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So many lawyers, so little time...

"The prospect of hanging focuses the mind wonderfully"--Samuel Johnson

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Location: Louisville, KY, United States

Gastroenterologist, cyclist, cellist, Christian, husband, father, grandfather.

Thursday, April 14, 2005

While we were passing gas...

Most colonoscopies are performed with conscious sedation, a pleasant concoction of a pain-killer and a sedative that induces a "twilight-zone" state in the patient. Once they're in that state, we can then do our examinations without causing much if any pain.

Not all patients do well with conscious sedation. Occasionally we call the anesthesiologist in to give industrial strength sedation, inducing a level of sleep that most gastroenterologists feel uncomfortable giving on their own.

During a recent case, the "gas-passer", as anesthesiologists are sometimes called, was in a fairly chatty mood.

"Doc", she said, "have you heard about that lawsuit in Arizona? Some doctor is getting sued because he didn't order a mammogram on a demented nursing home patient. But they're not suing him for malpractice. They're suing him for elder abuse!"

I hadn't heard about the case and still don't know any of the details.

"There is precedent for this kind of stuff," says I. "In California some family members wanted to destroy a physician and make a buck on it because they thought he undermedicated their dying father for pain control. California restricts non-economic losses to a mere $250,000, and of course there would be no way to generate economic losses on such a case, so they sued the doctor claiming elder abuse. The doctor was found guilty and the family was awarded $2,000,000. I doubt the jury realized that such a judgment would not be covered by malpractice insurance because it is a criminal case. The doctor was financially destroyed."

"When will this stop? When will they figure out that they've pushed too far?"

"When we all quit, which we're not likely to do because basically we enjoy the practice of medicine. Besides, we have no other marketable skills, and they know it."

So we don't worry about the simple malpractice case anymore. Instead we worry about being given a felony conviction so lawyers and families can make a buck and destroy us.

One way for us to escape this threat is simply not to see anymore Medicare patients. Because their Medicare reimbursements are slated to go down another 30% over the next few years, more and more doctors are thinking about dropping Medicare. The government has constructed huge barriers to doing this, and traditionally doctors haven't wanted to put themselves in the position where they "won't take care of Grandma".

Still, we live in a free-market society and sometimes the only thing the market understands is that a huge demand for a service or product that is in short supply will ultimately drive costs up and availability down. It seems to me that the only way things will change is when a patient calls 911 because of a medical crisis and is told that the only person they could find to man the emergency room is some third year law student.

In the meantime, I try to take solace in the words of Mother Teresa:

People are often unreasonable, illogical, and self-centered. Forgive them anyway.

If you are kind, people may accuse you of selfish ulterior motives. Be kind anyway.

If you are successful, you will win some false friends and some true enemies. Succeed anyway.

If you are honest and frank, people may cheat you. Be honest and frank anyway.

What you spend years building, someone could destroy overnight. Build anyway.

If you find serenity and happiness, they may be jealous. Be happy anyway.

The good you do today, people will often forget tomorrow. Do good anyway.

Give the world the best you have, and it may never be enough. Give the world the best you've got anyway.

You see, in the final analysis, it is between you and God. It was never between you and them anyway.


Anonymous rab said...

As I mentioned in one of your previous essays the medical doctors need to organize and refuse services to certain undesirable segments of society e.g. lawyers and their employees and family.

Sounds cruel and it is to the same extent that they are cruel to doctors. It wouldn't take long for a more pleasant equilibrium to present itself.

Net net I don't feel too sorry for y'all.

5:48 PM  
Blogger JusPasenThru said...

It's illegal for physicians to engage in collective bargining as such.

Strikes generate huge negative publicity. I ain't no Teamster.

Refusing to treat lawyers and their families violates the Hippocratic oath.

Other than that, I'm with ya.

6:12 PM  
Anonymous Anonymous said...


When I read the title of this blog I thought you were going to tie in one of your book report stories. I was sad you didn't.

10:42 PM  
Blogger JusPasenThru said...

You mean Amos Elburper's book entitled "The Battle of Stinking Creek" in which two arnies are locked in a despirate battle, run out of ammunition, and resort to eating large quantities of legumes in an attempt to generate gas attacks?

Never heard of it.

4:33 PM  
Anonymous Anonymous said...

Muy bien, muy bien!

5:19 PM  
Anonymous rab said...

Well.... to belabor a point there are a few states where doctors are allowed to organize. New Jersey is one of them

Here are a few quoted from the Hippocratic Oath-
"Whatever houses I may visit, I will come for the benefit of the sick,..."

Comment: When it comes to lawyers the emphasis is on the word "may".

"..and if he is in need of money to give him a share of mine.."

Comment: The malpractice lawyers have taken full advantage of this.

11:01 AM  
Blogger JusPasenThru said...

No es problema.

1:37 PM  
Anonymous rab said...

I prefer the Leo Durocher approach to that of Mother T

9:34 AM  
Blogger JusPasenThru said...

OK, I give. What is the Leo Durocher approach?

10:35 AM  
Anonymous rab said...

"nice guys finish last"

12:17 PM  
Blogger JusPasenThru said...

That was definately true when the Washington Senators were in existence.

2:32 PM  
Blogger George said...

How would you like a quick and easy way to keep track of all your important information and activities Medical . Medical

10:55 PM  

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