Comments on: Trying to do the right thing http://www.medrants.com/archives/2068 Contemplating medicine and the health care system Sat, 20 Mar 2010 04:42:37 +0000 http://wordpress.org/?v=2.9.2 hourly 1 By: arf http://www.medrants.com/archives/2068/comment-page-1#comment-4556 arf Sat, 04 Sep 2004 17:18:45 +0000 http://medrants.com/archives/2004/08/31/trying-to-do-the-right-thing/#comment-4556 Once again, look to this series in the Pittsburgh Post-Gazette: http://www.post-gazette.com/pg/03299/234499.stm 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. Once again, look to this series in the Pittsburgh Post-Gazette:

http://www.post-gazette.com/pg/03299/234499.stm

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.

]]> By: Aaron http://www.medrants.com/archives/2068/comment-page-1#comment-4539 Aaron Thu, 02 Sep 2004 21:06:24 +0000 http://medrants.com/archives/2004/08/31/trying-to-do-the-right-thing/#comment-4539 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. 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.

]]> By: Aaron http://www.medrants.com/archives/2068/comment-page-1#comment-4538 Aaron Thu, 02 Sep 2004 21:05:23 +0000 http://medrants.com/archives/2004/08/31/trying-to-do-the-right-thing/#comment-4538 Usually, in tort litigation, juries come back with verdicts of this magnitude when they decide that they defendant is lying. Usually, in tort litigation, juries come back with verdicts of this magnitude when they decide that they defendant is lying.

]]> By: Overlawyered http://www.medrants.com/archives/2068/comment-page-1#comment-4534 Overlawyered Thu, 02 Sep 2004 10:14:02 +0000 http://medrants.com/archives/2004/08/31/trying-to-do-the-right-thing/#comment-4534 <strong>Blogs on Poliner</strong> 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... 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…

]]> By: m http://www.medrants.com/archives/2068/comment-page-1#comment-4532 m Thu, 02 Sep 2004 03:40:40 +0000 http://medrants.com/archives/2004/08/31/trying-to-do-the-right-thing/#comment-4532 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.) 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.)

]]> By: arf http://www.medrants.com/archives/2068/comment-page-1#comment-4531 arf Thu, 02 Sep 2004 02:50:59 +0000 http://medrants.com/archives/2004/08/31/trying-to-do-the-right-thing/#comment-4531 "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. “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.

]]> By: m http://www.medrants.com/archives/2068/comment-page-1#comment-4530 m Thu, 02 Sep 2004 01:21:59 +0000 http://medrants.com/archives/2004/08/31/trying-to-do-the-right-thing/#comment-4530 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 "hey..it'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. 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 “hey..it’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.

]]> By: arf http://www.medrants.com/archives/2068/comment-page-1#comment-4526 arf Wed, 01 Sep 2004 23:46:42 +0000 http://medrants.com/archives/2004/08/31/trying-to-do-the-right-thing/#comment-4526 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. 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.

]]> By: m http://www.medrants.com/archives/2068/comment-page-1#comment-4523 m Wed, 01 Sep 2004 19:57:47 +0000 http://medrants.com/archives/2004/08/31/trying-to-do-the-right-thing/#comment-4523 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. 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.

]]> By: arf http://www.medrants.com/archives/2068/comment-page-1#comment-4522 arf Wed, 01 Sep 2004 18:26:33 +0000 http://medrants.com/archives/2004/08/31/trying-to-do-the-right-thing/#comment-4522 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. 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.

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