Pre-Law student in my class said...

[tugbug]

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Thought this might entertain you SDNers...

One of the students in an intro biol class I teach is headed to law school in the fall. Before class on Monday, she was saying she wished that the requirement that non-majors take the class be dropped. I told her that I agreed... at least for pre-law folks... they ought to trade the bio requirement for an "ethics of medical malpractice law" class.

Her reply was - "I would love to sue a Dr., pay off these student loans."

I suggested she just get a gun and hide in an alley outside a hospital... much quicker.

 

[JohnHolmes]

Originally posted by tugbug
Thought this might entertain you SDNers...

One of the students in an intro biol class I teach is headed to law school in the fall. Before class on Monday, she was saying she wished that the requirement that non-majors take the class be dropped. I told her that I agreed... at least for pre-law folks... they ought to trade the bio requirement for an "ethics of medical malpractice law" class.

Her reply was - "I would love to sue a Dr., pay off these student loans."

I suggested she just get a gun and hide in an alley outside a hospital... much quicker.

I assume she was joking?



If not, this just underscores the problem.

 

[tugbug]

She was pretty serious. I dont think she realized how what she said sounded until afterward.

 

[juddson]

Give me a break.

Judd

 

[tugbug]

Originally posted by juddson
Give me a break.

Judd

??? What sort of break are you looking for?

 

[JohnHolmes]

Originally posted by juddson
Give me a break.

Judd

I think he is looking for a kit kat bar ....

chocolate

 

[tugbug]

Originally posted by Cooper_Wriston
I think he is looking for a kit kat bar ....

chocolate

... or the big 'break' that pays off HIS student loans.

I cant imagine docs to be licking their chops at someone else's misfortune... meaning, I doubt I'll ever hear a pre-med saying "hope lots of my patients get cancer so I can treat them... pay off my student loans"

 

[juddson]

Originally posted by tugbug
... or the big 'break' that pays off HIS student loans.

I cant imagine docs to be licking their chops at someone else's misfortune... meaning, I doubt I'll ever hear a pre-med saying "hope lots of my patients get cancer so I can treat them... pay off my student loans"

I think the break I am looking for is the recognition that this young pre-law student was being funny - and possibly trying to get the goat of the OP. For one thing, EVERYBODY who is considering law school knows that personal injury law is the "bottom of the barrel" for law graduates. NOBODY seriously goes to law school hoping to become a personal injury attorney. Sure, there are a few people who make big $$$ as personal injury plaintiff's attorneys. But the VAST MAJORITY of them are among the lowedt paid of all attorneys. Of course MANY people go into law school hoping to be "litigators" or trial lawyers. But when these people dream at night, they dream of criminal law and civil rights litigation. Nobody's dreaming of insurance defense.

Yes, lawyers "lick their chops" at somebody elses missfortune!!! Your comments about how doctors don't "hope" for thier patients to get cancer in order to treat them is shallow and ultimately unhelpful. First of all, doctors are just like lawyers. They ABSOLUTELY depend on the missfortune of others in order to make a living (well this is 100% true of doctors - only a subset of lawyers depend on the missfortune of others to make a living). But you point is obvious enough. Doctors don't "want" their patients to get sick - and OBVIOUSLY lawyer sit around all day "hoping" that somebody has been injured by a doctor. This is just another attempt to dehumanize attorneys - to make them as anti-altruistic as possible.

Lawyers are people, just like doctors are. You need temper this dehumanizing bias - it makes you look like an idiot.

There are two realities that seem lost on you. First, neither doctors nor med mal attorneys "hope" that their clients or patients get sick in order to make a fast buck. BUT BOTH of the them "require" this none the less in order to earn a living. Secondly, a cure for cancer would just as surely put oncologists out of work as a cure for death would put estate planners out of work. THAT this somehow translates into doctors supporting a cure for cancer but lawyers surely not is baseless in fact and motivated by pure prejudice - a sense that lawyers are somehow sub-human as a species. It's ridiculous.

Judd

 

[juddson]

I do like kit kat bars (but not the Big Kat - the ratio of chocolate to wafer is too large).

Judd

 

[tugbug]

Originally posted by juddson
I think the break I am looking for is the recognition that this young pre-law student was being funny - and possibly trying to get the goat of the OP.

She really was serious. But, in her defense, I was probably putting her in an uncomfortable and defensive position by poking fun at her profession - AS HER TEACHER. She probably didnt feel she could just tell me to "go to H*ll." Still, she got the ball rolling with a joke about "never giving her any reason to make a case against me." Plus, Im not claiming this view represents ALL lawyers/prelaw students... but, it is reprepresentative of a pretty vocal and high profile subset of lawyers that dominate the daytime tv commercial time in Louisville, KY. These guys are, IMO, pretty damaging to nearly every industry/profession. So, when I catch something that fits the stereotype... It registers.

Originally posted by juddson
Yes, lawyers "lick their chops" at somebody elses missfortune!!! Your comments about how doctors don't "hope" for thier patients to get cancer in order to treat them is shallow and ultimately unhelpful. First of all, doctors are just like lawyers. They ABSOLUTELY depend on the missfortune of others in order to make a living (well this is 100% true of doctors - only a subset of lawyers depend on the missfortune of others to make a living). But you point is obvious enough. Doctors don't "want" their patients to get sick - and OBVIOUSLY lawyer sit around all day "hoping" that somebody has been injured by a doctor. This is just another attempt to dehumanize attorneys - to make them as anti-altruistic as possible.

Lawyers are people, just like doctors are. You need temper this dehumanizing bias - it makes you look like an idiot. .

Easy killer. I dont think posting the statement of a student, and poking fun at you - "makes me look like an idiot" I think you are overstating. True, both professions depend on the 'misfortune' of others, but it is, IMO, a tough sell to argue that med mal (etc) attorneys are as altruistic as the doctors they sue. An important distinction is that the clear intention of the doctors is to help with this misfortune. Im anticipating your response will be that lawyers are doing the same thing... but, in practice, I dont think this is the case. Just look at the unnecessary changes in OB-GYN standards of care brought about largely by the action of John Edwards et al, and the malpractice rates/practice options of certain specialties... these lawyers arent fixing ANYTHING. They are making the situation much much worse for everyone involved, except possibly the very few clients who benefit. Just my admittedly biased opinion as someone heading into Med school.

Originally posted by juddson
There are two realities that seem lost on you. First, neither doctors nor med mal attorneys "hope" that their clients or patients get sick in order to make a fast buck. BUT BOTH of the them "require" this none the less in order to earn a living. Secondly, a cure for cancer would just as surely put oncologists out of work as a cure for death would put estate planners out of work. THAT this somehow translates into doctors supporting a cure for cancer but lawyers surely not is baseless in fact and motivated by pure prejudice - a sense that lawyers are somehow sub-human as a species. It's ridiculous.

Judd

Again, "motivated by pure prejudice" "ridiculous"... you are overreacting and overstating, IMO. Geesh, Im not claiming all lawyers are subhuman. Just the "ambulance chasers." If you want to claim that these guys do not accurately represent the profession... fine. I agree. But, the drain on society caused by this 'small' subset of your colleagues is enough to earn this bit of negative press.

BTW, both King size Kit Kat and King size Snickers totally skew the chocolate/other stuff ratio... very disappointing.

 

[juddson]

I think you may have a rose-tinted outlook on the "altruism" of being a doctor. My experience suggests that there are as many "bad actors" in medicine as there are in law. Which is to say that there are plenty of physicians who are motived by little else than greed (just as there are attorneys who are similarly motivated). For an interesting analogue to the so-called "abulance chaser" consider the BOOM of MRI centers opening up around the country. Arguably (this is certainly the position of the official radiology organization) these MRI centers are unnecessary "profit centers" designed to capitalize the fears of hapless patients. Another example are the spikes of "self-referal" radiology studies ordered by non-radiologists who have been buying of radiological capital (machines) like its going out of style. Why? Because these machines are "profit centers" for these physicians and have an extremely tenuous nexus to the healthcare needs of the patients.

I anticipate your response will be that these represent just another example of CYA medicine prompted by the tort crisis. But that does NOT explain the standalone MRI centers who cater to self-referred patients - they fill a "market demand" and NOTHING ELSE. And in the case of doctor self-referal studies who own their own machines, the UNIVERSAL opinion among the radiology establishment is that theses studies are poorly performed and even more poorly read. Where's the medical necessity in that?

What about the OB/GYN in Florida and West Virginia who sees his income go from $300,000 to $200,000 a year because his insurance premiums are $100,000 a year now. These doctors LEAVE already uderserved markets (thereby leaving patients out in the cold) rather than earn a mere $200,000 a year (or $150,000 or whatever).

Don't talk to me about "greed" and "altruism". These are complicated issues and the vast majority of doctors and lawyers are motivated by exactly the same things. Sometimes altruism. . .sometimes professional satisfaction. . .sometimes money. It's the same for everybody.

Judd

 

[tugbug]

Fine. Leave "greed" and "altruism" out of the discussion. I dont doubt that there are good and bad individuals in both professions.

Just talk about the results of each. Would you claim that the effect of the med-mal cases is positive on patient care? On the availability/affordability of treatment? Quality of care? My understanding is that the EFFECT of all of the litigation is VERY negative in nearly every aspect of patient care, whatever the underlying intentions of the people involved might be.

I'd be for limiting the ability of individuals to enrich themselves at the expense of society... If that means that lots of the "fat" of certain specialties gets cut along with much of the litigation... great.

Anyway, justifying ambulance chasing lawyers by pointing out examples of less than altruistic doctors is NOT a defense of the med mal climate... I say get rid of these doctors AND the lawsuits.

 

[tugbug]

Also, you use docs moving from underserved areas because of malpractice insurance differences as examples of docs without "altruism"... assuming the states have taken the necessary steps to tie ins. rates to litigation risk, then it is very reasonable to move to an area where the litigation risk (and therefore the insurance rates) are lower. Money is not the only thing doctors with cases against them lose... it is a troublesome thing to have on a resume, and increases your chances of being sued in the future.

If Im at the beach and there is a sign warning of sharks in the area... I move to another spot on the beach .

 

[Kimmer]

Originally posted by juddson
First of all, doctors are just like lawyers. They ABSOLUTELY depend on the missfortune of others in order to make a living (Judd

Is pregnancy the "misfortune of others". I guess it is if you are a guy. Hmm. Same for menopause. So much for making a point that all medical practice is not based on misfortune.
I hope this rage works out real well for you!

 

[juddson]

Originally posted by tugbug

Would you claim that the effect of the med-mal cases is positive on patient care? On the availability/affordability of treatment? Quality of care? My understanding is that the EFFECT of all of the litigation is VERY negative in nearly every aspect of patient care, whatever the underlying intentions of the people involved might be.

Why would I be expected to make this claim. Lawyers are not in the healthcare field. They practice law. I was not aware that the "worth" of a plaintiff's attorney to society was grounded in his concern for the healthcare needs of patients. That's what doctors do, right. Lawyers, on the other hand, are interested in the securing the "legal interests" of their clients, NOT thier medical medical interests. Why you think this is an unsatisfactory situation, I can't imagine. How about this: Would YOU claim that doctors are concerned about the legal interests of thier patients? I'm assuming not. Why, because doctors practice medicine and lawyers practice law. These are seperate fields.

Nor could ANY claim be made that the tort system is "designed" to or "intended" to increase good patient care. And why should it. It's purpose is to protect the interests of injured patients, and that's it. Lawers are REQUIRED by the code of professional responsibility and the rules of professional conduct to be a "zelous advocate" for the legal interests of his client. And this is the way it should be. Doctors, on the other hand, have similar obligations to advocate for the health of their patients. As it should be.

As far the altruism of doctors, look - I think we are in agreement here. As you say, there is plenty of "fat" in the specialties to go around. let's just agree that lawyers AND doctors make more money than just about anybody else, and that BOTH vigorously defend these incomes as best they can.

Judd

 

[juddson]

Originally posted by Kimmer
Is pregnancy the "misfortune of others". I guess it is if you are a guy. Hmm. Same for menopause. So much for making a point that all medical practice is not based on misfortune.
I hope this rage works out real well for you!

Oh, that's not the point and you know it. Of course not ALL medicine depends on the missfortune of others (nor is this true for lawyers either). I think you understand my point. Basing this on my "maleness" demonstrates that you are really scraping the bottom of the barrel. There are plenty of male or general neutral medical areas that also fall outside the statement such as elective vasectomies, plastic surgery, etc.

In any event, it is laughable that I am the one being accused of "rage". On these forums it is the lawyers NOT the doctors who are repeatedly and vigorously villified by young doctors and premeds. Lawyers don't go around calling doctors "blood sucking bottom dwellers" and other such "rage" induced epitaphs (sp).

Judd

 

[JohnHolmes]

Originally posted by juddson
THAT this somehow translates into doctors supporting a cure for cancer but lawyers surely not is baseless in fact and motivated by pure prejudice - a sense that lawyers are somehow sub-human as a species. It's ridiculous.

Judd

I think he was jabbing at the callousness of her comment. Depraved indifference if you will. Law and Order is good for something...

 

[tugbug]

Originally posted by juddson
Why would I be expected to make this claim. Lawyers are not in the healthcare field. They practice law. I was not aware that the "worth" of a plaintiff's attorney to society was grounded in his concern for the healthcare needs of patients. That's what doctors do, right. Lawyers, on the other hand, are interested in the securing the "legal interests" of their clients, NOT thier medical medical interests. Why you think this is an unsatisfactory situation, I can't imagine. How about this: Would YOU claim that doctors are concerned about the legal interests of thier patients? I'm assuming not. Why, because doctors practice medicine and lawyers practice law. These are seperate fields.

Nor could ANY claim be made that the tort system is "designed" to or "intended" to increase good patient care. And why should it. It's purpose is to protect the interests of injured patients, and that's it. Lawers are REQUIRED by the code of professional responsibility and the rules of professional conduct to be a "zelous advocate" for the legal interests of his client. And this is the way it should be. Doctors, on the other hand, have similar obligations to advocate for the health of their patients. As it should be.

As things stand, lawyers have an aweful lot of influence on the standards of care in many fields. I just got a big dose of this with the birth of our first baby... and the realization that much of what my wife and I were 'required' to do, and the actions of the caregivers, were determined by how CYA medicine.

Therefore, it is VERY reasonable to discuss the negative impact of the litigation climate and the action of lawyers on medicine. My argument is that, in the interest of all patients, the tort system should be reformed. I understand that lawyers are required to be "zealous advocates" for their clients. Unfortunately, what helps their client often is very hurtful to everyone else. This outcome is unnacceptable. So, to answer your question, I agree that their is no requirement that an individual ambulance chaser act with the patient care needs of his community in mind... It is up to the rest of us to do this by limiting that lawyers ability to damage the system in his 'altruistic' attempt to help his client.

 

[JohnHolmes]

Originally posted by juddson
Lawyers, on the other hand, are interested in the securing the "legal interests" of their clients, NOT thier medical medical interests.

I pray you are wrong and lawyers are compelled by more than the self-interest of their profession. If you are right, we are in a far worse situation than I had previously thought...

 

[juddson]

Originally posted by tugbug
As things stand, lawyers have an aweful lot of influence on the standards of care in many fields. I just got a big dose of this with the birth of our first baby... and the realization that much of what my wife and I were 'required' to do, and the actions of the caregivers, were determined by how CYA medicine.

BTW, all these extra things you and your wife had to do? Worthwhile or no? Do you think they enhanced, had no effect upon, or diminished the probability that your medical outcome would be a good one? be honest now.

hitting the sack now.

Judd

 

[JohnHolmes]

Originally posted by juddson
BTW, all these extra things you and your wife had to do? Worthwhile or no? Do you think they enhanced, had no effect upon, or diminished the probability that your medical outcome would be a good one? be honest now.

hitting the sack now.

Judd

Good point.

 

[tugbug]

Originally posted by Cooper_Wriston
I pray you are wrong and lawyers are compelled by more than the self-interest of their profession. If you are right, we are in a far worse situation than I had previously thought...

I dont doubt that hes right on this. I would expect any individual lawyer to vigorously go after every possible cent in a case. Im not sure how the system would work if it wasnt this way. There should just be limits on how much damage this 'advocacy' can do. I dont expect an individual lawyer to limit their clients award 'for society's good', but I would hope that lawyerS would help regulate the system so that the whole ship doesnt go down so a few of their colleagues can fill their glasses with holes punched in the hull. I would hope doctors would show the same restraint.

 

[tugbug]

Originally posted by juddson
BTW, all these extra things you and your wife had to do? Worthwhile or no? Do you think they enhanced, had no effect upon, or diminished the probability that your medical outcome would be a good one? be honest now.

hitting the sack now.

Judd

Difficult to know. It definitely reduced our ability to tailor the experience to the patient's (my wife's) desires in ways that very likely did not increase the safety of the situation. She was not allowed to get out of bed, had multiple exams and internal monitors, ended with a rush c-section, baby spent a week in the NICU, etc... I do not claim to be an expert on OB care and I cant know what dangers we really avoided, so I have no real way to judge... but discussing our situation (and standards for OB in general) with our OB and others, and reading, makes it clear that MANY c-sections and surrounding activities are, at least in part, an attempt to avoid lawsuits.

So, I cant judge whether these things "enhanced the probability" of a good outcome in our specific case. But, I dont think it is a stretch to say that the increase in C-sections is largely due to things like the J. Edwards (et al.) cerebral palsy cases... and there is, if I understand correctly, no reduction in the rates of fetal injury that goes along with the increased rate of Csection. Therefore, docs/hospitals are inclined to do things, as they did with my wife, that decrease the liability risk without necessarily decreasing the risk to the patient to cover their A.

 

[Disenchanted 1]

judd, this whole discussion about lawyers is ridiculous. I am sorry to say that your analogy about doctors being lawyers is ludicrous to say the least. I don't understand why you are taking such an offense to such a true fact about lawyers (yes they are self-serving and if anything half the time they screw the system up....just look at all the ridculous law suits that ONLY occur in US......give me a [email protected]#@ing break!) If you are a "pre-law", then I dont understand what you are doing in a pre-med forum poking fun at medical doctors whle knowing that your "audience" are physicians or aspiring doctors....you are obviously not asking for much respect and sympathy if you ask my opinion. I am sorry to sound mean but it just makes me so mad when it seems like lawyers have made common sense and certain aspects basic to every society/profession disappear. Having lived in Europe, the law system of US to say the least is an eye-opener and a ridiculous reminder of what it will be like over there if too much power is given to lawyers....and by this of course I am not putting every lawyer in this category. As mentioned there are lawyers who do their job and do so with much dignity and there are those who abuse their power and the justice system!!

 

[juddson]

Originally posted by Cooper_Wriston
I pray you are wrong and lawyers are compelled by more than the self-interest of their profession. If you are right, we are in a far worse situation than I had previously thought...

That's not what i said. I said that lawyers were compelled by the legal interests of thier clients, not the self interest of thier profession. ??????

Judd

 

[juddson]

Originally posted by tugbug
I dont doubt that hes right on this. I would expect any individual lawyer to vigorously go after every possible cent in a case. Im not sure how the system would work if it wasnt this way. There should just be limits on how much damage this 'advocacy' can do. I dont expect an individual lawyer to limit their clients award 'for society's good', but I would hope that lawyerS would help regulate the system so that the whole ship doesnt go down so a few of their colleagues can fill their glasses with holes punched in the hull. I would hope doctors would show the same restraint.

You guys are hiding the ball. I said the legal interest of the client comes first, not the self interest of the profession. The goal is to protect and prosecute legal interests not to line pockets. But, as always, lawyers make a living too.

Judd

 

[juddson]

Originally posted by Disenchanted 1
judd, this whole discussion about lawyers is ridiculous. I am sorry to say that your analogy about doctors being lawyers is ludicrous to say the least. I don't understand why you are taking such an offense to such a true fact about lawyers (yes they are self-serving and if anything half the time they screw the system up....just look at all the ridculous law suits that ONLY occur in US......give me a [email protected]#@ing break!) If you are a "pre-law", then I dont understand what you are doing in a pre-med forum poking fun at medical doctors whle knowing that your "audience" are physicians or aspiring doctors....you are obviously not asking for much respect and sympathy if you ask my opinion. I am sorry to sound mean but it just makes me so mad when it seems like lawyers have made common sense and certain aspects basic to every society/profession disappear. Having lived in Europe, the law system of US to say the least is an eye-opener and a ridiculous reminder of what it will be like over there if too much power is given to lawyers....and by this of course I am not putting every lawyer in this category. As mentioned there are lawyers who do their job and do so with much dignity and there are those who abuse their power and the justice system!!

Not sure what to do with this.

Judd

 

[juddson]

Originally posted by tugbug
Difficult to know. It definitely reduced our ability to tailor the experience to the patient's (my wife's) desires in ways that very likely did not increase the safety of the situation. She was not allowed to get out of bed, had multiple exams and internal monitors, ended with a rush c-section, baby spent a week in the NICU, etc... I do not claim to be an expert on OB care and I cant know what dangers we really avoided, so I have no real way to judge... but discussing our situation (and standards for OB in general) with our OB and others, and reading, makes it clear that MANY c-sections and surrounding activities are, at least in part, an attempt to avoid lawsuits.

I understand the point you are trying to make, but I don't think that your situation provides much support for it (as you seem to suggest yourself). It wasn't as if your wife had an "elective" C-section, but rather it appears she had an emergency one, with your baby having spent a considerable amount of time in the NICU. It seems to me that, at least in your situation, the C-Section was almost certainly NOT CYA medicine and that appeared to be genuine indications of its necessity.

That said, neither of us can know for sure.

But what I can say is that there is a reason that the number of c-sections is risen and is on the rise, and that the tort system might only be the most "proximate" cause of this rise. And in this instance (that is, with respect to OB and C-sections) a case can be made that the tort atmosphere has increased the standard of care in OB. Certainly unless one suggests that the increase in C-sections is the result of a doctor's wish to merely "shedule" a birth (which is hardly the fault of lawyers), an increased incidence of C-section is probably accompanied with a decreased incidence of morbidity and mortality. That is, after all, the surest way to avoid a lawsuit, no? And certainly in your case (given the outcome) I doubt highly that you would have objected to this C-section.

In any event, I have no idea whether C-sections do or do not decrease morbidity and mortality. I am sure studies have been done.

Judd

 

[tugbug]

I think the data shows that the increased rate of C section births is NOT necessarily accompanied by decreases in the bad outcomes these supposedly help avoid.

Actually, our case may be the perfect example of this. Our doc was simply being VERY cautious, and her actions set in motion a chain of "cautious" decisions that didnt stop for a week. She would admit this. She has told us multiple times since the birth that most likely nothing was going on, but "better safe than sorry." Which I tend to agree with... But, I wish I had a better handle on what we were all being so safe about. I think there is reason to believe that part of the 'safety' she (and the medical community)was going after was from lawsuits.

The claim that the increased Csections (and Im assuming other changes prompted by docs attempting to avoid litigation) has improved patient care is just wrong I think. An OB might disagree, but it is at least debateable whether all of these Csections are helping medically. At least, they have NOT decreased the rate of cerebral palsy, J. Edwards main subject.

BTW, the reason for our Csection was just that our baby's heart rate stopped regularly increasing during contractions. It was still a normal heart rate and everything else looked good. The week in the NICU was because at birth they caught a small pneumothorax and, adding this to the "difficult birth", caused a neonatologist brought for the section to think the NICU might be a good idea. The pneumo cleared up after about 6 hours without any intervention, but at our hospital babies dont "step down" to a floor nursery once in the ICU. We got an extra ?1 or 2 days? in the hospital because the xray that showed the pneumo had cleared up, had what the neonat said "could be early pneumonia" Again, out of "caution", he recieved a course of gentimycin. The next xray showed no infiltration, and noone seemed sure there had been anything in the first place... but, "better safe than sorry."

Anyway, everybody involved has said that the steps taken were them being extremely cautious... for which I have thanked them many times. But, I wonder if this sort of "caution" is actually necessary/beneficial? Ive heard many docs say no... unless we mean beneficial for making the case that "you did everything possible" when staring down a litiGATOR after a bad result.