the good, bad and ugly
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Loading ...I have a few moments, so lets chat:
I will admit that I am one of those MD’s that bears his fangs whenever the word “lawyer” is stated. Of course, the human side of me knows that only a few percentage actually adhere to the common slick willie stereotype, I still writhe in hate whenever I read the latest vioxx story.
However, picking up the the latest businessweek bears the low standards that sometimes we adhere to when conferring MD as well as JD’s. It outlined the process by which some MD basically would sign BLANK diagnosis forms for diangosis of silicosis for mass claims. This fraud is now facing countersuit and the degree to which the physicians would slip the needed diagnosis based on no (not even weak) evidence is of course disheartening.
Of couse, I can’t let the lawyers off that easily. they, in order to back up their claim, hired an unassuming radiologist to reread the thousands of xrays. AS this radiologist was not informed of the gravity of his reads (he was told they were to be quick, 5-10 minute, $45 dollar each reads), he did a cursory read and popped out impressions. The lawyers then turned around and sumitted them as DIAGNOSIS of silicosis in a court of law. As soon as he found this out he filed that he NEVER submitted a diagnosis of silicosis or anything else in any of the xrays. This happening is still being hashed out in court I believe.
That and the best is the literal roving echocardiogram machines the lawyers would move from business lobbies to malls, looking for fen-phen users and taking quick echos on the spot in business lobbies, etc. “echo mills” they were called. For those unaware, phenphlramine in particular in fen-phen causes heart valve abnormalities, and echos are commonly used to diagnose these abnormalites . So they were “trolling” for valve leaks, so to speak. Of course, it has already been discovered that some of these echo reports were “doctored” (sorry) .
Sorry to see that corruption bears it’s head is so many places. It used to be that the money and prestige associated with being an MD maybe kept things better in the past. But with palty reimbursement rates, HMO’s now negotiating lump sums for seeing patients, (YES, these days managed care will negotiate a flat payment for seeing their patients with many doctors, regardless of specialty. See more patients and order lots of expensive tests/workups or god forbid a long hosptial stay for more patients than anticipated, and you could be in the negative. OR, order less agreesive testing and cheaper/less treatment and make a profit. Conflict of interest, HUH? But a reality now. Salaried MDs are not just for hospitalists, residents, and academic MDs anymore), and patient respect for MDs decliining, I can honestly see where making a quick buck would happen more often.
Medical and Health | Raul | 
November 3, 2005 9:16 pm
By enrico, November 9, 2005 @ 2:58 pm
Respect
I can say that, but I know that it’s a fine line (and an art I’m sure that comes with practice) to deftly deal with the patient who is informed and wants to leverage that information with the help of the doctor who knows more vs. the patient who is “informed” and thinks his/her doctor is stupid or incompetent because of not knowing the latest breakthrough mentioned on Good Morning America.
Do you think patient respect for MDs is getting that bad? Of course it’s not the same as it was 20 years ago, but that is more because of the wealth the patient has at his/her own disposal by way of the Internet. I think that informed patients are on the whole, better for medicine. Having been one of them
I know that a patient’s respect for their doctor and empowerment are not mutually exclusive, but I don’t know how often that is actually true. I know, I’m in Fantasy Land, but if you can’t be there in med school, when can you be?!
By Raul Benavides, November 9, 2005 @ 7:59 pm
patient empowerment
let me address that in a entry…. watch above