We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
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Wednesday, June 17. 2009
No good deed goes unpunished.
Well, that is surely not always true, but with the economic downturn, the charity medical clinic at which I volunteer one day per week has seen a sharp upturn in lawsuits against us Docs and the clinic this year.
The medical defence lawyer we have now engaged (we have had no complaints or suits for 10 years until January 2009) tells us that we should now regard each patient as a potential enemy. (Our clinic's founding Christian philosophy is to regard every patient as a friend and neighbor.)
He tells us that our notes must be guided by the principle of CYA (your notes are legal documents, not medical reminders as we had thought) and that every decision a doc makes contains some basis for a suit in the hands of a hungry lawyer because all medical decisions are judgement calls and every situation is unique.
He also told us that recessions tend to see more suits against doctors because more folks are looking for cash, and much more so in charity settings. Plus the tort lawyers are hungry too - but they always are. He also advised us to refuse to treat any patients with substance abuse histories for our protection - other than alcohol.
He actually said "Do not be kind. They will screw you whenever they decide to." He has been around the block a few times.
I do not like this at all. A Psychiatrist/Psychoanalyst cannot do the job under such conditions. Furthermore, I can not and will not endure any relationship in my life without mutual trust. I am considering resigning (even though I was one of the founders of the place) and finding some other outlet for my charity. Maybe prison work, where you can safely begin with the assumption that everybody is a liar and cheater and working the system - and take it from there.
My position on the Board, plus my volunteer time (all unpaid) doubles my legal liability. I just want to do my best, tithe and double-tithe my time, and avoid hassles that do not fit into my life - and legal fees that I cannot comfortably afford.
And no, I would never work for ObamaCare. Never. I did not go into medicine to be a government employee. I went into medicine to work for my patients, doing my best, with no intention of looking out for lawyers.
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But, but, but isn't Obama solving all these health care problems?
Bag it. You have done your share already and you don't deserve to be punished. Plus, if you're anything like me, you are already giving charity by seeing Medicare and Medicaid patients. In my case, as a gastroenterologist, I am actually PAYING to see Medicaid. I will probably drop it soon.
The way things are going, someone is going to lose out no matter what: either the poor lose health care because Docs like you have intolerable exposure, or Docs like you (and their families) suffer big and undeserved financial hits. When the population from which the lawsuits come begins to suffer the consequences, maybe things will change. When it's only "rich Docs" taking the hit, nothing will change. I'd say continuing at the charity clinic is being an enabler, actually.
Guys in prison can't sue you?
You might want to engage your charitable impulses on some kind of exercise that doesn't involve your profession.
I wonder if something akin to Good Samaritan laws for docs doing charitable work would be helpful. Of course, there are attorneys and so-called public interest groups that would oppose this. No law or laws will provide a perfect solution. But I think there ought to be some protection for docs when they are doing work without collecting a fee.
As far as I know, most Good Samaritan laws have been struck down. Blame the trial lawyers for that. Even a non-medical civilian can be sued today for cracking a crib while doing CPR on you.
Ah, yes, the atheist rapture. A work of fiction just like the Left Behind novels. And as about as effective a threat as "you'll be sorry when I leave you because you're a mean mommy."
But, if we can be serious for a moment, this is a specific problem faced by physicians who want to do charitable work. Few charitable workers are similarly imperiled by the threat of a lawsuit lurking around every corner. It is a serious concern for physicians and we ought to look at the possibilities for practical solutions rather than engaging in childish fantasies of retaliation.
There is a tension in such situations, especially as a Christian physician, between our moral duty and desire to help the poor through our profession and the increasingly untenable situation we are being put in through both litigation and the erosion of right of conscience protection. The likelihood that our society will "get it" regarding the destructiveness of excessive litigation is pretty much nil -- the odds of hitting the jackpot are far higher with a malpractice suit than playing the lottery.
Without profound changes in the legal system (e.g. loser pays, medical courts) the situation will only worsen (no chance that the Dems who are a wholly-owned subsidiary of the Trial Lawyers, will fix any of this). At some point even the most dedicated physicians will say enough, and quit.
Perhaps missionary work may be an alternative? It's a world where patients remain grateful for your gifts.
One of my hardest lessons was that there are no 'deserving poor'. The poor are generally dirty, lazy, grasping, thieving, unintelligent, foul, etc. etc., I'm running out of adjectives.
That is exactly Christ's point. These creeps are the ones who need charity the most and the ones to whom it is most difficult to give.
Tiny Tim is a myth - a sweet, kind hearted, pretty, crippled kid usually has a million people anxious to help. It is the dirty, foul-mouthed, stupid, violent, guttersnipe who needs you.
Call your lawyers, gird your loins, cover your ass, get back in there. They can be your enemies and need help too. Nobody asked you to trust them, just help them.
But I also agree you have done a lot so take a rest if you need it.
Nope. Not the answer. I agree with khornet. Bag it.
Would a counter-suit be feasible, especially if the attorney who filed the original malpractice lawsuit was listed as a defendant?
I don't think the counter-suit would be feasible, Gringo, but I bet it would be fun ....
An interesting article on charitable immunity and differences in laws from state to state. It looks like some states do have mechanisms to indemnify physicians doing charitable work.
I agree with #5.
When clients become enemies, seeking your destruction, while expecting service, it is time to shrug.
Interesting: Two view points, one from the world's top-selling book, and the other from the world's second top-selling book.
Shrug is right. Our charity should go to soldiers who suffer fighting for the tired and poor slugs who expect a handout.
I like #12.1
How about helping our Military men and women, Dr Bliss?
And their families. Deployments are difficult on the families.
Tort reform is needed more than health care reform. A lot of the CYA tests would stop and instant savings would result.
Dr Joy you have a big heart, and I know you are not stupid.
Anyone that bites the hand that is trying to help, or feed them deserves NOTHING!!!
This is another step along the pathway of the death of common sense.
Lawyers are using the courts as a means of extortion and the judges allow it to happen.
Can you imagine what will happen if ObamaCare is passed? No insurance company will provide malpractice insurance. The government will come to the "rescue". The extortionist attorneys and ambulance chasing lawyers will recognize that they now have the deepest pockets ever, the government, to sue. Lawsuits will explode and the tax payers will get soaked in yet another way.
Government run anything has been and will be a disaster. When it comes to medical care just talk to patients from Canada and the UK.
When I read posts like yours I become more convinced that the problem lies with people who are seriously ill.
We can not absolutely control reality, chaos is always ready to pop out and screw things up. But some insist we can, and they promulgate rules and regulations aimed at just that. When they fail -and they do- the call is for ever more detailed regulations under the belief that more detail means greater control.
What is needed is not reform, what is needed is comprehensive medical treatment for what amounts to an obsessive/compulsive disorder. A combination of medications shown to alleviate OCD behavior, along with cognitive therapy aimed at helping the patient lighten up. But before we do that we need to acknowledge that we are dealing with a serious pathology.
In short, legalism is a medical disorder and needs to be treated as such. When we start doing that is when we'll see true legal reform.
People joke about getting out of jury duty, but it's a serious issue. We should be serving on every jury we can. Tort lawyers and their clients who lack a moral compass will bring frivolous lawsuits until they find that juries are prepared to pour them out after they've wasted a lot of time and money. We should be making sure that juries genuinely represent the community, meaning that there will be a realistic percentage of jurors on each panel who believe in honesty and personal responsibility.
I wonder if we will come to the point where it's impossible to get a doctor to treat you unless he knows you quite well personally and has come to trust you and your character?
"I wonder if we will come to the point where it's impossible to get a doctor to treat you unless he knows you quite well personally and has come to trust you and your character?"
Actually, that would be a step in the right direction. Imagine if personal responsibility, integrity and a moral compass came back into play. What a breath of fresh air!!!