Legal - Medical Justice

Online Doctor Reviews – Do They Track Surgeon Volume, a Proxy for Quality of Care

August 15, 2024April 3, 2012 by Jeffrey Segal, MD, JD

From the Journal of Medical Internet Research

Managing Your Online Reputation

August 15, 2024March 31, 2012 by Jeffrey Segal, MD, JD

Journal of Medical Practice Management 2012, May/June By: Jeffrey Segal, MD, JD, FACS The world has changed. Patients, now euphemistically called consumers, head to the Internet before choosing their doctor. In 2012 there are over 80 doctor rating sites inviting patients to post their experiences. These posts, in aggregate, do have an effect on business. … Read more

When Doctors Sue Patients – Defamation Is Devastating, but a Lawsuit Could Make It Worse

September 4, 2024March 1, 2012 by Jeffrey Segal, MD, JD

Florida Medical Magazine By: Jeffrey Segal, MD, JD, FACS, et al. Before we dive in, some fast advice. Suing a patient for defamation is challenging. It will likely propel you and your practice into the spotlight – and not in a good way. If you are a doctor who is considering suing a patient for … Read more

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?

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

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.

Affidavits of Merit, Are They Worthless?

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

Jeff Segal, MD, JD, FACS

Affidavits of merit, are they worthless?

Probably.

Ohio provides but one example of how well intended legislation can be diluted by judges.

Ohio introduced tort reforms in 2005. Among the reforms, plaintiffs were now required to prove they had done some homework before filing. The plaintiffs had to assert that a qualified expert had reviewed the case and determined the claims had merit. That Rule was known as 10(D)(2). What’s not to like? It’s like Mom and Apple Pie. Hardly controversial.

The steps are basic. The plaintiffs must give the relevant records to one or more qualified physicians to review. The physician must determine negligence may have occurred. Then, that physician must memorialize that conclusion in writing – the Affidavit of Merit. That’s it.

One would think that if nine different specialists were named in a single lawsuit, records would reasonably be reviewed by different specialists – penning multiple Affidavits of Merit. Such a process, if honored, would surely have the effect of deterring frivolous litigation against potential peripheral defendants. It would also neutralize shotgun lawsuits – where anyone whose name is on the chart is sued.

Ohio doctors report that more than one Affidavit of Merit is rarely filed. But lots of different specialists are corralled into single lawsuits.

In a recent Ohio case, a plaintiff sued six defendants; four practiced different specialties. A single affidavit was presented, signed by an out-of-state physician who didn’t practice in even one of relevant specialties. Read that statement again.

The doctors asked the court to dismiss the case, arguing that the Affidavit of Merit requirement – the bare minimum needed to initiate a case – was not met.

Here’s what the court replied:

It Seems Everything is Bigger in Texas

August 15, 2024July 15, 2011 by Jeffrey Segal, MD, JD

Michael J. Sacopulos, Esq.

Earlier this month, the Supreme Court of Texas ruled that the medical malpractice statutes of the state cover a patient’s death from a spider bite. Classie Reed was a patient at the Omaha Health Care Center when she was bitten by a brown recluse spider. The spider bite ultimately resulted in Ms. Reed’s death. At issue is whether the claim was one that resided in medical malpractice or in ordinary negligence.

No Day In Court for a Minnesota Physician Who Was Slammed On Line

August 15, 2024June 14, 2011 by Jeffrey Segal, MD, JD

Michael J. Sacopulos, Esq.

Westlaw Journal recently reported that a judge has dismissed a lawsuit filed by a Duluth neurologist who claimed he was defamed by a patient’s son that criticized his bedside manner.

Dr. David McKee alleged in his lawsuit that Dennis Laurion of Duluth made false statements about McKee’s treatment of Laurion’s father to the American Academy of Neurology, St. Luke’s Hospital, colleagues and several internet websites that “solicit physician reviews and ratings.” Laurion alleged McKee failed to treat his father with dignity following a stroke. Further, Laurion posted that McKee treated his father as a “task and charting assignment.”

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