Doctors Fighting Back? NYTimes

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I don't see why people are having a problem with this. It just packages what is already public information into a convenient database.
 
In Texas, Hire a Lawyer, Forget About a Doctor?
By RALPH BLUMENTHAL

Published: March 5, 2004


OUSTON, March 4 ? As domestic security director for 16 north Texas counties, Greg Dawson of Fort Worth has many dealings with doctors and hospitals, preparing for a terrorism emergency he hopes will never come.

So, Mr. Dawson said, he was stunned this week to find that his name had been added to a little-known Internet database for doctors attacking "litigious behavior." His offense: filing a medical malpractice lawsuit against a Fort Worth hospital and doctor over the death of his 39-year-old wife, whose brain tumor was missed, and winning an undisclosed settlement.

For months, an obscure Texas company run by doctors has been operating a Web site, DoctorsKnow Us.com, that compiles and posts the names of plaintiffs, their lawyers and expert witnesses in malpractice lawsuits in Texas and beyond, regardless of the merit of the claim.

"You may use the service to assess the risk of offering your services to clients or potential clients," the Web site says.

For fees listed as low as $4.95 a month for the first 250 searches and thereafter 2 cents a search, subscribers are invited to search the database "one person at a time or monitor any sized group of individuals for litigious conduct." They can also add names to the database "from official and unofficial public records." Whether that could include a doctor's own files is not clear.

"They can sue but they can't hide," says the Web site.

A founder of the group, Dr. John S. Jones, a radiologist in Terrell, near Dallas, declined to respond to questions, saying through a lawyer, Vincent A. Bacho, that he had given one newspaper interview and had agreed not to give another before it was published.

The sponsors draw no distinctions among cases in what they say is the first effort to use public sources to compile a list of litigants in "predatory lawsuits" that are causing a medical crisis. One couple was put on the list after winning $40.9 million over a botched operation by a drug-dependent surgeon.

Mr. Dawson said he recently had trouble finding a doctor for his son and considered it possibly retaliatory. "I thought how amusing, I'm blacklisted," he said.

He said he learned he was on the list from Texas Watch, a consumer research and advocacy organization based in Austin.

Dan Lambe, executive director of Texas Watch, said: "Medical malpractice patients need more care, not hurdles. It's offensive on different levels."

One other doctor besides Dr. Jones, Hoyt Allen, is named on the Web site run by DoctorsKnow.Us, which registered with the State of Texas on Jan. 30, 2003. Dr. Allen did not respond to messages left with his medical office in Kaufman, also near Dallas. The group lists an address in Mesquite, Tex., that has no telephone. No one responded to messages sent to the group's e-mail address.

The American Medical Association said that it had just learned of the group and that it saw no ethical issues at stake.

"There's no question that physicians are totally frustrated by the relentless assault on the medical profession by trial lawyers," said Dr. William G. Plested, chairman of the A.M.A.'s board of trustees and a cardiovascular surgeon in Santa Monica, Calif. Dr. Plested said the government already maintained a database of doctors who had been sued, for use by medical professionals.

"Is it fair to come to me if you've sued the last 10 physicians you've seen and never collected?" he asked. "Is it fair for me not to know that?"

The Texas Medical Association referred questions about the group to its general counsel, Rocky Wilcox, who responded in a short statement: "We are not a part of and, in fact, don't even know who is running this service. The fact that it exists testifies to the continued frustration physicians feel as they try to care for their patients amidst the epidemic of lawsuit abuse."

How many people are listed on the Web site or what happens to them when they seek further medical care is not clear.

(Page 2 of 2)



But Mr. Dawson, 42, director of Emergency Preparedness Department for the North Central Texas Council of Governments, said that since last month he had been seeking some minor medical attention for his 18-year-old son and been turned away by half a dozen doctors. They said they had full schedules or rejected his insurance, he said.

Among other people listed were Dolores and Ricardo Romero of Humble, Tex. In 1998, Mrs. Romero said, her husband, then 40, went into the hospital to have a herniated disk repaired. The operation went awry and he nearly bled to death on the operating table, suffering serious brain damage. Now, he can barely walk or see and needs help feeding himself and using the toilet.

The Romeros's lawsuit revealed that the surgeon, Dr. Merrimon Baker, was addicted to painkillers, had once left a surgical sponge inside a patient, and on other occasions operated on the wrong hip and amputated the wrong leg. The jury, finding that the hospital acted with malice since it knew of the doctor's history, awarded the Romeros $40.9 million. A higher court overturned the malice finding and an appeal is pending.

Dr. Baker, who is practicing outside Houston, did not respond to a message left with his office.

"Well, I think it's ridiculous," Mrs. Romero said of her appearance on the litigants list. "My husband's a victim of a doctor's malpractice ? it's not frivolous."

A prominent Texas plaintiff's lawyer, Richard W. Mithoff, who represented the family and also turned up on the list, said he was not totally surprised. "I've heard rumors of such lists but I've never seen anything surface until now," Mr. Mithoff said.

Another couple listed, Rick and Sheila Beeson of Wichita Falls, Tex., also voiced dismay. Their son, now 7, suffered severe brain damage from untreated low blood sugar at birth. They settled with the hospital and doctors for $9.4 million.

"All we did was try to help our son," Mr. Beeson said. "My job as father is to look out for him, his financial security since they took all that away from him. It's not fair to do what we have to do and be put on a blacklist."
 
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Haha, it would be funny if a frivolous trial lawyer was denied medical care. :laugh:
 
Wow, that article gives you some things to think about. Do doctors need to be held accountable for gross malpractice? I think that everyone agrees that the answer is yes. Should people who go into doctor's offices looking for a reason to file a lawsuit be held accountable for the number of times that they file litigation against a healthcare service provider. I think that the answer is yes. Even if the attempt to sue is not successful, the doctor and hospital are out of a lot of money.

However, I do not like the idea of blacklisting people who had ligitimate claims of malpractice. I think that a better balance should be obtained so doctors and patients can both be protected. Maybe a database containing only failed attempts to sue a doctor should be introduced. In the end, normal working Americans pay for the large volume of bogus lawsuits through their high healthcare costs. There should be some form of accountability for those who chose to make the costs of healthcare greater for everyone else.
 
He tried to get appointments with only 6 doctors and he concludes he's blacklisted? Sounds like conspiracy theory to me. Their schedules probably ARE full. If you're establishing care with a new primary care physician they usually want you to schedule a first visit appointment (first visits are LONG - an hour or so - meant for the doctor to really get to know and examine the patient in a detailed fashion so that subsequent visits are more problem-focused). Getting a first visit appointment can take months, because the physicians are often incredibly busy and their first committment is to their established patients. He probably didn't try calling any of the younger/newer docs in town, they usually have appointment slots because their aren't as many established patients. Or, if it's an emergency, go to the ER. And anyway, no one gets turned away for their insurance being bad if they're willing to pay out-of-pocket. The offices who are telling him that they don't accept his insurance are helping him out by telling him beforehand instead of just letting him come in and then get stuck with the bill.

It's extremely unlikely that the entire state of Texas is on this obscure website and that's why this guy can't get an appointment. Makes for great sensationalist journalism though.

bpkurtz
 
Originally posted by BPKurtz
He tried to get appointments with only 6 doctors and he concludes he's blacklisted?

I have never inmy life had to call 6 doctors (primary care or specialist) to establish an appointment in Texas(and my mom's insurance changes on a pretty regular basis). He probably is blacklisted, especially if he's in a city.
 
Originally posted by BPKurtz
And anyway, no one gets turned away for their insurance being bad if they're willing to pay out-of-pocket.
Who wants to pay out of pocket for something they have insurance for??? That makes no sense. If a doctor told me he wont tak emy insurance I'd just keep on calling the next one...now if he said he called a listof doctors his insurance provided him and he was rejected, would you change your mind?
 
Originally posted by BPKurtz
If you're establishing care with a new primary care physician they usually want you to schedule a first visit appointment (first visits are LONG - an hour or so - meant for the doctor to really get to know and examine the patient in a detailed fashion so that subsequent visits are more problem-focused).

What primary care physician would ever spend an hour with a patient, first time or not? Insurance billing codes just won't allow for this. Sure, there are different "levels" office visits you can file for, but no way would a one hour office visit be reimbursed in any fashion like a 5-10 minute($65 insurance) office visit. No insurance company is going to pay $700 for a primary care consult visit.
 
This article is extremely biased towards trial lawyers.

But on a more theoretical level, how ethical is it to maintain such a list. To me, having such a list is entirely ethical, it's just information. But its how you use it that's the problem. I think it would be really stupid of doctors to use a "one and done" type scenario where anyone who sued a doctor once is blacklisted. If someone has a history of law suits, and of losing them, that might be a red flag though, and I guess each doctor has a right to act accordingly (though I still think its really bad to deny care to anyone). That said, it is still unethical to deny emergency care, especially, to a patient.

Frankly, I think such a list is pretty stupid for that reason, and that doctors ought to provide care regardless. If anything, doctors should create a list of ambulance-chasers and pseudodoctors who run around giving false scientific evidence to lawyers.
 
Originally posted by ndi_amaka
Who wants to pay out of pocket for something they have insurance for??? That makes no sense. If a doctor told me he wont tak emy insurance I'd just keep on calling the next one...now if he said he called a listof doctors his insurance provided him and he was rejected, would you change your mind?

Yes, that would change my mind (if he were telling the truth). That would be lying to people in order to avoid treating them, which I think would be unethical. If that's the case he should have complained to his insurance provider -- "hey, you said Dr. Smith takes your plan, he says he doesn't -- what gives?" Then presumably the insurance provider should take action.

bpkurtz
 
Originally posted by meanderson
What primary care physician would ever spend an hour with a patient, first time or not? Insurance billing codes just won't allow for this. Sure, there are different "levels" office visits you can file for, but no way would a one hour office visit be reimbursed in any fashion like a 5-10 minute($65 insurance) office visit. No insurance company is going to pay $700 for a primary care consult visit.

Uh, sorry, but I've worked with family practice docs who routinely spend an hour with a patient the first time they see them. They considered it good medical practice so that they could know the patients when they came in for their second appointment, with a complaint of mild asthma exacerbation or something. I agree with them. Most of the patient they saw in the day would be established patients, obviously, but when they were seeing a new person this was standard practice.

bpkurtz
 
Originally posted by BPKurtz
Uh, sorry, but I've worked with family practice docs who routinely spend an hour with a patient the first time they see them.
bpkurtz

What you are seeing, then, is a rarity.
 
"My job as father is to look out for him, his financial security since they took all that away from him."

This guy typifies a problem in our society. Namely, it is always someone else's fault and how am I going to get mine. It was not the doctor's fault the child was born with low blood sugar. Doctors do misdiagnose or overlook certain things because no one is perfect. That doesn't mean their career should be destroyed
 
Originally posted by Gleevec
This article is extremely biased towards trial lawyers.

But on a more theoretical level, how ethical is it to maintain such a list. To me, having such a list is entirely ethical, it's just information. But its how you use it that's the problem. I think it would be really stupid of doctors to use a "one and done" type scenario where anyone who sued a doctor once is blacklisted. If someone has a history of law suits, and of losing them, that might be a red flag though, and I guess each doctor has a right to act accordingly (though I still think its really bad to deny care to anyone). That said, it is still unethical to deny emergency care, especially, to a patient.

Frankly, I think such a list is pretty stupid for that reason, and that doctors ought to provide care regardless. If anything, doctors should create a list of ambulance-chasers and pseudodoctors who run around giving false scientific evidence to lawyers.


What if the doctor's insurance company settled out of court without the doctor's permission? A person doesn't have to have lost a lawsuit to have been looking to cash in. I have a lot of mixed emotions about this subject, but I can say that I get really disgusted when people assume that every mistake warrants a lawsuit and some sort of financial reward. I don't really blame the doctors for blacklisting patients who want to cash in, especially since they are hurting the medical system for others when they do so. I'll stop rambling now.

~AS1~
 
Originally posted by BPKurtz
Uh, sorry, but I've worked with family practice docs who routinely spend an hour with a patient the first time they see them. They considered it good medical practice so that they could know the patients when they came in for their second appointment, with a complaint of mild asthma exacerbation or something. I agree with them. Most of the patient they saw in the day would be established patients, obviously, but when they were seeing a new person this was standard practice.

bpkurtz

I'm not questioning your story, just saying that it's a strategy that is very difficult for the physician financially and it doesn't happen very often.

What is the most that can possibly be billed for a LONG primary care office visit by an FP/IM? I don't think it's more than $100-120 based on the few insurance plans I've looked at over the years. And yes, the physician could look at this as a one-time only thing, but many family practice offices don't see the same patients routinely on a regular or even semi-regular basis. In many ways, you are far more likely today to "get to know" a specialist because you are more likely to see them on a regular basis.

When I make an appointment with an FP(usually a different one every time), they don't care where I've been last and they probably don't think of it as taking on a "new" patient. If you look at all of the patients that walk into a suburban FP's office in a day, you'll find that most of them have either never been there before or have been there before but it's been a long time since they have come.
 
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