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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.

Monday, June 06, 2005

Free legal advise

One of the first lectures I heard in medical school was on gout. The professors enjoyed lecturing about it, in part because it was one of the first conditions for which a drug was specifically designed (allopurinol), and in part because it was a very fashionable disease. Not everyone would announce to the world that they had a bad case of tinea cruris, but anyone would take pride in having a good case of gout. You needed two things: the inherited trait, which was traditionally associated with only the very finest of families, and a diet that only the wealthy could afford, rich in red wine and red meat.

Some disorders are more fashionable than others. Here is my personal ranking of some of the more "popular" disorders, based on nothing scientific. Your list might look entirely different:

Disorders to be proud of:
gout (of course).
athletic injuries, especially skiing accidents.
"walking pneumonia" (a sure sign of toughness).
pilonidal cyst (I have absolutely no idea why).

Disorders with no stigma attached to them:
peptic ulcer disease (especially since we realize you don't have to be a "type A personality" to get it).
coronary artery disease.

Disorders a civilized society wouldn't talk about:
erectile dysfunction.

Very serious disorders that nonetheless have a certain je ne sais quoi about them (I think because so many creative, talented people have had these):
bipolar disorder.
attention deficit disorder.

Disorders struggling to escape an undeserved reputation:
depression (half the population has it, the other half belittles it).
Crohns disease and ulcerative colitis (sufferers were once thought to all be neurotic, but if some are it's because the illnesses take a tremendous emotional toll on them).
panic disorders.

Disorders you still had best keep to yourself (so to speak):
sexually transmitted diseases.
sociopathic personality disorder.

As a societal disorder, medical malpractice has generally been in the "best kept to yourself" category, but that is slowly changing. You don't have to saw off a wrong limb or try to perform a hysterectomy on a guy to get sued these days. Something as seemingly innocuous as ordering a CT scan on a psychic can trigger a lawsuit if the plaintiff claims that the CT scan somehow damaged her psychic power (such a lawsuit occurred, and the jury ruled for the plaintiff and awarded her well over $2 million in damages). The stigma of a malpractice case is not so significant anymore, so doctors are a little more willing to disclose their experience with their colleagues.

As I'm a little more open about my suits than most doctors, I'm viewed by some as a bit of a legal expert, so I'm occasionally approached for free legal advise. My advise is worthless, and they all know it, but it's an oddly therapeutic exercise for us, and I'm always happy to share my opinion.

"Doc", one of my colleagues said, "could I get your opinion on something? A short while ago an older patient without health insurance came into the ER here with a serious heart condition. He required emergency surgery, and he had an extremely rocky post-operative course. To be honest, he was a real trainwreck. About five consultants were called in, and I was one of them. After a month and several touch and go moments he was able to go home. It was a bit of a miracle.

"It turns out that this gentlemen had two sons who are lawyers. They approached the cardiac surgeon and told him that they were very unhappy with his care and were strongly considering a lawsuit. If the cardiac surgeon wrote off ALL of his charges, and if he convinced all the other consultants to write off all of their charges, too, they might get change their minds and, who knows, maybe forgive the doctors for their slipshod care.

"The cardiac surgeon approached me and begged me to write off my charges. He was so fearful of a lawsuit that he personally went around to all the consultants and pleaded with them all to do the same.

"What do you think I should do? I mean, this is little more than extortion, but I also know that any lawsuit becomes part of your record and can affect your insurability for the rest of your career."

"It's a pity that the surgeon is not a little braver, although I hardly blame him. As for your charges, I'd write them off. Even if the case were dismissed, it would probably hang over your head for at least two years. Who needs it?"

And that's what he did.


Blogger The Medicine Man said...

I'd have reported them to their bar association. That kind of behavior is unconscionable.


2:08 AM  
Blogger JusPasenThru said...

Our State Bar Association is worthless. We've had lawyers reported as sexual predators in my town and the Bar took no action.

7:14 AM  
Blogger The Medicine Man said...



2:11 AM  
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