Thursday, December 8, 2011

A day in the life

I've always liked the Muppets. One of my favorite songs is "Rainbow Connection," as performed by Kermit at the beginning of their first movie.

For those of you who don't know it:





Anyway, it may be corny, but the song got me through some shitty times. After I failed the first anatomy test in medical school (big time, too- I was the class low out of 120 people) I went to a used record store and bought the Muppet Movie soundtrack just to listen to that song. In a sappy sort of way it reminded me of why I was there in the first place, and I pulled my shit together, didn't drop out of school, and forged ahead.

Life goes on. Medicine is still fun. I mean, I like what I do. I have to earn a living, so I might as well be doing something I like.

And then, one day a few years back, I was having an ordinary day at the office. And toward the end of it was served with my first malpractice suit.

Nothing will kick the shit out of you faster than that moment. Yes medical students and residents, you WILL get sued. Get used to it. Someone on Sermo recently wrote "I have believed for a long time that unless you are practicing grossly negligent medicine your probability of getting sued is small." This is a remarkably ignorant statement.

Getting sued is like cancer- something that happens to other people. I think all doctors, on a superficial level, know it will likely happen. But you're still blindsided when it happens to you.

Obviously, I'm not going to go into legal details of the case, or who won, or even if it was dismissed. Because none of those are relevant to this post.

And I'm sure there are plenty of patients out there who can write how horrible Dr. Butcher maimed you. I'm sure some of you have legitimate claims. But I'm not writing about you.

Malpractice isn't black or white. It's really mostly shades of gray. I'm not biased against lawyers, in fact- my Dad is one, and sued several doctors for malpractice. But I'm not going to get involved in arguments about lawyers vs. doctors, either.

My point is just my own experience.

People portray doctors as being arrogant or uncaring. And I'm sure some are. But anytime a case goes bad, it's personally devastating for most of us. Even if you did nothing wrong. Sometimes shit happens despite your best efforts.

It hurts. A lot. You do your best day in and day out, and feel awful when things go wrong. And now someone is accusing you of having committed malpractice in your efforts. They tell you not to take it personally, but how can you not? Hell, they even name your spouse in the suit (really, they do).

You may be absolutely right. The literature may back you up completely. But that often doesn't matter.

You see, there is always another doctor out there willing to testify in court (for a nice fee, of course) that what you did wasn't appropriate. He's Dr. Jukebox. You put in money and he'll play whatever tune they want him to (it pays a lot better than seeing patients). The statements from these whores will make you feel like shit, and the legal language used makes you sound on a par with Dr. Mengele.*

No amount of medical competence can prevent someone from filing a lawsuit against you. Even if you did nothing wrong, there's always a hungry lawyer willing to take the case. After all, it only costs about $100 to file a suit, the potential payoff is 1/3 of the winnings, and he knows a Dr. Jukebox who will gladly testify that you're incompetent.

Your medical school teachers won't tell you what it's like to be sued, but I will.

It's devastating.

It kicks the shit out of you. You lie awake at night wondering if you're going to lose everything you ever worked for. You cry. You think about suicide, but have to go on for your family. With this sword of Damocles hanging over your head, you still have to go to work every day, and do your best for the patients who still depend on you. Some days it's pretty damn hard NOT to start drinking.

And, deep down, you wonder: Am I really incompetent? You question your own judgment. Suddenly every headache patient needs a brain MRI. Every person you see is a time bomb. You start to view them as the enemy.

People use the phrase "defensive medicine" in a derogatory fashion, meaning unnecessary testing doctors order to prevent themselves from being sued. But after it's happened to you, hell, you don't give a fuck how much money the "unnecessary" tests cost. You'll order anything to cover your ass.

And no matter what you did, Dr. Jukebox will testify that it wasn't the right thing. And no amount of literature in your favor will change his "expert" (i.e. well-paid) opinion. The people on the jury deciding your fate aren't medical people.

Even if you win, it still doesn't take away the living hell you and your family are put through for the 3-5 years (yes, years) it takes the case to play out. The sleepless nights, the gray hairs, the stress eating that shortens your time on Earth, and the spouse and kids who worry about you.

And, regardless of the case's outcome, it will forever destroy your Rainbow Connection, and the beliefs that once drove you to dream of being a doctor.


*For the record, I've been asked to do legal work against other doctors many times, and refuse. I may not be rich, but at least I can look myself in the mirror.

57 comments:

myoclonicjerk said...

I wish everyone had a close friend or relative who was a physician so they could see the entire picture.

Wormwood's Doxy said...

*For the record, I've been asked to do legal work against other doctors many times, and refuse. I may not be rich, but at least I can look myself in the mirror.

I understand--truly I do. But...

I have worked in a hospital. I have shredded disciplinary records for physicians who have no business touching patients. The chair of my department felt like you do--and I know for a fact that he allowed doctors with substance abuse problems to continue practicing, even when they came to work drunk or stoned. (In that particular specialty, precision work means the difference between life and death--or permanent brain damage.)

He was protecting his own. He didn't want to be "Dr. Jukebox."

I think most malpractice suits are just as you describe--some lawyer in a shiny suit decides to play the odds. But there ARE bad eggs out there--and circling the wagons because you don't want to be "Dr. Jukebox" ensures that they can continue to hurt people.

Just my 2 cents...
Doxy

Not House said...

Wow. Powerful stuff. Thank you for sharing that. I can't imagine going through that - though statistically speaking it's likely that I'll experience that at some point.

I hope it al worked out for you.

Grumpy, M.D. said...

Wormwood's Doxy- I am not including substance abuse in the above. To me that is a separate issue. I'm talking about doctors who are trying to do their best, and play by the rules. And still get reamed.

Anonymous said...

An interesting perspective - thank you for sharing that. People tend to forget about that human factor when they walk into their doctor's office with their aches and pains (they have feelings too, y'know). Sadly, every pharmacist I know of had malpractice insurance for the same reason of CYA.

murgatr
Pharm.Tech RDC'06

Anonymous said...

Dr. Grumpy: sorry to hear about your experience. The same thing happened to my father about 10 years ago. It was the worst three years of his life. The jury deliberated less than an hour before delivering a "not guilty" verdict. Witnessing this process convinced me that the system needs a "loser pays" rule, or some other method of reducing marginal cases. There will always be bad doctors, but the current system trashes too many of the good ones.

Anonymous said...

This broke my heart. I am not involved in the medical or legal field, but just hearing how it affects you and your family, makes me so sad. Thank you for sharing. I have always enjoyed your blog and now you seem even more real and human to me. Bless you and all doctors who try to do the right thing for their patients.

Elissa

Andrea said...

It feels like crap indeed. It's very hard not to start resenting the patients, or maybe worse, fearing them. Most seem to have this idea that bad outcome = malpractice.

Anonymous said...

Sigh. As a med student about to graduate in May, this daunting possibility is terrifying. In med school, they've told us you most likely will get sued at some point in your medical career, but if you do what you're supposed to do, it'll all turn out okay. But even I'm not naive enough to believe everything goes back to sunshine and flowers even when you're in the clear. Public opinion would like to paint us as greedy uncompassionate people instead of looking at our point of view. I love your blog and maybe someone out there will think twice before giving in to a snazzy lawyer's temptation to sue the doctor that's been taking care of them for years. Hopefully public will realize how screwed over we get in this profession sometimes and change things around

Anonymous said...

thanks for sharing, a powerful post!

Jono said...

I just went through some cancer surgery. There were a few complications, but everything turned out well. When I saw the doc last week I told him that despite my complaints of discomfort, etc. I wanted to thank him for saving my life. I caught him totally off guard. He stuttered and mumbled something and his eyes softened. It was the most fun thing I said to anyone in a while. Hopefully, he will remember it if some moron has a dream of early retirement by lawsuit.

Thatgirl said...

I want to share this with all of the medical students I am studying with, it is an important to know what they will face some day.

I love Rainbow Connection, it is the song I to my children at bedtime but they like to have their names in it so they replace the lovers and the dreamers.

Rebecca said...

Thank you for giving me the other side of this. I was permanently injured by a doctor who was trying his best, but chose to do something "a bit different" without asking me, without telling me. It does help to remember that he meant well, even that he thought he was doing the right thing. Like you, I lost some of my rainbow connection as a result.

bobbie said...

I was an "expert witness" against a physician who was being sued... even that was terrifying!
(Didn't help that the MD had accused ME of killing the patient!!)
Hearing you ~

Anonymous said...

Sorry about your experience. I am not in the medical profession, so I can't understand, but I know how a lawsuit can mess up your life, even when it's frivolous, because you sit there going - is it frivilous? Even if you change because of what happened, I hope you find your Rainbow Connection again.

I love the Rainbow Connection, and the muppets. Thanks for the video.

Anonymous said...

I get that this was a post about malpractice suits, but I just want to say that it made me feel better, in a weird way, to hear you talk about how much you struggled when that happened. I am in school right now, feeling completely overwhelmed (quite possibly a few days away from failing my own Anatomy exam!), and even though I know it's not at all the same thing, the way you felt when you got sued is kind of the way I feel now - feeling like you're getting the shit kicked out of you and not knowing at all what's going to happen in the future and if it's all going to be a horrible disaster.

So, in other words, thank you for sharing. When things are going wrong it can feel so lonely, so it's nice to remember that it happens to all of us, in some way, from time to time.

vmd said...

I agree - I think a lot of times patients forget that we are still human beings just doing our best - many assume there was some character flaw involved (maliciousness, laziness, pride etc.) in a bad outcome when it was always a possible end point. Grief often turns into anger and an unhealthy need for 'revenge' or 'punishment' and the doctor is always the most visible target. It's easy to forget that your target is a person. Feeling like you're being persecuted when you've done your best takes a huge toll.

Anonymous said...

It is wonderful to hear there are people out 'here' who behave as humans with moral principles.

It is devastating to be accused of those in one's own profession, peers, that one is not only involved in a freakish set of occurrences, but as medically licensed provider, to be charged that the result of injury to someone was from a deliberate action on one's part, whether incompetence, negligence, or poor decision-making skills.

I think there should be legally required responsibility allowed by counter-suitors, testimony provided by expert witnesses that given the same set of circumstances, others might do the same as you.

But! More than five years ago, in a pharmacy department somewhere, a
small group of peers in management sat in a cabal using modern technique of groupthink to condemn my actions. It was devastating as well, and I felt that I was going to go crazy with so many (three) in the department castigating my performance.

In the end, I went through the rigamarole essentially (not 'quitting', but fighting the charges) because I had to show my children that as their mother I was morally responsible to stand up for my principles for which I'd entered the profession, and I was not a bad person, nor had even participated in criminal activity. It was even better to find that as a result several years after the 'crisis', two of the players had quit or were fired, and the third felt need to apologize second-hand for their part in the incident. By then, I had moved on despite being green.

OldSquid said...

Saw Willie Nealson perform "Rainbow Connection" with the sun setting over the Mississippi. Great cover.

heterodyne said...

Thank you for that insight.
On the other had there are persons who were treated badly and have no chance of regress because doctors stick together. Both are completely unethical and not what I'd call a doctor (or would like to). It's a really big challenge for any judical system to find out which is which. Anyone have a solution? Sueing is too easy on one hand, too hard on the other .........

Polly said...

My dad was a neurologist too, and he was so naive that he didn't have enough malpractice insurance! (You know, because good doctors don't get sued.) Of course he got sued for a HUGE amount for doing something totally innocuous (the patient was no longer having seizures, so my dad stopped the anti-seizure medication, and the patient had a seizure). It was pretty ridiculous--at one point the patient's father said he thought my dad was on drugs because he smiled a lot. (He was trying to appear friendly because he had been warned that this guy was litigious!)

My dad went through a similar dark period--there was a lot of the "The best thing that could happen for this family would be if I died"-kind of talk. But things did work out for him, and his career was undamaged.

I guess my point is, 1. Yeah, you will be sued, so get the unlimited insurance coverage, 2. If you are, it is not, in fact, the end of the world. (Certainly not worth ending it all!)

Anonymous said...

I like Willie Nelson's version of the song. With his aged face and the character of his voice, he transforms the narrative from being about shiny beginnings to that of wistful retrospectives, and it seems even more powerful that way.

http://www.facebook.com/l.php?u=http%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3DdeebKNI-dTE&h=pAQEHXJ_NAQGta3JZ6EyY1Eozx1LegbOJke60JWEgnJc6-A

Robert said...

Concerning: "For the record, I've been asked to do legal work against other doctors many times, and refuse. I may not be rich, but at least I can look myself in the mirror."

Did you think all those cases were bogus? If you thought some of the cases were actually malpractice, didn't you have a duty to protect your patients , the public and indeed the medical profession by testifying and, hopefully, preventing the doctor who caused the injury from doing it again? How is the profession ever going to rid itself of the 2 percent who cause over half of the malpractice payments if good physicians refuse to do anything about them?

Diana said...

I get lawsuits across my desk regularly because a customer tripped and fell over their own feet, yet somehow our franchise is responsible for that. What I do know for a fact...taking personal responsibility for your own actions (or stupidity) is no longer done. It's a moral code that doesn't exist because there is someone out there that will take your case because 9 times out of 10 the insurance carrier wants to settle. We hate to settle anything.

History Doc said...

Oh, yeah. Frivolous lawsuits. They make a doc's day. Week. Month. Years.

And then you have to relive them every time you fill out an application to practice somewhere. You'll be explaining that some guy decided to sue you FOR diagnosing him with something (that he didn't want to have, but did have, really, whether he liked it or not) for the rest of your life.

Science Marches On Department said...

Agree with you completely.

Back when I was in practice, I had a simple rule: I told attorneys that I would review their cases and act as a witness, but they had to accept my written evaluation of the evidence.

They all knew that if I disagreed with them and put my view in writing, that it would be discoverable by the opposition. Then if they didn't like what I thought, and didn't bring it into the courtroom, the other side could destroy them in front of the jury. My policy meant that the attorney had to be confident that the evidence would produce a favorable evaluation from me.

The result of that policy is that I got very few requests to testify in malpractice cases, and every single one was a clear-cut example of really bad negligence.

Bob@thenest said...

Would have to know more to honestly judge, but not truthfully and completely responding when asked regarding other doctors makes my ears prick up a bit.

Having said that, from this patients' point of view, I'm very fortunate to be supported by outstanding doctors. Even so, I expect sooner or later one of them will eventually screw up. My neurosurgeon has done well by me five times now and has gone far beyond the tech requirements. I've had my million dollar neuro (that's not a $ figure, but it's what I call him) happen by, see me, and push my gurney from X-ray back to my room two floors up just so I wouldn't have to wait for patient transport -- he's a real person.

I believe there's a reason pencils come with erasers and I'd like to think that if one of my docs makes an honest mistake I'll be honest enough to react to it as such. Every one of my docs is human, so perfection is an unrealistic expectation.

Katherine said...

Hang in there, Dr. Grumpy! Thank you for sharing this powerful, personal story. Like others have said, I hope you find your Rainbow Connection again.

gloria p said...

I also hope you find your Rainbow Connection some day. And I hope your children find a career they love as much as you love yours.

Jacqueline said...

It's nothing in comparison, but I've been having a rough go in Medical Technology school...sometimes I think it was the worst mistake of my life...other times, I can see the light and that my dream will come true eventually. Today was an especially difficult day for various reasons, and your post was the encouragement that I have been needing for a long time. Thank-you, Grumpy...from the bottom of my pathetic exhausted and stressed little heart, thank you so much for making me feel less alone in my anxiety...for understanding what it's like when so many in my life do not understand why I am so stressed. Thank-you times a billion.

Liz said...

It takes a particular kind of person to become a doctor. Out of my matriculating class, perhaps 50% declared themselves premeds. Are they smart? Yes. Will they all become doctors? Hell no. You, sir, are awesome. For facing this shite and still getting back up and plowing ahead. For "doing the best you can for the patients who still depend on you" (LOVE that.) You made it here for a reason! :) My best wishes to you and your family.

Anonymous said...

I'm practising in Canada where there are occasional frivolous law suits but I don't hear of anything like what happens in the US. I wonder if the litigiousness is borne out of lack of health coverage. If you couldn't afford your medical care you might be more likely to sue someone to try and help with costs?

Or maybe it's just culture differences.

rural_obgyn said...

Spot on.

quixote said...

"The people on the jury deciding your fate aren't medical people."

From my limited experience, that's not just unfortunate luck. It's deliberate. The times I've been called up for jury duty, I've been excused the moment one side or the other hears I have a doctorate in biology. And it's not just me. One time there was also a JPL physicist in the pool. He was out the minute they heard that. There's something rather fundamentally out of whack when the presumption of ability to understand the evidence is grounds for dismissal.

That's all a side issue to your main point, of course. Like everyone else, thanks for posting it!

(Oh, and I like "Science Marches On" solution of how to mitigate the risk of becoming Dr. Jukebox.)

Anonymous said...

Sounds like the divorce I am going through. You think it is something that happens to other people and not you. It carries on forever, leaves you financially drained, it is life changing and you wonder if you are going to survive and come out on the other side alive. You question yourself and recounting a million times what happened. The whole thing feels like shit and leaves you with anxiety.

I identified with your emotions going through a life changing experience. I can't even begin to imagine what it must be like to be a Dr. and get sued.

Thank you for your well written perspective. It sounds like it was Hell to go through, but left you with a completely different perspective. I also think it is great that you have your "go-to" song that helps you.

Anonymous said...

I have never commented before, but this touched me. I once had a doctor who prescribed a medicine in too high a dose because his thoughts (it seemed) were elsewhere. I had a seizure because of this, knocked my head on the kitchen floor in the fall and got a concussion.

I noticed that my doc was wearing a hospital bracelet from the nursery. I suppose his wife had just had a baby.

I was a bit perturbed, but I decided NOT to sue, even though the ER Doc said I ought to. When I got a letter from the practice saying he had been fired,I figured the guy had already been through enough at that point,losing his job right after having a baby, and I wasn't dead or seriously injured. Maybe he had already been punished enough.

theangrypharmacist said...

This is some powerful shit, thanks for sharing it with us. Glad to see you drop some 4 letter words :)

On a more serious note,

Its only a matter of time before stuff like this happens to pharmacy. How many times have the pharmacists out there lay awake at night wondering if the one prescription you gave a glance to was really methotrexate 2.5 in a medroxyprogesterone 2.5 bottle? Or was the patient on warfarin when you filled that amioderone prescription?

Its stressful. Really, all aspects of medicine is stressful, and as we work longer hours for less reimbursement; stuff like this is bound to happen no matter how well we try to prevent it.

Regardless of what happens, you'll always get some dickhead pharmacist up there who hasn't worked retail a solid day in his life telling you that 20+ years of experience is dead-ass wrong. All for the tune of a $500/hr 'consultant' fee.

cliffintokyo said...

Just keep looking in that mirror and liking what you see, dude!

prisoneroftoday said...

Very interesting post, thank you for that one. I had a doctor that I was close to filing a complaint against for negligence (he got his ass covered just enough to stop it), and while this post doesn't change my opinion about that particular doctor at all, it definitely makes me appreciate the doctors I have now even more (Dr. Kickass and Dr. Fabulous, as I refer to them). While I've always appreciated how they treat me, and how stressful it must be for them to work such insanely long hours then go home wondering if every decision they made that day in terms of patient care was correct, I never really thought of the fear of being sued thrown on top of that. I definitely don't feel that they resent or fear me as a patient. 1 is a fairly new doctor so she probably hasn't been sued yet, but the other has been a doctor since before I was born, so it's quickly like she has been. As unbelievably horrible as it must be to be accused of malpractice, it is possible to past it and the fear or resentment it can bring up against patients and enjoy your work again.

Anonymous said...

Robert at 4:12 PM:

The current system is run exclusively for the enrichment of the trial attorneys, not the benefit of patients.

To participate in it as you suggest does not remove the bad apples, but serves to perpetuate a protection racket that is rotten from top to bottom.

Anonymous said...

Been there, got the T-shirt. You couldn't have said it better. I still cringe 15 years later when I see a letter with a lawyer's letterhead in the mail, even though I know they are the usual request for records for diaability evals etc.

Suzanne said...

Great post, as usual.

Yikes. Hopefully, it doesn't happen more than once to good doctors!

I was surprised to learn that I should, as a medical transcriptionist, get E&O/liability insurance but it is frightening to discover that just doing excellent work isn't actually protection from bad things happening to someone -- and I can only imagine how much worse the consequences of legal action would be for physicians.

By the way, is "Dr. Jukebox" your turn of phrase? I love it!

Anonymous said...

If it helps, you should know that for every patient who does sue, there are many, many who do not, although they are pressured by relatives and friends to do so. I have had a couple of bad health experiences in my life - one in which a doc made a wrong decision that a 2nd opinion literally saved my life from - and I cannot believe how many times I was urged to call this or that one's "brother the personal injury lawyer," because "you've got a real case here." Luckily, most patients do realize the difference between a simple mistake (or judgement call) and genuine negligence. Sorry you went through that though.

Anonymous said...

My impression is that usually when people sue it's primarily because they don't feel like the doctor cared enough or listened to them. (Not that I'm accusing you, Dr. Grumpy, of this.)

While I've never had any reason to sue any doctor, I've had occasional experience feeling ignored or patronized. I can only imagine how I'd feel if something subsequently went terribly wrong. It comes down to the idea that if doctors want "non-doctors" to understand their human imperfections, they need to tone down the arrogance and present themselves as human.

Again, not accusing you particularly of arrogance. (Really, you sound very much the opposite). I'm sorry a good doctor like you ends up feeling like your every move is questioned.
Maybe, in the U.S. at least, it's people's feelings of alienation and fear that have contributed to this problem. In any case, suing as a way to police doctors is a terrible system.

Barbara P.

burnttoast said...

Your description of the trauma of being sued was spot on. A partner was sued after a patient death. Physician was a brilliant guy, good doc, did nothing wrong, standard of care all the way. Five years of hell, made worse by the fact that doctors are told not to talk to ANYONE but their lawyer about the case. Evidence from autopsy presented at trial supported anaphylaxis. Jury found him not guilty. Patients family told him after trail that if they had known of the autopsy findings they would have never sued! Their attorney had not shared the results with them.
And the case where a physician clearly HAD committed malpractice, tried in a town where he had delivered half the population, found not guilty.
The system does one thing well, it enriches attorneys. Maybe two, it destroys physicians, and creates a barrier between them and their patients. But the isolation and vulnerability a physician experiences has got to be horrid. Nothing personal. Right. I say let the malpractice attorneys get up at 2 AM and take care of some abusive drunks who throw up on them. Nothing personal.

Anonymous said...

"Rainbow Connection" is sung by Kermit and Miss Piggy in the new Muppet movie...

rapnzl rn said...

Have also had my professional - and personal - life hanging for years in legal debate. Different song for me, but same 'muse', and motivation.

When you say, "I may not be rich, but at least I can look myself in the mirror", you've said it all. Money and reputation may come or go, but your honor belongs only to you. Thanks for sharing, Ibee. Too bad it's not required reading....

Anonymous said...

Several years ago, I developed an unexpected complication following a procedure performed by my physician. There were two most obvious causes, 1) I had failed to follow one specific post-op instruction, 2) she had committed a surgical error. I told her I needed her help to fix my problem, and I valued her as a physician. She promptly accused me of being a non-compliant patient, wrote untrue statements in the medical record, ordered numerous tests in duplicate when the first set supported my claim that I'd been a compliant patient, told me my insurance wouldn't cover testing done elsewhere in an effort to do damage control (easily verified as a lie by both the second hospital and my insurance company), then stonewalled referral for a second opinion. The second opinion confirmed she'd committed a common surgical error.

Do I think she's a bad physician? No. Do I think she deserves to go through the process you described? At this point, absolutely, because she's a rotten human being, which is why I contacted an attorney and told him I didn't want any damages for myself. I wanted any money won to go to his fees or to charity. My case, like so many, was for small damages, so she never faced a lawsuit. She did, however, receive a letter which will remain on file at the board of registration in our state forever. I'll never forgive her for what she did because among other things, she led me to believe early test results indicated I had a potentially fatal complication. On top of everything, I thought I was going to die, and had to potentially depend upon her to save me with emergency surgery.

The majority of malpractice cases lie somewhere in between well-meaning physicians facing litigious, greedy patients and innocent patients harmed by substance-abusing physicians. Many cases are like mine. The fact is, I know my physician was scared I'd sue her, but I didn't consult an attorney until I saw she really didn't care about helping me, and obstructed my seeking help elsewhere. She cared about the big number one, herself, first.

Not all physicians are ethical human beings. They're just as apt to CYA as any other human being when they make mistakes.

Watercolor said...

Totally understand. I'm an architect. We get sued for stupid crap, too. It's ridiculous.

I have a friend who is combative and argumentative with her doctors to the point of screaming obscenities when she doesn't think they are doing what she thinks should be done. And then furious when they refuse to see her again. Really? I wouldn't see her either. She's a law suit waiting to happen and everyone knows it. But I guess those are the easy ones, huh? Just cut her loose.

I feel for doctors. No one is perfect and doctors are not magic nor God. Things happen. Unless someone did something on purpose to make things worse, I'm assuming everyone is doing their best and hasn't discovered how to be all knowing.

Anonymous said...

A year ago, I got completely reamed in a review that came out of a complaint about the front desk at my clinic. They went crazy about tiny details, accused me of not providing some care I had clearly provided and documented, and made it quite clear that the mistakes I had made were clear evidence I should not be practicing. It was set up in a way designed to totally humiliate me and my clinic, and I think was not unrelated to contentious contract negotiations going on at the time. Because I had made some mistakes, I felt terrible about the whole thing. My boss, who was present for the whole thing, has been super supportive through the whole thing. I am generally well-respected in my community and have been given several awards for my care (including one the day after the scathing review, which I had a hard time accepting.) None-the-less, the only person whose opinion I can believe is the jerk who ripped me apart last year.

To the person with the problem with the surgeon: I sympathize, truly I do. However, when you read through what Dr. Grumpy and others have been through, do you understand why the thought of a lawsuit terrified her so badly that she went into a completely defensive mode? I think she handled it poorly and that she increased her likelihood of a lawsuit. However, when faced with something like that, the fear becomes so great for many of us that rational action disappears.

Right now, we have a system that requires superhuman effort on the part of the physicians to avoid errors (and believe me, most of us work hard to try to avoid them, but it is simply impossible to avoid all of them.) In addition, there is minimal monitoring, unless there is a complaint or a lawsuit, and then, too often, the response is something akin to using a nuclear bomb to get rid of mice in your garage. It's a system designed to leave a large number of physicians and other professionals an emotional wreck, and not at all designed to help patients get the best possible care.

C said...

there is a published set of cases in my state (which I happen to have read). It is about a diabetic patient who loses a limb and sues a hospital physician. When you read the first few lines, you think the patient has a gripe, but when you read all the documents, you discover that the patient sees numerous doctors, both for regular appointments and for emergencies. The patient repeatedly fails to follow directives, goes AWOL for months and years, does not take medications, nearly kills himself, gets life-threatening infections and does not get care until he has a zillion complications. After you read for awhile, you think that if the doctor is found responsible, there is no justice, because the doctor who is sued, ultimately, is an ER physician who sees this patient last, when the patient is already a huge mess. In this case, the doctor is absolved, but it left me wondering who the patient would see during his NEXT crisis, because from the case history, he seems like a perpetual crisis with no good outcome in sight.

Christy Thomas said...

Thank you for writing this. I'm a pastor, and often my discouragement mirrors yours for many, many reasons. Daily, I pour out my life for my church and for those in need, and generally the response is not doing enough or murmurs of wanting a different pastor. Don't get sued, just get extremely hurt in other ways.

Anonymous said...

My husband was not raised in the US and when he found about the medical malpractice issues here, I honestly don't think he believed me, "But, my love, that makes no sense. If someone works hard on your behalf, no matter what they may try to do for you, they can't possibly have full control over the outcome. It's one thing if they perform surgery drunk, but you can't take it out on the doctor if you don't like the outcome despite her best efforts." Then it happened to me and your description of the experience is remarkable...thanks for sharing.

Bio Geek with Patience said...

To be honest, I'm a little surprised you HAVEN'T been sued yet. Of all of the medical malpractice suits I've heard about from friends or family, almost all of them seem to involve either a neurologist or an ER doc. You guys have a pretty rough time, trying to do the right thing and help make peoples' lives better.

I'm sure there will eventually be a time where you sit back with Mrs. Grumpy and talk about remembering the good old days when you were sued, and wasn't that just so funny! Until then, best of luck. It doesn't take a fellow neurologist to figure out that you genuinely care about your patients and try to do everything you can for them. We'll all be thinking about you :)

Now I have the Rainbow Connection on repeat...

Anonymous said...

I am about to start practice in Canada (after 8 years of subspecialty training after medical school). Here, the CMPA (Canadian Medical Protective Association) is the main malpractice insurer for most physicians, and we are told that they NEVER settle, especially if what you've done is defensible. Because of that tenacity (and the overall Canadian mentality), the rate of lawsuits is quite low here. What we DO have to worry about, however, is a complaint to the College. Apparently, in a lawsuit, you are innocent until proven guilty. In a College complaint,you are guilty unless proven otherwise. And when there's a lawsuit, a College investigation is automatically initiated.

Case in point that the CMPA people told us about at a dinner one night. New cardiac surgeon had just joined a practice. Most of his OR time was allocated for emergency cases. He saw a woman in the hospital, scheduled a surgery, which she postponed for personal reasons. She left the hospital, and had her surgery scheduled for 6 months later. He checked with his colleagues, and they were booked solid as well. She died of a massive MI before the OR, and the family sued. The family lost the lawsuit, but the surgeon was found to be negligent by the College, because they stated that he should have called CV surgeons in other provinces to find someone that could fit her in. Crazy, huh?

secundum artem said...

Wow. That gave me a lump in my froat.Im a pharmacist and carry my own malpractice on top of my employers. My coworker was sued recently by the relative of a dope fiend-er-chronic pain patient. They cited gross negligence. After the facts surfaced it was disclosed that the dope fiend died from an unrelated ailment...not a drug overdose.(By the way, why is it OUR fault if they take more than the doc prescribed and a tragedy occurs-even when we warn them about the very unforgiving nature of methadone.) My coworker is relieved but still I would say he is shell-shocked. I know he agonized and second guessed his actions. He scrutinizes every detail. In this case, the Jukebox was an Rx School law professor.

Anonymous said...

Very sad. Especially that link regarding the woman who lost her psychic powers due to a CT scan... We have a special court system with trained judges to deal with antitrust cases because business is too complicated for the average juror but somehow medicine is considered easily grasped by any average person? Crazy

 
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