Trying to do the right thing


Category : Malpractice

Please go read this, but get a barf bag first. Physicians will remain frustrated with the tort system until there is legitimate reform. Even when we try to police ourselves the result is lawsuits – From the “damned if you do, damned if you don’t” files

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Comments (18)

It sound pretty outrageous, but then again, I don’t know the full facts of the case. And the fact that the site reporting this is called “overlawyered” makes me wonder if I’m getting a slanted version of the story.

this site is called medrants…

med + rants…

although the name suggests slanted opinions, one can research the sources very easily and expose the truths and falsehoods and comment on the specifics. in fact this specific link on overlawyered connects to a Dallas Texas newspaper.

I didn’t need a barf bag! I’m so proud that I have a stronger stomach than a doctor! 😉

More seriously, nobody ever said that better self-policing would eliminate all lawsuits. In this case, the alleged self-policing was found by 12 jurors to be hidden competitive malice. Would you just tell this doctor “tough luck”?

As for the amount of the verdict, which certainly seems high based on the facts presented by “Overlawyered”, the system has not yet run its course. It won’t make headlines, but there will either be a much-reduced settlement, or an appeals court will make a major change.

Criticizing the legal system for a case at this point in the process is a little like criticizing a heart surgery for causing a major wound before the patient is sewn up.

too bad the “system” has to run it’s current course, given the fact that the “system” requires huge sums of money to finance the
corrective action. Besides the winning legal team and the plaintiff… who benefits from such outlandish awards?
who suffers true harm?
who (besides the legal teams)benefits by the necessary legal re-action to the original outlandish award?

the analogy to the open wound from surgery is not even closely correct. for the past 10 years the number of sternotomies has radically decreased in favor of less invasive, less costly coronary revascularization procedures such as stents and keyhole procedures. In the medical side of the analogy great strides have been made and continue to be made to avoid costly open heart procedures by emphasizing cornary artery disease risk factor reduction and by performing cheaper less intesive procedures.
although open heart surgeries yeild tremendous sources of income for the medical teams involved in these surgeries, the medical field is fighting hard to prevent the development of coronary artery disease, fights hard to avoid costly open heart procedures. too bad the legal system doesn’t have a similar motivation to reduce legal costs to our nation.

too bad for us all.

what do you think of the suggestion in the above web site posted in comment (2) ?

this seems to be a very reasonable way to cut down on costly, wasteful, time consuming litigation.

Don’t know all the facts of this particular case, and DB, I for one would not reach for the barf bag without knowing those details.

Bad faith peer review is very real. It happens, and as far as I’m concerned, it happens A LOT.

As I read this, the targeted cardiologist is separate from the group of cardiologists who ousted him, and according to this source, the group of cardiologists did not get outside review of the case.

Failure to get outside peer review of a physician in this case is not only stupid, in terms of failure to protect yourself, it is a hallmark of bad faith peer review…… the sense that the established group did not want outside review for a good reason.

I HIGHLY recommend this newsletter.

Peer Review

Poliner v Presbyterian Hospital
Dallas, Texas Jury Decision

Dr. Poliner, a cardiologist, was told to stop doing heart catheterizations or face termination of his privileges. The hospital and the competing cardiologists who accused Dr. Poliner of inadequate care refused to get outside opinions of the care provided, a serious error. The hospital finally got the outside consultations after the fact and it shown by multiple national experts that Dr. Poliner was practicing good medicine. The hospital then restored the privileges but also upheld the earlier suspension of the privileges. Dr. Poliner sued the hospital and the Chiefs of Medicine, Cardiology and Cardiac Catheterizations. The jury awarded Dr. Poliner $366 million in damages for breach of contract, defamation, interference with contractual relations and intentional inflection of emotional distress. The jury split the award by $161 million from the hospital, $141 million from the Chief of Medicine, $32 million from both of the other two. The case will be appealed and Dr. Poliner will not receive anything even close to the amount awarded, if anything. I am sure that all four defendants are sweating since this is usually not covered by insurance.

true enough….legal representation is a vital right…but surely better methods exist to avoid the scenarios of suits and countersuits and appeals.

c’mon db, I showed you the Pittsburgh Post-Gazette series on bad-faith peer review a while ago, you even ran it here on your site.

Bad-faith actions, by physicians, against other physicians they don’t like (read: competitors) is unfortunately, all too common.

A better method in this case would have been to treat the physician fairly in the first place.

If you have a problem physician in your midst, step one is OUTSIDE REVIEW. Geez, that’s like having a female chaperone for intimate female examinations. Don’t do it, you are asking for a pile o’ trouble.

And the cases that have come to my attention, when they fail to get outside review, it usually means malicious intent on the part of the medical staff or administration.

They don’t like the competition.

yes…independent outside objective peer review is smart. But it seems that an initial award of 300 million dollars encourages other similar disputes to go to court, perhaps making 200, 100 or 50 million seem “reasonable”. this is what is sickening.

No argument from me on that regard. Hundreds of millions is a little ridiculous.

Problem is, peer review law is such that, even if the doc really was terribly wronged, I despair he will not see penny one after appeals.

sure…the wronged plaintfiff will likely have to settle for a non noteworthy amount…perhaps limited economic damages. (minus appropriate legal costs)

our legal colleague suggests that this is the natural good course of our legal system..akin to a post surgical wound that will heal.

oh really?

perhaps this is way off the mark… but… the initial awards (even if finally pruned down to a tiny sum)
send a message throughout the country.

how so?

insurers jack up premiums.
lawyers advertise and hunt for the “big one”. The public calls the 1-800 number for a “free consult”
what the heck “it’s free and I might get a big payout”

the press glamorizes these lottery payout judgements.

by virtue of media coverage we just expect at least a “million or two” for our
injustices. jurors think “’s only 1.5 million”

I saw it happen at a local restuarant recently. TRUE Story:
I walk in and see a very heavy patron lying in the common restaurant area. screaming in Pain. EMS called. I hear her ask for witnesses to write down their names and phone numbers to attest that she slipped on a restaurant take out plastic cup. ( if the slippery cup had not been negligently placed in the poorly lit restauraunt she would not have fallen.)

I later hear from a ER nurse about the heavy set patient who EMS brought in hysterical. despite mega costly work-up no fracture found.

who pays for this?

we do

who benefits? ? ?

sure the 366 million dollar judgement is uncommon (not rare) but the shadow effect of this is very long and a powerful motivator for a system that leads to more losers than winners.

“m” (can I call you “m” for short?) I hope we’re not talking across each other.

“ASSUMING” this really is a bad-faith peer-review case (I do NOT know the facts) and assuming the plaintiff really is the wronged party….

My problem is not that the award is excessive (which it is)…..

My problem is, for the typical bad-faith peer-review case, the law is so skewed against the targeted physician, that in the end, the plaintiff will not get one cent.

That jury could have awarded one hundred BILLION for all it matters, in the end, the plaitiff physician will get NOTHING.

The way the law stands on physician peer review today, the review and the actions taken in this case could be motivated by obvious bias practically advertised in the newspapers, done in a biased and sloppy manner, with the facts 99% wrong…..but if the defense has 1% on their side, they will likely prevail at appeal.

If you want citations and legal reviews on the subject, I will be glad to forward them.

I do think this rant brings up two distinct topics both are important.

topic one….peer review
As you suggest peer review can and too often is biased. It should be much better encoded in our laws to ensure as fair and unbiased process (ultimately transparency is the best protector of fairness)

I 100% agree peer review is too shoddy, influenced by politics and inuendo. it is a faulty system.

topic two…barf bag topic

what bothers me more is the fact that our legal system allows a 366 million dollar penalty for one case. The damage (even if further appeals cut it down to nothing) is still immense for society.

m is short for EMMMMMMM.

also I am not a girlyman, (lately it seems to matter.)

Blogs on Poliner
The medical blogs are naturally talking about the Poliner litigation, where a doctor who had privileges suspended for allegations of improper care sued everyone involved in the peer review decision and eventually got a jury verdict of $366 million (Aug…

Usually, in tort litigation, juries come back with verdicts of this magnitude when they decide that they defendant is lying.

A slightly better restatement – In those rare circumstances when juries come back with verdicts of this magnitude, most of the time it is because they have decided that the defendant is lying.

Once again, look to this series in the Pittsburgh Post-Gazette:

It is called “The Cost of Courage”. It is a series of articles, and follow-up stories, and it exposes the FREQUENT misuse of peer-review protections by physicians who act in bad faith against other physicians.

The motivations have included reprisal against physicians who speak out against bad medical practices (the bad doctors use peer review to drive out the good doctors), personal animosity, politics, economic competition (the good doctor gets more patients than the bad doctor, so drive out the good doctor)……and plain old-fashioned prejudice. Racism, homophobia, sexism, anti-Semitism.

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