any MDs onboard?
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Orthopaedic Surgeon here.
It is interesting to read the anecdotal stories of others and realize there are others with the same concerns.
Unfortunately, I see a little flaming starting here
and we all know where that goes...end of thread.
Happy driving everyone! Enjoy your toys.
It is interesting to read the anecdotal stories of others and realize there are others with the same concerns.
Unfortunately, I see a little flaming starting here
and we all know where that goes...end of thread.Happy driving everyone! Enjoy your toys.
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Joined: Jul 2003
Posts: 2,957
From: Texas
Rep Power: 456
Well, I expected this to happen but assumed it would happen much quicker. I quess we cant expect non-physicians to understand what its like to "donate" 30% of your services to indigent care and have your prices fixed by some third party. And then have all your decisions scrutinized by plaintiff lawyers with your reputation, peace of mind, and malpractice limits hanging in the balance. I sometimes wish the rest of society could experiance this type of treatment for alittle while....
But alas, I think thats too much to ask. So I agree with neverfastenough, let the thread go away.
But alas, I think thats too much to ask. So I agree with neverfastenough, let the thread go away.
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Posts: 49
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hooray for lawyers in this country!! 
Doctors getting charged for murder
PROFESSIONAL ISSUES
Malpractice or murder? Criminalization of medical errors is a troubling trend
Physicians traditionally worried about malpractice lawsuits and license suspensions resulting from their medical decisions. Now there's an added fear of landing in criminal court or possibly jail.
By Tanya Albert, AMNews staff. Oct. 22/29, 2001.
--------------------------------------------------------------------------------
When physicians picked up newspapers a decade ago and read about a colleague charged with a crime, it was most often a crime that had nothing to do with medical decision-making.
Today that's not always the case.
Increasingly, doctors are being charged with crimes as a result of medical decisions made in the operating room, emergency department or office exam room.
"Things have changed," said Kansas surgeon and lawyer Thomas R. McLean, MD, a physician attorney who teaches at the University of Missouri-Kansas City and University of Kansas schools of medicine. "As a doctor, I can go to jail for a medical error." He has been researching the criminalization of medical errors.
Over the past couple of years, doctors have been charged with murder for prescribing pain medicine. But they've also been prosecuted for underprescribing for pain. A state prosecutor accused one physician of treating wounds in a way that violated laws designed to protect the elderly. Doctors also have faced criminal and civil charges for the way they've billed Medicare and Medicaid.
Examples are being seen in Japan and England as well.
Doctors have been charged with murder for prescribing and underprescribing pain meds.
"There's been a small but a clearly disturbing number of cases where a doctor is charged with a crime," said American Medical Association President Richard F. Corlin, MD.
Medical and legal experts are quick to point out that the number of physicians who have been charged with crimes is relatively small, and the chances of an overzealous prosecutor pressing charges remain remote.
Nevertheless, they say the trend toward criminalizing medical decisions is troubling.
"The safest way to characterize the response of our members is that they are horrified," said American Academy of Family Physicians President Richard Roberts, MD. "If these kinds of cases become too prevalent, you will see physicians altering their behavior in a way that's not good for the patient."
"Applying criminal charges to medical decisions is counterproductive," Dr. Corlin added.
Chilling cases
Although the number of physicians charged with crimes is small, the examples of doctors who have faced criminal and civil accusations are already making some physicians think twice about the way they treat patients.
Pain management is one area where court interference has made it difficult for physicians to do their jobs without fear that they might face criminal or civil charges for their medical decisions. In the past few months:
Michigan prosecutors charged an Ann Arbor surgeon with three counts of second-degree vulnerable adult abuse for care he provided to patients at two Detroit nursing homes. Surgeon Frank Paul Bongiorno, MD, has said he hasn't done anything wrong. He is believed to be the first physician charged under the four-year-old law.
A California jury found internist Wing Chin, MD, guilty of elder abuse for undertreating a patient's pain. Dr. Chin prescribed Demerol (meperidine hydrochloride, Sanofi Pharmaceuticals Inc.) to an 85-year-old man to ease the back pain he complained of when he arrived at an area medical center. He sent the patient home with Vicodin (hydrocodone bitartrate and acetaminophen, Knoll Laboratories). A jury awarded the family $1.5 million. The judge reduced that to $250,000, the state limit on general damages in medical malpractice cases.
Denis Deonarine, MD, a Florida family physician, faces murder charges. He is accused of improperly prescribing a painkiller that contributed to a 21-year-old man's death. The charge is part of an 80-count indictment a Florida grand jury handed down that also accuses the physician of racketeering and drug trafficking involving oxycodone hydrochloride, alprazolam and diazepam.
Utah psychiatrist Robert Allen Weitzel, MD, awaits a new trial on charges that he overmedicated five elderly patients, ultimately resulting in their deaths. He is charged with negligent homicide and manslaughter.
"It's getting more and more difficult to practice medicine because whatever you do can be wrong," said Tucson, Ariz., internist Jane Orient, MD, executive director of the Assn. of American Physicians and Surgeons.
The association has publicly supported Dr. Weitzel and filed a court brief on his behalf.
What's driving the trend?
The shift toward criminalization of medical decisions likely started during the years Bill Clinton was president, experts say.
Among the regulations and laws imposed on the practice of medicine in the late 1980s and 1990s were physician self-referral laws that made it illegal for doctors to refer patients to services in which they had a financial interest. In addition, the Clinton administration took an aggressive approach to rooting out Medicare and Medicaid fraud by filing criminal and civil charges against doctors officials believed were cheating the system.
"I don't see it changing soon," said health lawyer Harvey Tettlebaum, a partner at Husch & Eppenberger in Jefferson City, Mo.
Several things seem to be driving prosecutors' willingness to charge doctors with crimes for their medical decisions. The profession's reputation isn't as strong as it once was, and physicians are making more complicated decisions than ever before.
New technology has given physicians more options for treating their patients, but that means they have even more decisions to make when choosing the best way to care for their patients. And what medical decision will result in the best outcome for a particular patient isn't always crystal clear, especially in end-of-life care.
"Medicine isn't a precise science," Dr. Roberts said. "If the science about the right thing to do isn't there, who is the DA to step in and say what has to be done?"
Dr. Roberts said that on some topics, every state Medicare peer review organization has defined different standards for the best way to handle the same procedure.
"If I can do 175 different tests for a senior in a nursing home ... and I only do 29 of them, will I be held criminally liable?" he questioned. "As a profession, we have so much that's not defined or clear."
But prosecutors are not the only ones feeling bold enough to second-guess physician decisions.
"Patients and the family certainly are part of the threat," Dr. Orient said.
Patients and their family members have higher expectations about what medical advances should be able to be provided, making them more likely to ask prosecutors to pursue criminal and civil charges.
"Basically, everybody and their brother think they can make medical decisions," Dr. McLean added.
What's next
Physicians and legal experts don't expect criminal and non-malpractice civil cases filed against physicians to disappear from the judicial landscape anytime soon.
Dr. McLean said physicians and the medical system as a whole need to do three things to help make that happen.
First, he said, physicians need to reclaim the trust they have lost since managed care came into medicine, some of which was lost after patients learned that some HMO contracts rewarded physicians who ordered fewer tests.
"Until doctors are viewed as acting in the patients' best interest, that is one thing that will continue to fuel the trend," Dr. McLean said.
Second, the nation needs to change the way it pays for medical care. Now, employers pay much of the cost for health insurance. They have tried to contain those costs by shifting to managed care, but that hasn't worked.
Third, Dr. McLean believes the False Claims Act, which is driven by whistle-blowers, needs to change.
Physicians nationwide have faced criminal and civil charges under the act. The government uses information from citizens to build cases against doctors they believe are defrauding Medicare and Medicaid.
Even in cases where the physician is cleared of any wrongdoing, hundreds of thousands of dollars are spent in legal defense.
Also, the accusations tend to take a physical toll on the doctors, and in some cases physicians have been forced to close their practices.
Dr. Orient agrees that the law needs to change so there is more allowance for honest mistakes. "They are using the False Claims Act in ways that weren't intended," she said. "We also need to repeal some laws, HIPAA [the Health Insurance Portability and Accountability Act of 1996], for example."
But legislative changes aren't likely anytime soon, so Tettlebaum suggests that one way for physicians to protect themselves is to approach the potential for criminal charges as a risk management issue.
To prove criminal charges, prosecutors need to prove that there was intent for the bad thing to happen, he said.
"This is no different than any other risk management issue," Tettlebaum said. "Corporate compliance programs are a good way to prove that the intent wasn't there."
Doctors getting charged for murder
PROFESSIONAL ISSUES
Malpractice or murder? Criminalization of medical errors is a troubling trend
Physicians traditionally worried about malpractice lawsuits and license suspensions resulting from their medical decisions. Now there's an added fear of landing in criminal court or possibly jail.
By Tanya Albert, AMNews staff. Oct. 22/29, 2001.
--------------------------------------------------------------------------------
When physicians picked up newspapers a decade ago and read about a colleague charged with a crime, it was most often a crime that had nothing to do with medical decision-making.
Today that's not always the case.
Increasingly, doctors are being charged with crimes as a result of medical decisions made in the operating room, emergency department or office exam room.
"Things have changed," said Kansas surgeon and lawyer Thomas R. McLean, MD, a physician attorney who teaches at the University of Missouri-Kansas City and University of Kansas schools of medicine. "As a doctor, I can go to jail for a medical error." He has been researching the criminalization of medical errors.
Over the past couple of years, doctors have been charged with murder for prescribing pain medicine. But they've also been prosecuted for underprescribing for pain. A state prosecutor accused one physician of treating wounds in a way that violated laws designed to protect the elderly. Doctors also have faced criminal and civil charges for the way they've billed Medicare and Medicaid.
Examples are being seen in Japan and England as well.
Doctors have been charged with murder for prescribing and underprescribing pain meds.
"There's been a small but a clearly disturbing number of cases where a doctor is charged with a crime," said American Medical Association President Richard F. Corlin, MD.
Medical and legal experts are quick to point out that the number of physicians who have been charged with crimes is relatively small, and the chances of an overzealous prosecutor pressing charges remain remote.
Nevertheless, they say the trend toward criminalizing medical decisions is troubling.
"The safest way to characterize the response of our members is that they are horrified," said American Academy of Family Physicians President Richard Roberts, MD. "If these kinds of cases become too prevalent, you will see physicians altering their behavior in a way that's not good for the patient."
"Applying criminal charges to medical decisions is counterproductive," Dr. Corlin added.
Chilling cases
Although the number of physicians charged with crimes is small, the examples of doctors who have faced criminal and civil accusations are already making some physicians think twice about the way they treat patients.
Pain management is one area where court interference has made it difficult for physicians to do their jobs without fear that they might face criminal or civil charges for their medical decisions. In the past few months:
Michigan prosecutors charged an Ann Arbor surgeon with three counts of second-degree vulnerable adult abuse for care he provided to patients at two Detroit nursing homes. Surgeon Frank Paul Bongiorno, MD, has said he hasn't done anything wrong. He is believed to be the first physician charged under the four-year-old law.
A California jury found internist Wing Chin, MD, guilty of elder abuse for undertreating a patient's pain. Dr. Chin prescribed Demerol (meperidine hydrochloride, Sanofi Pharmaceuticals Inc.) to an 85-year-old man to ease the back pain he complained of when he arrived at an area medical center. He sent the patient home with Vicodin (hydrocodone bitartrate and acetaminophen, Knoll Laboratories). A jury awarded the family $1.5 million. The judge reduced that to $250,000, the state limit on general damages in medical malpractice cases.
Denis Deonarine, MD, a Florida family physician, faces murder charges. He is accused of improperly prescribing a painkiller that contributed to a 21-year-old man's death. The charge is part of an 80-count indictment a Florida grand jury handed down that also accuses the physician of racketeering and drug trafficking involving oxycodone hydrochloride, alprazolam and diazepam.
Utah psychiatrist Robert Allen Weitzel, MD, awaits a new trial on charges that he overmedicated five elderly patients, ultimately resulting in their deaths. He is charged with negligent homicide and manslaughter.
"It's getting more and more difficult to practice medicine because whatever you do can be wrong," said Tucson, Ariz., internist Jane Orient, MD, executive director of the Assn. of American Physicians and Surgeons.
The association has publicly supported Dr. Weitzel and filed a court brief on his behalf.
What's driving the trend?
The shift toward criminalization of medical decisions likely started during the years Bill Clinton was president, experts say.
Among the regulations and laws imposed on the practice of medicine in the late 1980s and 1990s were physician self-referral laws that made it illegal for doctors to refer patients to services in which they had a financial interest. In addition, the Clinton administration took an aggressive approach to rooting out Medicare and Medicaid fraud by filing criminal and civil charges against doctors officials believed were cheating the system.
"I don't see it changing soon," said health lawyer Harvey Tettlebaum, a partner at Husch & Eppenberger in Jefferson City, Mo.
Several things seem to be driving prosecutors' willingness to charge doctors with crimes for their medical decisions. The profession's reputation isn't as strong as it once was, and physicians are making more complicated decisions than ever before.
New technology has given physicians more options for treating their patients, but that means they have even more decisions to make when choosing the best way to care for their patients. And what medical decision will result in the best outcome for a particular patient isn't always crystal clear, especially in end-of-life care.
"Medicine isn't a precise science," Dr. Roberts said. "If the science about the right thing to do isn't there, who is the DA to step in and say what has to be done?"
Dr. Roberts said that on some topics, every state Medicare peer review organization has defined different standards for the best way to handle the same procedure.
"If I can do 175 different tests for a senior in a nursing home ... and I only do 29 of them, will I be held criminally liable?" he questioned. "As a profession, we have so much that's not defined or clear."
But prosecutors are not the only ones feeling bold enough to second-guess physician decisions.
"Patients and the family certainly are part of the threat," Dr. Orient said.
Patients and their family members have higher expectations about what medical advances should be able to be provided, making them more likely to ask prosecutors to pursue criminal and civil charges.
"Basically, everybody and their brother think they can make medical decisions," Dr. McLean added.
What's next
Physicians and legal experts don't expect criminal and non-malpractice civil cases filed against physicians to disappear from the judicial landscape anytime soon.
Dr. McLean said physicians and the medical system as a whole need to do three things to help make that happen.
First, he said, physicians need to reclaim the trust they have lost since managed care came into medicine, some of which was lost after patients learned that some HMO contracts rewarded physicians who ordered fewer tests.
"Until doctors are viewed as acting in the patients' best interest, that is one thing that will continue to fuel the trend," Dr. McLean said.
Second, the nation needs to change the way it pays for medical care. Now, employers pay much of the cost for health insurance. They have tried to contain those costs by shifting to managed care, but that hasn't worked.
Third, Dr. McLean believes the False Claims Act, which is driven by whistle-blowers, needs to change.
Physicians nationwide have faced criminal and civil charges under the act. The government uses information from citizens to build cases against doctors they believe are defrauding Medicare and Medicaid.
Even in cases where the physician is cleared of any wrongdoing, hundreds of thousands of dollars are spent in legal defense.
Also, the accusations tend to take a physical toll on the doctors, and in some cases physicians have been forced to close their practices.
Dr. Orient agrees that the law needs to change so there is more allowance for honest mistakes. "They are using the False Claims Act in ways that weren't intended," she said. "We also need to repeal some laws, HIPAA [the Health Insurance Portability and Accountability Act of 1996], for example."
But legislative changes aren't likely anytime soon, so Tettlebaum suggests that one way for physicians to protect themselves is to approach the potential for criminal charges as a risk management issue.
To prove criminal charges, prosecutors need to prove that there was intent for the bad thing to happen, he said.
"This is no different than any other risk management issue," Tettlebaum said. "Corporate compliance programs are a good way to prove that the intent wasn't there."
Last edited by 996TTlover; Jun 10, 2004 at 11:39 AM.
Registered User
Joined: Sep 2003
Posts: 226
From: CA - Nor Cal
Rep Power: 32
Doctors, would you like some whine with your cheese?
Get out there and break your *** to get new customers/sick people. We all paid our dues one way or another, through education or business.
Get out there and break your *** to get new customers/sick people. We all paid our dues one way or another, through education or business.
Registered User
Joined: Jan 2004
Posts: 84
From: scottsdale arizona
Rep Power: 26
Aesthetic Surgeon
I love what I do, am passionate about it, and really do not care what others think. I did 8 years of surgical training, am a real plastic surgeon, and deserve to be grossly overpaid as people pay for my expertise. What could be more honest than that?
I love what I do, am passionate about it, and really do not care what others think. I did 8 years of surgical training, am a real plastic surgeon, and deserve to be grossly overpaid as people pay for my expertise. What could be more honest than that?
Senior Member
Joined: Apr 2004
Posts: 782
From: Pasadena, CA
Rep Power: 64
i guess steve c can just shop around for the best prices for his medical care...
lawyers, accountants can charge whatever they want for whatever people are willing to pay. the government does not tell them what their expertise is worth.
when physicians are willing to take care of our elderly populations as they get ill, break a hip... the government that insures them forces the doctors and the hospitals to accept 1/5th the usual rate for such services.
and to state that physicians have been historically overpaid?
it's insulting.
go and get your maladies treated by those willing to do so at the cheapest price.
i figure expert care and advice - i.e. medicine, law, and taxes, are worth a premium for a reason...
lawyers, accountants can charge whatever they want for whatever people are willing to pay. the government does not tell them what their expertise is worth.
when physicians are willing to take care of our elderly populations as they get ill, break a hip... the government that insures them forces the doctors and the hospitals to accept 1/5th the usual rate for such services.
and to state that physicians have been historically overpaid?
it's insulting.
go and get your maladies treated by those willing to do so at the cheapest price.
i figure expert care and advice - i.e. medicine, law, and taxes, are worth a premium for a reason...
Registered User
Joined: Nov 2003
Posts: 801
From: Southern California
Rep Power: 55
steve c,
It is probably a true medical medical problem within you to make you so irritating. i recommend a full colonoscopy to pull your head out of your *** (the sigmoidoscope won't reach).
It is probably a true medical medical problem within you to make you so irritating. i recommend a full colonoscopy to pull your head out of your *** (the sigmoidoscope won't reach).
Banned
Joined: Mar 2004
Posts: 313
From: NYC
Rep Power: 35
My Wife is a physician so I am a bit biased. But here goes.
She did:
4 years of college
4 years of medical school
1 year of transitional medicine
4 years of residency and
1 year of fellowship
During those 14 years she was paid a total of less than $100k and amassed over $125k in debt.
Talk about delayed gratification -- even if she made a F*ckload of money now, over a career of 25 years, it does not average out to be so great.
I, for one, want the smartest folks to go into medicine -- call me selfish, but I want to ensure that the best and brightest are watching after the health of my family and me.
Years ago, folks would choose medicine and understand that they would toil away and there would be a payoff down the road. Not so true today with all of the constraints on reimbursements, malpractice premiums and overhead.
Face it, if the payoff is not great, the field of medicine will not be as attractive to the very best who might see less training and a quicker (and larger) payoff in other areas.
Hey, my brother-in-law is brilliant and is double board certified in Pediatrics and Internal Medicine and he makes barely $120K a year. Where is the incentive in that? He is damn brilliant and loves what he is doing but is barely eeking out a living. He may leave the field and that would be a shame.
I, fortunately, have been successful in business, but cannot for the life of me understand why my wife - who saves lives - makes so little. That is just WRONG.
As for medical costs in the US being so high -- what is the point? -- We have the BEST doctors, hospitals and medical care in THE WORLD. Everyone comes here from all over because they know we have the best (you can have your socialized medicine and wait three years for an MRI or better yet, forget kidney dialysis if you are over 50 in England because the cost/benefit is deemed too low to care). I would say the economic incentives would account for some of why we have the best medical care in the world.
She did:
4 years of college
4 years of medical school
1 year of transitional medicine
4 years of residency and
1 year of fellowship
During those 14 years she was paid a total of less than $100k and amassed over $125k in debt.
Talk about delayed gratification -- even if she made a F*ckload of money now, over a career of 25 years, it does not average out to be so great.
I, for one, want the smartest folks to go into medicine -- call me selfish, but I want to ensure that the best and brightest are watching after the health of my family and me.
Years ago, folks would choose medicine and understand that they would toil away and there would be a payoff down the road. Not so true today with all of the constraints on reimbursements, malpractice premiums and overhead.
Face it, if the payoff is not great, the field of medicine will not be as attractive to the very best who might see less training and a quicker (and larger) payoff in other areas.
Hey, my brother-in-law is brilliant and is double board certified in Pediatrics and Internal Medicine and he makes barely $120K a year. Where is the incentive in that? He is damn brilliant and loves what he is doing but is barely eeking out a living. He may leave the field and that would be a shame.
I, fortunately, have been successful in business, but cannot for the life of me understand why my wife - who saves lives - makes so little. That is just WRONG.
As for medical costs in the US being so high -- what is the point? -- We have the BEST doctors, hospitals and medical care in THE WORLD. Everyone comes here from all over because they know we have the best (you can have your socialized medicine and wait three years for an MRI or better yet, forget kidney dialysis if you are over 50 in England because the cost/benefit is deemed too low to care). I would say the economic incentives would account for some of why we have the best medical care in the world.
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People go into business because they like money, people go into medicine because they like helping people. 120k a year for one person is enough to live normally.
I'de rather my md be in medicine because he enjoys it and not because of a big payoff.
I'de rather my md be in medicine because he enjoys it and not because of a big payoff.
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Joined: Sep 2003
Posts: 862
From: Bothell, WA
Rep Power: 57
People go into business because they like money, people go into medicine because they like helping people. 120k a year for one person is enough to live normally.
-Glen
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Posts: 1,745
Rep Power: 104
Originally posted by barev
People go into business because they like money...
People go into business because they like money...
Don't assume things dude.
