Tuesday, March 02, 2004

Mr. Hawkins links to this New York Times article on Charles Cullen. What kept Mr. Cullen working and killing may be summed up thusly:

Ms. Beckert refused to say how extensively Liberty had inquired into Mr. Cullen's past before hiring him. Two hospitals that say they called Liberty for references on him, though, say it did not pass along its concerns.

Liberty's apparent reticence was no anomaly. Mr. Cullen's case has exposed a fundamental weakness in health care: the difficulty of prospective employers to learn of someone's past troubles.

Employers frequently refuse to pass on negative information, even about people they have fired, for fear of being sued for slander by the former employee. And state and federal systems for warning employers of bad doctors and nurses are widely regarded as weak. The reporting requirements are so narrowly drawn that it is not clear they would ever have applied to someone like Mr. Cullen. And there are few penalties for hospitals that flout reporting rules.

"There needs to be some kind of safe harbor that would allow past employers who've taken adverse actions to share that, and to describe the associated facts, without fear of legal action," said Dr. Arnold Milstein, a health care consultant and one of the founders of the Leapfrog Group, a national business alliance dedicated to improving health care.

Several of the hospitals where Mr. Cullen worked said their policy was not to say anything about a former employer, good or bad. When someone calls for a reference, they give only the person's job title and dates of employment. So Mr. Cullen's career, which now looks so horrific, could have seemed unremarkable to hospitals hiring him.

So we have the lawyers saying on the one hand if we will just clean our own house and get rid of the bad apples, the medical liability problem will take care of itself. But when such efforts are made, the lawyers try to put a stop to it.

As an example: A physician is removed from the medical staff from a hospital, after extensive due process, for multiple patient care issues. They promise, not threaten, to sue if not reinstated. The physician's national specialty society is asked to come in and review the case, they agree. Physician promises to sue said specialty society if they become involved. Specialty society then withdraws their agreement. This sends the message that it is easier for hospitals, specialty societies, and even state boards of medicine to go along and hope that these physicians/nurses/EMT's don't hurt anybody else than to draw a line in the sand and say "No more".

Explain the logic in this to me, please.
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