Monday, January 18, 2016

Monday reruns

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.


Anonymous said...

Really sorry you and your family had to go through this. It's not fair, but one lesson I've tried to teach my now 27 year-old daughter is that "life isn't fair." We trudge on and do the best that we can! I'm sure a lot of excellent doctors have quit - or had to quit medicine because of these false malpractice lawsuits. And these false lawsuits make medical care (and probably health insurance) more expensive for the rest of us!

Anonymous said...

Excellent post that explains a lot to those who only see from a distance. Suicide, marriage failures, and PTSD frequently follow after suits also. Keep up the Grump!

ronstew said...

If I had been given a memory test about this post, I would have got it wrong. I would not have remembered that the Rainbow Connection post and the First Malpractice Suit post were the same post. And if you told me that they were the same post and asked me what the conclusion was, I think I would have said that revisiting the song these years after med school helped.

Wrong, and wrong.

RCS said...

I'll remind you of a different song from the same movie (not sure if it's on the soundtrack):

Life's like a movie
Write your own ending
Keep believing, keep pretending
We've done just what we set out to do
For the lovers, the dreamers, and you.

Doctor Sarcastic said...

Your post struck a strong chord with me. I'm a fairly recently graduated veterinarian and I got my first board complaint and litigation within my first year of starting practice. The majority of cases against medical professionals are by people that are lashing out because they don't like something or are upset and not because of any medical error, but that doesn't make it any easier when they try to drag you down with them. It hurts so, so much to be attacked and vilified despite trying your damned hardest to help people. What you described is how I felt (and still feel since my claim is still under investigation) going through this. You have it much worse though, being in the USA and in human medicine...things get so much more dragged out and there's so much more on the line. Even though what I'm going through is probably 1/10th your experience, I wouldn't wish it upon anyone. People can really suck sometimes. I hope things work out for you, and I'm sure that for every 1 litigation-happy jerk, there are 100 patients who appreciate you and all you have done for them, as well as their families.

bobbie said...

Hugs ~

Nurses too...

Moose said...

Argh. Go ahead and hate me more, but I see both sides to this mess.

On the one hand, the Average Schlub doesn't know the difference between an honest mistake and clear negligence. Mistakes are a horrible but inevitable part of life. They happen to everyone. Negligence is something that occurs either from malice, intentional ignorance, or indifference.

A mistake is thinking that someone with an infection has a blood clot, and taking appropriate steps to test and treat for the clot. Negligence is continuing to insist there's a clot when repeated testing shows no clot.

A mistake is prescribing or giving someone a medication they're known to be allergic to. Negligence is trying to claim it wasn't the reason why the person took a turn for the worse.

Of course these are over-simplifications.

Studies show that in cases of medical mistakes, an apology can go a long way towards helping the situation and can help avoid lawsuits. Sadly and ironically, some hospitals forbid doctors from apologizing, since it implies that they've done wrong and (allegedly) sets the hospital up for being sued as well.

Many doctors and hospitals have procedures and practices in place to help reduce medical mistakes. But in the same way as when my work was dealing with idjits trying to break into computers, you can only slow things down - you can never stop it 100%.

And lastly, on today's blatherfest, I will leave you with this transcript of a song (and link to the actual song) by two attorneys in Texas. It's about how they will no longer take MedMal cases because Texas passed a tort reform law, which means IF a suit wins, nobody gets much of anything, PLUS in some cases (such as ER doctors) it's outright illegal to sue, even in clear negligence cases. (I don't agree with the song 100%, but I still find it interesting.)

Anonymous said...

My husband's union keeps a lawyer on retainer for when he gets sued. He's a police officer, and in this day and age, it seems like that probability can only get worse. Been there when an ex girlfriend made a claim when her ex boyfriend's dog died shortly after surgery. Mind you, he knew the dog might not make it, she was very ill, and the ex girlfriend never so much as set foot in our building and had no involvement in the treatment whatsoever, but anyone can complain about anything at any time. It's not right, it isn't fair, and I do believe it's a big factor in why healthcare isvad outrageously expensive as it is. There should be a way to weed out the arrogantly incompetent, but the average healthcare professional should be better protected in my opinion.

Pam said...

I don't know you. Really you could be a Mongolian yak herder and I wouldn't know the difference. BUT if half of your posts here are true/sincere [as I believe them to be] I would want you to be my neurologist. Heck, I'd want you to be my friend.

I'm sorry. and I am glad that you are still practicing medicine. [or herding yaks, possibly those are the same things.]

Anonymous said...

Oh my goodness. Been there done that got the Tshirt. It's been nearly 20 years now and it does get better. However, I can promise that you will NEVER look at any patient the same way again.

Moose said...

Yeah, what Pam said.

Sometimes I gotta remember to be less lectury and more touchy-feely.

Sorry. I've never been so good with the touchy-feely. I'm more of a thumpy-ouchy.

Anonymous said...

In a dentist. I practice dentistry. I don't malpractice dentistry. Yet I've been accused of malpractice. I've recovered. I still try to practice the same but there are some patients that you just have a feeling about. More informed consent. More documentation. More involving them in treatment decisions than normally. Unfortunately these people take time. So yes, prevention is good but not a cure all. And prevention costs money. And prevention costs money! Certainly drives up costs...

The worst (for me) was getting deposed. I defended my actions but did it come across to the judge more believable than the jukebox dentist who can't read my mind but only knew about the case through papers and xrays? The jukebox doc who is well trained to testify and has been professionally coached. They do this for a living, not help the patient nor to seek justice.

Yes, it happened. My therapy is I talk about it. It helps...some...but it doesn't go away. Perhaps I'm a better person for it? I'd like to think so but I will never know otherwise.

Thanks for the heart warming, human post. And all the replies. It's good to know there are people who care.

A. Banterings said...

So let met get this straight, you are advocating for tests that you know are unnecessary just to cover your ass and the patient gets billed for these tests?

Unnecessary medical care sounds like the definition of malpractice.

This is why patients don’t trust physicians. Just like patients are reprimanded for stereotyping all physicians as bad because of the actions of a few, YOU ARE DOING THE SAME WITH PATIENTS.

Thank you for this post. It removes any guilt that anyone would have when filling lawsuit against a physician and just validates the stereotype….

Packer said...

The stress comes from that place inside of you that causes you to try and do your best for your patient and or client and when someone questions that it goes to your core and just tears it out. I know of what you speak, the stress is ever present and yes it can kill. A friend of mine threw a massive hear attack weeks after the State Bar Officials had done its inquisition on him. He was dead before he hit the floor at age 51.

Anonymous said...

I shudder at the troll comment by A. Banterings above. Obviously someone who has never been through this.

I'm a veterinarian, out 30 years, practicing emergency medicine. I've had two board complaints. Neither won, both were people upset that the animal died despite their DECLINING medical advice. Do I practice differently? I still offer gold standard diagnostics and treatment, but when going to plan B,C or E.... I document and make the owners sign an AMA( against medical advice). I offer testing that may not be necessary but could be. A negative test still gives pertinent information. Some don't seem to understand that, nor that there is an art to medicine, not a laying of hands to get psychic visions.

It's come to the point that I yearn for retirement....

Carolyn said...

About 20 years ago I was at a friend's house waiting for her to come home from work - she is a genetic counselor. She had diagnosed a condition where kidneys do not form in utero and the family made the choice to terminate the pregnancy based on the diagnosis. Afterwards, the fetus showed kidney buds. The condition the fetus had was incompatible with life, but those kidney buds where none were expected threw her hard. Luckily her husband is an MD so he could be helpful and talk to her ... all I could do is keep refilling her glass while she cried and doubted herself. That really stuck with me - she was hurting and horrified and it took her a bit to brush off.

I get people jumping down my throat for not being able to ship late orders or forcing them to follow procedures and all sorts of things no one should ever find important enough to raise their voice over ... that frazzles my nerves until I remind myself its not a matter of life and death. My nerves are frazzled just thinking about not being able to tell myself that, of my decisions mattering on a life and death scale.

Here's to you who are smart enough to see all the pitfalls of caring for living beings and still brave enough to do it anyway!

Anonymous said...

It's difficult, from the patient's perspective, to understand true malpractice or even negligence.

I'm a patient. I've been on the receiving end of care more times than I'd like, and twice I've had a doctor royally fuck me up. So much so, that the next doctor - the one who fixed the fuck up - urged me to sue or file a complaint...or both.

I did file complaints, but I never sued. I hoped that calling attention to stupid mistakes would be enough to deter future stupidity on the part of the physician.

Now, I wonder if suing for malpractice is the only way to get a doctor's attention. I mean, it certainly got yours, Grumpy.

I don't know. I just know that mistrust is a two-way street, and I'm the most informed bitch of a patient that any doctor will ever encounter. Any doctor who thinks me too brash is one I never return to.....and it's happened many times.

My current PC doc is a gem. She is able to handle me, and I've been with her for nearly 20 years. I trust her, completely, but I question her enough to give her a headache sometimes. It's my body, my health, my choices. I just wonder if less passivity might help and lend itself to fewer opportunities for malpractice suits in the first place.

I don't know. I just know how I am as a patient.

Anonymous said...

It's people like Banterings and awesomesauciness that are attempting to perpetuate a battle between doctors and society. Let's talk about what people who sue really want: revenge. Instead of believing that you are on the unfortunate end of an honest mistake, engaging a physician or hospital in honest dialogue about what happened and attempting to find solutions, you decide to strike back at the physician, and you do have the tools to do so. A malpractice suit is a powerful weapon, causing years of emotional turmoil, uncertainty, lost sleep, stress, loss of career satisfaction, and permanently altering the way physicians' views of patients: not as people to be helped but as potential adversaries. The outcome doesn't matter. Even if a physician ultimately prevails, and they often do, the damage is quite done. A physician will do anything to prevent this from happening again.

Many doctors are able to get through it, compartamentalize, retain enough belief and goodwill in what they are doing to continue on and treat the thousands of their patients who are actually grateful for what they do.

Others are not so lucky. Doctors kill themselves at a much higher rate than the rest of the public, and malpractice suits are a top reason.

Anonymous said...

Ummm...anony up there ^^^ I am pretty sure I said I didn't sue. Pretty sure, it again, I DID NOT sue..even at the request of other physicians.

I said I filed a complaint. I just wonder if doing so had any effect, and yep..looky there, I said that too.

Perhaps, and I'm just speculating here, reading comprehension is not your strong suit?

Anonymous said...

I know. That's why I said "people who sue" rather than "you." But you are also dodging my point by hurling personal insults.

Don't give yourself too much credit for "just" filing a complaint. This is still a public accusation and I think the end result is the same. As you yourself said, I'm not sure you did much (except further the battle and bad blood between you and your physician).

Maybe there should be a non-punitive process by which physicians and patients engage when there is a dispute to ensure that mistakes are minimized and quality is improved. But it's the "non-punitive" part that probably prevents this from happening.

Anonymous said...

Anon...good suggestion...sort of like mediation without anything binding. The problem with that is doctors with a god complex will learn nothing from it, and patients out for revenge will leave unhappy.

By the by, you did lump me in with someone who obviously had issues with a doctor in the past, so don't try to sidestep it now by telling me I'm insulting. I was merely separating me from him/her/whatever.

I filed the complaints for good reason. I'd do it again, and I did it then after all attempts to resolve the issues with the physician in question failed. The last one was funny. At my last appointment, I was led into what was obviously an exam room used for storage and told by the doctor's assistant that I was not going to see him ever again. When I asked why, she said because " represent a failure for him, and that is unacceptable...." I giggled, and told her I couldn't have been the first. She smiled, wearily, and gave a slight nod. Her eyes told me everything. I waited FIVE years (enduring increasing pain and constant infections) to trust another doctor to resolve my issue (with a 20 minute outpatient procedure), and it was she who practically begged me to file the complaint. I wasn't the first patient she'd seen and fixed based on the first doctor's incompetence and arrogance.

So, you see, there are times when complaints or suits are warranted. And, just as we cannot whitewash all doctors as incompetent, we cannot do the same for patients labeling them as revenge-seekers.

Anonymous said...

I have a brother-in-law, who, when in college, started having trouble with his sinuses. School Doctor said "sinusitis, here are some antibiotics", for a year. When he was home on Christmas break, he told his Mom he was having trouble with double vision. She moved heaven and earth to get him into an ENT that week. The doctor took one look in his nose and could see the tumor in his nasal cavity. It was growing around his optic nerve, that is why the double vision.

All the local oncologists refused to operate - too much risk of blindness. It took some cutting edge proton laser treatment in California to remove the tumor.

7 years later, and 2 kids, he is cancer free. He still has to deal with double vision and hearing loss from the radiation treatments, but he is alive.

He consulted with several lawyers about suing the School Doctor for malpractice, for not doing something sooner, like a referral, before he started losing his vision. But no lawyer would take the case. They all said, you are alive. In this State, the Juries won't award enough money in a case like this to be worth my time.

I don't know if my BIL's case was malpractice or not, but it sure made the family angry. We are grateful to the doctors who saved his life. But really annoyed it that treatment was started a lot sooner.

I am posting anonymously, because I don't want my BIL to know that I ever talked about his case on line.

Anonymous said...

awesomesauciness: Fair enough. :)

xrayangiodoc said...

I feel your pain. I was frankly amazed when after over 30 years of practice doing Interventional Radiology and ultrasound with thousands of amniocenteses, OB sonos, biopsies, angioplasties, angios, plain film readings, etc I was able to hang it up without ever being served. Perfect? Far from it! I've has complications, some serious, a very few fatal. I can only say that I have never tried to hide a problem or failed to fully document a complication. Most importantly I think, I always tried to fully explain to the patient and family what happened and what we would try to do address the problem. I think far too many doctors tend to withdraw after a complication which causes frustration and anger with the patients and family.
I would also suggest that not all physicians that testify on behalf of patients are money grubbing pimps. I was asked to testify for a patient that I believe had sustained an injury during a surgical procedure. I had actually performed a diagnostic procedure afterwards that demonstrated findings highly suggestive of an untoward event during the surgical procedure. The patient certainly deserved compensation for the significant injury suffered. Suggesting that physicians adopt a, "White wall of silence" would be a dereliction of our duty to the patient. By the way, the case was settled on the day I was supposed to have given testimony.
Don't take the suit personally. Like the Mafioso said, "It's not personal, it's business".

Anonymous said...

First of all, I'm sorry this happened, Dr. G. When something happens and even someone who's supposed to be a professional colleague turns on you, it's like a kick in the gut. Something that leaves you breathless for a while.

I felt a little like that when my son had a catastrophic health crisis at college and the 'health' insurance company that was part of my employee-contributed policy first of all said that they would only pay for 3 days stay in the hospital (over a weekend) ... and it got worser and worser ... and then they refused to pay the bill and all the necessary extra fees, drugs, rehospitalization, etc because they had refused to pay for the necessary amount of time to at least start him on the correct therapy, or at least so enough time to monitor for emerging side-effects (and the soonest he could be seen after discharge was two MONTHS).

My son was a college student at the time when he had the break, and he was just trying to lead his own life. The minute after he was discharged, he begged to go back to class so that he could finish the semester on time, etc.

The 'health' insurance company that was supposed to help with discounted costs for employee 'benefits' which I had contributed my fair share the previous seven years, and had NEVER used before, shortchanged my son and us.

I contacted the insurance company, and got the names of the 'professional' adjudicator that refused to find it necessary to fund the correct treatments.

I wrote letters to the psychiatrist adjudicator, the CEO, CFO, founder of the company, the person in patient relations, the finance company that the insurance company dealt with, and a letter to the consulting group that designed the guidelines that the adjudicator referred. I told them that their guidelines were irrelevant if the patient had no resources to access the necessary care in the community where the patient was discharged.

I was so angry and hurt that all these people were just doing their job in providing the bare minimum necessary for basically ensuring the safety of and 'housing' a patient, and it was the doctor that actually saw my son in the hospital that said he really needed to be here another week to see if the treatment will work. And he had already clearly stated that in the phone call and communication with the insurance company. All those pencil pushers were doing was reading the doctor's notes that he was breathing and had a heartbeat and wasn't going to commit suicide. They did not care a fig about the patient actually being able to function (and, indeed, if my son had had enough time at this first diagnosis, he might still be carrying on and enjoying the benefits of MODERN medicine).

I was so ashamed that I was a healthcare provider with a doctorate and knew that my son was not receiving acceptable and appropriate treatment. My son that never asked for any part of the diagnosis (no one asks for cancer, or a broken bone, but it's especially poignant to me if someone has always tried and is trying their hardest to get through school to get a good job and live out their life and then someone comes along and cuts the marionette strings).

They didn't know that before the episode that landed him in the emergency room and for which he was transferred to the psych, had IQ 135-151, was going to play violin in the Chicago Symphony, had won this and that prize and was attending college on a full-tuition math scholarship. They did not give one thin dime about the patient, the human being in the dilemma.

And, it was a psychiatrist that had gone over to the dark side working for a 'health' insurer that set the whole thing in motion. I felt that he was a traitor to his Hippocratic Oath, that he had sold out to the bean counters, and furthermore I would consider scum of the earth.

If my son had committed suicide, then, I would've sued everyone except the doctors and nurses that cared for him.

Anonymous said...

I'm still 'recovering' from a Neurological ("by-passing") procedure that was presented to me as better/easier on recovery, less invasive and safer,-if any- side effects/risks rather than using the older method of 'removing' the problem...
- NOwhere on the consent form was there anything about subtle (?) personality shifts, memory holes (pun intended...) and 'Personal Values' being affected.
They all have been, as I'm learning, the hard way...

My annoyance - apart from the cascading consequence of losing my job for 12 months - due to the 'route' taken for this New & Improved operation - and only finding out THREE MONTHS after discharge that this was the case... is the abysmal lack of communication with the Neurosurgeon and his ... entourage.

Consulting another Neurosurgeon is going to impact significantly on my dwindling finances...itself a source of constant stress, mental, emotional and physical. - Chest pains plus skin problems, both very common, so my Family Physician assures me.

The procedure was a success from a technical angle, simple, elegant, quick and should be 'semi-permanent' for a lifetime. No problems or arguments there.
But the financial, personal, mental/emotional turmoil is less acceptable... "Suicide Ideation" has not previously been something I needed to deal with.

Being an 'engaged' patient may have exacerbated the pain, - I won't tolerate information being witheld nor am I intimidated by the Blinding Whiteness of his Coat... and I show it! - but the same philosophy of actively seeking effective and HONEST medical advice is, despite the co$t, keeping me alive. - And not suing the shirt off the surgeon's back.

The sad thing is, IF he'd bothered to talk to me, listen, learn a bit about his patient, he might have opted for a more suitable treatment, or not, but with less total 'damage' to myself.
Despite the urgeings of my GP and Medical friends, I'm not bothering with an "Official Complaint", just an 'Advisory' to his departmental head and the hospital concerned. Frankly, he's wasted too much of my time already.

I'm not in a position to sue as Australian law and practice is different to the US.
But yes, 'Revenge' for MY sleepless nights, pain inflicted on my Wife, PHYSICAL plus mental health deterioration, false alarms for suspected heart problems, financial damage/job loss etc, is a sustaining fantasy for when I win Lotto...

Anonymous said...

I am a veterinarian. I've never been sued for malpractice or had a board complaint, though I've certainly had clients threaten me. In general, an apology and the truth heads off most angry clients.

I've been on the other side, too. One of my physicians committed malpractice then lied about it. Without going into detail, there is documentation (once she released it, which was a battle) and tests verifying what happened. Because the physical damage to me was below a certain monetary threshold, however, no malpractice attorney would take the case.

I didn't want money. I wanted her to admit she'd harmed me then lied. Nothing happened to her, but I hope she had plenty of stress. I hope she still thinks about what she did. I hope she has more integrity in dealing with her current patients, too.

Anonymous said...

" Because the physical damage to me was below a certain monetary threshold, however, no malpractice attorney would take the case."
Which is also a problem with our present system in that if your damages are not real big, you have little chance of recovery as the lawyers only go after the big bucks. Also is true in car wrecks, etc. and is a good argument for "no fault" insurance in that more people get justice, though the lawyers don't get rich off of it.

Unknown said...

Suffice it to say there are a lot of different opinions on this issue but we all probably agree that the system is broken. Any solutions out there?

Anonymous said...

Sad story and so well described from the emotional side. Yes, there is a solution. Practice defensively. Easy to say, harder to do. In any office or hospital setting a lawyer can tear apart your major defense - the informed consent. It's sad to see what sitting ducks we are because they really don't teach us how to protect ourselves. To that end, I wrote a book that should be out this month - From Waiting Room to Courtroom - How Doctors Can Avoid Getting Sued -
Keep in mind, lawyers have tons of books and training that they use to come after us. Perhaps it's time we started to make their job a bit harder.

Anonymous said...

Hey Grumpy...Mr. Marks up there has a good suggestion. Maybe post a follow-up to this, ask to hear from patients and caregivers alike, on handling the situation?

Anonymous said...

There are so many incompetent doctors out there that we patients don't trust any of you. And you will " never testify against another Dr." makes us want to get rid of doctors like you. The last GP I visited asked me to come back when my deductible starts again, and as the appt. ended, she asked why my temperature was elevated. Really?? What a dumbass. And you wonder why we don't trust you. You consistently make fun of your patients and as an aside you have a really foul mouthed wife who makes fun of everyone she works with. You all deserve obamacare.

Anonymous said...

I explained an issue (above) on what I thought was a similar tonal frequency as Dr. Grumpy's topic, seeing as how this type of 'betrayal' of public and private trust affects one's equanimity to move on with the same spirit as before its occurrence.

But, I don't agree that the 'system' is broken.

I am very thankful for 'Obama-care'. I fervently hope further legislation will improve and fine-tune the fundamental changes that have been made so far.

I applaud the national interest with which this very fundamental issue engendered in the consciousness of the average citizen who had absolutely NO idea of what was going on before. Though may still be wondering, I feel that people that have attempted to understand the issues are better equipped to understand what is right, what are rights, and to pinpoint how to make what happens right for themselves and others.

As a disclaimer: People that summarize their distaste for the changes that have been made as 'he said I could keep my same doctor' don't realize that eventually they would've had to change their physician no matter what happens ... in the future. The pace of the outrageousness of out-of-control price-gouging would've pushed the American public that much faster into the ranks of the 'rich vs. the poor'. But, I will refrain from making a personal comment on what I 'feel' about those same people who voiced their opposition to improvements on the pre-existing 'system'.

Anonymous said...

Guidelines are a catch-22. If we chose a treatment that made more sense for a patient, we failed to provide the standard of care. If we followed guidelines, we didn't treat the patient as an individual. This Skeptical Scalpel post ( makes some great points:

Malpractice lawyer says the much vaunted Choosing Wisely campaigns provide no such thing as "safe harbor" from malpractice: "I have a pretty set script here. To the effect of ‘so Doctor, you just didn’t care enough about my client to order this test?’ Or ‘so my client was just a statistic, just a percentage to you?’… [Juries] love that stuff!” This is a major reason our medical system favors often harmFUL over-testing.

This post struck a chord because I got sued during residency along with ~20 other doctors and everyone else who cared for the patient (they couldn't read everyone's signatures, so they just reserved the right to sue all the Jane and John Does). The patient was pretty well doomed before admission. I saw the patient once and actually provided excellent care including calls to the the patient's outside specialists. Thank God I thoroughly documented events and my actions but realistically I can't document every visit to that degree if I want to finish my daily work, eat a 1-2 meals, and get more than a few hours of sleep if I try to document to that degree.

I have always done my very best for patients, but that case changed my perspective forever. There will always be someone ready to blame me and other doctors for their bad outcome. Medicine just doesn't have all the answers and all of our treatments (and many of our tests) carry great risks. I wish I'd never gone into medicine and long to transition into a field where I can continue to do my very best without risking everything I hold dear.

Anonymous said...

In a US medical residency and will finish in about 1.5 years. I think you had a similar post about this a while ago and it sounds just as devastating as it did on the earlier post. I am so sorry and hope things get better. Stay strong.

Terra Tenshi said...

The problem is that even when it was an honest mistake and everyone knows it was it can still ruin someone's life.

When I was seven I had a sinus infection. At first the doctor thought it was allergies, then a cold, then maybe a sinus infection. She didn't want to give me antibiotics because she is concerned about antibiotic resistance and thought the infection would pass on its own. Unfortunately, she was wrong. The infection turned into full blown sepsis and I ended up in the hospital.

No one thought the doctor wanted that to happen because what kind of person wants a seven year old to end up in the hospital? But the fact that it was a simple mistake didn't change the fact that I was in the hospital. It didn't change the fact that even with insurance my being there was going to put my parents in bankruptcy. So they sued. And they won.

The problem wasn't that the doctor was malicious or stupid, she just made a human mistake. My parents didn't blame her and would have kept her as our doctor if not for the fact that we were asked not to. The problem was that her mistake cost something my parents couldn't afford and she couldn't just go to her insurance and say "I made a mistake, please just pay for this child's hospital stay."

My point is, don't take it personally. It's completely possible that the patient doesn't even really blame you for what happened. We're all just playing the game.

Anonymous said...

Maybe so. But I was just diagnosed with cerebellar lesion after 3 months of telling my doctor something was wrong. He finally found when I had my MRI. Then he tells me he really know what was going on he was just going through the motions and hands me my results to read.

C said...

this will make you feel better; you did not do this:

Candi said...

(waves) Back after a month of borked internet starting December 12th, and then Dad had surgery (minor, but painful), and then problems at my son's school... AND my hard drive borked, so I'm using the family desktop until I can get another laptop.

I've noted that while some lawsuits are sincerely motivated, far too many are looking for a payday or out of spite. They aren't looking to fix or resolve anything; they just want to attack and burn.

"Dr. Jukebox" is one of the best terms I have every heard for those paid performers who claim to be experts because they have a degree and read an article a few times a year. (Not from the respected journals, the watered-down versions in popular mags.) And the profession goes back at least to the Radium Girls of New Jersey.

My philosophy, which I tell anyone who asks, is mistakes aren't important because everyone is human, and humans make mistakes. What's important is the reaction to the mistake. My doctor and dentist have very few mistakes to their name -little ones, too- but they were very determined to sort things out when it was brought to their attention. (All but one involved billing issues. Got to love it when the paperwork is screwed up.)

As for college clinic doctors, I have seen so. many. stories from across the net about how much they **** up. One comment I read a couple years back said all they're good for is passing out aspirins and birth control. While I doubt every clinic, doctor, nurse, staff member, and so on, are all that bad, there are enough of them that cases of cancer and other severe conditions go undiagnosed until the student goes to ER, Urgent Care, or their family doctor. It's just sad, and I have no idea what the underlying cause might be.

Unnecessary test to cover their butts? Who are the ones that created this environment, the doctors, who would no doubt love not to deal with the hassle and the paperwork, or those who sue as a first, rather than a last, resort, and often for reasons that are spurious or irrelevant?

If a staff member, doctor, or hospital refuses to deal with a problem or discipline or even replace staff, there's a problem, and a good reason to go see that lawyer. But if they are willing to work with you to keep the situation from happening again, or told you your course of action was a freaking bad idea before the mess started, then serving papers should be on the back burner, though not entirely dismissed until the matter is resolved in a way that HELPS others and provides a constructive solution.

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