Dr sued $400k for communicating via writing instead of sign language interpreter

[walderness]

For all of the rest of you who don't live in La-La land: This deal reeks, and since to government isn't willing to pay for an interpreter, no business should have a reasonable expectation to shoulder the costs of someone else's disability.

It's not the disabled person's fault that they are disabled and require accommodations. That's why we have regulation.

That being said, when I am denied care, I call around to find a dr. who will accommodate me. I don't make a list of suable doctors. The travesty in this case was that both the dr. and the patient continued care when they both knew the patient was underinformed.

---

Members don't see this ad.

 

[gabeybaby]

Oh so Gerena says that because the doctor makes a lot of money, he should pay out of his own pocket for her treatment???? what a JOKE. I hope this lady chokes on all the money she stole. She's no better than a thief and all those jurors out there in Jersey should be eternally ashamed of themselves.

i know right?! this made me soo angry. such bull. i mean if the doctor makes soo much, why don't he just pay for her freaking medical bill?! i feel so bad for this doctor right now, if that was me, i would never conform to such treatment by the court. i mean, he did nothing wrong, AND he did have another form of communication with her (writing). UNLESS she is ILLITERATE then she should be able to understand everything that he says... i mean by talking or writing, youre basically transmitting the same message. and she fully understood her diagnosis, so it shows that 1) she's trying to get money for herself through the law suit or 2) she apparently has a grudge against the doctor and wants to put him through hell.

overall, i think ppl need to be more appreciative...these are the types of patients that i'm not looking forward to seeing if i become a doctor.

It's not the disabled person's fault that they are disabled and require accommodations. That's why we have regulation.

That being said, when I am denied care, I call around to find a dr. who will accommodate me. I don't make a list of suable doctors. The travesty in this case was that both the dr. and the patient continued care when they both knew the patient was underinformed.

It may be me, but i dont think the patient is "underinformed". Words on paper and words of mouth transmit the same message, if you want to say something you can always write it on paper. that's why we teach kids to learn how to read. unless she's hellen keller, she has no reason to file for this law suit.

 

[beachblonde]

True, but EMTALA is a little bit different, because EM physicians are salaried, right? So even if their patients are unable to pay their medical bills, the doctor still gets compensated.

But it's an example of when the government says "you must do this" but provides no money to back it up.

And yes, those ER docs do get paid, until the hospital goes into so much debt that they have to close because they aren't getting compensated for services rendered.

 

[walderness]

It may be me, but i dont think the patient is "underinformed". Words on paper and words of mouth transmit the same message, if you want to say something you can always write it on paper. that's why we teach kids to learn how to read. unless she's hellen keller, she has no reason to file for this law suit.

u missed the fact that ASL does not have an associated written form. she could not read well. and she thought the facial swelling was due to her condition, not a major side effect of the steroids the dr. prescribed. this should be considered underinformed.

 

[HolyGrail]

It's not the disabled person's fault that they are disabled and require accommodations. That's why we have regulation.

That being said, when I am denied care, I call around to find a dr. who will accommodate me. I don't make a list of suable doctors. The travesty in this case was that both the dr. and the patient continued care when they both knew the patient was underinformed.

Agreed, it is not the person's fault... I don't know where you got it in your head that I think it is their fault, I never said anything of the kind.

You are advocating what the law states:
The Doctor is responsible for a patient's disability.

I am making the argument:

This is not a reasonably expected thing for other organizations to do, therefore if we want to make this happen, as a society which values equity, we need to reform legislation in order to make it cost the same for a doctor to see both patients. What I am saying is that it should be subsidized, otherwise this type of problem breeds animosity and resentment. It is never fair to say that someone with money should pay for something because they have money... This is silly and provides no logical argument whatsoever. This is definitely a case of the begging the question fallacy, maybe burden of proof.

Would I love to take care of all the widows and orphans, deaf, mute, blind, disabled people of the world? Yes of course! But should the burden fall on me alone because I have money, or am closely related to the situation? I'm not convinced.

 

[LizzyM]

Let us consider the blind man who wants a taco. He goes to the the first taco stand and asks a lot of questions. They throw him out saying, "if you can't read the menu, get lost!" Did the taco stand, a business open to the public, have the right to throw him out because he was blind?

======================

The second taco stand, a little mom & pop place offers to read the menu to him. He buys a taco and it is good.

Later he goes to a big fast food chain that sells tacos. They do not have a menu printed in Braille. They offer to read the menu to him. He enjoys his taco but sues for failure to make a resonable accommodation.


Is it reasonable to expect the big chain restaurant with annual sales of $65 million to provide Braille menus? It is reasonable to expect the same of the mom & pop taco stand?

Is the law that requires a reasonable accommodation in facilities open to the public a just law? Should the size of the business (gross receipts, profit, etc) and the cost of providing the accommodation be used to come to a determination of what is reasonable.

or will you say, "damn people just suing over nothing." or "everyone wants free tacos -- I'm not sure I want to go into the taco business."

 

[pianola]

^ So if you follow the analogy out a little bit farther, HolyGrail, would you say that: the large restaurant chain shouldn't be solely responsible for providing Braille menus and that the cost of the Braille menus should be borne by everyone and not just the business?

I guess being a physician is a business and maybe treating the disabled (and all the requirements that come with it) should be considered a necessary cost of doing business (??)

 

[jinx520]

I guess being a physician is a business and maybe treating the disabled (and all the requirements that come with it) should be considered a necessary cost of doing business (??)

I agree with Pianola that this should be the take-home message here. Hospitals in my area hire on-staff interpreters. My cousin, who lives in Virginia, was even telling me that the state was looking for a psychologist conversant in KLINGON, just in case they needed one.

Whether we side philosophically with the doctor or the patient in this case is irrelevant. This is the direction the law is moving, and that is the reality of the situation. Given what happened in this case, it would be prudent for those planning on going into private practice to start looking into possible resources for interpreters and have a list of phone numbers on-hand. I do think that this is another argument in favor of physicians becoming more organized on a political level (but that's for another thread.) Someone needs to lobby to have Medicaid/Medicare recognize interpretation as a billable expense.

 

[HolyGrail]

^ So if you follow the analogy out a little bit farther, HolyGrail, would you say that: the large restaurant chain shouldn't be solely responsible for providing Braille menus and that the cost of the Braille menus should be borne by everyone and not just the business?

I guess being a physician is a business and maybe treating the disabled (and all the requirements that come with it) should be considered a necessary cost of doing business (??)

Yes Pianola this is EXACTLY what I'm saying =)

This way we, as a society, are doing two things:

1) The people making the judgment that Braille should be available are paying some of the cost, and thus have an invested stake in what they value(Not distributing it to people they think should be doing it).

2) There isn't some weird subjective judgment on who is too big or too small a company to make this braille menu, the mom and pop shop can now provide the same services because they get a subsidy to do it.

I guess what I'm saying is that it's too inconsistent to say some must, but not others. If we're going to do a thing, let's be consistent, let's be fair, and let's make it equitable.

 

[HolyGrail]

Let us consider the blind man who wants a taco. He goes to the the first taco stand and asks a lot of questions. They throw him out saying, "if you can't read the menu, get lost!" Did the taco stand, a business open to the public, have the right to throw him out because he was blind?

======================

The second taco stand, a little mom & pop place offers to read the menu to him. He buys a taco and it is good.

Later he goes to a big fast food chain that sells tacos. They do not have a menu printed in Braille. They offer to read the menu to him. He enjoys his taco but sues for failure to make a resonable accommodation.


Is it reasonable to expect the big chain restaurant with annual sales of $65 million to provide Braille menus? It is reasonable to expect the same of the mom & pop taco stand?

Is the law that requires a reasonable accommodation in facilities open to the public a just law? Should the size of the business (gross receipts, profit, etc) and the cost of providing the accommodation be used to come to a determination of what is reasonable.

or will you say, "damn people just suing over nothing." or "everyone wants free tacos -- I'm not sure I want to go into the taco business."

This is the thing we also have to consider:

When we make laws for accommodations such as these, if the physician has to incur the costs, he'll then pass it back on to the other patients.

As a patient, is it fair that I have to pay for an interpreter so that someone else can get adequate care?

In the end, everyone else, except the person who needs the accommodation ends up paying for it...

I feel we're much past the idea of "Human Dignity" now, which is a founding principle behind these original arguments(Dating hundreds of years back, they'd be astounded at what we consider "human dignity", not that they would be right in thinking we're generous).

I guess what I'm asking is this: As our average incomes increase, do we have a higher responsibility to make things more equitable, as those with disposable incomes are more capable to afford it?

I can see both sides of this issue, both arguments. I guess we err on the side of more equity? I don't have the answers... only more questions

 

[JJMrK]

Why does it matter how much the doctor makes? He was paying to see this patient. Does that really make sense?

 

[LizzyM]

Providing an interpreter, or a Braille menu, is a cost of doing business. In light of gross sales of >$20 million, a court might require a chain restaurant to provide a Braille menu. The court might give a pass to the mom & pop shop that is lucky to gross $90,000 year. Does that seem fair? Do you think that the government ought to subsidize both businesses or that it should require the expense of Braille menus be borne by both businesses equally?

Yes, when we go to a big chain restaurant, part of the cost of our meal is going to pay for Braille menus. Is that fair to us? Is it fair to the stockholders who are making a smaller profit or is it fair to make delicious fast food equally accessible to everyone, even the disabled?

 

[JJMrK]

Providing an interpreter, or a Braille menu, is a cost of doing business.

If repeated too many times, that business will no longer exist. If anything, this type of thing should be paid for by the patient's insurance. What's next, doctors paying for a patient's physical therapy or medications?

 

[THH]

Providing an interpreter, or a Braille menu, is a cost of doing business. In light of gross sales of >$20 million, a court might require a chain restaurant to provide a Braille menu. The court might give a pass to the mom & pop shop that is lucky to gross $90,000 year. Does that seem fair? Do you think that the government ought to subsidize both businesses or that it should require the expense of Braille menus be borne by both businesses equally?

Yes, when we go to a big chain restaurant, part of the cost of our meal is going to pay for Braille menus. Is that fair to us? Is it fair to the stockholders who are making a smaller profit or is it fair to make delicious fast food equally accessible to everyone, even the disabled?

It seems as though this analogy only works if the Braille menus are non-reusable, and cost $10.00 a piece when the customer is only buying a $2.50 taco.

 

[jinx520]

Providing an interpreter, or a Braille menu, is a cost of doing business. In light of gross sales of >$20 million, a court might require a chain restaurant to provide a Braille menu. The court might give a pass to the mom & pop shop that is lucky to gross $90,000 year. Does that seem fair? Do you think that the government ought to subsidize both businesses or that it should require the expense of Braille menus be borne by both businesses equally?

Yes, when we go to a big chain restaurant, part of the cost of our meal is going to pay for Braille menus. Is that fair to us? Is it fair to the stockholders who are making a smaller profit or is it fair to make delicious fast food equally accessible to everyone, even the disabled?

Fair or not, it is probably more cost-effective in the long run to print up the Braille menus than it is to get hauled off to court. Not to mention less stressful.

Although, in the discussion of fairness, any organization who demands that everyone provide Braille menus should shoulder some of the costs.

 

[pianola]

Providing an interpreter, or a Braille menu, is a cost of doing business. In light of gross sales of >$20 million, a court might require a chain restaurant to provide a Braille menu. The court might give a pass to the mom & pop shop that is lucky to gross $90,000 year. Does that seem fair? Do you think that the government ought to subsidize both businesses or that it should require the expense of Braille menus be borne by both businesses equally?

Yes, when we go to a big chain restaurant, part of the cost of our meal is going to pay for Braille menus. Is that fair to us? Is it fair to the stockholders who are making a smaller profit or is it fair to make delicious fast food equally accessible to everyone, even the disabled?

I think I agree with this. I think it's fair for the doctor to pay for the deaf patient so long the doctor is able to compensate for his loss with other patients (just like in the taco scenario). Dr. F was allowed to raise the costs for his other patients, right?

Remember that, as with the taco scenario, the other patients have the option of not doing business with the doctor if they don't like his rates.

It seems as though this analogy only works if the Braille menus are non-reusable, and cost $10.00 a piece when the customer is only buying a $2.50 taco.

Yeah, but even accepting your specifications, is that so bad if the chain gets 600 customers per day of which two are blind? The chain's still making money...

 

[LizzyM]

The reimbursement rate doesn't rise because the cost of caring for Ms. G. is higher than the cost of caring for the average patient. It is a cost that the business is expected to absorb, just as it absorbs a higher cost of disposable items used incidentally in the care of a patient with HIV.

 

[pianola]

The reimbursement rate doesn't rise because the cost of caring for Ms. G. is higher than the cost of caring for the average patient. It is a cost that the business is expected to absorb, just as it absorbs a higher cost of disposable items used incidentally in the care of a patient with HIV.

That makes sense, actually. It's one of the responsibilities that comes with having the right to open a business in this country, I guess.

 

[THH]

I think I agree with this. I think it's fair for the doctor to pay for the deaf patient so long the doctor is able to compensate for his loss with other patients (just like in the taco scenario). Dr. F was allowed to raise the costs for his other patients, right?

Remember that, as with the taco scenario, the other patients have the option of not doing business with the doctor if they don't like his rates.



Yeah, but even accepting your specifications, is that so bad if the chain gets 600 customers per day of which two are blind? The chain's still making money...

I understand where you're coming from, I just don't agree with the principle at play here.

 

[Revilla]

No. Nuremberg laws were anti-semetic set of decrees passed in Nazi Germany...an example - it is forbidden to marry a jew, and etc...

I was trying to make the point that people (and yes doctors) should not blindly follows laws. And as I stated previously, Nuremberg laws are an extreme example.

There's a saying -- if you don't like a law, help change it. You can't just agree to follow the laws you agree with and ignore the others. Well, you could, but they have places for people like that. They're called jails (at least in criminal cases).

 

[Revilla]

LOL... Only in America can someone who doesn't have enough money to pay for health care,

Do you have any idea at all how much health insurance is for someone diagnosed with lupus, which is what this woman has?

 

[Revilla]

LOL... Only in America can someone who doesn't have enough money to pay for health care, and gets health care for free through Medicare, even complain about the care that they get.

Ladies and Gentlemen of the future generation of physicians, let these situations be a reminder, your first job is not to treat patients, it's to watch out for #1.

Physician duties by importance:
1) Watch out for your own ass
2) Fill out paperwork so that #1 is never broken
3) Treat patients in the time between doing 1 and 2

People can feel free to insert things between 2 and 3 at their leisure in the following posts...

This is a very insensitive post for someone wanting to be a doctor.

 

[Live4Life]

Let us consider the blind man who wants a taco. He goes to the the first taco stand and asks a lot of questions. They throw him out saying, "if you can't read the menu, get lost!" Did the taco stand, a business open to the public, have the right to throw him out because he was blind?

======================

The second taco stand, a little mom & pop place offers to read the menu to him. He buys a taco and it is good.

Later he goes to a big fast food chain that sells tacos. They do not have a menu printed in Braille. They offer to read the menu to him. He enjoys his taco but sues for failure to make a resonable accommodation.


Is it reasonable to expect the big chain restaurant with annual sales of $65 million to provide Braille menus? It is reasonable to expect the same of the mom & pop taco stand?

Is the law that requires a reasonable accommodation in facilities open to the public a just law? Should the size of the business (gross receipts, profit, etc) and the cost of providing the accommodation be used to come to a determination of what is reasonable.

or will you say, "damn people just suing over nothing." or "everyone wants free tacos -- I'm not sure I want to go into the taco business."

I'm not saying that I don't agree with you, but then why has the government made the FMLA only applicable to companies with greater then 50 employees? Government recognizes that they cannot place the burden equally on businesses of all sizes because not all have the capital to withstand the financial implications. I'm not saying that the FMLA is the same as the ADA, rather I'm comparing how they are applied to businesses. This is just a very sticky situation, and I agree that the patient needs an interpreter, but I would need to think more in depth about who should be responsible for this added cost.

 

[LizzyM]

I'm not saying that I don't agree with you, but then why has the government made the FMLA only applicable to companies with greater then 50 employees? Government recognizes that they cannot place the burden equally on businesses of all sizes because not all have the capital to withstand the financial implications. I'm not saying that the FMLA is the same as the ADA, rather I'm comparing how they are applied to businesses. This is just a very sticky situation, and I agree that the patient needs an interpreter, but I would need to think more in depth about who should be responsible for this added cost.

Family Medical Leave Act (FMLA) is an excellent analogy. In both cases, the federal government says that a certain action on the part of businesses is good for society but that the burden would be too great for a very small business (FMLA measures it in number of employees, ADA uses a reasonableness standard that takes into account the cost of the accommodation and the earnings/income of the business.) Not everyone is treated equally: the 500 employee multi-specialty group practice is held to a different standard than the 5 employees in a solo practioners office. Politics is the art of the possible and it wasn't possible to pass FMLA without making an exception for small businesses.

 

[Live4Life]

Family Medical Leave Act (FMLA) is an excellent analogy. In both cases, the federal government says that a certain action on the part of businesses is good for society but that the burden would be too great for a very small business (FMLA measures it in number of employees, ADA uses a reasonableness standard that takes into account the cost of the accommodation and the earnings/income of the business.) Not everyone is treated equally: the 500 employee multi-specialty group practice is held to a different standard than the 5 employees in a solo practioners office. Politics is the art of the possible and it wasn't possible to pass FMLA without making an exception for small businesses.

Then, why should a solo-practitioner be required to provide an interpreter because you would think that due to the small size of their business they would be exempt?

 

[JJMrK]

Not everyone is treated equally

To me, that's the problem. If a certain measure is thought to be too difficult for a small business to endure, why should it be applied to larger, more successful business? That is punishing the successful.

 

[LizzyM]

Then, why should a solo-practitioner be required to provide an interpreter because you would think that due to the small size of their business they would be exempt?

Although he was a solo practioner, he did a high volume business. It was estimated that the cost of the interpreter service would equal one-quarter of 1 percent of his income (0.25%). Interpreter service is a business expense just like gauze pads and telephones. The jury decided that it was not unreasonable to expect the practice/doctor to spend 0.25% of income to meet the needs of a disabled person who could not hear and who had a limited ability to understand written English and who had requested an interpreter.

 

[HolyGrail]

This is a very insensitive post for someone wanting to be a doctor.

I'm not the first person to say this, just read PandaBear's posts...

I don't see how that post in particular is insensitive, I've definitely made some much more insensitive posts(mostly for argument).

 

[LizzyM]

To me, that's the problem. If a certain measure is thought to be too difficult for a small business to endure, why should it be applied to larger, more successful business? That is punishing the successful.

So, because the little taco stand can not afford the $2000 that it would cost to have its menu translated and reproduced in Braille, the big corporate chain with annual sales of >$20 million per year should not be required to spend what would amount to $25 per restaurant to produce menus for the visually impaired? (more restaurants means fixed costs can be spread over a large number of stores, but each store will need a small supply of menus meaning higher variable costs of making copies.)

 

[JJMrK]

So, because the little taco stand can not afford the $2000 that it would cost to have its menu translated and reproduced in Braille, the big corporate chain with annual sales of >$20 million per year should not be required to spend what would amount to $25 per restaurant to produce menus for the visually impaired?

Correct, IMO.

 

[HolyGrail]

To me, that's the problem. If a certain measure is thought to be too difficult for a small business to endure, why should it be applied to larger, more successful business? That is punishing the successful.

I understand what LizzyM is saying, I simply disagree on how she's saying to implement it.

LizzyM's argument: You're a more successful business, therefore a part of that success comes from being a part of our culture/society where we say that certain things are, or are not, acceptable. If you're successful enough, you should be able to afford the small fraction of cost that it would take in order to own a business or provide a service in our country.

I understand the argument, I simply think that it's going to be pawned off on the consumer eventually, which basically gives me no option but to pay for it...

**Sigh**

I'm wary of future implications, when we, as humans, devolve into blobs or masses that "sit" in chairs and think, without any real sense of who or what we are, just that we have immediate needs, and want them fulfilled at whatever cost to society.

This is far off, and obviously not what is occurring today. I'll concede, not that I think it's perfect, but, as I said before, I'd rather err on the side of being slightly too helpful than not being helpful enough.

 

[LizzyM]

Using JimmerJammerMrK's logic, because a solo practioner serving a poor community and grossing $120,000/yr cannot afford a particular accommodation for the disabled because it is too expensive, the government should not require or expect that particular accommodation for the disabled in facilities grossing $120 million per year.

Reasonable goes out the window and no accommodation is required for anyone. All the disabled can just go pound sand....

The legislatures and the courts have seen this differently.

Do you really want to lobby for fewer accommodations for the disabled?

 

[THH]

This is a very insensitive post for someone wanting to be a doctor.

You just came very close to breaking Burnett's Law.

 

[JJMrK]

If the government wants to mandate it, they can pay for it (and do so without raising taxes).

 

[scarletgirl777]

But it's an example of when the government says "you must do this" but provides no money to back it up.

And yes, those ER docs do get paid, until the hospital goes into so much debt that they have to close because they aren't getting compensated for services rendered.

So true

 

[LizzyM]

If the government wants to mandate it, they can pay for it (and do so without raising taxes).

The government makes a lot of mandates that are unfunded. They are particularly demanding if you accept Medicaid or Medicare. The one who pays the piper calls the tune. Get used to it or learn to dance without depending on the poor, aged or permanently disabled as part of your patient base.

If you are a pre-med, be sure to work into your PS or your interview that you don't intend to accept Medicare or Medicaid because the government's unfunded mandates take too much money out of doctors' pockets.

 

[HolyGrail]

Using JimmerJammerMrK's logic, because a solo practioner serving a poor community and grossing $120,000/yr cannot afford a particular accommodation for the disabled because it is too expensive, the government should not require or expect that particular accommodation for the disabled in facilities grossing $120 million per year.

Reasonable goes out the window and no accommodation is required for anyone. All the disabled can just go pound sand....

The legislatures and the courts have seen this differently.

Do you really want to lobby for fewer accommodations for the disabled?

I doubt(At least I hope I doubt), that anyone wants to lobby for less accommodations for the disabled, but I think what most of us are(or at least I am) arguing is that if the legislature thinks that this should be implemented, then either the legislature should start an excise tax for it so that all companies can abide by the law by pooling the money, or the companies themselves should start a pool so that they can abide by the law, so that every business/service has the same accommodations.

 

[scarletgirl777]

I'm not saying that I don't agree with you, but then why has the government made the FMLA only applicable to companies with greater then 50 employees? Government recognizes that they cannot place the burden equally on businesses of all sizes because not all have the capital to withstand the financial implications. I'm not saying that the FMLA is the same as the ADA, rather I'm comparing how they are applied to businesses. This is just a very sticky situation, and I agree that the patient needs an interpreter, but I would need to think more in depth about who should be responsible for this added cost.

You know I personally had the same example in my head, and I still think it's kind of ridiculous. If people have a right to take unpaid time off to take care of their parents or children or other family emergencies, that right should happen anywhere. If that small company will experience hardship and we feel bad about that as a society, then we as a society (i.e. the govt) should all chip in and pay/give whatever services we need to support that company. So in the case of the mom and pop store, the quality of your taco experience should not depend on the profitability of the taco establishment.

 

[LizzyM]

I doubt(At least I hope I doubt), that anyone wants to lobby for less accommodations for the disabled, but I think what most of us are(or at least I am) arguing is that if the legislature thinks that this should be implemented, then either the legislature should start an excise tax for it so that all companies can abide by the law by pooling the money, or the companies themselves should start a pool so that they can abide by the law, so that every business/service has the same accommodations.

Honey, the legislature did pass this law and President Bush (41) signed it back in 1990. So it has been the law of the land for some time. Businesses are expected to make reasonable accommodations and most do. When someone believes that they have not been treated fairly under the law because they have been denied a reasonable accommodation, they can sue. This deaf woman sued and won. (back in the 1990s someone sued Clint Eastwood for failure to make accommodations avaiable at an inn he operated in California... he won because the accommodations he had made were considered reasonable given the size and scope of his business). This is the law and this is how it works. There is no need for a one size fits all approach to the law (the mom & pop shop is fine reading the menu aloud to the occasional blind customer and Taco Bell is OK with distributing Braille menus upon request) and there is no need for everyone pool their money and have some central bureaucracy tell them how to spend it.

 

[Revilla]

I'm not the first person to say this, just read PandaBear's posts...

Yeah, but that doesn't justify it.

I don't see how that post in particular is insensitive, I've definitely made some much more insensitive posts(mostly for argument).

Your other posts aside, what made this one insensitive was your argument that those who can't afford health insurance have no right to complain about the medical care they receive, without any consideration for this specific situation. This isn't a woman who can't afford health insurance because she refuses to work and wants to sit on the sofa and eat potato chips all day. This is a woman who has an illness that's probably outside her financial scope. And on top of that, she's disabled. But assuming for a second that she was on Medicare for other reasons, I can't believe you think that the poor are less worthy of adequate medical care.

 

[hopefulmed195]

I didn't read the whole thread, but here's what i think. First of all, it seems that a lot of you are going into the field of medicine for money. A doctors is responsible for providing genuine medical care to his patients. If he has to pay to care for his patient, so what? It's his job. He signed up for this since he entered into medical school. If he doesn't like it, then he can go somewhere else and become a lawyer or something. Second, the patient has a right to get an accommodation. What if he's poor and can't afford to get an accommodation, while someone else with his same disability can? It's not fair. Doctors and even hospitals must provide equal access for all patients. Third, I took ASL classes and learned about the deaf culture and community. ASL is a separate language from English with different sentence structures. It's visual, not spoken or written. Some deaf people didn't have equal education as we do. They may have poor literacy skills and even vocabulary skills! Having that said, interpreters don't "translate." Otherwise, they would be called translators. But they aren't. They change the term or vocabulary into simpler one so the deaf people can understand. One time I shadowed a doctor with a deaf patient and an interpreter. The doctor just threw a term at the patient. I looked at the interpreter. She really described the term, setting up a visual image of what's wrong with the patient. When she was done, the patient nodded and looked like he understood. Writing is totally different from interpreting. You can't write everything, so you will be underinforming your patient. Interpreter, on the other hand, would help inform the deaf patient of his own health.

 

[Revilla]

You know I personally had the same example in my head, and I still think it's kind of ridiculous. If people have a right to take unpaid time off to take care of their parents or children or other family emergencies, that right should happen anywhere. If that small company will experience hardship and we feel bad about that as a society, then we as a society (i.e. the govt) should all chip in and pay/give whatever services we need to support that company. So in the case of the mom and pop store, the quality of your taco experience should not depend on the profitability of the taco establishment.

Yeah, but how many small businesses would fold under that model?

 

[LizzyM]

If that small company will experience hardship and we feel bad about that as a society, then we as a society (i.e. the govt) should all chip in and pay/give whatever services we need to support that company.

The taxpayers don't feel that bad.

Americans, through their legislators, require a lot of big business but exempt small businesses because small business owners are a pretty strong lobby and because they are an incubator for job creation.

Just wait until employers are required to provide health insurance or pay into a pool. Wanna bet that very small employers will be exempt?

 

[JJMrK]

The one who pays the piper calls the tune.

Or you can set a price, and if someone doesn't want to pay it, they don't have to see you. You know, the same way every other business in the country works.

If that small company will experience hardship and we feel bad about that as a society, then we as a society (i.e. the govt) should all chip in and pay/give whatever services we need to support that company. So in the case of the mom and pop store, the quality of your taco experience should not depend on the profitability of the taco establishment.

Are you serious? Why don't you just move to North Korea or something? The market rewards hard working small business owners. If a business can't get over an obstacle on it's own, it doesn't deserve to exist.

 

[HolyGrail]

Honey, the legislature did pass this law and President Bush (41) signed it back in 1990. So it has been the law of the land for some time. Businesses are expected to make reasonable accommodations and most do. When someone believes that they have not been treated fairly under the law because they have been denied a reasonable accommodation, they can sue. This deaf woman sued and won. (back in the 1990s someone sued Clint Eastwood for failure to make accommodations avaiable at an inn he operated in California... he won because the accommodations he had made were considered reasonable given the size and scope of his business). This is the law and this is how it works. There is no need for a one size fits all approach to the law (the mom & pop shop is fine reading the menu aloud to the occasional blind customer and Taco Bell is OK with distributing Braille menus upon request) and there is no need for everyone pool their money and have some central bureaucracy tell them how to spend it.

There's no need to resort to pet names.

I'm quite old enough, and capable enough, to understand an argument without you trying to persuade me by implying I'm a child.

Your Braille menu is one analogy, your deaf person is another story, you're oversimplifying.

I was more outraged about this before I knew what I know now, it's obvious the article doesn't completely accurately describe the situation that must have transpired.

 

[pianola]

So in the case of the mom and pop store, the quality of your taco experience should not depend on the profitability of the taco establishment.

But LizzyM, don't you agree with at least this part? Or are we just going to accept that there are inequalities in the taco experience for most visually impaired people and there are inequalities that will exist for deaf people based on whether or not the physician can afford an interpreter?

 

[LizzyM]

But LizzyM, don't you agree with at least this part? Or are we just going to accept that there are inequalities in the taco experience for most people and there are inequalities that will exist for deaf people based on whether or not the physician can afford an interpreter?

Exactly! It is unreasonable to expect the taco stand owner or the solo practioner just scraping (Dr. F was not just scraping by) by provide Braille menus or ASL interpreters. Reading the menu to the blind man or finding some inexpensive way of communicating with the deaf is a reasonable accommodation under the circumstances.

When a business is much bigger than those small shops, then what is a reasonable accommodation might be different. What is reasonable varies with the financial circumstances of the business.

 

[Revilla]

But LizzyM, don't you agree with at least this part? Or are we just going to accept that there are inequalities in the taco experience for most visually impaired people and there are inequalities that will exist for deaf people based on whether or not the physician can afford an interpreter?

I'm not LizzyM, but my above comment about small businesses folding was actually about the lack of consideration for the size of the business. I think that if you enforce one standard for all, small businesses and mom and pop shops won't be able to keep up. I don't see the everyone-pitches-in-and-picks-up-the-tab scenario as a realistic option.

 

[Revilla]

Exactly! It is unreasonable to expect the taco stand owner or the solo practioner just scraping by provide Braille menus or ASL interpreters. Reading the menu to the blind man or finding some inexpensive way of communicating with the deaf is a reasonable accommodation under the circumstances.

When a business is much bigger than those small shops, then what is a reasonable accommodation might be different. What is reasonable varies with the financial circumstances of the business.

Nail on the head, IMO. I agree with everything you said here and upthread.

 

[walderness]

Come on. We live in a civilized society where the law stipulates that services provided on a large scale are provided equally. This physician had a large scale practice and in order to provide equal care to a deaf woman, he needed to bring in an interpreter.

Disabled people carry huge financial burdens of their own let's not forget. I recently bought an $18k car, but in order to drive it, I had to pay $35k to modify it. I couldn't pass this on to other drivers purchasing cars from this dealership. And my disability was caused by an able-bodied bad driver! He's not even paying my bills. Even travelling to med interviews, I had to fly 2 people, me+caretaker, and stay at a hotel v. student accommodations. On top of it all, I lost my job making $60k a year after the accident. We don't go around getting rich off lawsuits. I got stuck in a bathroom at a hospital that was not ADA compliant. It was quite annoying and immasculating, but I can't sue the hospital.

You all are coming at this from the perspective of "whats this gonna cost ME in the future." Try the other perspective for once.

And just because there's not a rational place to cut off income v. undue burden doesn't mean that one shouldn't be in place. (ADA has 15 employee cutoff as I previously mentioned). Suppose we go the other way, hotels don't need to provide disabled equipped rooms (most arent ADA compliant btw), no elevators at doctors offices because they're expensive, etc.

Bottom line. The cost of the interpreter was immaterial to the physician's practice, he refused to pay for it, and he was appropriately punished under the laws in place to provide for equality of service.