Wednesday, May 17, 2006

Your lawyer is going to kill you.

This is a post I have been meaning to write for some time now, but did not come around to doing for various reasons. No time, not in the mood, thinking about what to say and how to say it... excuses. In reality it's too depressing; depressing because nothing I - or anyone else for that matter - do will change the fact: Your lawyer is going to kill you.

Before you ask me to lay off the "good stuff", a little bit of background. I come from a family of doctors and have been around Medicine all my life. The feel of it, the idea of it, the practice of it. Hell, my brother and I made up children's songs containing medication brand names when we were 6-7 years old. Now I have myself been practicing for four years - add to that the six, seven years I studied Medicine and you'll see that, while by no means an expert, I have some idea about how the Art is faring in Greece.

More background: Medicine has taken a huge beating in Greece in the last few years. Scandals - true and alleged - of corruption, money changing hands, horrible briberies and other soap opera material appear in the news weekly at least. Doctors, probably because we have multiplied to an oppressively high degree, are taken for granted. No longer standing on a pedestal, we don't even tread the same ground as everyone else. Rather we are parasites, greedy and readily replaceable by other parasites waiting to take our place should we falter or not please our clientelle.

This has been going on for the better part of a decade, slowly and surely. Only recently though, not more than two, three years ago, a new animal made its appearance in the jungle we call home. An animal imported from the far more dangerous and exotic jungles of foreign lands - mainly the U.S.A: The lawyer specializing in medical malpractice lawsuits.

Oh you should see him (or her)! How warmly he speaks of the deceased! How he cradles the horribly wronged patient in his arms! As he would his best friend, nay! His own brother! And how - his countenance radiating with divine wrath - he calls upon Justice and Hygeia to be his witnesses, God to be his helper in this his most uphill climb, this cross he has to bear. And yet, much like St George did, he will slay the dragon. He will make the degenerate, incompetent doctors pay (literally). And if not, oh well, on to the next - true or alleged - victim.

As I said, the "fad" is new and imported, mainly - although not exclusively - from the U.S. Let me quote a few numbers before I go on. One thousand two hundred and sixty-eight (1268) doctors in "high risk" specialties (surgeons mostly, but not exclusively) in Pennsylvania were asked to fill out a questionnaire:

- 824 doctors replied.
- about 50% had been sued for malpractice in the past three years.
- almost all replied that they had held back on treatment (using only conservative, tried and true approaches) at some point or other.
- almost 60% replied, they asked for more tests than really necessary.
- 33% replied they prescribed more medication than really necessary.
- 32% admitted to asking for invasive tests to confirm diagnoses.
- 39% admitted to avoiding high risk patients.

Let me try to read between the lines. Even if we cut these numbers in half, most doctors look upon you as a potential opponent in litigation. Most doctors will hold back and not give you their full expertise. A third of doctors will put you through painful procedures and give you dangerous medication you don't need. Are they insane? Are american physicians just bad doctors? Obviously not, they are among the better trained and respected anywhere in the world. What happened? You happened. Whether lured by an eloquent lawyer or tricked by ignorance, whether venting grief and anger in the wrong direction or scoping for quick cash, you will end up causing harm. Harm for yourself and for others. Because face it: An over-cautious doctor is a bad doctor, just as bad as a reckless one.

For god's sake, doctors are humans. You hire someone to paint your house and through no great fault of theirs, the nice pastel pink you picked on the color sheet turns out to be a horrible greyish-purple. So a mistake was made, you accept it, or repaint your house and that is that. At worst, you ask for a free repaint - and sometimes you get it. What do you think happens when a doctor makes a mistake? And he will, get that through your skull. Your doctor has and will make mistakes. Big ones and small ones and - every now and then, hopefully never, but in truth it does happen - someone will die. That is the price of appointing a human to be a demi-god. To dispel disease, to mend the broken, remove the inflamed, restore the damaged. It - does - not - always - work.

Does this mean that we will just give doctors free reign? Care if they want and not if they don't? Heal or cripple at will? Of course not! There are bad doctors, there are doctors who just don't pay attention, who are sloppy and probably should not practise. The law should - and does more or less - weed those out, but that's a far cry from slapping every doctor who may or may not have made a mistake with a big lawsuit. Did you know that most of the latter are either totally bogus or end up in acquittal? Fine. Who will pay for the nights of lost sleep, the days of lost labor? Who will pay for the descent into cynicism, the loss of faith in humanity, the breaking of the spirit of the doctor?

We all will.

6 comments:

Anonymous said...

Lawsuits level the playing field for the patients. Although costs may rise, it sure is nice to know that if I am hurt by a doctor's negligence that there may be fiscal remedy awaiting me. In the past in Greece, I probably would have been lucky to receive a "SIGNOME" for malpractice.

Are there any stories out there?

Flubberwinkle said...

Excellent post Doc. If I may suggest, please translate it in Greek and send it out to the Greek media, because in my humble opinion, the slandering of doctors on prime time news without proof has gone way overboard.

We, Greeks, are the first to whine, bitch and moan if a doctor from a public hospital "asks" for an "envelope", yet we are the same ones who will hand him/her an "allowance" even if they don't ask for it; as a matter of fact, we demand they take it as if money will insure the transformation of these professionals into gods. Then, to top off the irony, we nod our heads and say "doctors aren't gods", everyone will verbally agree that they are allowed mistakes like any other professional, but secretly cross our fingers that the "fakelaki" will work its miracle.

Greeks have a serious shortcoming when it comes to their health. They know NOT the meaning of a second opinion. I'm a strong believer in science of healing, but I'm also a strong believer in different approaches. If two doctors disagree I will get a third opinion and hope for two out of three same diagnosis. If not, usually I place my and my loved ones' health in the hands of the doctor who takes the time to explain the pros and cons of a therapy and makes a sincere effort to treat me like a human/patient and not a statistic number/patient.

On a negative note, however, I'd like to add that your last paragraph is a bit of any oxymoron. The law... weeds the bad doctors out. True, but some relative with a slaphappy-malpractice lawyer probably weeded him/her out and if they hadn't done it he/she would still be practising (?)...
I'd personally prefer if the medical professionals weeded out their incapable own so that the integrity of qualified doctors isn't doubted.

Anonymous said...

zardoz says:
Dear THANOS
i think flubberwinkle pretty
much covered me.
Tried a couple of times to
chalk up ............
a sincere comment up , but
got too emotinally involved
too write , nice article
would be useful on greek blogs
at least to change some of the
mentality or at least give it
a new perspective. yours works
= z =

teacher dude said...

After being in and out of hospitals here for the best part of a year I have to say that I have absolutely no complaints about the level of treatment provided.

I was always been treated with the greatest respect and caring by everyone concerned, irrespective of whether it was an expensive place such as The Valkaniko (paid for by IKA, I might add) or a public hospital such as Ippokratio.

Anonymous said...

Thanos,
Good points. Yes, you are right. Limits on lawsuits is a fair notion. Maybe Greece can fix the errors of the U.S.A.'s system as we both know the amounts given sometimes are more like lottery winnings than compensation.

But, correct me if I'm wrong, but in your case, as a Military Officer/Doctor, you cannot be sued. Is this correct?

Anonymous said...

What do you call someone who graduates dead last in their medical school class?








DOCTOR.