Ethics collapse over malpractice insurance cost.
The Los Angeles Times
The following op-ed commentary was published in The Los Angeles Times on Sunday, June 13th, 2004:
As the American Medical Assn. holds its annual meeting in Chicago this week, organized medicine is in danger of breaking the cardinal rule of medicine — “First, do no harm” — by giving its blessing to physicians who decide not to treat patients who bring medical malpractice lawsuits.
A resolution to be voted on by the AMA‘s House of Delegates would make it ethical for physicians to refuse to treat plaintiffs’ attorneys and their spouses, except in emergency situations and as otherwise required by law.
The resolution represents a trend among physicians angry over high malpractice insurance premiums. Instead of striking back against insurers, whose profits jumped 1,000% last year, doctors are now targeting attorneys who sue doctors and even patients who bring suits. Texas physicians recently created a website blacklist of patients who had sued for malpractice. Consumer groups and news organizations report instances of doctors refusing to treat plaintiffs in malpractice cases and of doctors requiring patients to sign contracts agreeing not to file “frivolous” lawsuits.
If the AMA, which represents one-third of the nation’s doctors, does not specifically reject “mad doctors disease” it will drastically change the face of medical ethics. Exercising your constitutional right to go to court should not be a bar to medical care or choosing a doctor. Nor should being a lawyer who represents injured patients.
If the AMA allows mad doctors disease to go mainstream this week, patients should take matters into their own hands. When confronted by an angry doctor, or just to prevent a physician from becoming infected, here are some remedies:
* Call your doctor by his or her first name. “Mad doctors disease” is born of an arrogance that doctors often possess because of their ability to heal. In medical school, it’s called the God complex. In this context, it’s about a belief that doctors are above the law, and that no medical negligence case is ever legitimate. Just because a doctor wears a white coat doesn’t mean he or she is always right. Being on a first-name basis will bring doctors back to earth.
* Don’t wait for your doctor for more than half an hour. Arrogance keeps doctors from respecting our time as much as we do theirs. If the doctor is not tied up in a hospital or on a real emergency, walk out after 30 minutes of waiting. Doctors will start to get the message.
* Know the law. Doctors have to treat patients in emergencies, and in California it is their legal and ethical duty not to stop treating you in the middle of your care, say when they discover your legal history. If a doctor takes you on as a patient and then decides to stop treating you, report him or her to the state medical board.
* Remind doctors that they sue too. Recently, physicians have collected hundreds of millions of dollars by getting together in class-action lawsuits brought against big HMOs for unfair dealing. Doctors who don’t want to treat plaintiffs’ lawyers might consider that without plaintiffs’ attorneys HMOs would not be paying the doctors’ bills on time.
Remind doctors of their good fortune. According to a 2003 survey by Medical Economics magazine, OB/GYNs made an average of $220,000 in 2002 after paying deductible expenses like malpractice insurance. After expenses, invasive cardiologists averaged $360,000 and gastroenterologists $300,000.
Society depends on doctors to be there to treat everyone who is ill, not to select their patients based on their occupations or whether or not they’ve ever sued a doctor in the past. If the AMA won’t stand up for this principle, it’s up to patients to stop mad doctors disease, one physician at a time.
Consumer actvist Jamie Court is the author of “Corporateering: How Corporate Power Steals Your Personal Freedom and What You Can Do About It” (Tarcher/Putnam, 2003), which is just out in paperback.