Endangered species

In a few months I'll reach a milestone in my career: twenty years as a practicing gastroenterologist, and twenty-one years as a practicing physician (I was a general internist for one year). Over that time the changes in medicine have been truly amazing. In the 80's patients recovering from "open cholecystectomy" would languish about the hospital for days, only to be restricted to light duty for six weeks after. Last year I underwent laparoscopic cholecystectomy one Friday morning, went home that afternoon, and returned to my office on Monday. I now prescribe medications which were only theoretic constructs when I was in medical school.

My own abilities have also undergone improvement, at least in my chosen field. Endoscopy has become progressively easier, which is a blessing to a middle age man. My ever-shrinking bladder capacity restricts the amount of time I can spend on any given task without looking rather nervous and twitchy.

More importantly, I'm learning a more holistic approach to patient care. I wonder if my more relaxed approach to medicine is due to my gradual accumulation of the Wisdom of the Ages, or from having so little energy that I just can't raise a ruckus anymore.

The statistics are that an average physician gets sued about once every seven years. If I've done the math correctly that would mean that the average physician in practice for twenty-one years would expect to have been sued three times. I'm afraid that makes me an average physician. I've had three lawsuits: one went to trial and two were settled out of court for non-trivial sums of money. One of the suits involved the (reputed) cat-killer and should have been dismissed.

The other two are a lot more difficult to write about, not only because they were more complex but also because there was obviously enough of a case against me that I settled rather than risk an adverse judgment. Being sued for $8 million makes one a bit reluctant to take their chances with a jury trial.

"All physicians over the age of fifty want to retire within two or three years". I don't know who first asserted this, but I have no doubt it's true. Sadly, we may not have much of a choice in the matter. Three lawsuits brand you as a "high-risk" insuree. In an earlier era I'd be at the apex of my career, old enough to have the grey hair that accompanies Wisdom and Good Judgment but not so old that I forget where I am or lose control of bowels or bladder during a procedure. Now, I'm facing the oblivion of the uninsurable.