Monday, November 13, 2006

Losing My Virginity; Part Three

The aspect of malpractice suits that lawyers seem congenitally unable to understand is how devastating it is. "Ho hum," says a lawyer who read my first two posts in this series. "Get out the violins." It's as if, because I make my living operating on diseases, I were to say to my patients crying in my office about their cancer diagnoses, "yada, yada, get a life..." That such a thing is devastating is not, from my point of view, a reason for derision. If you make a living suing doctors, fine. It's what you do. But why laugh it off?

From the moment I found out about the suit, I felt branded. It was in the papers. People were saying awful things, in writing. In my mind, there was a visible stain on me, surely evident to every patient I faced. In no small measure, of course, it was because no matter what the facts were, I felt awful about the outcome of the case. "The case." How tidy a term... I'm absolutely certain that if I'd operated six hours earlier the outcome would have been the same -- and so were all the experts and colleagues I consulted afterward. But whenever I remind myself about it -- and this series of posts is a hell of a reminder -- I wish to God I'd operated at midnight. (Nor do I doubt that if I had, there'd be a lawyer/doctor team claiming that by going in before fully rehydrating, I set the stage for the clot to form...)

After the first few months, during which the afore-described papers trickled in (each arriving in a large envelope marked "Personal and Confidential," handed to me with trepidation by my nurse, and having been through the hands [so it seemed to me] of half the employees in the clinic before it got to me), there began a long period of chess-playing, carefully (I'm sure) crafted to provoke the greatest possible anxiety and disruption, aiming to make my life as miserable and uncertain as possible. The better, naturally, to till the soil of capitulation.

Trial dates were announced, my schedule was cleared for that week, and then within a few days of the date, it was canceled and rescheduled. Once again my schedule would be cleared, once again the day would approach, and be canceled once again. It wreaks havoc with a practice, in obvious ways. Lawyers, conceivably, are no more stupid than the rest of us (well, there's a bell-curve); I'm sure it was a game well-played. With each cancellation, there came notification that the amount of money being sought was lowered. Sometime after the prayer (that's the official term for the amount of money in play: "prayer." Hmm.) was lowered to well within the limits of my coverage, I heard from the "personal" attorney I'd hired. He wanted me to request settlement. Hey, wait a damn minute!! Much as the idea of being hammered on a witness stand frightened me, I'd long since gotten to the point of anger-fueled certainty that I'd prevail (well, that's too strong a word: not certainty, but resolution to proceed), and settlement was the last thing on my mind. The reason, he told me, was that since I'd originally been sued for more than my coverage, if it were to go to trial and I were to lose, and if the judgment were for more than my coverage, then, having requested settlement, I'd be able to demand full payment by the insurer. Well, I told him, I'm not sure. I don't want to settle this thing. This is about your self-interest, he told me. It's what you should do. He sent me a letter, and, feeling sick at it, I signed and sent it.

More trial dates. Couple of trips to Oregon to meet with the main attorney. "Stick to the facts, don't let him bait you, let me handle it...." sort of stuff. It dragged on for over a year, more setups and cancellations, more envelopes with flashing neon identifiers. Then, a call from the attorney. "I've got great news," he said. Unbelievable, I thought. They tossed it, finally. "We settled," is what he said. Thud. Stunned. Not relieved: pissed. The amount of settlement was paltry, particularly compared to the original "prayer." And given the amount the attorney would carve out, the family would get a pittance. To what end? What had been the point? The point, it's clear, is that everyone made out but me. The system was gamed perfectly: find a case, pay an opinion-for-price "expert," sue for more than the doctor's coverage, play a master baiting game for a year or so, make a few bucks. Pretty much guaranteed. Every lawyer, and that street-walking doctor got paid.

I suppose, after the set-up of the first two posts here, it's a let-down. I got off easy, except for the feeling I'd been played like a fish, by people who made the rules for their own benefit, who have seen to it that they'll get theirs.

And here's the point: there IS such a thing as malpractice. When it happens, the patient is, without question, entitled to compensation. But the system does not distinguish between bad outcomes -- which are inevitable, given that in complex situations there is NO decision we make whereby the result is guaranteed -- and bad care. In my mind, malpractice means sloppy care, decisions made with obvious ignorance of the situation; refusing to respond; failing to follow accepted practice in the evaluation or treatment of a condition; clearly making the wrong surgical move: there are many items on the list. Approaching a difficult situation with well-reasoned choices, conducting the care properly and carefully, yet ending up with a bad result -- whatever that is, it's not malpractice. And there needs to be a distinction. Not just for the doctors' sake; for the patients'. As is, it's an all-or nothing lottery jackpot, with the lawyers -- over the long haul -- the ones most likely to cash in. People who suffer harm from proper care are, I'd say, usually deserving of or in need of some sort of help. Surely it's possible to design a system in which help can happen. You are offered collision damage coverage when you rent a car; extra flight insurance; title insurance (ok, that last one is a ripoff). Ought it not be imaginable that some sort of parallel coverage to augment health insurance could be designed? Paid for in part, perhaps, by malpractice insurers? Ought it not be conceivable that there'd be a way to track such situations into a non-adversarial process, leaving true malpractice to be dealt with as it should?

I'm not blind. I'd be the seventeenth to say that the era of widespread malpractice litigation has accomplished some good: there are now in place universally (or nearly) controls and committees and processes by which doctors and their product are scrutinized much more effectively than when I first toe-dipped into the pool. That's a good thing. And I'm told most cases are decided in favor of doctors. Whoopee. But I'd say that's just an indicator of how broken is the system: surely when actual malpractice occurs, the odds ought to favor the patient. So if most cases result in verdicts for doctors, to me it means that most cases that go to court aren't actual malpractice. Trial lawyers, I'm sure, will say it's because of the conspiracy among doctors: cover up each other's mistakes. I never saw the contract. I haven't signed on to such a thing. Were I to see an instance of malpractice, I'd say so.

In the thirty-six years since I began surgical training, I've had two more cases in which money changed hands, while doing literally two and a half times as many operations yearly as the national average (national average: 250 [I'm pretty sure]. Me: 700). In one, I'd saved the life of a six-month-old with the right operation at the right time, and ordered the right dose and delivery of narcotic for post-op pain. When the nurse saw redness in the vein after injection, she called the pediatrician instead of me, and the order was changed to a different drug but at the wrong dose. Unaware of the change, when I got a call in the wee hours that the baby seemed painful between doses, I asked how long it had been and was told "three hours." The pediatrician had properly switched drugs, but improperly ordered IV dosing as if it were IM (in the muscle instead of the vein, which needs a higher dose at longer intervals.) Unknowing, I said it could be given hourly. After a couple of doses, the baby stopped breathing. He was revived quickly, and had no injury; yet I was sued over giving the order, and despite the fact that the insurer's team admitted it was not I that had erred (the hospital had, as well, in not informing me of the change nor of reviewing the dosing) I was asked to "take one for the team," rather than get into a finger-pointing session, since the parents were willing to settle for five grand. I wish I hadn't, because it's on my record, but I did. The other was a man with an extremely rare anatomic problem with his esophagus, which I fixed. He developed swallowing difficulties later, ultimately seeing another surgeon who was sure I must have screwed something up and reoperated, finding nothing. Around that time the patient was diagnosed with Parkinson's Disease, and neurologists and gastroenterologists who saw him agreed the swallowing disorder was most likely due to Parkinson's. Yet I was sued, and because the man was by now in a wheelchair and miserable from his disease, making a sympathetic witness, and since the original problem had been so unusual that there was no uniform literature on how to address it, the insurer recommended settlement, and that's what happened.

I've never been on a witness stand. Like going to Vietnam -- which I didn't enjoy but which I've always been glad I did because it was the seminal event of my generation -- I sort of wish I'd had the experience. From my brushes with the law, I'm left with an extremely discouraged view of it: patients who are deserving get less than they need from a system designed by and for lawyers, who get plenty, abetted by whoring "doctors" who become professional testifiers because they can't make a living practicing medicine. Good doctors are aggrieved -- to put it mildly -- by a process that as part of the gameplan seeks to destroy them mentally in order to create a result, making no distinction between care well-rendered (which is usually the case) and incompetence. I simply don't accept that even with trial lawyers having much to lose it's impossible to find a way to help those in need without harassing doctors: patients are doubly screwed, as they fail to get what they often deserve, and as they suffer the effects of doctors bailing out of their careers, or choosing less litigious arenas in which to practice. But I ain't holding my breath for the solution.


Anonymous said...

Well, if it makes you feel better, the wave of socialized medicine will sweep the trial lawyers away too. Ironically, it's the Democratic party that they support so strongly that will kill them.

For now, though, we'll all take the shaft from them - physicians and patients alike.

Anonymous said...

Well, that does serve to partially reconcile me to New Zealand's compulsory no-fault accident insurance, which separates the patient's compensation completely from the issue of malpractice.

Sadly, we still don't seem to have ideal systems for malpractice and compensation, but at least the two issues are dealt with separately.

Someone who's been injured is dealt with by the Accident Compensation Corporation, which has the job of ensuring they get adequately compensated and supported. Sometimes, ACC even get the level of support and/or compensation right.

Someone who thinks their doctor has acted unprofessionally is able to make a formal complaint, I think to the Medical Council, which is then investigated. The doctor is then disciplined by being removed from practice, if they seem to be a danger to their patients in any way. Sometimes, this seems to work out right.

Neither system really works as well as it should, though, sadly.

DK said...

It’s sad about lawyers really. Once upon a time lawyers were there to protect the rights of individuals and uphold the law. Now, it seems they play a grand game of chess with their clients as the pawns.

I had to do some searching, but I found an old post from A Chance to Cut that shows some of the true colors of today’s trial lawyers.

Copy of the full article he quotes(no login required)

Anonymous said...

John: I have no idea why you are accusing me of trolling. It seems a rather obvious fact that no meaningful change to the malpractice system is on the horizon, and likely that when socialized medicine hits (which seems inevitable) the status quo will become unacceptable as the current "pathos lottery" system of malpractice awards will be too costly. I was merely pointing out the irony of the trial lawyers assisting in their own demise by giving so much money to the Democrats.

Anonymous said...

Wow... not making me feel to great about deciding to go into medicine, doc. ;)

But I'm glad you got some sort of resolution, even if it was a frustrating mess.

Anonymous said...

I should add, you did make me feel a little better about not going into law, though. :)

D said...

Dear Doc:

A Google Alert for “title insurance” guided me to your blog. I’m a title insurance agent and for the record would like to assure you and your readers that title insurance is not a rip-off.

Thank you for taking the time to share your experience. In every profession we have competent, honest, caring people and we have those who are not. The legal profession has a higher percentage of “those who are not”.

As a non-attorney title insurance agent, I work with lots of attorneys. I think they start their professional lives with the same natural percentage of honest and caring people, just like doctors.

Folks who are attracted to the medical and legal professions, in my opinion, unless they have a higher calling, are looking for the so-called good life - respect, money, and a challenging career. If you’re not good at biology, maybe you go for law. Medicine guarantees job security. People will always need a doctor. Law, on the other hand, is not so necessary.

Many lawyers find there just isn’t enough business to create that good life. They have families, wives and children, who expect a standard of living they can’t afford. Therein lies the motive to turn to the dark side. It’s slippery slope that starts with churning, make a case just a little harder so it takes longer and you make more money. The desperate create cases to litigate with or without merit, and some sad cases finally end their careers with malfeasance, stealing the escrow account.

It takes something more than desperate attorneys to create a litigious society. Attorneys need a willing client base and they find it now in our cultural disintegration. We are losing touch with nature. Nature teaches children about life and death and everything in between. Modern media doesn’t help when they hype fault with every story to make it interesting. A culture with no real life grounding in natural weather and human frailty, goaded on by a hyped up media’s insistence that someone always has to be at fault, is fertile ground for hungry lawyers.

I wish every parent would allow his or her child time to play and absorb real life. Get their hands in the dirt, plant, and walk in the woods, collect butterflies. Let them get hurt just a little to understand little hurts are part of normal life. Let them see death and life. Allow them to experience life in a way that makes them stronger, building a tolerance like an immune system. Help them to understand that we can’t control everything and that while life is perfect in symmetry, that perfection includes health and illness, life and death, wealth and poverty. The beauty of life can only be experienced with its imperfections. We can learn once again to appreciate a kind doctor making every effort to save life, and understand that he is only human, and understand what that means.

patch615 said...

I guess the way to tell if you really want to go into medicine is to see if you still want to do it after hearing about these horid problems with the feild.
the whole malpractice structure sickens me, and it looks more and more like this is the worst time possible to go into medicine. I guess its definately what I should do if none of this flags my drive towards medicine.

Anonymous said...

Folks who are attracted to the medical and legal professions, in my opinion, unless they have a higher calling, are looking for the so-called good life - respect, money, and a challenging career. If you’re not good at biology, maybe you go for law. Medicine guarantees job security. People will always need a doctor. Law, on the other hand, is not so necessary.

Good life, respect, money? There is a lot of studying, training, clinical, sacrifice. (Sometimes on a personal level.) I didn't become an MD, but a Nurse and EMT, and I can tell you, (only on my end), There isn't a lot of money in it. And we can still be called to testify. I don't feel we've earned a decent living doing what we were trained to do. I, personally, do feel it's a calling. There are things you see, and hear, and smell,that you live with for the rest of your life. It had better be a calling. If your heart isn't with those suffering and in need of help, go.
Lawyers are needed. The good ones! The ones wondering if they are bad, just because their profession is notorious for going after the medical profession. How about educating them, and finding, and nuturing the ones coming up?( That have a heart.) The ones that have integrity. The ones that can, and will be an advocate for protecting those that face the system that is ours today? How many people have to go home after a long day, and think, and hope, and wonder how someone, (they feel responsible for), is doing? The only profession I know that does that, with the level of stakes this high, is the medical profession.

Anonymous said...

If yu had no insurance and messed up your shoulder four months ago ok probly longer what would you do ?

Bongi said...

commenting on what chrysalis angel said. i haven't yet seen the so called good life. i fully agree it should be a calling. not always the case though.

MedStudentGod (MSG) said...

When you have 1-800 numbers for lawsuits related to *anything* medical then you know the system is bad. This does scare me - a lot. I hate the judicial system, but more over I hate medical professionals for allowing this abuse to occur.

Bottom feeding trial lawyers and unscrupulous, incompetent "expert" physicians have allowed a system designed to assist patients crumble into one that's a money making dynamo - except for the patient truly victimized.

What's even more concerning to me is that while I enter medicine with concerns over what field, the malpractice rates of states, and insurance costs there are law students entering their field with only one ambition - to sue doctors. My brother in law (law student) has told me several times that people in his class are only out to get doctors because that's where the real money lies.


Sid Schwab said...

Yes, I strongly disagree that we choose our calling by a vision of "the good life." I do think that there was a time when people choosing medicine were of a sort that believed in hard work and excellence, and that hard work and excellence would have its rewards. As that is less and less true in medicine, I fear that there will be a shift in those choosing it: people willing to work very hard will go elsewhere. It's particularly true, I think, in surgery where the work gets harder and harder as the compensation gets less and less, and the recognition of excellence is lacking; at least in terms of compensation. It's in my book...

Buck said...

I am going to write a much longer version on my blog, but there are a few points I want to make. First, I am very sorry that my cyberfriend got sued. Certainly, that is one of the worst things that can happen to a surgeon, second only to divorce in its emotional impact. The system is truly set up by and for the lawyers. There is no consideration given to the doctors and the patients. It is obvious that a better system could be devised, but the lawyers will not permit it.

Don't count on the tidal wave to sweep away the lawyers. They still control both chambers--check it out. What they don't directly control they have bought. The trial lawyers haven't spent those big bucks in order to lose.

Medicine and surgery are still about the most satisfying careers I can imagine. Think of it as hard fun, not hard work. And note that we still enjoy a more favorable public opinion than lawyers and politicians in every poll that I have seen.

Unfortunately, the most likely outcome of the recent election is that any meaningful tort reform is dead at the federal level.

Anonymous said...

Sid: Wait one minute. I had trouble following the story.

First, did you sincerely believe you made a mistake that hurt a patient? If you did, a settlement is proper.

If you did not, did the insurance company settle without your permission? If they did, did you agree to that in your insurance contract?

If you feel this lawsuit was unjust, what were the names of the plaintiff, of the plaintiff attorney, of the plaintiff experts, and of the judge? Each had express, statutory duties toward you.

Anonymous said...

Sid: I guarantee lawyers are as upset about getting sued as everyone else.

I strongly advocate that organized medicine lobby for the end to all self-dealt immunities of lawyers and judges. Forget tort reform, a waste of time and effort.

Torts will help to deter lawyering and judging that falls below the standard of due professional care. It will work to deter and improve their professions.

If medicine chooses this path, it will be enthusiastically supported by all productive sectors of our nation that are victimized by tortfeasing lawyers at about 10 times the rate as doctors.

Anonymous said...

Just to follow-up Supremacy Claus:

Insurance companies ALWAYS have the right to settle a case, because (a) they're paying for the defense of the case; and (b) they're liable to pay the money if you lose at trial (excess verdicts notwithstanding, and even then they face risking a bad faith suit if they had a chance to settle for less than the policy and didn't).

Not that it makes defendants of any sort feel better about settling.

Anonymous said...

Supremacy Claus

I have a whole blog devoted to the proposition that the legal ethics system is broken, corrupt, a fraud.

The way to fix it is to take rule making and ethics enforcement away from the courts and put it in the hands of a non lawyer commission with court-like powers.

My blog is "Law, Lawyers, and Politics" at http:\\

I think it could be done fairly cheaply in Colorado. At the moment, though, the newspapers are pretending that there are no problems, so the public has no mechanism to understand its scope.

The legal system thinks I will go away. They will be disappointed.

Sid Schwab said...

S Claus:

I did not think I made an error. I said I wish I'd operated sooner only because it's the only thing I could have done differently; even though, as I said, I'm sure it would have made no difference, and even though, as I also said, I expect a suit based on rushing to the OR without adequate fluid resuscitation might have been filed.

As to settling: as I said, I was advised to write a letter requesting settlement because the original amount sought was above my coverage. I didn't want to do it, but followed the advice I was given. I was given no advance opportunity to agree to the settlement when it happened; as I wrote, I was called and given the news ex post facto.

Anonymous said...

Roadkill: This blog is about Sid, however he may enjoy this too.

The Disciplinary Counsel system is lawless.

1) the Rules of Conduct are written by the Supreme Court of the state. That is a legislative task, not a judicial task. They often copy Model Rules of Conduct word for word. These are written by the ABA, a quasi-governmental, private guild organization. Imagine, Tony Soprano writing the enforcement regulations for organized crime laws.

2) The Disciplinary Counsel deems himself a prosecutor, with all the immunities and discretions. Prosecutor is an executive branch officer. In this case, his employer is the Supreme Court. The Supreme Court is judging a case brought by its employee. Does it have a bias when its own employee advocates a prosecution? In cases of judicial review, judges have been castigated for having their wife's law firm be remotely affiliated with a party before them. Now, their own employee is a party to a claim before them.

3) The salary for the disciplinary counsel comes from licensing fees collected by the state bar, a private organization. This makes the DC an agent of a private organization and not of the state. The immunity of the state from the 11th Amendment and from the Hans case do not apply to the state bar, a private professional society, not a government entity, and their agents the DC. I find it misleading and offensive that the Cali Bar has a ".gov" on the end of its website name.

4) The DC has almost never prosecuted a complaint brought by a member of the public. Let a judge, or an officer of the bar file, and the lawyer is destroyed, no matter how powerful, rich and smart. There are rules, such as that prohibiting the filing of a frivolous lawsuit. That has never been enforced.

5) The DC informs any complainant that their immunity is conditional upon maintaining utter confidentiality. Imagine saying that to someone reporting child abuse. They have silenced the public seeking accountability. They have prevented other victims of the same lawyer misconduct from coming forward, and they have violated the public's First Amendment Free Speech rights with threats of litigation for making a complaint public.

Basically, the DC system is a tool for guild orthodoxy enforcement. The public is almost never protected. And any lawyer opposing the hierarchy may reliably expect to get crushed.

Try to find an in-state lawyer to enforce the law against the DC. "I cannot commit suicide on your behalf."

Anonymous said...

Sid: Read your malpractice carrier contract. Can they settle without your consent? If you wrote a letter requesting settlement, that was your permission.

It is still worth reviewing the facts with an aggressive litigator, especially if you feel misled or treated unfairly.

If a doctor feels he made no mistake, it is worth putting up resistance, even if very costly. The reason is that lawyers learn from experience. If a claim works, they return with many. If a claim fails, they do not return. It is short sighted of the malpractice carrier to settle for a small amount. The total amount of subsequent similar claims will be very expensive.

One may never predict a verdict. However, juror like doctors, and favor most defendants.

Anonymous said...

For anonymous #1--I used to think that socialization of medicine would amend the tort problem; soemwhat in the manner of a military doctor working as a government employee couldn't be personally sued. But don't believe it--if MD's were to be part of a socialized medicine system in America, they'd be private contractors of a universal insurance plan. They'd get paid less, yet still have all the same lovely liability they have now.

Sigh. "Who is John Galt..."

SeaSpray said...

Here's to wishing you a belated Happy Birthday! (I saw your comment on Urostream)

I have a dear friend who had an open and shut case for winning a malpractice suit. She has suffered for years from a chronic condition and one of her treatments was to get monthly allergy shots. An emergency came in to the doctor's office minutes before she was to get her injection. Distracted by the previous patient's emergency, the nurse gave my friend an injection for 10x the amount of her required med dose and she immediately went into an anaphylactic rxn. The next thing she remembered was waking up in ICU 3 days later. Her husband had been told to gather the family together because they didn't think she would survive the ordeal. She was discharged with meds for her newly acquired heart condition which resulted from the incident. She told the doctor that she knew it was a mistake and didn't want the nurse to get in trouble for it and also that she was NOT going to sue him. To quote my friend:" If one of my kids makes a cake and they leave an ingredient out, then the cake won't turn out right but if a DR. or nurse makes a mistake they could kill someone." She knew it was an accident and that we all have the potential to make an honest mistake. She was allowed to go on vacation but had to stay in the beach house. While away she sent the physician's office a post card telling them she was doing alright. When she went back to the office they all hugged and cried and were so glad to see that she was alright. A few months later she was taken off the heart med after a test revealed her heart was normal again. My friend was concerned for the Dr and the nurse because she knew how awful they felt about everything. Now a couple of years later and she still goes to that physicians office. We need more people like this woman in the world!

I am sorry you had to endure those law suits! Thank God the big one didn't discourage you from your obvious calling to facilitate healing in those requiring your surgical skills! :)

Anonymous said...

I think the problem lies with the Health Insurer and not the doctor. Although the doctor should always do what is best for the patient, in the current environment, that could lead to the doctor being forced out of the Medical Group for excessive expenses.

In the meantime, you have Health Insurers cancelling policies, denying care and generally pissing off your patients and since you are on the frontline, you get the brunt of it.

Look at the recent Health Insurer mergers that give the CEO hundreds of millions of dollars for making the merger happen. Even worse, a CEO who is reported to have 1.6 Billion in stock options while back dating them since 1994.

I have noticed lately that doctors are beginning to fight back and refusing to sign contracts that pay them less than Medicare would pay. I have also noticed that hospitals are starting to fight back as well.

Until the problem with the "For Profit" Insurer becomes the "For Patient" Insurer, the doctor will keep taking the blame.


Anonymous said...

Come to Canada , boys and girls!
The CMPA has a "no negligence , no settle " policy - one of my friends is a trial lawyer who once spent CAD 15000 defending an opthalmologist against a spurious suit over a CAD 2000 dollar pair of multifocals!
My wife is a barrister who says that most lawyers in BC will only take on cases where there is CLEAR malpractice ie TKR on wrong leg etc because the cost of going up against the insurers is so prohibitive. I am and ER / OBGYN ?GP doc and my insurance is $4000 a year - tell CJD and his bottomdwelling mates to kiss your asses and look for work here , EH?

Sara said...

One of the central problems is the adversary court system being the way that medical problems - whether they are negligent or malpractice or not - are handled. This prevents the right thing from being done willingly, ever. When something like this happens, the doctor most wants to set it as right as possible, to apologize. Due to the legal system, this becomes, rather than the moral thing to do, an admission of guilt. Patients, except for the ones really out to screw people for money, want to be mostly acknowledged, or to blame someone somewhere for their suffering. The physician, an ideal person to help them and counsel them into understanding and accepting what has happened, can no longer do this without risking his career.

The problem is the massive amounts given, out of all proportion to anything, that end up tempting people to do the wrong thing. No-fault recompense helps.

And whoever the guy is that said people go into medicine looking for a good life and status - obviously has not been through any medical training. You give up your youth, if you are female, your best child-bearing years, time with your family, nightmares of gore that 99% of the population doesn't even know exists, and if you figure per hour wages, don't make much more than average.

Anonymous said...

Now that it has been years later and I am only now coming across this blog (from KevinMD), do you have any other thoughts to add to this?
It's interesting to read the comments now as medicine is very different than it was 8 years ago when the comments were made - but not the lawsuits...

Sid Schwab said...

I've reread my posts, of course, as Kevin has republished them. No new thoughts, I guess; but it still bothers me as much now as it did then.

Anonymous said...

Thanks for your article. You are a great writer. I wish I could write like you. I am also a physician and am in my 60's around for Vietnam as well and know where I was when Kennedy was shot. I and am involved in my first but horrific law suit. I feel I did nothing wrong, but the outcome for the 75 y/o patient was paralysis and I am the one they are blaming and being sued for 5 to 10 million and will likely settle if I can. There was a very questionable area of abnormal signal on an MRI in the spine that I thought was from motion. Even retrospectively I would have read the film the same. It turned out to be an AVM, a very rare condition in the spine, that bled resulting in paralysis. Where I live out in the boonies we could not have even treated her. She was transferred to a major medical center 3 hours away where they imaged her again which now showed a very obvious bleed. They eventually did surgery on her. The end result was paralysis. I am likely going to loose this case and retire when it is all over. I wanted to use my background in electrical engineering and radiology to design Artificial Intelligence algorithms for CT and MRI. The science of using Fourier transforms taking frequency domain to time domain into K space and running the data through the python software program with NVDA and instantaneously generating a computer report fascinates me kinda of like the tricorder from Star Treck. However, after this event I am so physically and mentally drained that I am done. The lawyers win. I don't see how one can get satisfaction out of making a living by suing docs. I am just going to go for my long runs, play my violin, invest in my stocks which have made me much more money than I have ever made as a doc and be with the people I care about. I am sorry you had to go through this. I admire surgeons. Surgery is one specialty I could never do, as it calls at times for split second decisions. I like to take more time to think things through. I guess sometimes this doesn't work too well.

Sid Schwab said...

Thanks for your comment. Obviously, I know exactly what you're going through; even reading it conjures my old feelings. Glad you're in a position to call it a day. Sounds like you'll have more than enough to provide satisfaction and joy.


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