WhiteCoat

Quarterback Offense

Quarterback

 

Hello all, ERP here.

What is the Quarterback offense?  No, it is not some weird audible in football or a Quarterback sneak. It is a tactic used by plaintiff lawyers (and expert witnesses) to sack ER doctors in court.    How does it work?  Let me give  you an example.

A guy I know who is an excellent ER doctor (and probably more cautious and careful than most) who was sued along with a neurologist for not giving TPA to a patient who presented with stroke symptoms to the ER within the three hour window for its use.

Now, there are MANY, MANY reasons to not give TPA to a stroke patient other than that they presented too late.  The symptoms could be too mild to warrant its risks, there could be a contraindication such as having a coagulopathy, etc.   Regardless, this guy presented to the ER with some RESOLVING symptoms (I can’t remember exactly but I think he had some slurred speech) that was virtually gone by the time he got put into a room in the busy ED.  The ER doc assessed him quickly, and even though he thought himself that it was not appropriate to give the drug, he called the neurologist on call to run the case by him for confirmation. The neurologist agreed and the TPA was not given. The guy was admitted and, and the time of leaving the ED, he had zero symptoms.  Perfect! Right?

Wrong.  A few hours later up on the floor he suddenly stroked out big time and after a long deterioration, died.   The ER doc and neurologist were sued for not giving TPA.

Now, this is related to the title of the post as such.  The plaintiff-sponsored “expert” witness (an ER doctor whose smiling mug is frequently plastered across the pages of many Emergency Medicine magazine/journals as the “face” of a large contract management company.  (Makes me nauseated)) claimed that my friend was not being a good “Quarterback” by FORCING the neurologist to come in and examine and thus administer the drug.

Now, we are supposed to send out a hit man squad to twist the arms of consultants I guess.   Never mind that the guy would not have been given the drug by any prudent ER doc or Neurologist.

Well, the good news is that the jury thought this was silly as well and found in favour of the defense and my friend and the neurologist were exonerated.

What’s next?  The Blitz?  The Double Reverse? The Hail Mary??!??!

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51 Responses to “Quarterback Offense”

  1. cynical says:

    What is the expert witness name? Since closed cases are public it is ok to shine the light under the rock.

  2. Wayne Conrad says:

    Your remind me of the best story I heard of sensible jury acceding to a good defense. This came to me from an engineer who was on the jury for a slip-and-fall at a marina. According to the engineer, a thorough case presented by the plaintiff’s attorney established that the man had been running when he hit a patch of water, slipped, fell and had a boo-boo. After a long closing statement by the plaintiff’s attorney, the defending attorney gave his closing statement, which was simply: “Ladies and gentlemen of the jury, what did your parents always tell you? ‘Don’t run around water.’” The jury deliberated for all of five minutes, awarding not a penny to the plaintiff.

  3. ndenunz says:

    The sad thing is, HAD the patient received TPA and then had a cerebral hemmorhage the same expert would have testified against the plaintiffs, albeit for a different reason. Heads you win, tails I lose.

  4. HH says:

    Yes – identify the “expert witness”!!
    No reason not to.
    I once heard of a plan to start a registry of “expert witness” docs.
    Start now.
    Why would you not identify this “expert”?

  5. Greg Rosellini, M.D. says:

    Doesn’t AAEM have a mechanism to post the names of low life doctors who testify AGAINST other doctors in such frivilous cases? It is a way to publicly discredit such cretins!
    If ANY doctor agrees and is paid to be an “expert witness” against another doctor they SHOULD be publicly chastised (I personally believe they should have much worse happen to them!)!

    • Katy says:

      If a doctor were blatantly irresponsible, dangerous, unethical, had been warned as to why their methods were wrong, and still continued, and I were a doctor, I would have no problem testifying against them.

      That doesn’t apply to this story, however. I can’t believe things like this actually get to court.

    • Matt says:

      “If ANY doctor agrees and is paid to be an “expert witness” against another doctor they SHOULD be publicly chastised”

      So you think that no matter how egregious the act, a physician shouldn’t testify against another physician? This is why physicians shouldn’t be allowed to judge their own.

  6. ERP says:

    We are in the process of providing the info to AAEM for just such an unveiling.

  7. paul says:

    despicable.

  8. DreamingTree says:

    Most important question: Why the Brady Quinn pick? Please tell me that you aren’t a Cleveland Browns fan!!

  9. Matt says:

    It’s always amazing how many people can tell the merits of testimony from a paraphrased story heard secondhand.

    If you want to know his name call the clerk and order a copy of the transcript. Or just go to the clerks office and look In the file for the witness list. It’s public record. No magical unveiling necessary.

  10. MJH says:

    Love the Quinn pic (as a Browns fan). And yes… I know they’re 0-4.

  11. throckmorton says:

    Matt:

    Many of us have lived through these types of suits. I was involved in a case where a patient presented with a classic CVA. He received TPA according to protocol. He had no history of bleeding problems. After the TPA he had a severe GI bleed and had a long, protracted hospital course. The ED physician, neurologist and hospitalist were all sued. The case lasted 2 years and was eventually dropped.

    The case ERP discussed and this one both show that even when we follow the strict guidelnes and protocols that are considered “standard of care” they still will not prevent you from being sued. In this last case, sure it was dropped but after considerable time and expense by the defense.

    • Matt says:

      I don’t doubt you have. I just don’t know why one would use brief secondhand paraphrasing from an obviously biased source to reach a conclusion about hours of testimony. You certainly wouldn’t if you’d heard it from a friend of the plaintiff.

      I would think before one condemns another as a fraud or a “whore”, they would at least go to the trouble to read the actual statements, given how easily available they are.

      Incidentally, if you don’t want all three parties to be sued, agree to be deposed prior to filing suit. Since you won’t, what avenue does the plaintiff have other than filing suit to determine what happened? Outlaw lawsuits, and there will still be some method of investigating a claim that you’re not going to like.

  12. ERP says:

    Nah, I am not a Browns fan. I just used the pic because it was not copyrighted!
    As for the suit, I absolutely think physicians should testify against one of their own IF there has been malpractise or negligence. However, in this case (and I actually read the testimony myself), it was clear that the witness was just saying whatever needed to be said to find the defendants guilty. What he said was ridiculous to the point of laughability from an evidence-based medicine point of view. I can’t believe this guy would have actually practised any differently unless he was so incompetent to the point where he needs to demand consultants come in for every case to verify treatment plans.
    If you go AAEM’s website (http://www.aaem.org/aaemtestimony/), you sometimes can find transcripts from trials where ER docs have obviously spoken bullsh** on the stand to make a few bucks.

    • Matt says:

      Does AAEM ever “unveil” physicians who testify for the defense?

    • Matt says:

      Since you read the transcript, you should probably give the people here who want to know more the name and case number of the case, and the county where it was filed so they can order a transcript themselves.

    • HH says:

      This link seems to be outdated. I will search the AAEM site for info, but for others, it might be beneficial to post a new link.
      Thanks.

  13. TK says:

    If it is questionable, then yes.

  14. ERP says:

    I would Matt, but that would “out” myself and my friend. Thus, you will have to take my word for it for now. However, that gives me an idea. I think I will try to find other such examples(away from where I practise) and post them. I remember reading one a while ago that occurred in California that was egregious. I will try to find it.

    • Matt says:

      Your friend is already “outed”. He’s the named defendant in a lawsuit. The plaintiff, for that matter, is already outed. In fact, you were just bragging about how the plaintiff’s expert was going to be “outed”. How do they out him without telling us the case?

      Sorry, but when it comes to politics and money (but I repeat myself), which this issue is, it’s hard to put much stock in anonymous claims about cases someone heard or even claims to have read. As I said, I am sure if the plaintiff told you that their expert was great and really nailed the defense, you would be quite the skeptic without seeing some original sources.

      You didn’t say – how often does AAEM go after defense experts?

      • ERP says:

        Matt, I blog anonymously for the same reason White Coat does. Also, my friend would probably not want to be outed in the blogosphere as well.
        If you don’t believe me, fine. But it is the truth. Stay tuned for any other cases I happen upon where I can comfortably state the witness’s name. I would encourage concerned people to email their bosses and hospital administrators until such time that ABEM decides to officially reprimand them (assuming they are boarded).
        As for defense witnesses, I don’t work for AAEM so I don’t know if they have published questionable testimony from that side. However, I see no reason to think that they would not do so if it was a clearcut “make sh** up” case. Personally I would censure such testimony just as much as if it came from a plaintiff witness.

      • Matt says:

        I understand your position with respect to yourself. Not really sure about your friend, again, since the whole trial is public record and he’s going after the other side’s expert through the professional society. Not sure what you’re keeping “secret” there. If he’s going to seek censure of someone else for criticizing him, not sure why he should be anonymous.

        I wouldn’t hold my breath on finding any defense experts on that list.

        I don’t disbelieve you. I am sure from your and his perspective that is the case and you sincerely believe it. I’m just open to the possibility that there are two side in every dispute, and one of the parties to it may not have the most open minded understanding.

  15. A. J. Campbell says:

    As always, Matt argues that no one is entitled to hold an opinion about the merits of a lawsuit or the validity of an expert’s testimony unless s/he has attended the entire trial or read the entire transcript. However, in the Trial of a WhiteCoat series, when the jury returned a defense verdict, Matt didn’t immediately show up in comments to say, “Okay, they heard the whole trial, so it was unquestionably a meritless case.” Rather, he again trotted out the fact — for about the 27th time — that an early defense reviewer, who looked at the case before there was any testimony to read, was critical of WhiteCoat. Apparently you’re not entitled to express an opinion on the validity of a case or testimony unless you heard or read all the testimony AND can demonstate that no one in a position similar to yours has ever expressed a different view.

    • Matt says:

      You need to read what I said, not what you think what I said.

      The jury found for the defense in WhiteCoat’s trial, and I have no reason to disagree with them. They set through what, a week of evidence? Heck of a lot more than I, or you, know about the case, and they had no skin in the outcome.

      Nor does a finding for the defense indicate the case was entirely “meritless”. If you and I have a disagreement about a vague phrase in a contract between us, and after hearing all the evidence the jury finds for me, it doesn’t mean that your position was “meritless”. What I said about WC’s expert shopping was that the opinion of the first one he had did in fact indicate that the plaintiff’s case was not wholly lacking in merit.

      What I actually said here was that before the posters here rush to condemn a witness, one ought to look at what they actually said, rather than third hand accounts from people who have a bias. Acknowledging a bias is not the same as lying. If I were to tell you a story about what a doctor did to me that was negligent, I would expect you to withhold judgment on the physicians actions until you had heard the other side or at least reviewed the evidence. Because I would have an obvious bias, as the person who felt they were a victim.

      I’m not sure why not simply believing one side’s version of a dispute and taking the time to review ALL the facts before reaching a conclusion is such an offensive concept to people like AJ and cynic (particularly cynic, given his name). It seems pretty common sense, but I guess common sense and evaluating the actual facts is in short supply these days.

  16. cynic says:

    Alas, Matt shows up with his infinite wisdom.

  17. Doc99 says:

    Before seeing the patient, the ER doc should have consulted with the lawyer to learn the outcome.

  18. Matt says:

    Here’s someone sticking up for America’s beleaguered physicians:

    http://myespn.go.com/blogs/truehoop/0-45-30/Blaming-the-Doctors-is-a-Cop-Out.html

  19. Nurse K says:

    As a nurse in the ER, I’d refuse to give tPA to a patient who had significantly resolving symptoms, especially if it was only a mild speech deficit. We’re all trained in the usual indications/protocol/NIH stroke scale just like the docs and that, to me, would be an obvious rule-out on the tPA. YAWN.

  20. Andy Walker, MD, FAAEM says:

    AAEM does post “remarkable” testimony on its website, and will post remarkable testimony whether given on behalf of the plaintiff or the defendent. For testimony to deserve the appellation “expert”, it should be based on published, peer-reviewed evidence. Physicians who are willing to testify based on anything other than legitimate scientific evidence have prostituted themselves. While it is possible to prostitute oneself to either the plaintiff’s bar or the defense bar, we all know that the prostitutes almost always work for the plaintiff. The defense doesn’t have to find a prostitute, since the scientific evidence and reasonable standards usuallly favor the defense, as shown by the fact that 85% of all medical malpractice suits end without any payment to the plainfiff.
    If anyone would like to post testimony at the AAEM website, whether it’s remarkably good or bad, just go to http://www.aaem.org and follow the links. If the deposition or trial transcript is accepted for posting, the expert witness will be offered a chance to respond and that response will be posted too.
    By the way, I apologize to any prostitutes I may have offended by associating them with tort lawyers and mercenary expert witnesses. Actual prostitutes are far more honest, hard-working, and constructive.

    • Matt says:

      Yawn. Another lobbyist attempting to justify themselves as a public interest group looking out for us all by attacking others rather than being honest about what they are.

      I’m glad you and yours are immune from harm and will never need the services of an attorney. If only we were all so endowed with that gift then we wouldn’t need lawyers or insurers.

      Docs like you make me really look forward to single payer.

      • fyrdoc says:

        You said: “Sorry, but when it comes to politics and money (but I repeat myself), which this issue is, it’s hard to put much stock in anonymous claims about cases someone heard or even claims to have read. As I said, I am sure if the plaintiff told you that their expert was great and really nailed the defense, you would be quite the skeptic without seeing some original sources.

        You didn’t say – how often does AAEM go after defense experts?”

        After this query is answered, you then attack the group. But cry foul when your group is attacked. The difference between the AAEM and lawyers? AAEM actually serves the pubic good by developing and publishing standards, providing education and advocating for increased access to care. Lawyers are despicable scum who, if abolished as a profession, would not be missed. (And yes Matt, there may be disagreements between people that require the law to sort out. That should be left for the two people to sort out before a judge – not for lawyers. Police detectives could represent the “people” in criminal cases.)

      • fyrdoc says:

        “Docs like you make me really look forward to single payer.”

        Lawyers like you make me pray daily for repeal of EMTALA so that I can throw you and your family out of my ED. Let’s see how proud you would be of your profession if we made access to care as difficult for you as you and your ilk have made it for large segments of the population…

      • Matt says:

        “After this query is answered, you then attack the group”

        The query was not answered. Read closer.

        ” The difference between the AAEM and lawyers? AAEM actually serves the pubic good by developing and publishing standards, providing education and advocating for increased access to care. Lawyers are despicable scum who, if abolished as a profession, would not be missed.”

        You’re right, if there were no lawyers, physicians would pick up the slack. They’re the ones who would help people like my clients get out of abusive relationships, get protective orders, collect the debts on their small businesses, enforce their contracts, etc. Because physicians are useful like that.

        “. That should be left for the two people to sort out before a judge – not for lawyers.”

        People can sort it out. Unless you’re a legal entity like a corporation or an LLC, you can represent yourself all day long. Yet most people choose to get lawyers. Sounds like the market is making a decision as to our value.

        “Police detectives could represent the “people” in criminal cases.”

        Have you asked the detectives if this is what they want to do? Learn the rules of evidence and put on cases as well as investigate them? Or are you just volunteering other people for work.

  21. Matt says:

    “Lawyers like you make me pray daily for repeal of EMTALA so that I can throw you and your family out of my ED.”

    Unless you own the hospital, it ain’t your ED. You are an employee essentially of the taxpayer and the insurers right now. And pretty soon it will be just taxpayers. Pray all you want, your wish ain’t coming true. You keep taking my tax money, you’re going to treat me. You’re going to be just another federal employee within a decade, and probably not even smart enough to join a union. You’ll treat whoever comes in the door because it’ll be your job.

    ” Let’s see how proud you would be of your profession if we made access to care as difficult for you as you and your ilk have made it for large segments of the population…”

    Please, not the access to care argument again. You guys cry “we’ll lose physicians” every time your vending machines break. No one but you buys that you’re going anywhere. If someone lives in the sticks, you ain’t moving there to help them, and if they live in the city they’ll have more physicians than they need. Same way it’s always been.

    If you care so much about “access to care”, why do your lobbyists arbitrarily limit the number of slots in medical school? Why not simply set hard standards for getting in in terms of MCAT and GPA and grade harder after getting into school? After all, setting a fluctuating cap based on a lot of open ended factors at the front end isn’t really judging it based on whether someone has the requisite skills to be a great physician, it’s simply a way to restrict supply and keep salaries up at a rate 2-5x that of any other country.

    I mean, if you’re being honest about giving more people access, why don’t you permit more doctors? And don’t say it’s to preserve quality – you guys do a piss poor job of policing your own and offer the public no way at all to measure or rate you based on your skills. And if you wanted to preserve quality, you’d grade it more heavily coming OUT of medical school, not getting in.

    Your Hillaryesque access cries are nonsense. And you know it.

  22. DensityDuck says:

    Why do you guys keep feeding the troll? Surely you have better things to do with your time.

  23. Greg Rosellini, M.D. says:

    First off – let me clarify my first post: I assumed that using the word “Frivilous” covered the type of suits I think doctors should NOT be involved in as witnesses. THE VAST majority of suits ARE frivilous the ones that usually make it to court ARE frivilous. The ones where the doctor has truly performed some egregious malpractice are routinely settled before going to court. Just don’t be “an expert witness” unless you have a darned good reason. Otherwise you are being a despicable low life!
    Next, to respond in part to Matt, I would hate for med schools to lower standards any more to let in more people. They can increase spots but to a point. Having been involved in the admissions panel for med school I can tell you that the standards are indeed lowered for certain groups of students to help get them in. Unfortunately the outcome for doing that was having students that weren’t prepared for the true rigors of Medical School. The school routinely put these “kids” on 5 year plans and they would bomb tests, rotations and the boards. This is even after intense tutoring that was NOT made available to everyone! IF we lowered the admissions standards in order to get more into the schools we, the medical community, would be innundated with REALLY crappy doctors.
    As ER docs we all see the broad quality of doctors in the community even with todays standards. Keeping the doctor work force low is not because we want to protect our incomes but because we want QUALITY OVER QUANTITY! It takes a long time to train a doctor (12 plus YEARS). An ER cannot be manned safely with JUST PA and NPs (they do a great job but cannot cover the most critically complex patients) BECAUSE they just don’t have the training and knowledge base (it can’t be taught in just 2 years!).
    Furthermore, it is illegal in most states for doctors to unionize!
    Next…( Well, I had written a tomb answering your arguments but stopped. Your arguments aren’t all invalid but just misguided. I can go on and on about how we do a better job policing ourselves than the other professions, we are held to unrealistic standards even outside of the work place, we have to be retested every so many years and complete a large number of CMEs to stay certified and licensed etc. There just isn’t enough space to fit all my arguments against yours! I have heard and countered your exact arguments many a time. They are not stupid but just ignorant. Go through the training and work in an ER as a doctor and truly understand all the work, educational, institutional and NOW governmental stresses on us and see if you still say the things you say! I used to feel like you did on many things but now that I am an ER doctor I KNOW that I was just ignorant about those arguments!

    • Matt says:

      “THE VAST majority of suits ARE frivilous the ones that usually make it to court ARE frivilous. ”

      This statement is frankly just wrong. Truly frivolous cases, those with no basis whatsoever in fact, rarely if ever make it past summary judgment.

      ” I would hate for med schools to lower standards any more to let in more people. ”

      If there were firm standards in terms of GPA and MCAT scores I would agree with you. But there are not as far as I can tell. It’s an arbitrary number designed to artificially limit the number of physicians. Nothing more. If you truly wanted to get the best, you would have objective standards for getting in, and then grade on development.

      “Keeping the doctor work force low is not because we want to protect our incomes but because we want QUALITY OVER QUANTITY!”

      Nonsense. You all know physicians you would never let touch your family, but at the same time you’d never report them to the medical board, and there are physicians who are addicts, have multiple judgments, etc. still practicing without limitation.

      http://www.washingtonpost.com/wp-dyn/articles/A39677-2005Apr9.

      “Go through the training and work in an ER as a doctor and truly understand all the work, educational, institutional and NOW governmental stresses on us and see if you still say the things you say!”

      I completely respect the work you do. However, the governmental regulations are something physicians brought on themselves in exchange for the taxpayer dollars.

  24. Andy Walker, MD, FAAEM says:

    I have no intention of crawling into the pig sty with the likes of Matt, and thus will not become part of this endless argument with tort lawyers. No one BUT tort lawyers doubts the righteousness of tort reform. I only posted to answer the question from another emergency physician about AAEM’s publication of remarkable testimony.
    I’ll be signing off now, there is too much venom here for my taste. May God bless my fellow emergency physicians, who carry the medical system of this country on their backs by taking care of roughly half their patients for free; by taking care of anyone who comes to the ED, no questions asked; and by donating an average of over $140,000 of uncompensated care per emergency physician every year. What you do is noble and heroic. Don’t let the cynicism, selfishness, and ingratitude of a minority blind you to what you achieve every day. Most of your fellow citizens look at you with gratitude and admiration. Hang in there, things are bound to get better (maybe even with Matt’s single-payer system!).

    • Matt says:

      “. No one BUT tort lawyers doubts the righteousness of tort reform.”

      Yes, everyone believes in having insurance and tobacco lobbyists decide the value of cases. And eliminating the jury trial. Everyone but our country’s founders, and those of us who believe in individual rights, the Constitution, etc.

      “and by donating an average of over $140,000 of uncompensated care per emergency physician every year.”

      You don’t actually “donate” something if your salary remains the same regardless of collections. And what you do call a “donation” is a tradeoff at your hospital for getting taxpayer dollars. You’re not subject to EMTALA if you don’t take the government cash. But by all means, continue to erect that statue to your own selflessness.

      ” Hang in there, things are bound to get better (maybe even with Matt’s single-payer system!).”

      It ain’t mine. It’s the Democratic party’s. But physicians are standing aside and letting it happen. Even their chief lobbying arm, the AMA, is cautiously on board. (Yes, I know, not all of you are part of the AMA, but we all know they are the main lobbying vehicle for physicians whether you like it or not – in fact, they set the number of medical school slots).

      “I’ll be signing off now, there is too much venom here for my taste.”

      You’re a lobbyist who wants to screw over the injured by making their lives worth whatever number you pull out of a hat – don’t pretend you’re a venom virgin.

    • Matt says:

      He is right about one thing. What you do is noble. You’re professionals, and you perform a valuable skill.

      But you don’t act like it. You go to the government for everything. You lobby for CMS or health insurers to throw a few more crumbs your way. You all get paid pretty much the same regardless of your respective skills. You don’t value your time or your actual knowledge, rather you’re primarily paid by procedure. You’ve allowed yourselves to become distributors, not practicing professionals.

      And lobbyists like the AAEM don’t seem to be making much effort to change that. There is no move to reform healthcare, and more importantly your payments system, in a way that rewards your skills, rather than your ability to move people through.

      Most of you can wax poetic on the need for tort reform, which is just you going back to the government for protection, even though it has minimal effect on your bottom line or the way you practice. But few if any of you can point to legislation to release you from the grip of this payment system you’re in. Why? Because the insurers and the tobacco industry and the rest of the tort reformers aren’t backing you.

      You’re on your own in your fight to take control of your profession from the government, and your lobbyists are apparently clueless, or they’re helpless. Either way, you’re going to be federal employees soon if you don’t get your crap together. And frankly, we’ll all lose as a result. But you’ll lose most of all.

  25. ERP says:

    Hey Matt, read this. http://www.nytimes.com/aponline/2009/10/09/us/politics/AP-US-Health-Care-Malpractice.html?_r=1&scp=4&sq=CBO%20new%20analysis%20of%20malpractice&st=Search

    Looks like we can save 41 Billion by limiting medical malpractise suits. Much higher than previously thought.
    I do agree with you that we need to reform the way we are paid – we should be paid for our time and clinical judgment, not how many procedures we do.

    • Matt says:

      Actually it’s not a “limit on malpractice suits”. It’s actually $54 billion over a decade if one arbitrarily caps the value of all cases regardless of merit and IF you can federalize malpractice claims. Which constitutes less than .5% of the cost of healthcare over that period. Which is actually much less than previously claimed. Many tort reform advocates put the defensive medicine savings at 10% of all healthcare costs.

      You should be careful saying that is a number worth saving, because it’s likely just as much if not more could be saved cutting payments to physicians. Which would be much easier than federalizing malpractice claims.

      What is happening here is that some federal, and thus minimal tort reform, is being dangled as a carrot in exchange for you signing on to the initial single payer version. In other words, you’re playing the dupes again, but instead of it being for insurers and the tobacco industry, it’s for the single payer advocates.

  26. ERP says:

    Well Matt, capping pain and suffering awards (given by easily swayed and overly sympathetic juries) is a start until we can get medical courts, although not ideal. Also, in terms of the amount saved, I personally don’t think the main reason to reform the system is for the country to save money. A big part if it is to avoid putting patients at RISKS associated with unnecessary tests (radiation, procedural complications during the test, false positives which then lead to more testing and eventually invasive procedures). It will also diminish the use of unnecessary medications (like Abx) and all their concomitant side effects. It is also to make practising medicine more pleasurable and enticing as a career (this along with reforming the way we are paid which as I said before should not be primarily procedurally based). It can allow more OB’s to go back to delivering babies instead of just doing GYN stuff. It will allow more MD’s to take on riskier patients. It will bring our BP down when we are working.
    And by the way, I am in favour of a public option – if done right, it could make everyone’s lives easier.

  27. Matt says:

    “Well Matt, capping pain and suffering awards (given by easily swayed and overly sympathetic juries) is a start”

    Besides being so easily proven wrong (after all, physicians win about 75% of the time at trial, verdict amounts are down overall in tort cases), this statement is ridiculously arrogant. Why do physicians believe that every other voter is some weak kneed sap who is so easily led astray by a plaintiff’s lawyer while the defense lawyer twiddles his thumbs? It’s certainly not from any experience trying cases, so tell me, where does this arrogance come from?

    And you say it’s a start – a start to what? Give the government control of literally every area of our lives? Run over a Constitutional right in the name of protecting insurer profits?

    “until we can get medical courts, although not ideal.”

    I’m all for medical courts, IF every other industry gets to judge themselves. For example, when physicians sue health insurers for failing to properly reimburse them, I think the jury should be made up of health insurance executives.

    ” It will also diminish the use of unnecessary medications (like Abx) and all their concomitant side effects. . . . . ”

    You guys always say this, but there’s no evidence this is true. We’ve had tort reform in California for 30 years, and in other states for at least a decade, and every one of your promises about what will happen if you get it doesn’t come to pass. Healthcare costs the same, physicians still do the same testing, and rural areas remain underserved. Why should we believe you now, after 30 years of it not being true?

    “And by the way, I am in favour of a public option – if done right, it could make everyone’s lives easier. ”

    Then you’re a sucker. I promise you, as the public option takes hold, your salary will be cut drastically. You are currently paid between 2-5x as much as your counterparts in other countries. You will likely be brought into line.

    And I know you hate having to answer to a jury – what do you think will happen under single payer? Do you think it will be easier, or harder, to tell your position to some faceless bureacracy which will be docking your pay based on your negligence since it costs the system more? These countries whose legal systems you want to emulate? Their doctors dislike their review system or whatever they have to replace our jury system, just as much.

  28. Greg Rosellini, M.D. says:

    You are not a well person Matt! I don’t know where this anger and vehemence stems from. Why are you posting here anyways just to start fights?
    Walk a mile in our shoes then pass judgment on us.
    Ignorance is curable but stupidity is forever. You are not stupid Matt, but you ARE ignorant.
    I won’t continue to engage you any further. I KNOW that I am correct in what I have said. YOU are NOT! You just won’t/don’t get it! When you finally do, post it and let us know!
    Andy Walker, THANK YOU! Your last post sums up the majority of our feelings nicely!

    • Matt says:

      Greg, if you read closer I’m actually begging you to recognize your own value. Pleading with you actually, before single payer breaks the taxpayer and diminishes you as a professional even further.

      I’m also begging you not to screw over those injured by a physicians negligence, but really either would make me happy, although I wouldn’t quit fighting for the other.

      I’m posting that here because you are the ones who can do the most about the former, and you’ve allowed yourself to be the face of the latter, obscuring the real parties who seek it.

      If those things make me ignorant or unwell, I can live with that.

  29. ERP says:

    I was going to answer Matt again but now after reading Greg’s comment, I agree. I am exhausted with this back and forth.

  30. Matt says:

    Frankly guys, your personal attacks are not surprising. It’s what people do these days in lieu of dealing with actual facts. From believing jurors are ignorant to making up tort reform benefits, your positions are devoid of a factual basis. We both know it. Especially the one about what a great job you do policing yourselves, as the article I linked about the physicians with substance abuse problems illustrates. What’s sad is that you have formed opinions and then gone searching for facts. It’s supposed to work the other way. But this is politics in America these days, I understand.

    As to walking a mile in someones shoes, I would challenge you to walk a mile in the shoes of someone severely injured or killed by malpractice whose quality of life for the rest of his days you want to make worth less than the average surgeons yearly salary. Apply your sanctimony to someone besides yourself, if only for a moment, if you dare. Or go on playing the insurance and tobacco industry front man. Like I said, in five years single payer will render this all pretty much moot anyway.

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