Be careful when writing a letter of recommendation

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.

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

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.

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Are we headed toward “shot clock” medicine?

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?

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Survey says

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:

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Your collection agency might hurt your medical malpractice defense

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.

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“Unique” New Medical Malpractice Claims

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

We Told You So….

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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Tort Reform for Medical Malpractice System, Another Study Needed?

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

Medical malpractice reform is in the news again. Of course, for the medical profession, the medical malpractice system is the wound that simply will not heal. For the plaintiffs bar, in contrast, the medical liability system is the gift that keeps on giving. I have argued that the current system fails on four important fronts.

  • Efficiency
  • Cost
  • Fairness
  • Quality Improvement

I admit readily that my profession has not been as diligent as it should be in holding ourselves accountable. We have not been forthright in admitting our medical errors, although can you blame us under the current medical liability construct? There is merit to the argument that tort reform is

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