Jun 11 2011

Political Malpractice In America

OK. This is one of those posts in which I won’t be talking about medical malpractice, per se.  But I am keeping it related.  Because today I have to vent about political malpractice.

There are no true standards of care that we make politicians in this country follow.  Sadly, we’ve come to expect the worst from our politicians, and find solace when they turn out to be not quite as unethical, dishonest, (you fill in the blank) as we suspected.

But this Weinergate thing got me thinking.  And if you are not familiar with the story, here it is in simple form, courtesy of CBS New York. Essentially, Rep. Anthony Weiner, a brash, outspoken product of NYC who might have been its mayor, sexted lewd comments and photos to women not his wife, got caught, lied about it, then fessed up at a teary news conference.  Many from his own Democratic Party, and almost everyone Republican, are calling for his resignation, based on the poor judgment Weiner showed during this titillating affair.  Maybe they’re right.

But then the “flippin” Palin emails started reaching the public, years after they were requested. And that jogged my memory, back to a dark time in American political history:  when John McCain chose Sarah Palin as his running mate in a presidential election.  To say McCain properly “vetted” Palin is to engage in fantasy.  Yet he chose her for what might have been the second most important job in America, vice president. Even allowing McCain the benefit of the doubt regarding the selection process, Palin soon proved herself to be a the silly political dilletante many suspected her to be, and a distraction to the McCain campaign, to put it generously.  Yet McCain hung onto her, as he continued to stonewall the American public regarding his medical history and cancer prognosis, a failure in transparency that continues to this day.

What if McCain had somehow won the election, Palin and all?  And what if he became physically incapacitated or died?  Sarah Palin would be the leader of the free world.  Could this scenario have failed to cross McCain’s mind, and that of his supporters?  In other words, was it a foreseeable event?  Obviously, it was.  And therefore, it was negligent, and worse, for McCain to continue his campaign with Palin as a possible VP.  It was reckless and stupid and selfish.  It was political malpractice of the worst kind, the kind that might have resulted in the starting of world wars and the attendant mass incinerations of human beings, for starters.

So how come no one has asked for John McCain’s resignation?  Could his actions have had more serious consequences for his constituents and his country?  Do you really have to think about that?

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May 31 2011

Tort “Reform,” Texas Style

The State of Texas loves to crow about it’s allegedly successful tort “reform” program.  Of course, whether or not it has been successful depends on which article you read, and whether you’re an insurance executive or a wronged patient.  And Texas does not like to acknowledge that one clear result of its efforts is that it has become one of the most expensive states in which to receive healthcare.

But here is something else that Texas would probably not want medical consumers to know.  If you are a neurosurgeon from, say, Minnesota, who has inflicted enough harm on your patients that your ability to practice has been severey curtailed, all you need do to kick start that  income stream is–you guessed it–move to Texas.  Just pay your licensing fee, and start practicing, just as Dr. Stefan Konasiewicz did.

According to the Duluth News Tribune, Minnesota is as much to blame as Texas in this unfortunate scenario, as sanctions accrued in that state need not dog a doctor when he moves to another.

So, yes, this is yet another example of the abject failure of the tort “reform” movement to address a real cause of medical malpractice: unskilled physicians who are rarely, if ever, disciplined in a manner that prevents harm to the medical consumer. Tort “reform” is not going to solve this problem.

But it would be nice if hospitals and medical societies stopped looking the other way when doctors under their supervision injure and/or kill patients.  It would be nice if “doctor discipline” was more than just a sometime-uttered phrase.  And actually imposing recommended discipline would lend the medical societies in every state more credibility when they talk about what’s good for healthcare.

Will this happen? Probably not. But a medical consumer can dream, can’t he?

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May 30 2011

Tort “Reform” Works–To Deprive Medical Malpractice Victims Of Their Right To Recourse

It’s always heartening and reassuring to see that large corporations that manufacture poisons for human consumption–think Phillip Morris here– have gotten their money’s worth from their efforts to promote the great lie that is tort “reform.”  You know.  It’s the same story, basically, repeated over and over again. The plaintiff with the faked injury who conspires with the ethics-challenged plaintiff’s lawyer, who limps into the courthouse with a frivolous case, i.e., one entirely lacking in merit, and somehow manages to fool the defense lawyers, their expert physicians who have examined the plaintiff, the judge and 12 jurors into awarding him millions of “jackpot justice” cash. I mean, think about it! Those poor defense lawyers at those large firms paid handsomely by the medical liablity insurance companies were fooled for about 3-4 years, the time it usually takes a medical malpractice case to get to trial or settle.  The defense lawyers gained no insight from their opportunities to depose the plaintiff for sometimes days at a time.  Their understanding of the case and its merits benefited not one bit from the crates of medical records obtained from every doctor that ever looked at the plaintiff prior to the lawsuit, even after these records were analyzed by physicians on staff with the insurance company.  The defense lawyers had no chance to observe the demeanor and credibility of the plaintiff during those drawn-out depositions, so that they would of course have no idea whether a judge or jury would appreciate their narrative of events at a trial.

Not surprisingly,  medical malpractice suits are down, according to technorati, while injuries resulting from malpractice are up.  That is the kind of perversity that results from well-funded efforts aimed at keeping the negligently injured out of the courthouse.  How is that accomplished? One favorite tactic is to shorten the time one has to bring the lawsuit.  Another is to place arbitrary caps on damage awards, insuring that victims who have already suffered debilitating injuries will think twice before embarking on a painful, drawn-out journey that will not result in very much compensation at the end, even if the journey is a successful one. But the favorite tactic is the one described above–tarnish plaintiffs, their lawyers, their motives for seeking redress in court, everything about them.

Maybe it’s time for a different way of thinking about victims of medical malpractice.  And maybe an organization devoted to consumer safety has a suggestion worth hearing.

“There is a crisis in medical malpractice, not lawsuits,” said Taylor Lincoln, research director for Public Citizen’s Congress Watch division and the author of the new study. “Trying to stop people from being compensated for catastrophic injuries is not the answer. We should instead concentrate on making hospitals safer and disciplining doctors who repeatedly commit malpractice.”

I think Mr. Lincoln has a point.  And I know, based on a recently concluded study right here at NY Presbyterian Medical Center, that an OB/GYN patient-safety initiative, properly adhered to, will save lives, and millions of dollars in liability costs for hospitals. Yet a bill that proposes using such a system in all New York State hospitals is being virtually ignored.  I think that says something about the state of our civil justice system in New York.  Unfortunately, because this is a family blawg, I can’t print that statement here.

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