Posted on 07/08/2004 6:18:29 AM PDT by MississippiMalcontent
Only in an emergency would FedEx do business with UPS, and some doctors have begun taking the same approach with trial lawyers: they'll treat a lawyer if it's a matter of life or limb, but an aching back may have to keep on hurting.
The matter came to a head last month at the annual meeting of the American Medical Association, where one physician proposed an official policy that would exclude trial lawyers from medical care. The resolution was soundly defeated, but the principle lives on.
"It's a symptom of the extreme frustration that physicians feel about the medical liability crisis," says Tupelo family practitioner Edward Hill, president-elect of the AMA. "The frustration is extreme, and when you experience that, it brings out behavior that you wouldn't expect from a physician."
In Mississippi, which has become the gladiator pen for doctors and malpractice lawyers, a growing number of physicians say they are avoiding trail lawyers and their families. Few doctors openly refuse to treat these people; instead, they simply use excuses, saying the practice isn't accepting new patients or the earliest appointment is months out.
"It's more subtle now than it was," says plaintiff attorney Lance Stevens, of Jackson, Miss. "There was a doctor down the street from me who had a plaque on the door, coming and going, saying they don't treat trial lawyers, their families or their employees.
"They are absolutely serious that trial lawyers, employees and family were being denied treatment," he says.
Stevens is a partner in Stevens & Ward and former president of the Mississippi Trial Lawyers Association. He's quick to note that no trial lawyer has gone without necessary emergency care, but upwards of 85% of all health care is maintenance or cosmetic. People don't die of a collapsed lumbar disk, but their life can be miserable.
Animosity has been brewing for years, Stevens says, but peaked in 2002 during an 82-day special session of the Mississippi General Assembly, called specifically to address tort reform. Dominated by attorneys, the Legislature acted after Mississippi had developed a national reputation as the place to go for damage awards that rivaled lottery jackpots.
"Unfortunately the relationship between doctors and lawyers just deteriorated to the point where it is difficult for them to speak about malpractice issues," Stevens says. "We didn't have anything to do with it; I don't understand why the doctors can still talk to the insurance companies, when they're the ones raking the docs over the coals."
Stevens contends that the problem of rising malpractice and other forms of insurance stems from poor performance of insurance company investments after the tech bubble burst, and exacerbated by 9/11.
"I just got my malpractice renewal and it's tripled," he says. "I'm not doing surgery or treating anybody in the ER. My homeowners (insurance) has gone up, so I guess they're blaming us for tornadoes. I'm waiting for them to blame lawyers for 9/11.
"We are such an easy subject to vilify so the easiest thing is to blame your problem on us," he says.
Vilification can be a two-way street.
Gov. Haley Barbour called another special session earlier this year to set maximums on non-economic damages for all civil suits. The governor and Senate leaders wanted to limit these pain-and-suffering damages to $250,000, while trial lawyers wanted to leave the figure open for juries to decide.
One bulwark for the lawyers' side was Rep. Earle Banks, D-Hinds.
The special session began May 19 and resulted in a final bill with a medical malpractice limit of $500,000, and $1 million in most other cases. The Legislature passed it June 8 and sent it to Barbour.
A day later, Kimberly Banks went to physician Michael Kanosky of Lakeland Facial and Plastic Surgery in Jackson seeking cosmetic treatment of some burn scars on her arm. When Kanosky declined to treat the woman, she called a press conference questioning Kanosky's ethics and claimed it was retribution because her father had voted against liability reform.
What went unspoken was that Kanosky was targeted because his wife, Charmin Kanosky, is director of government affairs for the Mississippi State Medical Association, making her the top lobbyist in the state on behalf of physicians.
Barbour signed the bill into law June 16.
"A lot of trial lawyers would like to make this a huge issue," says Starkville general surgeon Thomas S. Parvin, president of the state association. "But if you see a patient and have a conflict of interest, we have procedures to go through."
That includes explaining the conflict to the patient and providing referrals to other doctors in the same specialty. If it's a chronic condition, the doctor is ethically bound to continue treatment until another physician accepts the case.
At the AMA's annual House of Delegates meeting last month in Chicago, a South Carolina doctor took it a step further, introducing a resolution encouraging physicians to not treat trial lawyers or their families. The meeting considered more than 200 resolutions mostly put forward by 174 professional societies.
General surgeon Chris Hawk of Charleston could not find an organization to carry his resolution and so invoked his rights as an individual member to get a hearing. At a committee hearing, more than a dozen doctors spoke against the idea and none supported it. Hawk withdrew it just prior to the open debate, saying it had served its purpose.
"I saw the proceedings of the AMA and thought the AMA did the right thing for the wrong reason," says otolaryngologist Neal Beckford, president of the Memphis & Shelby County Medical Society. "The AMA stated that ethics could not condone the limiting of care to trial lawyers or denying access to trial lawyers because it might create more ammunition for trial lawyers to come after us.
"I think ethically they should have voted it down because, from the professional standpoint, it's the wrong thing to do," he says. "We're in this profession to help people, so it's just not the right thing to do."
Beckford believes medicine is an art and a science which doesn't break well to the saddle of business discipline. It's being forced to by the insurance industry, which constantly squeezes the margin out of reimbursement.
In that, Stevens says, doctors and lawyers have a common adversary.
"The people who are bringing this to the attention of the public are the trial lawyers," he says. "I want to get back to where docs and lawyers are professionals and can talk to each other."
Bravo to the doctors!
A doctor has the constitutional right to work where and when he/she wants. If it just so happens the doctor wants to take time off when the scumbag lawyer walks in - well - it's just a coincidence.
What ethics issue? Physicians are not required to treat anyone except in an emergency. Ditto for anyone else in a private business.
Let the trial lawyers pay more to go to doctors who will treat them. Seems to me the perfect marketplace solution ...
Excellent. Let the trial lawyers treat each other.
The ethics are that the lawyers are driving up the cost of medicine such that the little guy cant afford to get treated, or ANYONE for that matter....
Vote Kerry-Edwards . a vote for Kerry -Edwards is a vote for higher malpractice rates.
If treating one trial lawyer can put you and your family out on the street, wouldn't you have second and third thoughts about treating for anything other than serious injury?
All that aside, the lawyers claiming insurance companies are to blame is ridiculous. One of the biggest causes for medical costs skyrocketing is trial lawyers.
I'm still perplexed about how John and Elizabeth Edwards found an OB-GYN physician to follow Elizabeth through two very high risk pregnancies she carried when she was 49-51 years old.
The ethics are that the trial lawyers are denying us medical services. They lack skills and are clearly the ones at fault.
Awwww, those poor lawyers.
"I'm in favor of tort reform, but am curious as to the ethics of refusing treatment to a patient."
As a physician, I do not have to accept a person as a patient. However, if a physician/patient relationship is formed, I must provide care up to the standard of practice.
In the emergency room, all comers must recieve an evaluation and be stabilized. After that they can be released from care including having a large man with a gun show them the door if they won't leave voluntarily.
Good job!
"I'm in favor of tort reform, but am curious as to the ethics of refusing treatment to a patient."
If it was "life or death" I would be concerned as you are. The fact that its not makes it okay with me.
Especially when you consider the lack of "ethics" thats made the Trial Lawyers infamous, made health care costs 400 times higher than they need to be, and is causing a huge sea change in how many qualified doctors our nation realizes each year.
If the Trial Lawyers are not stopped, the future as it relates to healthcare is frighteningly bleak.
If nothing else, this will get the media's attention.
I appreciate the explanation. Truly, I did not know if and how physicians were bound or obligated to provide treatment.
They need to expand the "do not treat list" to liberal politicians who don't support tort reform.
Why wouldn't a lawyer go to a veterinarian in the first place?
That's where I take MY sons-of-b*tches.
Scumbag lawyer, heal thyself!
Good for them!
Kerry - Edwards.
" We both got our millions by screwing someone...."
"...made health care costs 400 times higher than they need to be, and is causing a huge sea change in how many qualified doctors our nation realizes each year."
Do tell, I'm concerned about the squeezing iron triangle of declining insurance/HMO/Medicare reimbursements, exploding insurance/HMO/Medicare paperwork and mickey mouse administrative requirements and ever-higher malpractice premiums (exponentially higher for certain high-risk specialties, most notably obstetrics and neurosurgery, think about that the next time you conk your head).
I would sure like to know where you get that "400 times higher" quote Badeye, what I DO know is that I've been hearing for years of the decline in people entering the medical professions. Let's be serious here: What enterprising youngster would want to go the medical route nowadays, put themselves a hundred thousand or so in the hole in student loans as they study and work their grueling residencies for ten to fifteen years or so, all too often wrecking their own health in the process, just so they can enter a profession where it is becoming all but impossible (again, depending on specialty and locale) to make a decent living let alone practice it according to the ancient ideals. Sorry dudes, self-sacrificing altruists have always been in short supply. Television shows like "ER" portraying the work as hellish and thankless have not helped much either.
My Mother in law is a Mass. yankey. She told me three months ago she has "proudly" voted for Kerry in every election he has come up. She is also a registered nurse, and last night she told me due to the fact that he chose a trail lawyer as a running mate, she was voting for Bush.
Grr. In this city there is a civil war between groups of physicians. Physicians will not refer to nor see patients of the other group. Makes it hard when you need a good specialist and there may be only one and he is on the "other side." The common practice here is to make you sit in a cold waiting room for two hours if they don't like the last doctor you saw (hoping you will leave.) I have absolutely had it with the childish antics of these bozos. Whatever happened to going into medicine to help people?
Never sell a house to a lawyer or anyone that works in a law office or is related to a lawyer.
Why did you go into medicine, if I may be so bold to ask?
You are so right.
"I would sure like to know where you get that "400 times higher" quote Badeye,"
While it is an exaggeration, ask any Doctor in Mississippi about the costs of malpractice insurance. Or any other state, for that matter.
I find it telling you seem to think "giving birth" is a High Risk "specialty".
I'm an employer, and I have to offer my employees a brutal choice. Health Insurance, and 30% pay cut to off set it, or a very high rate of pay (comparative to where I'm located in Southern Ohio).
While you can make a valid argument concerning the "red tape" the fact is small business owners like myself can't give basic health care coverage due to the unbelievably high premiums. And its getting worse by the year, some increases have come quarterly as you might be aware.
When you have Trial Lawyers "channeling dead babies" as John Edwards once did (See Ann Coulter's latest column) for record jury awards.....you realize that lawyers are killing off the medical profession, one state at a time.
I agree that the refusal of treatment raises ethical questions - HOWEVER, these are the same slugs who are driving doctors out of their practices. In too many states, medical practioners who have previously accepted high risk patients have had to either limit their practice or close their office and move to states where the medical practice laws are not so draconian in favor of the trial lawyers.
For the doctors, in other words, it has become an issue of survival. From their perspective, what value would their be in healing and releasing the enemy, only for the enemy to return and slaughter those who healed them? That begins to fit into the definition of insanity.
I also see this issue as Mississippi pulling thre "welcome" mat out from under the John-John ticket. Trial lawyers (Edwards), not wanted.
"We're in this profession to help people, so it's just not the right thing to do."
You may think you are in the profession for that purpose, but you are in practice to make money. You have to make money at the practice in order to continue the profession. Does this doctor accept patients who have no insurance 100% of the time knowing he likely won't get paid because its also the right thing to do? Of course not, he puts business decisions ahead of ethics. Why should those same considerations not be applied to any patients who are deemed a substantial risk of suing for malpractice?
Sounds like some sort of civil war is brewing in ol' Miss.
Why oh why could that be, Stevens ?
Do you accept every case that walks into your office?
No?
Then why should the doctors have to accept YOUR sorry a$$ just because you walk into theirs?
"We're in this profession to help people, so it's just not the right thing to do."
Well, that's refreshing. From the sniping and pettiness I have seen in the medical "profession" around here, you'd think they thought of the patient as just a well-insured cash cow. Non-emergencies if left untreated can become emergencies.
I think I will go take two aspirin now....
Blackmail comes to mind.
SO9
"From their perspective, what value would their be in healing and releasing the enemy, only for the enemy to return and slaughter those who healed them?"
omg
Maybe the better tactic would be to offer to treat them -- provided there was a defense attorney present for every consulatation, everything was videotaped, and every diagnostic test known to man was used. All at the patient's/trial lawyer's expense, naturally.
Sometimes I proof. Really.
Don't lawyers often turn down potential clients?
Another--locally--responded by slyly and slightly changing the subject. Watch for the slimes and their misdirection.
See Ann Coulters latest, too. Edwards is slime.
"Don't lawyers often turn down potential clients?"
For a lawsuit, not a lumpectomy.
I understand your predicament, I would refer you to a very educational thread I posted on...
http://www.freerepublic.com/focus/f-news/1158835/posts
One of the best lines was:
"End the employer-provided health care system - Simultaneously eliminating corporate taxes and the welfare that goes along with it (the two are roughly the same amount) while expanding President George W. Bush's Medical Savings Accounts (MSAs) to all Americans would (1) eliminate the tax incentive to "pay people in benefits" (2) allow Americans to save for their own high-deductible health insurance. This would lead to a truly consumer-driven market."
If that was implemented it would really take the chains off the economy, especially for small business (incidentally removing most of the logic behind ageism, health record snooping and making it easier for the chronically ill to find work), it would require showing some cojones on the part of certain republican pols, however, as democrats don't like to give up any control over us commonfolk (and make no mistake, that is what gummint-controlled medicine is all about).
Concerning Edwards, I know from reading elsewhere that his folksy, populist manner does indeed come from his courtroom schtick. Southern ambulance chasers have it down to a science; through venue shopping and jury selection they see to it that they have a jury of Jerry Springeresque trailer trash (I'm gonna get my butt flamed, but oh well) they then work the class envy song-and-dance for all it's worth, portraying themselves as the friend of the little guy, of course. So there you have Edwards appeal. He's a one-trick pony, but for all I know that might be enough.
Like committing abortions? The AMA and ethics? Puhlease.
Lawyer haters ought to go to an adoption and see the absolute joy involved. There are some bad lawyers, school teachers, clergy and doctors. Lumping them all is silly. I am used to walking into ERs and putting self employed on the paperwork when one of my kids gets hurt. I have been doing it for years. I also make sure the people doing work for us do not know what anyone does for a living because they tend to overcharge and screw over lawyers . Am I offended when lawyer jokes are told at gatherings? Not at all. The kids heard the nasty stuff also but were aware of the great reputation their father has and the long hours he put in as a lawyer and an Army Reserve Officer. He put in two tours in Vietnam and they know it. He does not have to put up with anyone insulting him or what he does for a living. He just knows that he often saves the arse of a lawyer hater. Eagles up!
Sooner or later doctor shortages will pop up in places other than just Mississippi where the situation is the worst.
...that's why -- I believe-- author John Grisham does so well. He continally shines light on the cockroaches in the legal industry and was Mississippi reared and trained.
Next chapter in this story is that some scumbag lawyer will go to a doc for elective treatment. He will get the "not accepting new patients" excuse. Then he will find evidence of 5 other new patients that were accepted that week (Hell, he'll probably pay them to become new patients). Then he'll sue the doc for giving him an invalid excuse and get him on the stand and ask him how come he was not accepting new patients and then he was.
"Southern ambulance chasers have it down to a science; through venue shopping and jury selection they see to it that they have a jury of Jerry Springeresque trailer trash (I'm gonna get my butt flamed, but oh well) they then work the class envy song-and-dance for all it's worth, portraying themselves as the friend of the little guy, of course. So there you have Edwards appeal. He's a one-trick pony, but for all I know that might be enough. "
I agree with your comments regarding MSA's, having looked at it a while back, and found it a possible solution.
As for the trailer trash comment.....yep. Bottom line is every jury these days is made up exclusively from those not smart enough to get out of Jury Duty.....(grin)
Scary thought, that one.
I caught that caller to Rush yesterday, and he got his butt kicked in my opinion.
"Never sell a house to a lawyer or anyone that works in a law office or is related to a lawyer."
You can't refuse to sell a house to certain types of people. If you advertise it publicly you can't pick and choose.
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