This New York Times article describes a Texas company that operates a website which scours the public record for the names of people who’ve been involved with the plaintiffs side of malpractice suits, builds a list of the names, and allows subscribing doctors to search the list. They apparently include any suit, regardless of validity.
Doctors who use this facility to decide which patients to take–which is obviously its purpose–should not be allowed to practice medicine. How the hell can they reconcile refusing treatment to people who’ve been involved with (possibly unambiguously valid) lawsuits with the duties of their profession? Do they not see the irony of this business being based in Texas?1 Do they not understand the contempt this company shows for the legal system in our country? The implications of this system are fucking scary: Sue a doctor for malpractice, don’t get treated. I pit the owners of this company and the doctors that use it.
(1) Texas recently passed some fuck-the-consumers “tort reform” that imposed an arbitrary cap on non-economic damages in malpractice suits: Doctor accidently cut your legs off instead of removing your appendix because he was high on crank? No more then 750k for your pain!
This is not a one-way situation. Are you aware that several states (including New York, Florida and Massachusetts) post detailed information on their health department websites concerning litigation filed against doctors? In New York, according to the British Medical Journal site: “This information will include education, hospital affiliations, professional awards, malpractice history, and hospital dismissals that resulted from harm to patients. The state health commissioner must post a notice in hospitals and doctors’ offices giving the website and also a free telephone number for patients to call to get the listings.”
As far as I know, these sites do not distinguish between meritorious and non-legitimate suits. For doctors to have information about which patients have filed suits does not seem, in itself, to be unethical. If a person has a habit of suing over dubious pretexts you’d want to think twice about having them as a patient in a non-emergency setting. Punishing someone who suffered as a result of one-time bad practice is another matter.
Info about state medical board disciplinary hearings involving MDs and other health professionals is also available online in many states.
I think it should be a one way situation. The patient is putting his or her life in the doctor’s hands, not vica versa. Yes, it’s a great burden on the doctor, but they are ultimately well compensated.
I don’t think the solution to the medical malpractice suit problem should involve doctors witholding treatment from people who persue legal recourse. Making people suffer (which is what withholding treatment does) is contrary to the ideals of their profession. If there’s a problem with the legal system, then change the legal system.
Isn’t this exactly what doctorsknowus.com is doing by compiling information on anyone who has filed a suit or been involved with the plaintiffs side of a suit? One of the cases in the article involved a father who was involved in a malpractice suit having difficulties finding a doctor for his son. They also collect the names of plaintiff’s lawyers and expert witnesses: presumably they shouldn’t get medical care either.
I don’t think the point is to screw customeers, but to protect them in the long run. Several states have had their malpractice insurance cost go so high doctors can’t pay it. Texas is taking steps to make sure that doesn’t happen.
I’m not asserting anything about the motives of the Texas legaslation, just the result: When you set an absolute upper bound on non-economic damages, you’re hurting consumers. Medical malpractice is a problem, but I don’t think the Texas legislation is the right solution. It’s better then a blacklist, though!
I really doubt there is going to be any widespread pre-screening of patients to see if they’ve filed suit against docs. Too expensive and unwieldy, for one thing. There could be situations where, for example, someone comes in for a condition like irritable bowel syndrome and something sets off an alarm with the treating physician. He/she checks and finds out that the last four MDs who’ve treated the patient have been sued. Should the M.D. have the right to then suggest that the patient get treatment elsewhere? (and medical boards typically regulate the circumstances under which transitional care is provided while a patient finds another doctor). If a decision is made to continue working with a potential problem patient, the physician is forewarned of what may lie ahead and can protect him/herself with extra documentation, specialty referrals and the like.
I also did not see in that story any documentation that physicians are “blacklisting” patients, or that anyone had necessary treatment withheld because of data on the website.
DoctorsKnowUs.com is charging $4.95 a month for the first 250 searched, and $0.05 for each search thereafter.
Should the doctor have the right to do it? Yes. Do I think the doctor is acting ethically when he excersices that right? No.
So someone with a history of complaints gets more attention and treatment? Shouldn’t the doctor be giving the same level of care to all his or her patients?
I don’t think such documentation needs to exist: This company clearly intends its product to be used as a blacklist.
You are aware that civil trials are public, and the outcome of a civil trial is also public? All this website is doing is making it easier for a physician to find information that’s ALREADY publically available. And doctors have been acting on that publically-available knowlege for years, also; patients in a community who get a reputation for being “difficult” or “lawsuit-happy” have always found it difficult to find a new physician.
Physicians have been trying to effect changes in the legal system for many years - and have largely gotten nowhere with their efforts. If they cannot effect changes, what other recourse is left but to try to avoid those individuals whose past record shows they’re more likely to file a non-meretorious lawsuit?
And physicians are not under any obligation to treat a person they haven’t already established a patient-physician relationship with (contrary to what you apparently believe).
So you don’t trust physicians to investigate to see if a patient who’s filed a malpractive suit to investigate to see if it was an unjustified suit but you apparently DO think that patients do that when they consult the on-line databases Jackmanni mentioned. Funny, that.
I have mixed feelings about the website mentioned n the NYT article; it’s not something I personally would have created - but I have a very hard time arguing that collecting publically-available information and posting it on a website is a terrible action.
I’m kind of surprised that this isn’t a HIPPA violation (Health Insurance Portability and Accountability Act of 1996) and a patient’s right to privacy. But I guess since they brought it into the public by suing the doctor/nurse/caregiver/hospital/clinic etc, it goes public domain.
I agree with Metacom that this service is probably going to blacklist litigious people. I’m sure that emergency rooms won’t be using this type of service due to time constrictions as well as the 1986 the Emergency Medical Treatment and Labor Act that states that if any person goes to the emergency department of a hospital for treatment, the hospital has to provide a "medical screening examination. (Although that law is being attempted to be repealed by Bushco in a poor attempt to create tort reform and lower hospital expenses).
I’m all for tort reform but that shouldn’t sacrifice quality care for everyone which is what this website, imo, attempts to do.
Yes, I’m aware that civil trials are public. I don’t see how that’s relevant to my argument that physicians shouldn’t use that information to deny people treatment and that by trying very hard to make that kind of discrimination quick, cheap, indiscriminate, and easy doctorsknowus.com is a reprehensible piece of shit.
Keep trying. Changes can and do happen (see Texas). The implication that there must be a recourse available to doctors is false.
“Any” obligation? So that’s why doctors aren’t obligated to treat someone who walks into an emergency room dying!
Obligations between doctors, patients, and society at large are way too complex to be dismissed with such broad terms.
No, I don’t. We have an entire legal system in-place to determine if suits are justified or not.
Well, yeah. I explicitly said that when I said there should be a double-standard (my exact words were “one way situation”) and justified it by saying that doctors are put in a position of power and authority over their patients. Such double-standards exist all over the place in such situations, and I don’t think that’s a bad thing. I don’t think it’s funny.
Just have your LAWYER provide you with medical treatment! Plus, he’ll give you a discount !
Seriously, the problem of litigious patients is a severe one…I don’t see anything wrong with a doctor shoosing NOT to treat a patient who has a history of filing frivolous lawsuits.
I have tried to point out the difference between withholding emergency care (a situation which does not occur, possibly excepting some freakish instance where the doctor would be prosecuted and face loss of license) and not wishing to be responsible for the continued care of a patient in a non-emergency situation. My state medical board, and every other that I know of, has specific guidelines that cover continued care where problems develop. And contrary to what you may believe, there is no obligation that a physician must accept every potential patient who walks in the door.
the physician is forwarned of what may lie ahead and can protect him/herself with extra documentation, specialty referrals and the like.
The extra, potentially redundant/unnecessary steps taken by a doc facing a possible conflict with a patient may not translate into “quality of care”. If the patient is encouraged to seek treatment with another M.D. and there is a higher level of mutual confidence, costs will be lower and all will benefit.
It is not unethical for doctors to consider the opportunity costs of treating a patient. And considering doctors as an infinite source both of cash settlements and of medical care is naive.
For instance -
misses the picture.
Unlimited awards are one of the factors driving malpractice insurance rates. In order to practice, doctors need to be covered against suits, both justified and unjustified, by patients. That coverage can come from private insurance, which is expensive. The costs are then passed along to patients, making health care both more expensive, and, since higher rates drive some doctors in high-risk professions like obstetrics out of the business, harder to obtain. The Texas limits on awards to “only” $750,000 are an attempt to hold down the cost of delivering health care.
Some patient lawsuits are justified. Others are simply a shake-down. Many are somewhere in between. You could consider the online database as a blacklist, or a way to determine who regards you as a health-care provider and who regards you as Father Christmas, with an unlimited bag of money to be tapped at will.
Simply saying that doctors should suck it up and absorb the entire cost of litigation is unrealistic.
You’ve taken what I said to Artemis out of context: she asserted an absolute–that doctors were never obligated to provide care when there wasn’t previously a doctor-patient relationship–and I provided a counterexample to prove that the situation was more complex then she was portraying it.
But to address the point you raised; if you take the concept behind DoctorsKnowUs.com to its logical extreme (namely, that all physicians will use it to screen their patients), then it won’t be that much different then withholding emergency care: refusing preventative care and basic non-emergency medical attention is likely to be just as harmful to the patient as withholding emergency care.
I’m not saying medical malpractice suits aren’t a problem. I’ve said that before in this very thread. All I’m saying is that doctorsknowus.com is the wrong approach. It obviously intends to be a deny-care list, otherwise they wouldn’t include lawyers and expert witnesses on it.
I don’t believe this. I’ve never said I believe this. I’ve said that I don’t think it’s ethical for doctors to blacklist patients based on past litigation. This is very different argument then asserting that a physician must treat every patient who walks in the door.
Unless that other MD also uses DoctorsKnowUs.com and refuses to treat the patient! Then there ain’t gonna be much confidence on the patient side of the equation.
You realize this isn’t going to happen right? I don’t think anything can be implemented to reverse the trend towards total lack of personal accountability, that genie is out of the bottle.
Slavery reparations? Let’s sue companies who were engaged in a tasteless yet perfectly legal practice over 100 years ago, yeah that’s the ticket!
The system needs to be blown up, and if some people get chewed up in the process, so be it, it will be better for everyone in the long run.
I think they should put all those litigious assholes on a big, bright, neon green colored list.
Fortunately, I don’t believe this. If I did, I wouldn’t have said that medical malpractice suits are a problem!
I agree! That’s why I never said that limiting awards was bad! I said setting absolute upper bounds was bad. That’s not the same thing as saying that awards should be limited. I’d receptive to some kind of standardized sliding scale that took several factors into account.
I agree that $750,000 is a lot of money, but I think there are situations where a larger award is reasonable. And why did you put “only” in quotes? I never used that word to describe the $750,000 amount.
If the people who created DoctorsKnowUs.com (the subject of this thread) didn’t intend for it to be a blacklist, then why do they include lawyers and expert witnesses?
I think I saw a few extra bales of straw in GD this morning, in case you run out here.
Are you saying that there’s no such thing as a valid malpractice suit and that everyone involved with them is an asshole? Because the list we’re discussing includes everyone who’s been involved with the plaintiffs side in any malpractice suit.
And what has happened recently that has proactively addressed this culture of lawsuits and has been successful?
No straw, I was using that as an example of how out of control the problem has become. Assholes who see deep pockets and then reverse engineer a lawsuit to pick them.
Of course not, but I have no qualms with putting everyone on the list and leaving it to people reading the list to conclude their own facts from it.
People seem to think that medicine is some perfect science, it’s not.,
The Texas malpractice cap that’s been mentioned several times before in this thread. I think it’s misguided, but that it’s definately evidence that change has happened and can happen in the future.
So how precisely do you suggest physicians protect themselves from the risk of being unjustly sued by a chronically disgruntled patient looking for a quick buck?
Don’t simply say “it’s a part of being in practice, so just suck it up”, because physicians aren’t required to “suck it up”; we’re not slaves, and are just as free to change our career path as any other American citizen. Increasingly physicans are leaving medicine rather than continuing to practice it in the hyper-litigious current environment, and are avoiding entering subspecialties where the risk of being sued is especially high. And this hurts the public at large FAR more than this online database does.
And yet you’re complaining vociferously about the very mild changes Texas has implemented! The cap you’re so busy deriding is limited to pain and suffering only; there are no caps in place on actual economic damages.
“Any” obligation? So that’s why doctors aren’t obligated to treat someone who walks into an emergency room dying!
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In fact, doctors are NOT required to treat that patient; the hospital is. It’s a subtle but important difference. And the hospital is only required to provide care until the patient’s life-threatening problem is stabilized. They’re under no obligation to provide non-emergent care to anyone who walks through the Emergency Room door.
We also have a system in place to discipline and if necessary remove the licenses from subpar physicians, yet you obviously have no problems with patients refusing to simply rely on that system to protect themselves.
The malpractice system in this country is broken; it’s inefficient, wasteful of resources, and resembles a state lottery more than an effective compensation system. Fix the malpractice situation and physicians will have very little interest in sites such as the one listed in the OP.