Jeffrey Segal, MD, JD

Many years ago, I treated a patient for neck and arm pain. I removed his cervical disc. The procedure was uneventful, and by all measures, he should have returned back to work quickly. (Many years later, a surgeon removed a cervical disc fragment from me and I went back to work part-time the following day).  The patient, a postal worker, did not go back to work quickly. In fact he never went back to work at all. He said he was too weak to even lift a cup of coffee to his lips. He had zero objective neurologic deficits – and I was skeptical he was disabled.

Unbeknownst to me, this postal worker bragged to a fellow employee how he was scamming the system and would soon be collecting permanent disability paychecks — all courtesy of Uncle Sam. Did this new confidante succumb to envy? Hell no. He was a bigger person than that. He called his boss and a sting operation was birthed.

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Guest post by Michael M. Rosenblatt, DPM

Leonard Bernstein smoked cigarettes until his very last day. Pianist and composer Sergei Rachmaninoff smoked at least 2 packs/day and died of cancer.  It is astonishing how many pop/acting legends and entertainers fall into and die of self-destructive behaviors. It’s not an uncommon problem.

There are a number of reasons why you need to prepare yourself ahead of time to deal with self-destructive (SD) patients:

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Dr. Philip Leggett learned of a surprise. His patient, Vector Thorn, apparently had an axe to grind. Thorn was a web designer who purchased the domain name philiplegget.com (remarkably similar to the legitimate site drlegget.com).

On the bogus web site, Thorn used the surgeon’s logo and detailed his professional experience. He then added fictional patient comments and responses. Here’s a sampling. “Not so sudden death.” “Not my problem.” “Deal with it, Junkie.” “Kicked to the curb.”

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A sad case. A 39 year old woman had extensive plastic surgical procedures — a mommy makeover. This included breast lift, tummy tuck, and other procedures. She died two days later from what the coroner labeled a pulmonary embolism.

Now the lawsuit. The family’s plaintiff attorney alleged the patient was taking oral contraceptives. She was cleared for surgery by her internist.  Both her internist and plastic surgeon were aware of the oral contraceptives.

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We continue with our series of articles penned by one attorney, an MD, JD, giving you a view of the world through a malpractice plaintiff attorney’s eyes. In this article, the author addresses “Assumption of risk versus informed consent..” This attorney is a seasoned veteran.  The series includes a number of pearls on how to stay out of harm’s way. While I do not necessarily agree with 100% of the details of every article, I think the messages are salient, on target, and fully relevant.  Please give us your feedback – and let us know if you find the series helpful.

“The patient signed a consent.  He understood the risks. Why can he sue me now??? Why can’t my lawyer just present the signed consent and get this case dismissed?”

You have probably heard it from colleagues.  You may have even asked it yourself.

The subtext is a reference to an affirmative defense (a defense the defendant must plead and prove) called “assumption of risk.”

What is assumption of risk as a legal defense?

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We continue with our series of articles penned by one attorney, an MD, JD, giving you a view of the world through a malpractice plaintiff attorney’s eyes. In this article, the author addresses “Can Doctors Form a Union”. This attorney is a seasoned veteran.  The series includes a number of pearls on how to stay out of harm’s way. While I do not necessarily agree with 100% of the details of every article, I think the messages are salient, on target, and fully relevant.  Please give us your feedback – and let us know if you find the series helpful.

Can doctors form a union? Not a civil union. But a legal entity to “collectively bargain.”

Doctors are a ferociously independent lot – the proverbial unherdable cats – but as financial and regulatory pressures mount –  this question is increasingly asked: Can we form a union to level the playing field?

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We continue with our series of articles penned by one attorney, an MD, JD, giving you a view of the world through a malpractice plaintiff attorney’s eyes. In this article, the author addresses “Dealing with a sham peer review.” This attorney is a seasoned veteran.  The series includes a number of pearls on how to stay out of harm’s way. While I do not necessarily agree with 100% of the details of every article, I think the messages are salient, on target, and fully relevant.  Please give us your feedback – and let us know if you find the series helpful.

The purpose of peer review is to improve medical care.  However, all too often this process is corrupted to carry out vendettas against disfavored physicians under the guise of improving the quality.

This is not to say all such reviews are shams.  Therefore, if you find out you are being reviewed, the first issue is whether there is any validity to the alleged claims.

If so, hire an attorney knowledgeable in the healthcare disciplinary domain. He can engage the hospital or group on your behalf to formulate a plan of corrective agreed-upon steps, a specified end-point, and objective criteria for evaluating whether you met the required standards. The plan should also specify that even if your privileges are limited as a result of the agreement, that no report will be made to the Data Bank (NPDB) during the period of correction and re-evaluation. Alternatively, if such a report must be made because of NPDB regulations, see if an agreement will allow the report to be withdrawn or amended if you successfully complete the program.

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Not a common headline: “Doctor Arrested for Perjury in Boone County.” Actually, it’s not a common headline in any county. Apparently, Dr. Melvyn Flye, a St Louis surgeon, testified in a medical malpractice case involving gallbladder surgery performed in 2010. The media noted that Dr. Flye allegedly lied under oath about his own surgical experience, how often he had been sued for malpractice, and the status of his surgical credentials at a St. Louis hospital. He was released on $50,000 bond.

Every week I receive a call from a doctor stating an expert witness lied– and he or she committed perjury.

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Many doctors worry about a single lawsuit.

In Indiana, clinicians and their carriers are responsible for the first $250,000 of a judgment or settlement. Its Patient’s Compensation Fund covers any excess liability up to $1 million.

Dr. Mark Weinberger, a sinus surgeon, was sued by over 300 patients and recently the Indiana Patient’s Compensation Fund wrote checks totaling $63 million. Dr. Weinberger’s carrier added $3 million to the pile.

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