s been deleted.

    • Mandy

      The Brookoff case was probably not the best example to use. There are so many cases where doctors HAVE actually been sued for completely ridiculous reasons that using this case doesn’t seem very helpful. If the fact that he ended up killing himself was meant to evince sympathy, it didn’t. Suicide is a selfish and cowardly act and I refuse to buy into any emotional blackmail that implies I must feel sorry for them or that their acts must be forgiven.

      But that doesn’t mean that there AREN’T completely baseless ambit claims being filed every day. Talk to any doctor and you’ll hear stories which might help you understand why they get so defensive about this subject.

  • Suzi Q 38

    Thanks.

    • http://twitter.com/medmalpatient Patients First

      You are welcome! This thread is crazy,

  • buzzkillerjsmith

    Think of the the folks on death row, on the verge of being killed, exonerated by DNA evidence. Now that’s a stress syndrome.

    In truth, the legal profession cares very little about the effects on peoples’ mental state. Not their concern. I have buddies in both criminal defense and criminal prosecution. They would be stunned to learn that some crazy people think that psychology is their concern. To them all this is just business.

  • http://twitter.com/AnikaSchaedler Anika Schaedler

    You were a victim of medical mismanagement, that is clear. I’m sorry for your suffering and pain. However, your complete lack of compassion for those on the other side (not the ones in your case but those who are sued when patients have bad outcomes through no fault of the physician) is startling. I do not know of a single physician who does not feel terribly when something has gone wrong and they are sued as a result. Some struggle and some take their own lives.

    I don’t think the original blog post was meant to dismiss patients who have suffered at the hands of medical mismanagement but rather to provide awareness that health care professionals suffer too. This is important because at some point we will ALL be consumers of health care, and the mental health and well being of our providers is important for OUR well being.

    • http://twitter.com/medmalpatient Patients First

      You need to understand something. The compassion that I had and still have for that CRNA and anesthesiologist would fill a football stadium. They cried when they heard me tell my story and I cried when I heard their story. Do you know how many times I wanted to just reach out and say I was sorry for putting them through this and give them a hug? Do you know how much thought went into deciding to file the lawsuit? It made me feel dirty and it made me feel greedy.
      I had to sue to keep us from losing everything. I was the bread winner with a hard working husband and three young children. I lost my six figure career, because of this tragedy. I lost me. My children will never know the person I was before this happened. My husband lost the woman he married. I spent 200k plus fighting for what I lost and for the safety of future patients. The jury did not find in my favor, because they could not see my injury and my baby or myself did not die. This has tortured me for 3 1/2 years and I will never get over this entire experience. It was the most sickening thing to watch from the plaintiffs side and the defense side.
      I do not hate the healthcare providers that were in that OR that morning. I do not even dislike my former ObGyn for leaving me on that OR table and returning to his office, because he thought I was going to die. I am a good person with a forgiving heart.
      I will admit that I opened a can of worms with the way I started my first post, but I did it for a reason. There is so much support for the physician defendant, but little to none for the patient. When will healthcare providers acknowledge that we suffer just as much as they do?
      I am sorry the MMSS article really upset me. Everyone was upset and stressed during this lawsuit and 5 week trial. It doesn’t deserve a label though. I have PTSD, because of what I went through in that OR and I also lived through a horrific lawsuit and trial. It felt like a slap in the face to read an article talking about Medical Malpractice Stress Syndrome.
      There is no doubt in my mind that the CRNA and MD suffered tremendously through this entire lawsuit. My heart goes out to them and any other physicians that have had to go through something like this. I worked with physicians for over 13 years. My best friend is a physician and pushed me all the way to the attorney’s door to pursue the lawsuit. Her medical malpractice carrier was the one who fought me.
      I did the right thing. They needed to be held accountable for what happened. I want patients and physicians to know my story. I want patients to understand that our medical and judicial systems are not perfect systems. I want physicians to understand that it is not all about them and the patient suing is not always the bad guy.

      • http://twitter.com/AnikaSchaedler Anika Schaedler

        Thank you for sharing this. You did come off a bit harshly in the beginning, but I can hardly blame you. My intent was never to minimize your very real tragedy and suffering, so if you felt I did that I apologize. I cannot being to imagine what you went through and are still going through. I am so very sorry.

        Obviously, I am not unbiased, though I have a better look at the other side – the toll med mal and litigation take on physicians. Again, I did not mean to be insensitive to YOU personally or any patient who has been harmed by medical mismanagement. I am simply empathetic to the way lawsuits affect physicians and appreciate the point being made in the article. Certainly the dangerous physician who harms patients does not deserve any sympathy, but I truly believe the large majority of physicians who are sued are neither dangerous nor intend to be harmful.

        An overhaul of the civil justice system is desperately needed, because as you’ve experienced, there are no winners, and the process is brutal. There needs to be recourse for the poor patient who has been harmed by negligence while some type of weeding out process of the meritless or frivolous lawsuits (contrary to the post above, there are a good number of these as in the down economy lawyers are more keen to taking on these cases on a contingency).

      • southerndoc1

        “I do not even dislike my former ObGyn for leaving me on that OR table and returning to his office, because he thought I was going to die”

        ?

        • http://twitter.com/medmalpatient Patients First

          Fire away! What is your ‘?’ ?

      • Diane Cotugno

        Not that I am trying to minimize your experience, but were you ever told by anyone that you got a “high spinal”? That is when the medication that is injected into the spine travels up higher than anticipated, and it can cause respiratory paralysis if it travels high enough. The treatment for that is respiratory support until the medication wares off. You don’t say how long you were in the hospital, if you were on a ventilator or in ICU. I read your story, and of course without knowing more about the medical part of it, it’s hard for me to say. You don’t say anything about feeling the OB make the incision for the c-section, so I am assuming that awareness of the pain wasn’t one of your claims. I’m just curious, that’s all. It’s got to be a horrible feeling when you are paralyzed & cannot breathe—shame on the CRNA for not recognizing that you had, what I suspect to be, a high spinal.

        • Noni

          I thought too that was exactly what happened. That she lived through a 30-45 minute surgery indicates she likely had some sort of assisted ventilation (though I did not see that she was intubated or sedated). Seems too there was a lapse in communication; what if the CRNA had simply told her what was going on and that it would subside? Might that have changed everything? It’s amazing how even a little communication can help so much and how often even that is not done.

  • http://twitter.com/AnikaSchaedler Anika Schaedler

    Are you familiar with the work of one John Edwards? Many an OB Gyn in NC might argue otherwise when you claim that med mal doesn’t result in the loss of private property for a physician. Additionally, the “scientific” evidence of malpractice put forth by Edwards to obtain large financial awards for the plaintiffs were later debunked. This tends to leave a bad taste in the mouths of most physicians when considering medical malpractice litigation.

    Ever watch the news or read the paper? How many ads do you see for “call us if you took medication x or surgery y, you may be entitled for compensation.”

    This type of behavior by the legal system does itself no favors and harms the patient who has been truly harmed and has a legitimate med mal claim.

    Further, physicians in high risk specialties are paying 6 figure medical malpractice insurance premiums, so the cost of malpractice litigation ends up being much more than $20,000.

    Our civil justice system needs major reform, both for patients and practitioners. Both suffer as a result of a dysfunctional system.

    • Mandy

      “This type of behavior by the legal system does itself no favors and harms the patient who has been truly harmed and has a legitimate med mal claim.”

      Exactly. Looking at things in perspective, the anger of patients who have genuinely been harmed should be aimed as much at those lawyers who abuse the system for their own gain, as towards the doctors/hospitals they are trying to get redress from. It really isn’t doctors who have turned the med mal system into a nightmare.

  • http://www.facebook.com/danny.long.7758 Danny Long

    This article is so insulting to the real victims, I am not even going to give it keyboard time with a comment…..

  • http://www.facebook.com/danny.long.7758 Danny Long

    PS Anyone who even knows a real victim would never publisize such an intentionally insulting disgust for human life like this… I feel nothing but shame for writer.

  • http://www.facebook.com/saferhealthcare Jeni D Safer-Healthcare

    Litigation is NOT the answer for victims of medical harm.
    We must find a new and innovative way to solve this issue. I have some ideas if anyone is interested. Having been an advocate for patient safety for nearly two decades and counciling hundreds of harmed individuals and families I have heard all sides of the issue. If we really want pure healthcare reform, we must consider reforms for the aftermath of medical harm.

  • http://www.facebook.com/michelin.anderson Michelin Anderson

    The premise for this article was shot down by the first commenter using reality based facts. Does KevinMD ever edit for content? Patients who have been harmed are judged by peer reviews done by biased board certified medical care givers – actually, they are denied from the very beginning by every ‘safety agency’ with no reporting and no investigation. Each time I read a comment by a medical care giver – it is so clear to me that they are medical care givers or spouses or drug reps – never fails. . None are so blind as those whose existence depend on not seeing the harm done by their actions.

    • advocate

      Yup.

    • SBornfeld

      Do you have anything to say about Dr. Gorman? She did write the essay, after all.

      • Caitlin Peebles

        It looks like a lot of the non-doctors are wanting to make the point that their empathies lie with the malpractice victim here (and malpractice victims in general) and not the doctor-author (and doctors in general). Medical malpractice is obviously one of those hot-button topics that gets people going. But as you pointed out down the page, the way the American med-mal system works now tends to leave both patients and doctors frustrated and even angry. The only players not complaining are the lawyers. That should bother both the patient and the doctor camps.

        • SBornfeld

          I think anyone who’s been personally involved at either end is pretty bothered.

          • Caitlin Peebles

            Yes, but I’d rather see a comments section where both patients and doctors let rip at lawyers than at each other :)

  • Victoria James

    This is an insult to harmed patients everywhere! I am sure that those horrid profiteers at Select who harmed and killed my Mother have NO remorse whatsoever! Despite being under a congressional investigation and Cited for Violations, they are still perpetrating the same negligent behavior four years later!! They DO NOT CARE!!! And as for “Losing your lifestyle??!!” etc etc etc What about how we patients have LOST sooo much, our loved ones, our lives, our savings to PAY for your abuse and negligence — and then you doctors have the NERVE to force into illegal silences when we attempt to regain any small portion of our losses! Disgusting! Your flash cars are more important to you than our very lives, and we don’t have flash cars!!!

  • http://twitter.com/StopMicra Stop MICRA!

    My disabled sister died last year due to SEVERAL physicians incompetence. Poor things…now they’re suffering from depression? They should have thought of that before they killed my sister with their incompetence.

    My sister sat in horrendous pain for 15 hours before any pain medication was given to her. Then when they gave her some, they gave her Dilaudid, which is 7 times stronger than Morphine, and which she had at least 6 contraindications for. Shortly thereafter they had her drink Gastrografin for a CT scan, which due to the sedative effect of the Dilaudid, caused her to aspirate it into her lungs causing pulmonary edema and sent her into cardiac arrest. Then, they stood around doing nothing because they wrongly thought she was a DNR. The doctor that prescribed the deadly 1 mg of Dilaudid, also prescribed it in a 2 mg dose, which would have been doubly as dangerous. Imagine if they had given her that amount first.

    On top of this, more than just these two doctors stood around not thinking she was in dire need of emergency surgery. Turns out she had a strangulated bowel that burst sending toxins into her abdomen causing sepsis. She should have gone into surgery the moment we hit the ER. 2 days later, there was still no surgery scheduled. Yes, they had to lower her Warfarin level, but they didn’t even start giving her Vitamin K until three hours before she died on the 3rd day. And they all stood around knowing this was going on. Sepsis is never even mentioned in her record, but it’s mentioned about 2 dozen times that she was “mentally retarded.”

    Guess they thought her life just wasn’t worth an emergency situation.

    Poor doctors are probably all sitting around depressed since I’m suing their asses.

  • http://twitter.com/StopMicra Stop MICRA!

    My disabled sister died last year due to SEVERAL physicians incompetence. Poor things…now they’re suffering from depression? They should have thought of that before they killed my sister with their incompetence.

    My sister sat in horrendous pain for 15 hours before any pain medication was given to her. Then when they gave her some, they gave her Dilaudid, which is 7 times stronger than Morphine, and which she had at least 6 contraindications for. Shortly thereafter they had her drink Gastrografin for a CT scan, which due to the sedative effect of the Dilaudid, caused her to aspirate it into her lungs causing pulmonary edema and sent her into cardiac arrest. Then, they stood around doing nothing because they wrongly thought she was a DNR. The doctor that prescribed the deadly 1 mg of Dilaudid, also prescribed it in a 2 mg dose, which would have been doubly as dangerous. Imagine if they had given her that amount first.

    On top of this, more than just these two doctors stood around not thinking she was in dire need of emergency surgery. Turns out she had a strangulated bowel that burst sending toxins into her abdomen causing sepsis. She should have gone into surgery the moment we hit the ER. 2 days later, there was still no surgery scheduled. Yes, they had to lower her Warfarin level, but they didn’t even start giving her Vitamin K until three hours before she died on the 3rd day. And they all stood around knowing this was going on. Sepsis is never even mentioned in her record, but it’s mentioned about 2 dozen times that she was “mentally retarded.”

    Guess they thought her life just wasn’t worth an emergency situation.

    Poor doctors are probably all sitting around depressed since I’m suing them. Imagine the depression the victim’s families experience for a lifetime, when a doctor is negligent.

    • advocate

      Thank you for speaking up. What a nightmare you and your family have been through, yet it seems far from unique. Even in this case, if you read the author’s novel you will see how the patient infected with Hep C is described in the most demeaning terms because of her educational level and occupation. The pain and suffering of high-school dropouts, strippers and disabled people apparently doesn’t matter as much as that of the more privileged and entitled classes.

    • Diane Cotugno

      I’m sorry about your sister. Having experience on both sides of the fence, in the medical field & in the legal field, I can see things more clearly than most. One thing I can say is that I have personally witnessed the “bias”, if you will, of how patients are taken care of. The elderly, the mentally disabled, people who are alcoholics or addicts, and other ‘undesirables” often get thrown on the back burner while “more important” patients receive urgent care. What happened to your sister sounds like in an emergency room. Having been in the medical field for over 25 years, I can honestly say that I have seen many changes—and not for the better. Emergency rooms now are like war zones—way too many patients for the number of staff that are working. In my humble opinion, the whole “You can’t be turned away if you go to the emergency room” thing has produced disastrous results—-instead of using the emergency room for its intended purpose, EMERGENCIES, people use it as a clinic. Got a sore sore throat? Go to the ER. Headache? ER. Have some heartburn after spicy food? ER. You threw up once this morning? Go to the ER. It’s ridiculous. And a vast majority of people using the ER as a clinic are uninsured & have no abiity to pay, causing the hospitals to continuously run in the red. There has to be a coherent thought process both on the part of the medical community AND on the part of the patient community to come to a middle ground. Just because you don’t feel like sitting in the clinic waiting to be seen doesn’t mean you can just trot down to the ER to save some time. Far be it for me to say what the circumstances were surrounding your sister, but generally a strangulated bowel & peritonitis causes certain specific symptoms, like a board-like abdomen. I hate to say it, but the whole health-care system is going down the crapper at a phenomenal rate—and it is only going to get worse. 1mg of Dilaudid is a lot to give all in one shot—any nurse that has half a brain would give it in divided doses because usually a patient doesn’t need the whole thing to relieve that pain. Anyway—I’m sorry for your loss.

  • advocate

    A negligent doctor demanding sympathy for alleged “post traumatic stress disorder” for having permanently and irreparably harmed a patient is demeaning beyond belief to those who have been permanently and irreparably harmed by doctors.

    Do the precious, entitled, glasshouse flowers who blog here understand that their posts aren’t private, that they are in fact read by a lot of non-doctors (which means by a lot of people who have been or who know VICTIMS of doctors)?

    Way to appear callous and out of touch, docs. I’m sure the next person you give Hep C to will think twice about suing, knowing that it might hurt your precious iddy-widdy FEELINGS if they do.

    • Noni

      And what are your feelings towards the generally competent physician who has made a mistake and is apologetic about it? Do you view them with as much scorn and hatred? Should they suffer until they die and will you relish it when they take their own lives? Of course not, because you are not an evil person. Neither are most docs.

      There are no “demands” for anything here. The author has written an article that is geared towards a specific audience: physicians. That you are so offended by that clearly shows that you didn’t understand the article wasn’t written for the layperson. It’s written for the physician, primarily one who has either been sued or is at high threat for being sued.

      • http://www.facebook.com/michelin.anderson Michelin Anderson

        Noni – what you are defending is indefensible. Especially in the face of 250,000 reported cases of iatrogenesis causing death or life altering harm. Some one commented – you just go to a attorney – huh! What a horrid joke. To file a malpractice suite one has to have a board certified medical professional agree. Out of those harmed figures how many MM suits are filed? 1% – 2%? There are doctors doing surgery with known dysfunctional/harmful devices, using black boxed drugs against manufacturer’s guides, doing unnecessary surgeries, falsifying records, altering x-rays, and so on. The example offered – the patient had suffered from an earlier event just prior to the one that caused her death. Laypersons and their loved ones know their bodies – share what they are feeling and doctors ignore their words, their tests, their x-rays showing what is indeed happening or has happened. If they speak loudly — Drop the Patient,Syndrome or Deny and Defend Syndrome takes over. There was a clear ‘demand’ by this author – to understand how horrible and difficult such intelligent, superior beings are being subjected to – rubbish. The attitudes are appalling – the lack of respect for patients practiced with impunity – disgusting. Clearly there is a ‘feeling’ among MD’s – they just aren’t paid enough – ever. Which is counter to “do no harm’, since a lot of the harm is done intentionally – conscientiously or unconsciously. Knowledge of data on drugs and devises – the tools of their ‘trade’ is expected and warranted. That has completely been done away with by the AMA – strongest lobbyist bar none. That is why the iatrogenesis figure is so high. MMSS or $$$$? There are good doctors, charitable, competent doctors. The ialrogenesis figure is not close to the real figure though – something is very wrong that they do not report bad ones and it is all on their shoulders since they are the only ones to judge. The entire medical system is defunct, simply because there is no care in medical care and it was orchestrated by lobbyists. Until physicians can see the layperson, the ‘little’ people as human beings, having a life with value – we all lose.

        • Noni

          Ah, but there’s the rub. You have doctors doing intentionally harmful, even criminal things mixed in with doctors who are generally conscientious all being handled by the same dysfunctional civil justice system. Who in their right minds would have any sympathy for these greedy, arrogant, harmful individuals? The lawyers paint all sued physicians with the same brush, and what is the general public going to believe?

          I agree with the poster who stated that the example provided in the article is not the best one. What would have been better would have been the generally conscientious physician whose patient had a bad outcome and was sued. There are thousands of these individuals. Their practice and approach to patients is forever changed, and that effects us ALL.

          • karen3

            Noni, first, most people can tell the difference between a genuine, oh carp and a jerk who harmed someone because he/she was a jerk. The ‘it was just a bad outcome’ is a denial mechanism and nothing more. The doctors who think their poop don’t smell just have plugged noses. So no need for the word “conscientious.” The reality is that it is very expensive to sue, and no lawyer worth beans will take a suit unless it is pretty much a slam dunk winner. And where is the patient left disabled and a lifetime of medical bills left in your “no harm to physicians” world? On welfare? Dead?

          • Noni

            And I know several physicians who’ve been sued. This is because, as the author mentions, the lawsuit rate for physicians (particularly in high risk specialties) approaches 100%. Does that make any sense to you? Not one of the physicians I know is a reckless, arrogant a-hole who set out to harm a patient for financial gain.

            It’s not that I’m unsympathetic to patients harmed by med mal. It’s that I am, unlike many on this board, sympathetic to physicians who are sued inappropriately. I can assure you that it has NOTHING to do with the temperament of the physician or even whether or not they apologize! I’ve seen physicians sued who apologized, had wonderful relationships with their patients, had patients sue them due to bad outcomes that were EXPECTED after their high risk hospitalization or procedure, and even patients who sued who had no recollection of the physician they were suing (you can’t make this stuff up!).

            Around here there are plenty of attorneys who will take cases on contingency knowing hospitals and physicians will settle as opposed to dealing with the hassle of litigation. These suits are not uncommon. It is detrimental to the patient who is legitimately harmed by med mal.

          • SBornfeld

            …and yet we are told (I am in healthcare, but not a physician) that satisfied, happy patients rarely sue.
            Malpractice carriers are the first to tell policyholders to admit nothing. This is the way the game is set up, and it thwarts even those who would otherwise show contrition.
            Obviously there is a lot of anger out there. Obviously there are patients who have been wronged and not compensated. Obviously there are good doctors who get sued–for both legitimate and illegitimate reasons.
            Is this system set up so that everyone but the attorneys and insurance companies hate it? Seems like it. And just as in our politics today, it’s easy to see things in black and white. The fact that Dr. Gorman is scarcely mentioned in this thread demonstrates why this is a real issue. I wish her well in her recovery.

          • http://twitter.com/sherrygmd Sherry Gorman, MD

            Thank you SBornfeld for attempting to redirect the attention to the topic of the article. I hate the thought of patients being harmed. I feel the utmost empathy and compassion for those who have suffered because of a bad outcome. But that wasn’t what this post was about.

          • SBornfeld

            I can only try. It’s too easy to forget that doctors are people too.
            My best to you!

          • karen3

            And you are in denial that most doctors are sued very appropriately. If you weren’t there, how are you to decide. just because someone is congenial to you in the lunch room does not mean that they are competent or that they are similarly pleasant to patients. There are some doctors who are true Jekyll and Hydes.

          • Noni

            Point noted. Similarly though, I must ask you, if you weren’t there, how can you say most are sued appropriately?

        • http://www.facebook.com/marilyn.shively.5 Marilyn Shively

          in order to prove negligence and to get your case in to a court of law, you have to have a physician (preferably board certified), but not necessarily board certified, provide an Affidavit of Merit (in states that require it), in the same specialty as the defendant, state that the standard of care was breached and the breach resulted in the injuries/damages, including death. That makes sense because we know that there are bad outcomes, that is to say, bad things can happen that are not the result of negligence; so, in order to prove negligence you have to prove that the standard of care was breached. I don’t think that is unreasonable.

      • Suzi Q 38

        If they are apologetic and want to correct the mistake, fine.
        they can have their mal practice insurance care for my doctor’s visits, treatments, and hospitalizations. That is what insurance is for.

      • Diane Cotugno

        Why wouldn’t a doctor not welcome information? Because they’re on a time schedule, and if they spend too much time on your complaints & symptoms, then they won’t be able to see their daily quota in order to pay for their leased Mercedes Benz. While I have been involved in medicine, health care & medical malpractice, & have seen things from both sides of the fence, I can honestly say that physicians are, more than likely, on a time schedule to see as many patients they can see in a day. Many physicians I have met believe they are without fault & simply cannot make a mistake because they’re “that good”. As a nurse, I’ve corrected MANY errors made by physicians in their orders, & even in things they were getting ready to do in an operating room. Is it blatant “negligence”? Is being too tired to perform surgery negligent? Is working 36 hours straight negligent? Is seeing 86 patients a day negligent? I don’t know. What I do know is that our healthcare system, the cost of medical education & the litigation process have created a vicious cycle. Doctors are graduating with several hundred thousands of dollars in school loan debt, so they have to make a certain amount to pay off that debt. Seeing more patients & doing more than they mentally and physically can do causes exhaustion and a person’s judgment is not good when they’re so tired, which often results in the errors & “negligence” that cause the injuries. The other side of the coin is that their work ethic is based on plain greed, & their egos can’t bear driving anything but an expensive German car, or living in the best part of town, or wearing hand-made Italian loafers, or wearing anything but diamind earrings. Somebody has to pay for all of that.

        • Suzi Q 38

          Thanks for the explanation. It puts more perspective on my situation for me.

    • http://www.facebook.com/marilyn.shively.5 Marilyn Shively

      I have been involved in medical malpractice for 30 years, a Risk Manager in large health systems and later, employed by a personal injury attorney who handles medical malpractice cases. I have seen my share of frivolous litigation and it is out there. However, I have been involved in cases of horrible negligence resulting in severe injuries and death. I can honestly say from my experience I have seen mostly arrogance on the part of many physicians who are sued; i see an inability to own up to their responsibility for what they have done and it makes me angry. I have to agree with most of the people who commented here: I am saving my concern for the true victims of medical malpractice.

      • Suzi Q 38

        Thank you for your comments.
        If I wanted to file a frivolous lawsuit, I would have filed it long ago. You just runoff to the lawyers office and they file the papers.
        The problem was, I did not realize that anything was seriously wrong with me. The doctors called it a “nerve or muscle thing.” But no one told me that letting month after month go with minimal treatment could result in permanent loss of mobility.
        Come to think of it, most of my doctors were a bit arrogant.
        I don’t know why a doctor would not welcome information about symptoms from his or her own patient.
        Especially one like myself that freely verbalized “clues” to the contribution of a big problem.
        I asked for additional tests; or advice as to whether or not I should seek treatment at another facility. I was told “no” to all questions.
        One physical therapist told me that I should have been more forceful and demanding. I told him that how do you do that with arrogant doctors that are fairly nice people with huge egos that KNOW they know it all?

        I don’t have the medical degree, so they dismiss my suggestions about further testing, which, would have BTW, revealed the spinal stenosis in my neck and nerve damage in my legs in my legs a year earlier. I finally told the neurologist when they discovered my spinal stenosis: ” I am upset that this was undiscovered for so long; but I am glad that this serious diagnosis forces you finally believe me. I bet you thought I was a hypochondriac.”

        I try to lean on the physical therapist to communicate with the neurologist about both of our concerns, thinking that the PT person has much more clout than I do, with his knowledge of the human anatomy, but he just writes his concerns in his chart and “doesn’t want to make waves.”

        Most doctors “stiffen up” and get very defensive when you start talking about your problems. Especially if it is after one of their surgeries. My gyn/oncologist said flat out that it couldn’t have been “his daVinci hysterectomy.” How arrogant.
        It could have been anyones surgery. Surgery inherently has risks, that is why we have to sign the papers before the surgery.

        If he was a good doctor, skillful at diffusing objections,
        He would have said: Mrs. P., I don’t know what is causing this, but we will find out and treat you. We will do our best to discover what is causing this.” I think that whether or not it is the surgery or something coincidental is irrelevant to whether or not the patient needs care before he/she declines. Instead, my doctor asked me to give it time. Maybe, it will “go away.” After a couple months, I knew it was not going away, when I reported this to the doctor, it took me another month to get him to write a referral to a neurologist.

      • http://twitter.com/ZansD94 Dana

        They do refuse to own up when they are wrong and reporting them to the Medical Association doesn’t help as they are run by doctors who protect their own

      • Diane Cotugno

        I can say the same, having been involved in many of the same thing you have. I have NEVER seen a physician fess up to doing something wrong that really injured a patient, even if what they they did was pure negligence & not even a “mistake”. However, the public also has the seed of litigation planted in their heads by the commercials on TV, “Have you been injured by (insert reason here)? Call the law firm of Dewey, Cheetham & Howe!!!”

  • William Osler

    One legitimate reform to the malpractice issue in this country would be to ensure that 100% of the settlement goes the victim or victim’s family. Attorneys should be paid a flat fee for these cases rather than earning more for themselves when the settlement increases. This could potentially motivate lawyers to take more legitimate cases of negligence rather than chasing the big “payout” they receive when their client wins the case.

    • Suzi Q 38

      I agree.

    • Mike Miller

      Lawyers deserve pay for their hard work bringing narcissistic physicians who exhibit reckless disregard for their patients safety to reparation. Many physicians care for their patients, but when they cause harm, they lie before the court to get out of it. Think about it, most of the experts in their field are their colleagues. Physicians are willing to defend a colleague’s poor medical decision, not to mention lying about their own negligence. This occurs again and again.

      • Noni

        And what about plaintiff’s “experts?” These are paid whores who will and do say anything to get their money and help a plantiff, whether it’s appropriate or not, get their $$. The system is broken and no one wins, except for lawyers.

        Of course lawyers deserve pay for their hard work. However, you need to prepare to be hated for exploiting both physicians and patients in order to collect your check!

        • Mike Miller

          Not all consider it being hated. Many consider it pursuing a balance. Helping patient’s exercise their legal rights when they have been violated is important. Malpractice attorney’s may be hated, but I would argue that some are even altruistic.

        • Diane Cotugno

          No different than defense experts. They’re all hired guns. What would change things is to have medical malpractice cases heard by a panel of their peers, meaning doctors, nurses, etc. No expert—plaintiff or defense—is going to bullshit people that know better.

  • http://twitter.com/bergamotley Dorothy Pugh

    There’s another side to this, too: the impact on other patients of the doctor being sued. The doctor’s judgment can suffer, and I’ve been on the receiving end of that, though it took me years to put the facts together, after I had to go to another medical center entirely.

  • Mandy

    I don’t know what the answer is, but there HAS to be a better system than the one we currently have. Look at all the anger and frustration in the comments here. Patients who themselves may have been harmed, or whose loved ones may have been harmed, are justifiably frustrated and angry at the way they’ve been treated (or maltreated) by the system. Doctors who themselves have been sued not by patients whom they have actually personally harmed but by jackpot-seekers (aided and abetted by greedy lawyers) are justifiably frustrated and defensive in response. Nobody wins, save perhaps the lawyers.

    The rights of patients to seek redress – and yes, to see blatantly careless or incompetent medicos punished – when they have been GENUINELY harmed, must be preserved. But there also must be some way to weed out the obviously ridiculous ambit claims, which can turn doctors’ lives upside down for years; and worse, irreparably harm doctor-patient relationships for all of us.

    I know there are a lot of smart people working on reforming the system, and I wish them the best of luck. I have no answers, I only know that things can’t go on the way they currently are. It’s not good for either patients or for doctors.

    • Mike Miller

      Few bogus malpractice claims make it to court because of the high cost of bringing litigation against a physician. Physicians want the perfect lfie, better than the rest of society. They want to practice their job with high pay and be immune to lawsuits.

      • Noni

        It depends. A scrupulous attorney will do a “wallet biopsy,” and a disgruntled, traumatized patient will pay to get their day in court (never mind that it may be months or even years from the incident in question). The result? A settlement that is offensive to all parties or a legal battle that wears on everyone.

        • Suzi Q 38

          This is so true.
          The plaintiff is told that they do not have to pay much.
          That is a minimum of 10 or 20K for a case that is not easy to prove.
          If it is blatant, it still costs money but is accepted on a contingency basis.

          This means, huge lawyer fees and court costs, plus in the case of medicine…expert witnesses. Expert witnesses are expensive…about $1500.00 or more for each one.

          It ends up like this: About 60-70% goes to the lawyer and other fees, and the other 40% or less goes to the patient.

          Of course if the lawsuit is without merit, then you lose completely.
          If the doctors lie for each other, which, happens, then you might lose also. So much of what happens is in the office, so it is your word against theirs.
          You may or may not be perceived as credible as a physician.

          Also, many times, we as patients perceive a poor result to be the fault of the doctor, when there are other contributing factors (health wise) that made the poor result so evident.

          We have to be really honest as far as what really happened, and who is truly at fault, if anyone.

      • http://twitter.com/ZansD94 Dana

        Exactly

  • http://www.facebook.com/profile.php?id=100000045709688 Lynda Schwemmer

    I am from Colorado too and knew of both of these cases from the newspaper. The tragic events on the patient side are fairly easy to see but I did not know of the terrible toll that was taken on Dr. Gorman and Dr. Brookoff. I am so sorry for everyone involved–except for the lawyers.

    • http://twitter.com/sherrygmd Sherry Gorman, MD

      Thank you.

  • Mike Miller

    The challenges a patient must face to bring a physician to justice are incredibly immense. Even when patient harm results from a pager not going off and the intern makes bad decisions. The physician got out of the case justifying the intern’s bad decisions. How do I know, because the doctor confessed this to me and a colleague.

    The physician won the lawsuit, the patient remains injured. Yep we need malpractice reform. Doctors need to get away with harming more patients.

  • http://twitter.com/ZansD94 Dana

    Payne well said. I used to respect doctors but not anymore. I rank them with lawyers. I am sure there are some kind and wonderful doctors out there but I have met many that need to find a new profession. Doctors spend like 10 minutes in a room with you because they are OVERBOOKED you spend 2 hours waiting and they charge you as they hurry off to see their next patient.

    I had an ER doc once ask me “what I was there for” I told him I had been seen that morning at the cardiologist and give him a synopsis of what they cardiologist said. The doctors NEXT question was “Do you have a cardiologist” My friend and I about fell on the floor, the man had listened to NOTHING~

    So no sympathy here for you poor little stressed doctors. The rest of us in the world are stressed too, maybe you should get one of your doc pals to give you a script for all those drugs you are constantly pushing on us.
    Try teaching a class of first grades for a day, or working out in the heat building roads, or try being an RN !!!!!! You are no better than the rest of us you just went to school longer. Booo hooo poor doctors

  • http://www.facebook.com/anima.belle Anima Belle

    pls is it possible to get an email adress for dr kevin pho ? i will like to contact him privately on an important issue. thanks

  • Otto E. Caveda M.D.

    I don’t know if my previous and longer message reached you. Here is a shorter version. I am one on the lucky “one percenters” that slipped the gauntled of the malpractice lawyer gang. I am now retired. How safe? I do not know.
    I know a bit about PTSD or PTSS.from my stint in Vietnam as a war surgeon
    where I collected a Bronze Star and a Soldiers medal for my exposure to carnage and moments of extreme fear. I subsequently have practiced GS for 30 years and 10 as GP/Officinal Surgery in NYC. I believe my civilian practice, -under the terrorism of lawyers- has been infinitely more traumatic than my war experience.
    drcaveda@aol.com

    • http://twitter.com/sherrygmd Sherry Gorman, MD

      Dr. Caveda,
      Thank you for your response and for sharing your impressions. I hope you are enjoying retirement.
      Best,
      Sherry Gorman

      • Otto E. Caveda M.D.

        maricones