The L Word: Doctors and Litigation Podcast

[icarus8]

I rarely if ever post, but I do lurk hard on this forum....
A podcast was recently recommended to me that I have found really really interesting as a relatively young attending.
It is at times infuriating but very educational.
I thought the readers/posters here would enjoy it.

Doctors and Litigation: The L Word | Gita Pensa MD

The majority of physicians will be sued during their career, yet the topic is largely taboo. This podcast for physicians discusses malpractice litigation and litigation stress, with the voices of doctors who have been through it. Music by @BenJamin Banger....

thelword.podbean.com

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[Birdstrike]

Thanks for posting. I'd like to throw something out there that I wrote on this "taboo," as well. A quick read:

Why a malpractice win for doctors feels like a great loss

Even though I was vindicated, there was no “win” in being falsely accused of committing malpractice.

www.kevinmd.com

 

[RustedFox]

Thanks for posting. I'd like to throw something out there that I wrote on this "taboo," as well. A quick read:

Why a malpractice win for doctors feels like a great loss

Even though I was vindicated, there was no “win” in being falsely accused of committing malpractice.

www.kevinmd.com

So much this.
I just had my deposition on Monday for a MLP case that I never saw.
I woke up, had my coffee. Didn't have to work that day.
Wife made my favorite breakfast. Potatoes, pepper/onion mix, Spanish sausage. Hot sauce.
Put in my cufflinks and cinched that tie.
Wife patted me on the ass on my way out the door. "Go get 'em, baby."

Had to wait an hour or so for the prosecutor to show up. And then there was the problems with the court reporters.
I couldn't help by think; "Where's MY satisfaction survey right now? After all, this was rescheduled three times so that attorneys could be accommodated. Nobody cares to accommodate me."

I was "perfect" according to my attorney.
I made that prosecutor look silly.
Those of you on here who know how creative I can be with language can imagine how I did so.

I came home, and ... I was still being sued. For a case that I never saw. In a system that makes care for those who don't need it "free", except for those who do need it, and can afford it. Then, it costs a "premium" in the 1000 dollar range. A month. Oh, and then there's that "deductible".

I took off my socks, and put my feet in the grass.
I cried. Not much. But I cried.

 

[cyanide12345678]

So much this.
I just had my deposition on Monday for a MLP case that I never saw.
I woke up, had my coffee. Didn't have to work that day.
Wife made my favorite breakfast. Potatoes, pepper/onion mix, Spanish sausage. Hot sauce.
Put in my cufflinks and cinched that tie.
Wife patted me on the ass on my way out the door. "Go get 'em, baby."

Had to wait an hour or so for the prosecutor to show up. And then there was the problems with the court reporters.
I couldn't help by think; "Where's MY satisfaction survey right now? After all, this was rescheduled three times so that attorneys could be accommodated. Nobody cares to accommodate me."

I was "perfect" according to my attorney.
I made that prosecutor look silly.
Those of you on here who know how creative I can be with language can imagine how I did so.

I came home, and ... I was still being sued. For a case that I never saw. In a system that makes care for those who don't need it "free", except for those who do need it, and can afford it. Then, it costs a "premium" in the 1000 dollar range. A month. Oh, and then there's that "deductible".

I took off my socks, and put my feet in the grass.
I cried. Not much. But I cried.

A couple of questions, what's the gist of what you said that made the prosecutor seem silly. And secondly, did you ever post about the Blockbuster lawsuit that you had?

 

[RustedFox]

A couple of questions, what's the gist of what you said that made the prosecutor seem silly. And secondly, did you ever post about the Blockbuster lawsuit that you had?

1. I'm too scared to give any allusion as to what I said. Its been a bad week.
2. No, I never posted it. I keep working on it - but I get upset each time, and life has not been kind to me as of late. I feel totally free to write my big, giant, red "X!" on the wall with that suit; but I don't.

 

[Apollyon]

A couple of questions, what's the gist of what you said that made the prosecutor seem silly. And secondly, did you ever post about the Blockbuster lawsuit that you had?

When I testified in a criminal case 10 or so years ago, I made the public defender look like a chump. That wasn't my intent, but it was the first time I had ever been involved in a trial. I was a bit nervous, and, thus, sounded a bit like a dick, but I made factual, scientific statements, and those statements punched holes in the defense theory.

 

[namethatsmell]

So much this.
I just had my deposition on Monday for a MLP case that I never saw.
I woke up, had my coffee. Didn't have to work that day.
Wife made my favorite breakfast. Potatoes, pepper/onion mix, Spanish sausage. Hot sauce.
Put in my cufflinks and cinched that tie.
Wife patted me on the ass on my way out the door. "Go get 'em, baby."

Had to wait an hour or so for the prosecutor to show up. And then there was the problems with the court reporters.
I couldn't help by think; "Where's MY satisfaction survey right now? After all, this was rescheduled three times so that attorneys could be accommodated. Nobody cares to accommodate me."

I was "perfect" according to my attorney.
I made that prosecutor look silly.
Those of you on here who know how creative I can be with language can imagine how I did so.

I came home, and ... I was still being sued. For a case that I never saw. In a system that makes care for those who don't need it "free", except for those who do need it, and can afford it. Then, it costs a "premium" in the 1000 dollar range. A month. Oh, and then there's that "deductible".

I took off my socks, and put my feet in the grass.
I cried. Not much. But I cried.

Our medmal system is so, so broken. It is completely illogical and immoral.

Do we sue firemen to help compensate for damage when somebody's house burns down?

Are stock brokers sued by their clients when their portfolios under-perform?

Can you sue pilots when your flight is cancelled due to them being hungover and you miss a critical job interview?

I don't know how our current system arrived, but it needs to go.

Stay strong man. 99% of people could not function under the pressure you do at a regular day in the ED, let alone with this extra frivolous burden.

 

[cyanide12345678]

1. I'm too scared to give any allusion as to what I said. Its been a bad week.
2. No, I never posted it. I keep working on it - but I get upset each time, and life has not been kind to me as of late. I feel totally free to write my big, giant, red "X!" on the wall with that suit; but I don't.

Hopefully things get better. Good luck. Deep breath, eventually you just have to tell yourself that it's a stupid game for these lawyers. All they are after is the insurance money.

 

[thegenius]

I've just listened to several of the OP's podcasts.

Kind of makes you want to barf.

Especially the section on Expert Witnesses - seems as though they are hard to impugn.

I also understand that the cases they presents are probably some of the worst of the worst. Like the ER doctor who diagnosed a very large ascending thoracic aneurysm/dissection causing aortic regurg - and he dies minutes after transfer. He did everything right (although probably should have started a beta-blocker).

 

[Birdstrike]

Both times I’ve been sued, I followed standard of care, and took the most conservative and careful course possible, yet still got dragged through a prolonged, painful process each time. But I got through it each time and I feel I’ve come out the other end a stronger person, in each instance.

 

[TooMuchResearch]

We all know the beta blocker won't save the patient who is about to die. But getting sued isn't about "we."

I've just listened to several of the OP's podcasts.

Kind of makes you want to barf.

Especially the section on Expert Witnesses - seems as though they are hard to impugn.

I also understand that the cases they presents are probably some of the worst of the worst. Like the ER doctor who diagnosed a very large ascending thoracic aneurysm/dissection causing aortic regurg - and he dies minutes after transfer. He did everything right (although probably should have started a beta-blocker).

 

[thegenius]

We all know the beta blocker won't save the patient who is about to die. But getting sued isn't about "we."

No a beta-blocker wouldn't have done anything. The patient was a ticking time bomb ready to die at a moment's notice. If I heard it correctly it was an 8 cm aneurysm?

 

[thegenius]

So if the plantiff's can call an expert witness, can't the defense too? What if the defense calls 5 expert witnesses in defense of the doctor? Doesn't that count for something?

 

[RuralEDDoc]

I try to counsel physicians that lawsuits are to be expected and a cost of doing business. We’re not the only profession that gets sued - cops, university professors, home inspectors, you name it. We know there are certain things you can do to decrease lawsuits, but there is still a very random element which is what drives us all crazy and makes it feel personal. As ****ty as it is, we have to accept that the medmal system exists and we are part of it.

 

[Birdstrike]

So if the plantiff's can call an expert witness, can't the defense too? What if the defense calls 5 expert witnesses in defense of the doctor? Doesn't that count for something?

I don't know of any limit to the amount of experts you put on the stand in your defense, but in my opinion, one persuasive witness of average intellect and short on facts, is worth more than 10 brilliant but unpersuasive witnesses with the facts on their side. It's much easier for a jury to decide who they find most believable, that to decide a case on facts alone in a highly technical field.

 

[Groove]

We're essentially slot machines for lawyers. How long your suit lasts depends on how many quarters they want to put in before the cost of playing outweighs their chances of winning a jackpot. I don't worry about it anymore. @RuralEDDoc said it well. Suits are just part of doing EM and that's what you have malpractice insurance for....don't make it personal.

 

[TooMuchResearch]

I document what I think is needed (without bloat or padding) and order probably more tests than needed, and I don't worry at night.

We're essentially slot machines for lawyers. How long your suit lasts depends on how many quarters they want to put in before the cost of playing outweighs their chances of winning a jackpot. I don't worry about it anymore. @RuralEDDoc said it well. Suits are just part of doing EM and that's what you have malpractice insurance for....don't make it personal.

 

[MoMoGesiologist]

Both times I’ve been sued, I followed standard of care, and took the most conservative and careful course possible, yet still got dragged through a prolonged, painful process each time. But I got through it each time and I feel I’ve come out the other end a stronger person, in each instance.

After those experiences, do you feel being conservative in testing and consults and writing a lot in your notes is protective or beneficial? Has it changed how you practice and document medicine?

That sounds like such a gut wrenching experience (trying to help someone then getting sued). Sorry you had to go through that twice.

 

[e30ftw]

This seems like the worst possible use of an EM physician's free time.

 

[Birdstrike]

After those experiences, do you feel being conservative in testing and consults and writing a lot in your notes is protective or beneficial?

Getting sued is more about bad outcomes than your charting or you performance. Once a lawyer told me, “Give me a bad enough outcome involving a sympathetic enough patient and I’ll find liability, whether it’s there or not.”

What being conservative & charting well does do, is to make your chart more defendable in the event you do get sued.

You can be perfect and still get sued, if the outcome is bad enough and the witness sympathetic enough. You can’t control that. You can only control how defendable your chart is going to be, when the inevitable happens.

Has it changed how you practice and document medicine?

It reinforced my commitment to conservative care and defensive charting.

That sounds like such a gut wrenching experience (trying to help someone then getting sued). Sorry you had to go through that twice.

The first one was gut wrenching but mostly infuriating since my care was so reasonable, careful and essentially unquestionable. The second one (having also met and exceeded standard of care) was mainly just irritating, having already gone through the process and knowing how much of a farce it is.

Thanks for your kind thoughts.

 

[thegenius]

Once a lawyer told me, “Give me a bad enough outcome involving a sympathetic enough patient and I’ll find liability, whether it’s there or not.”

Probably the single most depressing thing I've read on SDN.

What's equally as depressing as well is there's an ER doctor on the other side of the isle who is testifying that you did bad work.

 

[deuist]

Probably the single most depressing thing I've read on SDN.

What's equally as depressing as well is there's an ER doctor on the other side of the isle who is testifying that you did bad work.

There sure are a lot of Uncle Toms in medicine.

 

[icarus8]

Probably the single most depressing thing I've read on SDN.

What's equally as depressing as well is there's an ER doctor on the other side of the isle who is testifying that you did bad work.

Maybe there is.
Or maybe, like the very lucky podcaster from the original post, your plaintiff's "expert witness" is a Canadian hematologist who has let their board certification lapse because they've figured out that expert shill work is more lucrative, testifying about how you managed an undiffirentiated ED patient with critical illness outside his field. Because, as I learned, many states do not require that the plaintiff's expert be in the same specialty as the defendent! Or be board certified! In fact, as she learned in her trial, they can lie and say they are even though they aren't, without any repercussions.
Truly a crazy and blood-boiling situation. I have tremendous empathy for those of you who have gone through it and I'm dreading my eventual turn in the stocks