Doctors to patients: "You're fired!" I know I've been talking about malpractice-related topics a bunch lately, but what can I say: That's what's brewing in the world of medicine right now. In a previous Daily Dose (8/31/04), I wrote to you about a Texas on-line database of malpractice plaintiffs. This "blacklist" helped docs in the Lone Star state to pick and choose whom to treat based on their likelihood of suing. After that, docs in South Carolina, Mississippi and New Hampshire began refusing treatment to malpractice lawyers and sympathetic lawmakers (and their families, too). One outraged M.D. even proposed that the AMA allow physicians to withhold care to malpractice attorneys! The motion was voted down, but the message in all of these instances seems clear enough: Doctors are fighting back against malpractice profiteers. If this story out of Washington state is any indication, the next step in this trend is not to blacklist patients after they've successfully sued for malpractice, but to screen them for lawsuit-friendly leanings beforehand. According to a recent Associated Press story, a Washington obstetrician named Mark Mulholland has in effect "fired" one of his patients because she wouldn't sign a petition to limit malpractice awards in the state. Citing "philosophical differences," the OB told his patient he'd gladly render emergency care for a 30 day period and refer her to another doctor, but has remained resolute that he won't treat the woman - even after she complained to the state medical disciplinary board. As quoted in the AP story, Mulholland claims his malpractice insurance rates have jumped 30% in the last year. So far, he's collected north of 2000 signatures for the initiative, which a group of Evergreen State doctors have submitted to the legislature. I'm not sure how I feel about this, since both sides have compelling arguments. On the one hand, individual doctors aren't government agencies - they're private practitioners, and can legally discriminate against anyone they want. Who can blame them for wanting to protect themselves? On the other hand, if every doctor adopted these kinds of "litmus tests" for their patients, there might be no one left to treat certain people (like those who have sued in the past for legitimate malpractice claims). It's a tough call to make. One thing I do know is this: Malpractice reform is the next major battleground in mainstream medicine. Best be ready for it. And speaking of "legitimate" malpractice claims... **************************************************** Toxic Shocker It's everyone's worst nightmare: Laying down on a surgery table and never waking up again. And it's always a risk when you go under the knife... But especially so when doctors make stupid mistakes (and they often do)! Case in point: A Seattle woman who submitted to surgery for a brain aneurysm died during the procedure - but not because of any risks inherent to the operation itself. No, she died because they mistakenly injected her full of TOXIC ANTISEPTIC instead of the harmless marker dye used to pinpoint the aneurysm on X-rays. Needless to say, the chemical shut all her organs down and the poor woman promptly expired. According to the AP story about the snafu, her next of kin have not yet decided whether or not to sue the hospital. Now, this is what I'd call a legitimate case of compensate-able malpractice. If ever a hospital or surgical staff should be held accountable, it's in this instance. But what if this had happened in Texas, where that malpractice "blacklist" I mentioned in today's first segment is kept? Would the family members who sued on the dead woman's behalf now be unable to find medical treatment in the future? And if not, would that be RIGHT? Doesn't seem right to me. But refusing care to the LAWYERS involved, welllll...
Seeing all sides - and calling 'em like I see 'em,
William Campbell Douglass II, MD | 
