Saturday, March 06, 2004

Concerning a few items making their way through the medical blogosphere....
First off the debate surrounding the DoctorsKnow website and the controversy it has set in motion. The story has been reported in the New York Times and The Wall Street Journal. Dr Smith has shared her thoughts as well as DB with the usual lively debate in his comments section.
I can see the problems on both sides of this issue. Some malpractice litigation is legitimate and some patients have suffered due to negligence (as the examples in both stories point out). The database apparently does not provide many details of the litigation, so it may be difficult to separate the wheat from the chaff as it were.
On the other hand the data that is available to patients about physicians can be impressive. While the National Practicioner Data Bank is not available to the general public, some states publish the claims history of physicians in their state. Several commercial physician research sites exist to provide patients information about the physicians that they are seeing. This database may be a way of leveling the playing field:

"There's no question that physicians are totally frustrated by the relentless assault on the medical profession by trial lawyers," said Dr. William G. Plested, chairman of the A.M.A.'s board of trustees and a cardiovascular surgeon in Santa Monica, Calif. Dr. Plested said the government already maintained a database of doctors who had been sued, for use by medical professionals.
"Is it fair to come to me if you've sued the last 10 physicians you've seen and never collected?" he asked. "Is it fair for me not to know that?"

The articles used such tried-and-true phrases such as "blacklist" and "chilling effect" to describe the effect the database may have on patients who have previously sued and try to find a physician.
Texas Watch a self-described " non-partisan advocacy organization working to improve consumer and insurance protections for Texas families" has this reply via the New York Times:

Dan Lambe, executive director of Texas Watch, said the site is attempting to scare patients.
``This type of blacklisting runs counter to the Hippocratic Oath to the ethical and moral goals and obligations of medical professionals,'' Lambe said.

Mr. Lambe, however was not as eloquent in his press release:

"This contemptuous disregard for the public health and the Hippocratic Oath is moral malpractice," said Dan Lambe, Executive Director of Texas Watch. "It is pure thuggery intended to blacklist patients who have already suffered tremendous harm and loss by medical malpractice."
This new website is the latest in a growing movement among extremist doctors across the nation who are denying medical treatment and ignoring their duty to patients simply because they have turned to the courts for justice in the past. Texas Watch has noted stories of doctors in Florida, Georgia and Texas denying or threatening to deny care to patients or patient advocates as well as communication between New Jersey medical professionals advocating that doctors inconvenience patients and delay care in order to highlight the medical malpractice issue.

As seen in their report on courts in Texas from their 501(c)(3) organization, Texas Watch is no friend of physicians.

I would find the claims of moral outrage from the trial lawyers and others more plausible if the decision making process by an attorney in a medical liability claim was based only on "Was this patient harmed by medical negligence?" and not by "Can I get an award from a jury to make this worth my time?" As I posted earlier, in battles such as these physicians will always have a hand tied behind their back because of the basic responsibility that physicians feel to care for their patients. On a more practical level, it is often forgotten that physicians, except for emergencies, may refuse to provide treatment for anyone they see fit.

The other story, brought to my attention by GruntDoc, about the ordeal a physician went through over a false claim of sexual assault. I agree that this physician went through hell over this and is entitled to ask, as former Secretary of Labor Ray Donovan did, "Where do I go to get my reputation back?" If only he had a chaperone at his side, this could have been avoided. IMHO, he should have dismissed the patient from his practice after he declined to testify in his civil suit.

I think the problem is going to get worse before it gets better.
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