Okay, okay, nobody really sues God. I mean, nobody in his or her right mind would even contemplate suing the Almighty, right? But they can and do sue the next reasonable facsimile thereof. They sue doctors.
Why do people sue doctors? Because many people are hurt and/or killed every day by the very profession that is supposed to help them, or at the very least, ‘do no harm’. But isn’t it the right of each and every American to sue those who have caused us harm? Well, yes, within reason. However, recent events have shown us that this practice has quickly outgrown the bounds of reason.
So, what then, is causing the dramatic increase in malpractice suits and monetary awards? There are several answers to this question, but each answer is in reality a problem that begins and ends with the physicians themselves.
The first major problem with the medical profession is one I like to call the ‘Circle the Wagons’ syndrome. In my career as a nursing home supervisor, I saw many mistakes, errors and lapses in judgment by attending doctors. Whenever I became aware of one of these blunders, I would bring the error(s) to the attention of the offending doctor in a timely and courteous fashion. Only once did an appreciative physician thank me for calling his attention to a mistake in a prescription that would most surely have cost his elderly patient her life. The majority of the time, I was verbally abused and sometimes even threatened with the loss of my job if I didn’t ‘forget what I saw’. The only reason I persisted in this course of action was that my first loyalty and duty were to my patients, not my fellow health care providers. Or course, not everyone can or will take this stand, and I eventually burned out of the field of geriatrics due to stress. Many of us lesser mortals, the nurses, CNAs, and other ’secondary health care providers’, are leaving the field due to incidents like these, and for us, doctors are the worst offenders.
There are far too many practicing doctors who make mistakes on a near-daily basis. Quite frankly, I have personally known some doctors who did not deserve the title ‘M.D’. Every day in this country and throughout the world, I hear about some horrendous medical mistake. Last week, a doctor removed the healthy breasts from a woman. She had been mistaken for a patient with advanced breast cancer. As a woman, I can deeply identify with the horror of this case of “Oops, sorry, mistaken identity”. As a former health care provider and a present consumer of medical services, I know that a mistake like this can happen to me. And that terrifies me.
We have also heard about surgeons deliberately desecrating the sanctity of their patients’ bodies. One surgeon carved his initials on a woman’s stomach, and another surgeon carved the initials of his favorite sports team on a woman’s uterus. In both cases, these doctors were ‘victims’ of substance abuse, and/or were under the influence of drugs/alcohol at the time of the perpetrated outrage. Does this excuse their actions? No, it doesn’t, not any more than the “I was drunk” excuse mitigates the results of a deadly DUI vehicle accident or a fatal domestic violence incident.
In 1990, a study conducted by the Harvard School of Public Health estimated that, each year, more than 3% of patients in New York State hospitals suffered some form of a medical mistake, which resulted in serious injury. Nationally, the Harvard Medical Practice Study estimated that, each year, more than 180,000 people die, at least in part, because of medical mistakes. Public Citizen, a non-profit organization that advocates the rights of consumers, estimates that, each year, 1.3 million injuries are caused by physician/health care facility negligence, and that more than two-thirds of these injuries are preventable. The most disconcerting factor in these figures is the understanding that these figures represent only those mistakes that are honestly reported. How many mistakes are deliberately covered up, lied about or go unrecorded? Remember too, that this study was done over 12 years ago. How many deaths in the year 2002 were due to medical incompetence? 250,000? 300,000?
How many of these substandard physicians end up losing their license to practice medicine? Not enough. Most of them end up just paying a fine and/or having their malpractice insurance rates raised, and the few who do lose their license in one state can easily move to another state and set up their (butcher) shop again. Why is there no nationwide database on physicians who have been found guilty of malpractice that is available to public scrutiny? If a physician is convicted of deliberate patient abuse, malpractice or practicing under the influence of drugs or alcohol, why aren’t they banned from practice in all 50 states and all U.S. protectorates, such as Guam, Puerto Rico and the Virgin Islands? Because the medical profession continues to claim that it can adequately police itself, and that it is doing a good job of censuring its renegades without outside help. The statistics show otherwise.
We all know that there will always be rotten apples in every job/barrel. In truth, physicians and other health care providers have done a terrible job of policing their respective professions. Instead of rooting out and getting rid of medical miscreants, the medical profession protects them. It is very, very rare to hear any one doctor privately or publicly disparage another doctor. Physicians consistently refuse to testify against each other. Why? Because all doctors recognize that they could be the next one defending their actions in a court of law.
Publicly admitting on the stand to an error in judgment could cost a doctor a tremendous amount of money, horrendous publicity and even their practice. The stakes are very high in this game of life. However, by subscribing to this shortsighted viewpoint, doctors are dealing themselves out of the game, thanks to the increasingly high malpractice insurance rates. Bad doctors hurt all doctors, but this obvious truth is too bitter a pill for the medical profession to swallow.
The second major problem with the medical society of today is the tremendous disparity in the power structure of the physician/patient relationship, and the willingness of the physicians to listen to their patients. Doctors are still almost worshipped by a majority of people outside the medical field. (Those of us with experience within the medical field know better.) To the layperson, a doctor has a nearly ‘mystical’ knowledge of the human body that they lack. Because of this concept, nearly all of the power in this relationship lies with the physician. The doctor is the ‘expert’ on the human condition, and his/her word is law. At least that’s what a lot of doctors seem to think, or at least that is the stance they strive to project onto their patients. What is most unsettling to me is that many physicians believe that they do indeed have nearly ‘Godlike’ powers over life and death. But unlike God, who makes no mistakes, physicians can and do err. By refusing join the rest of the common people in experiencing the humility of mere humanity, physicians set themselves up for retribution and retaliation at the hands of those they harm.
In a substantial number of magazines on the rack today, I see articles on ‘How To Talk With Your Physician And Get The Results You Want’ or some such nonsense. These articles give very specific directions. Among them are notions such as these: 1. Make a list of your physical complaints. 2. Make a list of questions you need to ask. 3. Ask for clear and specific instructions in language you understand. 4. Expect respect from your physician. This line of action sounds good, and many people, especially women, try to follow these well-meaning guidelines.
In my experience as a health care provider, I can tell you that this is a good idea that usually doesn’t work. I have witnessed the majority of those people who actually do these things deeply resented and charted as ‘list doctors’ by their personal physicians. Instead of opening up lines of communication, these actions are, by and large, cause for ridicule of the patient behind their back as soon as they leave the office. I have not only heard it from the mouths of the doctors I have worked with, I have experienced this attitude when my former physician directed it at me. Now, these guidelines could indeed foster clear communications, but it is the rare doctor who has the patience or the proper mindset to appreciate the patient’s effort.
While the above suggestions on effective communication are actually a very bastion of common sense, they cut into the physician’s power base. You see, many doctors hate, absolutely hate to recognize the fact that they, as human beings, are just as prone to error as the rest of the human race. When a patient actually takes tries to take some responsibility for his or her own personal care, or gives the slightest appearance of questioning the judgment of the attending physician, ‘God’ is not happy. How dare a mere patient even begin to suggest that a prescribed course of action that is/isn’t in their own best interest? Who is the doctor here? Who is the expert? I have a news flash for all physicians. Each and every patient is an expert on his or her own body. Only the patient knows how he/she feels at any given moment. Only the patient knows where it hurts, how bad it hurts, and what gives relief from the pain. Only the patient knows when and how a prescribed medication acts after being taken for his/her condition.
Until and unless each and every physician in this country can show me proof positive that he/she has been living inside each of their patient’s bodies for the entire lifespan of the patient, and can tell me exactly how each patient feels at any given moment, from conception to the grave, I will persist in my belief that physicians are only making an educated guess on any given treatment. After all, why do doctors themselves call it “My Practice’ and ‘Practicing Medicine’? Isn’t practice something you do until you perfect it? Are doctors perfect? Is the present state of available medical care in this country perfect? Will it ever achieve perfection? All together now: Duh.
We are not clones, we are not the same person, each of us is a diverse life entity, and what may work for one patient may sicken or kill another patient. I can tolerate the use of antihistamines extremely well – my best friend can take one and be knocked out for the rest of the day. I’m not allergic to Penicillin – my brother could be given Penicillin and die from anaphylactic shock. This one-treatment-fits-all approach to medicine is the most prevalent yet misguided application to health care in this country today. It is directly contrary to what each person instinctively knows, that each of us is different, and we react differently to any given treatment because of physical, mental, emotional, psychological and genetic differences. Medical care must be tailored to each individual, and the only correct way to do that is to listen to and respect each patient’s communication about their perceived state of his or her health.
It is this unwillingness to listen to subjective patient input that causes the majority of problems for both the patient and the physician. When patients feel that they are not being heard or taken seriously, when they see that their attempts at effective communication are negated by the arrogance of the doctor, well, quite frankly, their feelings are hurt. Since the power structure of the physician/patient relationship is so unequal, what other avenues do patients have to make doctors take them seriously? If a patient brings in literature or a suggestion about their health care, how many doctors will listen or be willing to discuss it? How many physicians contemptuously dismiss any attempts at such communication by their patients or will even label the patient as a hypochondriac or worse, non-compliant? Trust me, receiving the label of ‘non-compliant’ is the kiss of death to your insurance coverage. Doctors know this, of course. It is one of the weapons they use with great frequency against big-mouthed patients who dare to think that their personal opinion has merit.
Another news flash, doc. An overwhelming majority of patients now have access to an awesome amount of medical information. The Internet has done more to level the medical playing field than any other devise or institution in history. At the touch of a finger, any reasonably intelligent patient can pull up complete prescribing information of any given medication, in fact, the exact same information supplied in the Physician’s Desk Reference on Drugs. Patients can check for themselves any possible drug interactions, they can read about their medical conditions, and they can communicate with others who suffer the same condition. They can read, learn and intelligently decide for themselves what actions they may reasonably take to insure their quality of life. They deserve to be heard, and they certainly deserve respect for their ideas, fears, concerns and conjectures. They have a computer, and they’re not afraid to use it.
Do doctors begin their medical education with this attitude? For the most part, no, they do not. This attitude is acquired in medical school, and it is driven home by the de-humanizing burden of school workload, internship and residency. Instead of requiring residents and interns to be adequately rested and take proper breaks between shifts, many young doctors are forced to work 60 to 80 or more hours without rest. What idiot dreamed up this scenario? In what other profession are beginners required to work such long hours without respite? What effect does this have on the new doctor? Well, if you were forced to see hundreds of patients without a break, wouldn’t you eventually begin to view the patients not as people, but as mere bodies with problems? Would you not easily lose sight of the human being inside the flesh? With many doctors, this de-humanizing of the individual person lasts their entire career. They will always be cold, detached and emotionally A.W.O.L. from the pain of the human condition. A patient becomes just a body, just a bag of meat and blood that needs to be fixed. (Oh, and by the way, if it can’t be fixed, it is ALWAYS, always the fault of the patient, rarely if ever, the doctor.)
If the Department of Labor and OSHA can regulate all other work professions, why haven’t they lowered the boom on the medical profession? Working such long hours under such adverse conditions leads to extreme physical and mental fatigue, and places patients in danger of a medical misjudgment performed by an exhausted physician. Why hasn’t the medical profession itself addressed and corrected this scandalous and unwarranted practice? Is this deliberate? Is this being done on purpose to create an impenetrable distance between the suffering patient and the almighty doctor? Some doctors have admitted that this is the desired goal and have even claimed that this acquired emotional distance is necessary for a physician to be good at his work.
Fortunately, this brainwashing does not take hold with every doctor. There are some outstanding physicians out there who recognize that their ability to emotionally connect with their patients is absolutely necessary to dispense quality medical care. Luckily for me, my General Practicioner happens to be one of them. That’s why I chose him as my G.P. – he listens to my concerns and respects me as a reasonable, intelligent human being. We discuss all options of my health care and make decisions together. We have a partnership, and he has an investment in me as a human being who trusts him with her health care. He regards this as the sacred trust that it is. This is what a patient-physician relationship should be. Unfortunately, my doctor is a member of a very small minority in the community of physicians. I just wish that there were many more like him.
Third, and most importantly, doctors, physicians and health care facilities are not seeing the forest for the trees. I refer to the highly publicized ongoing attempts to legislate monetary caps on malpractice awards. Would the passing of these limits forestall malpractice suits? If you believe this, I’ll have the Hope Diamond up for sale on eBay next week and I am looking forward to receiving your first bid.
Let’s break it down here. Bottom line, who benefits from malpractice suits? The victims? The families of the injured parties? No, the primary beneficiaries of malpractice suits are attorneys. Always, first and last, attorneys. Personal injury and malpractice attorneys. To cite one example, several local children were severely injured in an automobile crash. In one family alone, one child died of his injuries, and the remaining sibling was totally mentally incapacitated for life. The insurance company for the offending driver refused to pay, so the family engaged an attorney. They won their lawsuit, and the award was in the hundreds of thousands of dollars. How much money did the family receive to provide lifetime care for their permanently brain-damaged son? Not one red cent. The attorneys on the case claimed every penny for their ‘services’. This family continues to struggle financially to this day to provide adequate care for their son. In this case, as in so many others, Lady Justice was blind drunk.
Several years ago, a young friend of mine was paralyzed, at the tender age of 17, from the shoulders down by a surgeon who severed his spinal cord. The boy had had a severe curvature of the spine, and the purpose of the operation was to insert steel rods next to the vertebra to straighten it. The surgeon was operating impaired under the influence of drugs, and cut the boy’s spine during the operation. The young man and his family filed a malpractice suit against the doctor. The surgeon immediately fled the state. After an extensive trial, the boy was rightfully awarded thousands of dollars for wrongful injury. How much of it did he receive? Just enough to buy for him a vehicle with hand controls. His attorneys claimed the rest for ‘expenses’. Oh, by the way, this surgeon continues to practice medicine in another state as I write this. I have to wonder, how many other people has he crippled for life since he ruined the life of my young friend?
What the extended medical community refuses to face is the fact that their worst enemies are not just themselves and their cranial/rectal inversion attitude toward their patients, but the entire malpractice/personal injury law community. Who benefits from being sued? It certainly isn’t the patient/victim. No lawsuit can give my young friend back the use of his body. Besides, he isn’t even the one who received all that cash. In actuality, very little of these outrageous amounts of money awarded in malpractice is going to the victims. Most of this money is making malpractice and personal injury lawyers rich. “Thar’s gold in them thar ills!” Do I hear another ‘Duh’?
Now here’s the crunch. Doctors are not stupid. But they know that most lawmakers on the State and Federal levels are – you got it – lawyers. Attorneys are certainly not about to kill the golden goose that allows them to feather their nasty little nests so nicely. Why doesn’t the medical profession go head to head with the source of the infection? Because they figure that they cannot win against the legal profession.
So, enter monetary caps on malpractice awards. What will this accomplish? Will it ensure that the injured party/patient/victim receives some decent compensation for wrongful injuries? Will it put a stop to frivolous lawsuits filed by greedy attorneys? No, but it will give physicians, health care facilities and other health care professionals the illusion that something is being done to correct continued abuse of a flawed system. In fact, if malpractice awards are limited, I predict that even more suits will be filed in order to maintain the standard of greed the legal community has openly and proudly established for itself!
Malpractice insurance rates are completely and totally out of line now, and the problem will simply continue to worsen with the passage of legislature. So, what needs to be done? The A.M.A needs to take the lead in addressing the real problem, which is an out-of-control legal community that is preying on the medical community and patients alike. I would like to see every member of every medical society and association lobby for limits not on malpractice awards themselves, but TO LIMIT THE AMOUNT OF MONEY ANY ATTORNEY OR LAW FIRM CAN CLAIM FOR EACH SUIT TO A SMALL PERCENTAGE OF THE AWARD. Say, like 20%. You see, as doctors, you all know that the easiest and best way to kill a fast-growing cancer is to cut it out, or cut off its’ food source. As long as it can continue to exist and to feed, it will continue to grow until it absorbs the organism. A little food for thought there, Doc.
As a course of action against the abuse of the medical community, I respect the rights of the West Virginian surgeons to go out on strike. I respect the rights of anyone who feels they are being abused to go on strike. But in this case, the strike was directed at the wrong people. Who was hurt by this strike? The patients and the health care facilities that had to scramble frantically to cover for needed care. If the medical community wants to utilize the strike option effectively, they need to carefully select the correct target. My suggestion is for all physicians, health care facilities and health care professionals in every field, in every state in the United States, to refuse health care to their enemies.
Who are these enemies? Why, malpractice and personal injury attorneys, of course, and those who uphold them. Since nearly every lawmaker in the country is a former or present attorney, imagine what would happen when the members of Congress went in for a check-up, only to be told, “We reserve the right to refuse service to anyone.” Wow. The medical community actually does hold the power of life and death in its’ collective hands. What a tremendous weapon they have, if they would only realize it, and could muster the guts to use it. It’s high time they began using their power not against their patients, but against those who are causing their demise.
Otherwise, perhaps we should just declare open season on malpractice and personal injury attorneys. No bag limit, and no tags required. Hey, it’s only fair. If these vultures persist in endangering our lives by forcing our physicians to quit caring for their patients, then I see no reason not to rid ourselves of this vermin by whatever means it takes. In the vernacular of Southwest Virginia, a varmint is a varmint, and the only good varmint is a dead varmint.
Okay, doctor, here is my prescription:
Physician, heal thyself.
Tags: attorneys, dead americans, deaf doctors, doctors, greedy lawyers, insurance, malpractice, medical mistakes, patients
