Hi 围观生活,
I like all your articles but disagree with your points in this one (although I laugh a lot when read it).
1. The main reason to set the highest bar for doctors is to select the highest quality person.(one error kills one person)
2. when comparing medical quality between China vs. US, it has to be apple vs. apple. Usually, we don't take advantage of the best medical service here. For example, how much you pay, how much info of doctor you get before you see him/her?
3. Obama's bill will change US competitive ability forever, just look at Canada & Europe.
In the Courts. By Bonnie Booth, AMNews correspondent. Jan. 16, 2006.
IN THE COURTS
Analyzing the impact of recent court decisions on physicians
SEE ARCHIVES
It has been 10 years and nine lawyers since neurosurgeon Lenard J. Rutkowski, MD, was sued for medical malpractice. He holds out hope that sometime in 2006, he will finally be able to put the saga behind him.
Unlike many physicians who are loathe to talk openly about the experience of being named in a lawsuit and its personal and professional ramifications, Dr. Rutkowski has plenty to say.
He is willing to relive the details of his case as often as necessary to get his colleagues to heed his warnings and take his advice. He said he sees it as his duty to use his experience, as best he can, to help his colleagues.
To that end, he and some attorneys advise:
* Keep no possessions in your name.
* Keep cash on hand if possible.
* Keep checking accounts and credit cards which are separate from your spouse.
* Invest in asset protection with a qualified and experienced attorney.
* Have no joint accounts and no co-signers.
* Get licensed in any state you might want to live and work in at some point in the future.
If you believe legal experts who say that plaintiff's attorneys rarely go after physicians' assets if a verdict is more than the physician's coverage amount, these steps might seem a bit drastic.
But Dr. Rutkowski is living proof that being one of those "rare" cases can be devastating for a physician and his or her staff, patients and family.
A long road
Dr. Rutkowski's story begins sometime in 1991 or 1992. He can no longer remember exactly when the middle-aged man who later became the plaintiff came to him seeking a third opinion on a work-related injury that was causing pain, numbness and tingling in his left arm. Two previous physicians recommended surgery on vertebrae C5-C6 and Dr. Rutkowski said it was feasible that a surgery might need to be done on C6-C7 as well. The man decided he wanted Dr. Rutkowski to perform a diskectomy.
Dr. Rutkowski said the patient's weight made it difficult to see all the vertebrae because he had to be x-rayed from front to back rather than on his side. As a result, he said, what he thought was C5-C6 and C6-C7 turned out to be C4-C5 and C5-C6.
For the next three months, Dr. Rutkowski saw the patient on a monthly basis. Following the surgery and physical therapy, Dr. Rutkowski said, the weakness in the patient's left triceps muscle was gone, but some numbness and tingling remained.
Eventually he sought treatment elsewhere, and that neurosurgeon said Dr. Rutkowski should have operated on C6-C7 and the patient was still experiencing pain because Dr. Rutkowski hadn't.
In 1995, the patient sued Dr. Rutkowski and the radiologist who interpreted the films used for surgery. Dr. Rutkowski's insurance company, ISMIE Mutual Insurance Co., appointed him a lawyer.
In early 2001, before the case was scheduled to go to trial, Dr. Rutkowski told his wife about the lawsuit. He had not told her before, he said, because he did not want to upset her. She wanted him to settle, and they asked Dr. Rutkowski's corporate attorney to write a letter to ISMIE to that effect.
Dr. Rutkowski says the letter was ignored, despite the fact that the plaintiff's attorney had indicated his client would be willing to settle for the policy limits and threatened to go after the physicians' assets if he won at trial.
An ISMIE spokesperson said the company does not comment on individual cases or individual physicians.
The case went to trial in November 2001 in Will County, Ill. Dr. Rutkowski said the plaintiff testified that he could not lift a coffee cup. The defense showed the jury a 38-minute surveillance videotape of the plaintiff lifting and moving two- and four-drawer metal cabinets.
The jury awarded the plaintiff $5.6 million, $2.6 million more than the coverage Dr. Rutkowski and the radiologist had between them. In polling the jury, Dr. Rutkowski's attorney learned that at least one juror thought the videotape was an invasion of the plaintiff's privacy.
Dr. Rutkowski appealed the verdict.
For several months, he said, he received very little information about the status of the lawsuit.
Then, in August 2002, his wife went to the bank and found out that all their corporate and personal assets had been frozen, including $100,000 worth of checks for payment of liability insurance, payroll and general bills. He was forced to turn over to the plaintiff's attorney all leases, 1040s for seven years, bank statements and deposit slips for the same time period, investment statements, housing records and accounts receivable, among other things.
A settlement following the judgment had not been reached, and the plaintiff's lawyer wanted the full amount of the verdict.
Dr Rutkowski said he was left with no choice but to file bankruptcy.
On Sept. 5, 2002, with the help of two new lawyers, he filed corporate bankruptcy, which a government lawyer was appointed to oversee. For six weeks, he was unable to pay his staff. His assets were liquidated and his wife was forced to scrounge together funds to buy his office furniture and equipment to keep the practice running. In November of that year, Dr. Rutkowski began receiving a salary determined by the bankruptcy court.
In October 2002, he filed Chapter 11 personal bankruptcy as well, and he had to hire another lawyer to handle that.
Then, in June, 2004, the Illinois Appellate Court, Third District, overturned the jury verdict, leaving both sides to contemplate whether they were willing to endure the stress and expense of another trial. The parties decided to go to mediation and eventually reached an agreement in which the plaintiff settled for policy limits and signed off any rights to appeal.
By this time, Dr. Rutkowski said, he had accumulated more than $400,000 in legal fees.
He became a "poster child" for tort reform in Illinois, and his county medical society was one of the first to hold rallies and purchase billboard space to publicize its cause.
But, in the end, Dr. Rutkowski became one of the many neurosurgeons to be driven from the state by the medical liability climate. He now practices in Mississippi.
The settlement agreement provided for money to be returned to him. His corporate bankruptcy has been rescinded, but his personal bankruptcy has not, due to some disputes arising solely from the bankruptcy proceedings. He holds out hope they will be resolved soon as well.
He believes he and his family have been made stronger by the experience -- which he calls enlightening, educational, expensive, exasperating and excruciating. But that doesn't mean he would wish it upon anybody else.
Indeed, he wants his colleagues to take his story to heart and be as prepared as possible to protect their families and their careers.
回复haha的评论:
"中医？建议您到庙里求点香灰，好了得也许更快。'----you are so funny, ok, i think we should close all medical schools and hospitals (save money) and sent all patients to temples or churches, :)
azr 发表评论于
Legal responsibility. When bad result happens, any decision with good intention for patient's convenience and financial concern may still work against him/her in court.
Thanks for offering a place for discussion.
llbyw 发表评论于
就是universal health care。现在的所有问题症结都是因为医疗利益挂帅。追求利益的及至就是贪婪，欺骗和垄断。美国的好多行业已经是这个样子比如华尔街和医疗。美国的capitalism已经在多方面
失去了capitalism的最大优点自由竞争。否则为什么要救华尔街？不是要自由竞争吗？既然破产了，为什么要政府救？比如看医生，现在有渠道知道那个医生好那个医生差吗？差医生不是照样拿高薪吗？买个包不喜欢都可以退，看了个蒙古大夫你能把钱要回来？那里有竞争？
"中医？建议您到庙里求点香灰，好了得也许更快。'----you are so funny, ok, i think we should close all medical schools and hospitals (save money) and sent all patients to temples or churches, :)
回复eeoo的评论:
Who told you US Dr needs to learn Physics. There are MD students with BS in literature, economics. They need to learn Chemistry and Bio in pre-med.
在米国培养一位医学院的学生很不容易：）），要做好一名优秀医师，仅仅有爱心不可以，只有聪明才智也不行。技术好，责任强，爱心肠，忠职业等，才称职吧？
Do not put these empty words, they need good memory in learning. If you are not smart, you do not even have a chance to pass Math test. If you are not smart, but with good memory, you can pass Medical school test. Dr. needs experience, be responsible and some fine motor skills in practice.
俺也是听说来的，供你参考：美国的医生培养经过4个阶段，分别是普通本科4年（Undergraduate education），医学院学习4年(Medical school )，住院医师培训（residency）和专科医师培训（fellowship）。 专科也的看哪儿种，最多可达到15年才可成为临床医学博士（MD）。
后来人家医生突然问“你有几个性伙伴？”你说这种问题叫人咋回答？最近一次的问题改进了“你性活跃吗？ARE YOU SEXUALLY ACTIVE?” 这个比较好回答：）
ahniu 发表评论于
There are two sides. If doctors don't make good money, we don't get enough smart student to become doctors. If doctors make good money, we don't have good doctors. Doctors charge more, because the risks are higher. Chinese medical doctors cost less, because you are on your own.
回复农民大伯的评论:
一点都没错，就是美国医生太少，这个是造成医疗体系破产的一个关键.
我觉得美国人不可能看不到，但是我不知道怎么看不到有美国人真正挑战这个问题.
Another reason is that America Medical Associate (AMA) makes long training for Dr to make them distant from working people. A lot of people know there is shortage of Dr, but they do not know that the shortage is made liberately by Drs themself to get high salary. I personally had not known the dirty of AMA until I had two Drs (one PCP, one diabete specialist) as my room-mates.
我觉得美国人不可能看不到，但是我不知道怎么看不到有美国人真正挑战这个问题.
Because American Medical Association (AMA) donated a lot od money to political compains. AMA also lobbies heavily to those elected officiers in congress to strengthen their monopoly and medicare payment.
There are a lot of debates on the high healthcare cost in US. Actually, the root problem is Drs themselves. Why, because they deliberately limit number of Drs allowed to work in this country. This way they can keep their salary high. Every Dr to practice in US need to have residency in this country even if you practice in other country in many years. What Drs union (American Medical Association) do is to limit number of residency slots available. This way they limit supply of Dr with the purpose to keep their salary high. That is a big crime. They inflated the price of healthcare. Not only they looted from the public, they are responsible for 40,000 death of uninsured and under-insured.
The thing also make me angry is that the corrupted government and congress allowed this happen for more than hundred years. Itself is a joke to allow Drs themselves to decide how many Drs in this country. Any reform without get rid of Drs’ union on the controlling the Drs’ supply, will not workyour
祖传中医688 发表评论于
回复llbyw的评论:
Like how? How "Democrats addressed the major problem right from the beginning"? LOL
I think I liked you much better when you were more gracious to your critics. Seems you like you really resent doctors - so much that you have lost your normal sense of humor and coolness. sigh.
I usually like your pieces - but this one is very much an example of 管中窥豹.
Hope you can find a doctors that make you happy. You have a large following here on WXC, so like it or not, you are now one of these people who obligated to really know what you are talking about before you offer your opinion.
llbyw 发表评论于
Democrats addressed the major problem right from the beginning. But republicans said NO NO NO ! democrats had to make compromise. The current passed bill is the result of the compromises. But it is still to the right direction.
回复祖传中医688的评论:
OB's healthcare reform addresses none of the problems you presented. The supply of MDs will continue to be low. You will still be "one illness away from bankruptcy". Everyone knows that the U.S. healthcare system should be reformed. The debate is about what kind of reform we need. The Ob's bill does not address the no. 1 problem in the U.S. healthcare system: cost of care. And for that, you can only say that the bill is piece of crap.
祖传中医688 发表评论于
OB's healthcare reform addresses none of the problems you presented. The supply of MDs will continue to be low. You will still be "one illness away from bankruptcy". Everyone knows that the U.S. healthcare system should be reformed. The debate is about what kind of reform we need. The Ob's bill does not address the no. 1 problem in the U.S. healthcare system: cost of care. And for that, you can only say that the bill is piece of crap.
. . .to an embarrassing problem: "I fart all the time, Doctor Johnson, but they're soundless, and they have no odor. In fact, since I've been here, I've farted no less than twenty times. What can I do?"
"Here's a prescription, Mrs. Barker. Take these pills three times a day for seven days and come back and see me in a week."
The next week, an upset Mrs. Barker marched into Dr. Johnson's office: "Doc, I don't know what was in those pills, but the problem is worse! I'm farting just as much, and they're still soundless, but now they smell terrible! What do you have to say for yourself?"
"Calm down, Mrs. Barker," said the doctor soothingly. "Now that we've fixed your sinuses, we'll work on your hearing!"
回复围观生活的评论:
如果是美国的医学院毕业的，不至于match 不到吧？ 医院 出的 match 数目是超过医学院毕业的数目的，所以才有这么多外国训练的医生在美国成功执业。弯区 Frement 印度医生都过50％了
eaglewings 发表评论于
围观, 开个玩笑:
A man walked into his doctor's office and sit down in the waiting room. while he is waiting his turn to be seen, a casual acquaintance walks in and sits down next to him.
The new comer asked, " W w what are yyy you ddd doing here? The man replies, "I'm waiting to see the doctor.
"W wwhy dd do yyy you wwant to ssss see hhim?
The man replies, " Well, if you must know, I have a prostate problem. A pp prostate ppp problem, wwwhat's ttthat?
"Well, if you must know. I pee like you talk."
lucky8910 发表评论于
回复围观生活的评论:
有些忧郁药是缓解一下症状，放松一下，类同安眠药，short term used不是用来治疗抑郁症的。
你说得对美国也有滥用药问题。不过滥用抗菌素的问题中国太严重了。
回复围观生活的评论:
not hard to learn from all the health programs on internet. the speakers are experts. watch as many experts as possible as everyone has his/her blind corner and you can limit bias and comprehensively understand our own body and treat her right.
riverside 发表评论于
回复围观生活的评论:
Oh, yea, I purchase antibiotics in China. I just don't want to spend the time and pay the copay to see a doctor here for common cold and not getting the medication that I needs.
I have prescribed so many antibiotics in China to treat my patients, and now I have no say when I feel I need it? It is rediculous.
回复围观生活的评论:
No, it can not be me. I don't see patient who can not pee. I just see patient who are crazy, are you crazy?
By the way, your comment about antidepressant is wrong. It takes several weeks for an antidepressant to be effective (and that is after it is increased to an effective dose).
I like your way of writing that is funny, but if you make mistakes in details of the facts, you are going to be criticized. That is actually also my own experience, haha.
围观生活 发表评论于
回复sar的评论:
生产自救了：）
老中回国，好像都带点药回来。
围观生活 发表评论于
回复nightrose的评论:
还为病人负责呢？早晚等到问题大发了再看，没有更不负责的了。
当然中国又过了。
sar 发表评论于
I mainly use american doc for tests and exams. but learning chinese medical theories to self treat. work well for me. not hard to learn and much safer and practical. feel so lucky of the chinese heritage and know the language to learn the treasure of zhonghuayangsheng that accumulated over thousands years.
