Jeffrey Segal, MD, JD - Medical Justice

Medical malpractice reform losing physician support

August 15, 2024November 9, 2011 by Jeffrey Segal, MD, JD

Michael Kirsch, M.D. – author, MD Whistleblower

With regard to physicians’ support for medical malpractice reform, the times they are a changin’. These iconic words of Bob Dylan, who has now reached the 8th decade of life, apply to the medical liability crisis that traditionally has been a unifying issue for physicians.

The New York Times reported that physicians in Maine are going soft on this issue, but I suspect this conversion is not limited to the Pine Tree State. Heretofore, it was assumed that physicians as a group loathed the medical malpractice system and demanded tort reform. The system, we argued, was unfair, arbitrary, and expensive. It missed most cases of true medical negligence. It lit the fuse that exploded the practice of defensive medicine. Rising premiums drove good doctors out of town or out of practice.

What happened? The medical malpractice system is as unfair as ever. Tort reform proposals are still regarded as experimental by the reigning Democrats in congress and in the White House. The reason that this issue has slipped in priority for physicians is because our jobs have changed.

Be careful when writing a letter of recommendation

August 15, 2024November 3, 2011 by Jeffrey Segal, MD, JD

Michael J. Sacopulos, Esq.

A Louisiana physician was fired for diverting Demerol from his patients and reporting to work under the influence. Upon the dismissal, a colleague wrote a letter of recommendation for the physician. The discharged physician took his glowing recommendation and found a new job thousands of miles away in Washington State.

About a year into working at this new job, the physician was caught “under the influence.” Further, he was caught after he failed to properly administer anesthesia and his patient fell into a permanent vegetative state, according to court records. The patient’s family filed a malpractice lawsuit against the physician and the medical center where the surgery took place. The case was settled with the physician paying $1 million and the medical center paying $7.5 million.

But the story does not end there.

Now starring in the role of witness, the world famous actor.…

August 15, 2024October 28, 2011 by Jeffrey Segal, MD, JD

Jeff Segal, MD, JD, FACS

If you’ve ever faced a malpractice suit, you know the potential pitfalls associated with an expert witness. Juries rely on expert testimony to explain complex medical issues, elucidate the standard of care and judge whether that standard was followed. Unfortunately, instead of an impartial expert, plaintiff attorneys often employ a “hired gun” – a professional expert witness with suspect motives, willing to testify to a specific point of view.

Now, in addition to problematic experts, doctors with malpractice suits in Florida could face another questionable tactic – professional actors reading statements for witnesses who cannot attend the trial. Reuters reports on Actors at Law; a company that supplies professional actors to read statements for absentee witnesses in court.

Are we headed toward “shot clock” medicine?

August 15, 2024October 20, 2011 by Jeffrey Segal, MD, JD

Jeff Segal, MD, JD, FACS

One of the most common complaints patients have is about waiting times.

Doctor Smith was fantastic, he saved my life, but I had to wait 45 minutes for my appointment.

The WSJ reported that some health systems with multiple ER’s are implementing unique actions to address this common complaint – posting waiting times so that patients can choose the facility with the shortest queue. In fact, Akron General Health System in Ohio began streaming waiting times for 2 of its ER departments on highway billboards. The idea is that patients with minor needs can choose the facility with the shortest wait times; reducing “left-without-being-seen” rates and improving patient satisfaction.

But does this innovation come with a down side?

Survey says

August 15, 2024October 7, 2011 by Jeffrey Segal, MD, JD

Michael J. Sacopulos, Esq.

Earlier this year, the Pew Internet and American Life Project released “The Social Life of Health Information, 2011.” The study was based upon telephone surveys conducted by Princeton Survey Research Associates International. Although the full report is approximately forty five pages in length, here are some interesting highlights:

Your collection agency might hurt your medical malpractice defense

August 15, 2024September 27, 2011 by Jeffrey Segal, MD, JD

Michael J. Sacopulos, Esq.

Several months ago the South Carolina Appellate Court issued a scary opinion (Burke V. AnMed Health). A standard medical malpractice case had come before a trial court in South Carolina. Prior to trial, the defense attorney asked that prospective jurors who owed bad debts and judgments to the healthcare provider be excluded from the jury. The trial court Judge did exclude several potential jurors who had judgments against them by the healthcare provider, but the Judge refused to excuse several jurors who owed debts to the medical provider. One $250,000 judgment later, the defendant appealed the matter to the South Carolina Court of Appeals.

“Unique” New Medical Malpractice Claims

August 15, 2024September 22, 2011 by Jeffrey Segal, MD, JD

Michael J. Sacopulos, Esq. As the general counsel for Medical Justice, I see a number of bizarre and unfair medical malpractice claims. However, recently I have read several claims that were so odd as to attract my attention. The first involves a surgical patient at Baylor Health Hospital in Dallas. A Nebraska man had traveled … Read more

Pay-Per-Call Marketing; Twenty First Century Marketing Programs Impeded by Twentieth Century Rules

August 15, 2024September 21, 2011 by Jeffrey Segal, MD, JD

OFPSA 2011, Fall By: Jeffrey Segal, MD, JD, FACS, et al. and Michael Sacopulos, JD Download 2011_08_OFPSA_Magazine_SegalSacopulos.pdf

Mistakes in Studies Surge – Lawsuits Sure to Follow

August 15, 2024September 21, 2011 by Jeffrey Segal, MD, JD

Jeff Segal, MD, JD, FACS

The Wall Street Journal recently reported on the growing number of scientific papers that are being retracted due to mistakes. In the article Mistakes in Scientific Studies Surge, the Journal reports that since 2001, while the number of papers published in research journals grew 44%, the number of articles retracted grew by more than 15-fold.

We Told You So….

August 15, 2024September 8, 2011 by Jeffrey Segal, MD, JD

Jeff Segal, MD, JD, FACS

We have written recently about social networking group discount programs – like Groupon. We cautioned that such programs might be deemed fee-splitting; a practice prohibited by federal law, state law, and licensing bodies. We now have some additional data points to share.

Not everyone knows what Groupon is. Here’s how it works. A local merchant, like a restaurant or hair salon, offers a discount – often 50% off or more. This gets a lot of attention. But, the discount isn’t activated until a critical mass of Groupon subscribers ‘tip” the deal. Enough people must commit to “paying” for the discount. That’s how Groupon gets paid.

I’ll illustrate a Groupon offered by a restaurant. The deal is 50% off a meal valued at $100. The deal is sent to thousands of people in the restaurant’s draw area. The deal requires 20 takers to “tip the deal.” Once 20 people commit, those patrons are charged $50 on their credit cards. Groupon will then give the patron a $100 “gift certificate.” Groupon then pays the restaurant a sum – which might be $25; maybe more; maybe less.

So, Groupon gets paid a handsome sum. The patron gets a great discount. And the merchant delivers products or services at a discount. The restaurant “pays” twice: a discount to the patron; and a fee, deducted by Groupon, for the marketing. The marketing fee correlates with the volume of business the restaurant receives.

In healthcare, this can be perceived as fee-splitting.

The federal government prohibits fee splitting for specific transactions unless there is a safe harbor. There is no safe harbor for social networking group discount programs.

State governments often have anti-kickback statutes, and to date, we know of no state that has carved out safe harbors for social networking group discount programs.

Finally, licensing boards have long standing policies against fee-splitting. And two such boards have recently spoken.

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