Malpractice

The medico-legal climate in the United States has far passed the point of absurdity. Our legal system seems to be turning out an ever more creative cadre of parasites who delight in the widespread misery wreaked on society at large, and physicians in particular.

A few examples will suffice to enlighten the reader to the situation we must endure.

1. Several years ago a hospitalized patient sued all of her treating physicians because of a bad outcome. One of my colleagues was named in the suit because his name appeared in the chart. It was erroneously documented that he had placed a telephone order for Tylenol. My colleague easily confirmed that he was out of the country when the nurse incorrectly transcribed the verbal order. Also, the patient did not have any sort of adverse effect from the Tylenol that was administered. Nonetheless, he was named in the lawsuit, which dragged on for several years. While the suit was wending its way through our clogged legal system, my colleague’s malpractice insurance carrier abandoned the state. Since my colleague was named in an ongoing suit, he was unable to acquire malpractice insurance from any of the remaining insurance companies.

Another colleague, a thoracic surgeon, was walking through the emergency room one day when a nurse asked him what to do about a patient who had been shot, and was suffering from a sucking chest wound. The surgeon advised the nurse to place a bandage over the wound, to call the on-call trauma surgeon, who was in the hospital, and to advise the operating room. The on-call surgeon arrived in, perhaps, 1 minute. However, the patient did not survive surgery. One again, everyone was sued, including the surgeon who was just passing by.

2. A family physician evaluated a patient for a cough. The chest x ray showed a large mass, so he referred the patent to a surgeon. The surgeon biopsied the mass, and the tissue was sent to the local community hospital. The pathologist at the hospital, which is part of a network of 4 hospitals with very extensive resources, reported that the patient had lymphoma. The family physician then referred the patient to a board certified oncologist, who administered appropriate chemotherapy for the diagnosis. Unfortunately, the patient died. An autopsy revealed that the patient never had cancer.

The pathologist apologized for the error in diagnosis. Since both the hospital and the pathologist were covered under sovereign immunity, the patient’s family sued the medical oncologist and the family physician. When the jury came back with an 8 million dollar judgment against the physicians, they assessed a 1 million dollar judgment against the family physician. No reasonable person can figure out what he did wrong. Now the primary care physicians want the oncologists to get a second opinion on all pathology reports, a virtual impossibility.

3. This year I learned another rather disgusting aspect of a legal system designed by attorneys for attorneys. A colleague is suing a third party for wrongful termination. This should be a simple matter relating to the contract between the employee and his employer. However, in order to inflate the potential damages against his employer, the employee made a slew of scurrilous claims against a variety of individuals and entities. That’s when I learned that a plaintiff can make any claims in an allegation, no matter how outlandish. That is called protected speech. If the same claims were made in the hospital cafeteria, the individual could be sued for slander. Worse, the allegations can, and were, published in local papers. That is also protected, because the allegations in a lawsuit are public record.

   As an example, the plaintiff could claim that he was terminated because he objected to his employer fraudulently billing insurance companies. He’s allowed to say that, even if he knows it’s not true, as part of his allegation of wrongful termination. Then the papers report, “Dr. X alleges that he was terminated because he objected to his employer’s fraudulent billing practices. Attempts to reach Dr. Y, or his attorney, were unsuccessful.”

With a legal climate like this, is it any wonder that it has become less fun to practice medicine in the US?