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Justice Clarence Thomas, Seething Black Conservative Hero Tells Us How Bad It Has Been

Category: Seeing Clearly Now

There have been more than a few voices expressing, in various ways, discomfort, surprise or puzzlement over the tone and substance of the Clarence Thomas media blitz publicizing the Justice's newly published book. A good example:

Is Clarence Thomas Playing the Race Card Again?

When I watched the Clarence Thomas confirmation hearings many moons ago, I was more than a bit surprised to hear him fight back with a claim that the Anita Hill allegations of the hearings were, in his words, a "high-tech lynching for uppity blacks."

Judge Thomas once again walks down the road of blaming racism for the sexual harassment investigation.

Eric Turkewitz, New York Personal Injury Law Blog

My reaction to the Justice Thomas "Still Mad As Hell" book tour is that he has had ample time to put the past behind him and focus on performing the 40 year job he has been given by the American people, both black and white, liberal and conservative. Yet, he wants to relive every offense against his inner goodness so we can appreciate his triumph over evil.

None of us should be pleased to learn a Supreme Court justice continues to seethe over issues magnified by his need to brood about his perceived black victimhood and to polish his self image as the heroic, unbowed TRUE BLACK CONSERVATIVE. As I have stated before, Justice Thomas is the most persuasive argument for a reasonable term limit for all Supreme Court justices. Twenty years of warped judicial insight should be more than enough for our country to endure.

The Elaborate Ritual Improving Medical Care

Category: Seeing Clearly Now

Over at Bad Science Ben Goldacre discusses the placebo effect.

Now as I have said so many times before, the placebo effect is not about a sugar pill, it's about the cultural meaning of a treatment, and our expectations: we know from research that two sugar pills are more effective than one, that a salt water injection is better for pain than a sugar pill, that colour and packaging have a beneficial effect, and so on. Interestingly, there has even been a trial on patients with arm pain specifically comparing a placebo pill against a placebo ritual involving a sham medical device, modeled on acupuncture, which found that the elaborate ritual was more effective than the simple sugar pill. "Placebo" is not a unitary phenomenon, there is not "one type of placebo".

Ben provides some of the results of a recent study of the benefits of acupuncture for patients with chronic back pain. From his point of view the study has more to say regarding the placebo effect than acupuncture per se.

Firstly, 27% of the medical treatment group improved: this is an impressive testament to the well known healing power of simply "being in a trial", since medical treatment hadn't helped these patients for the preceding 8 years. Meanwhile 47% of the acupuncture group improved, but the sting is this: 44% of the fake acupuncture group improved too. There was no statistically significant difference between proper, genuine ancient wisdom acupuncture, and fake, "bung a needle in, anywhere you fancy, with a bit of theatrical ceremony" acupuncture.

Ben got me to thinking. If an elaborate ritual can work for patients might it also work to improve the conduct of doctors? If we could devise an elaborate ritual with a significant cultural meaning could we use it to upgrade the quality of medical care dispensed by the medical profession?

Then, it struck me - we already have such a ritual. It is called the medical malpractice claim.

Is The Tooth Fairy Causing Increased Hospital Infections?

Category: Seeing Clearly Now

Are hospital infections actually rising by over 7 percent each year? Or, is the apparent increase just a mirage resulting from hospitals doing a better job?

Upward Trend In Frequency And Cost Of Infections In US Hospitals

A new review of inpatient data from US hospitals shows that the number of infections caused by a common bacterium increased by over 7 percent each year from 1998 to 2003. The attendant economic burden to hospitals increased by nearly 12 percent annually. The research is published in the November 1 issue of Clinical Infectious Diseases, now available online.

Staphylococcus aureus (also known as staph) is a significant cause of a wide range of infectious diseases in humans, ranging from minor skin infections to life-threatening diseases such as pneumonia and meningitis. In 1998, US hospitals reported a little more than a quarter-million staph infections and slightly over 7 percent of those patients died. By the final year of this study, 2003, hospitals reported nearly 390,000 infections, representing 1 percent of that year's inpatient stays.

The authors suggest one possible reason for the increase in infections is the documented increase of a particularly dangerous type of antibiotic-resistant staph infection known as MRSA (methicillin-resistant Staphylococcus aureus). A more benign possibility is that doctors and hospitals have improved their infection detection and reporting practices.

The third possibility is that the tooth fairy is not washing her hands as she makes her rounds through the wards.

Post-Claims Underwriting Makes Insurance Coverage Disappear

Category: Seeing Clearly Now

By the time you are 50 years old your medical history is beginning to look like a lengthy novel. But, unlike a novel, it is not neatly written in a single bound volume. It is scattered throughout the country in the records of various health care providers, hospitals, health insurance companies and laboratories. It is also poorly recorded, with major league errors and omissions, in your cluttered memory.

All of this is well known to the insurance industry. It is the underlying corporate rationale for the industry's post-claims underwriting. Your filing of a significant health insurance claim is the trigger for the medical sleuths in your insurance carrier's underwriting department to roll up their sleeves and find something, almost anything, you failed to include in your insurance application. Then, comes the announcement: If we had known this fact we would not have provided this coverage to you. Sorry. Your refund check is enclosed.

It is this despicable business practice that is the subject of an article at Law.com.

Plaintiffs Await Ruling on Canceled Health Insurance Policies

William Shernoff says he has been bringing lawsuits over canceled health insurance policies since the 1980s. Lately, however, that part of the Southern California plaintiff lawyer's practice has exploded: Last year, Shernoff filed about 70 lawsuits for people who have gotten stuck with hefty medical bills when an insurance company revoked their coverage by claiming they falsified or omitted important details on their applications. He's on pace to file about the same number this year.

So far, Shernoff says, litigation over the insurance companies' practice -- often referred to as post-claims underwriting -- hasn't led to any significant case law. He said most cases end with dismissals or confidential settlements, adding that the settlements can be substantial, a point disputed by lawyers for insurers.

But next week, the Santa Ana, Calif.-based 4th District Court of Appeal will hear arguments in a closely watched case that challenges Blue Shield of California's practice of rescinding coverage based on inaccuracies in an application. If the challenge in Hailey v. California Physicians' Service, G035579, succeeds, plaintiff and defense lawyers say more cases may wind up in trial -- or lead to more lucrative settlements.

Blue Shield argues...it can rescind coverage when someone's made a misrepresentation material to the company's decision to offer them a health plan.

Plaintiff attorneys in the field contend...that a showing of willful misrepresentation is required before yanking coverage...

From Law.com

The difference between a misrepresentation and a willful misrepresentation is one that matters a lot to the insurance industry. It knows finding the former is a relatively simple and frequent occurrence. But, finding the latter...that is far from easy.

Greedy Trial Lawyer Fixer - Using Blame For Good

Category: Seeing Clearly Now

As a greedy trial lawyer who has sought just compensation for those who have suffered because of bad medical practice, I don't have a lot of time to involve myself in other social causes. It takes major-league time and effort to get medical providers to do the right thing. Only an occasional doctor has announced during his depostion, "I blew it." The rest have waged all-out war to defend really stupid actions. I have been forced to go into surge mode in just about every claim.

Despite my decades of operating in a hostile environment, I believe making the healthcare system acknowledge its mistakes and compensate the victims of incompetence has been a worthwhile personal crusade.

After reading an article by Trisha Torrey I now recognize how much I have helped my clients and the medical profession by being a Fixer.

Blamers and Fixers: Which One Are You?

I've put the people who write to me about medical errors they have suffered into two categories: The Blamers and the Fixers

The Blamers are those who [are] livid-angry, and they ask me to do things that will help distribute their anger further. They want me to help them write letters to doctors or hospitals or others who have wronged them. They want me to help yank a doctor's license to practice, or help them sue a provider, or participate in whatever form of punishment they believe is appropriate.

Their anger is just so palpable. And I get it! I was there! After my misdiagnosis, I talked to anyone who wanted to listen in hopes it would somehow diffuse my anger.

The Fixers are a step beyond. Fixers are people who have been hurt by the system, and have turned that bad experience into something else more positive.

Among my advocate-colleagues, you'd be amazed at how many of us are fixers. Very few have just chosen to take up the cause of patient advocacy out of the blue. Instead, their children have been killed by bad surgeries, or they've lost a spouse or parent to a medical error, or a diagnosis has been missed (or misdiagnosed all together) and someone they love -- or they themselves -- have been treated incorrectly.

The Fixing itself becomes the catharsis for the anger, and it is extremely powerful.

From Every Patient's Advocate

I know there will be some who want to tag me as a Blamer, but sometimes you've got to throw some blame around to fix things.

Is Your "Financial Adviser" Over-Titled?

Category: Seeing Clearly Now

The free lunch you ate at the recent noon financial planning seminar may give you or your family severe indigestion.

Investment Pitches Prey On Elderly

Government officials worry that unscrupulous financial advisers are preying on retirees by calling themselves senior experts, using fancy titles to lure the elderly to marketing seminars and then locking up their savings in investments that carry high commissions and withdrawal fees.

Federal regulators and authorities in seven states are set to release the results of an investigation of firms that run "free lunch" investment seminars, which draw large numbers of retirees. The results, said Securities and Exchange Commission Chairman Christopher Cox, are "deeply disturbing" and have produced multiple law enforcement referrals.

SEC leaders and their state counterparts will host a day-long summit Monday to discuss a nationwide approach to combating bogus yet official-sounding titles that salesmen use to curry favor with older investors.

From the washingtonpost.com

Tomorrow I am going to cancel my upcoming meeting with my Financial Analyst, Financial Adviser, Financial Consultant, Financial Planner, Investment Consultant, Mutual Funds Expert, Insurance Guru and Wealth Manager. My time may be better spent with a dart board.

ER Doctors May Have Less Experience Than You Think

Category: Seeing Clearly Now

Why you may want to ask your ER doctor this question: So, doc, have you sutured any wounds lately?

Are emergency department junior doctors becoming less experienced in performing common practical procedures?

A questionnaire was designed to assess junior doctors' experience of performing common practical procedures. Six procedures commonly performed in the emergency department were selected following discussion with the emergency department consultants as follows:

*Colles fracture manipulation

*Dislocated shoulder manipulation

*Suturing wounds

*Exploring wounds

*Abscess drainage

*Chest drain insertion

A perceived reduction in experience was noted for all listed procedures between the junior doctors in 2005 and those in 2006. The decrease in experience of performing shoulder manipulation, suturing and exploring wounds was statistically significant.

Emergency Medicine Journal 2007;24:657-658

Crocs Eat Flip-Flops For Lunch

Category: Seeing Clearly Now

In the midst of our national debates over Iraq and Health Care there has been the ongoing footwear controversy: Are Crocs better than flip-flops? The latest salvo:

Flip-flops causing slips and trips -- and serious injuries

This summer has been the season of the flip-flop, particularly among women ages 25 to 35, said Harold B. Glickman, DPM, past president of the American Podiatric Medical Assn.

The ubiquitous footwear, once only seen at the beach or pool, has become acceptable workplace attire, Dr. Glickman lamented.

"They really give no support to the foot and ankle. They are dangerous in the sense that if caught in an intersection with the light changing and having to run, you can fall, slip and really injure yourself," he said. "And not just your foot and ankle, but the rest of your body, too."

Stubbed and broken toes and ripped-off toenails have been seen too often this summer. "A lot more discretion should be used in wearing them," Dr. Glickman said.

As for that other shoe of summer, Crocs, there is good news. Despite news stories about the soft, often vividly hued, plastic shoes getting caught in escalators, they are generally regarded as safe and certainly better than flip-flops. "I don't know that I would wear them 24/7," Dr. Glickman said, "but I do wear them around the house and for garden work."

They provide good traction and may even be a good substitute for sneakers because they aren't as confining, Dr. Glickman said.

Shades of the boxer-brief debate!

"Unlawful" Is As "Unlawful" Does - The Bush Doctrine

Category: Seeing Clearly Now

Do you see a difference between aliens and illegal aliens? We now have evidence that the Bush Administration may not.

AP: WH Urges Judges to "Look Beyond the Letter of the Law"

The AP reports "The Bush administration argued Friday that discrepancies between the nation's new terror law and the way it is being carried out should not stall one of the Pentagon's first terrorism trials."

Arguing before the newly formed U.S. Court of Military Commission Review, government attorneys urged judges to look beyond the letter of the law when deciding whether the military undermined its terrorism tribunals at Guantanamo Bay.

The case hinges on a single word: unlawful. Before terror suspects can be prosecuted before military commissions, the law requires they be deemed "unlawful enemy combatants." But Guantanamo Bay tribunals have simply been calling them "enemy combatants."

Lawyers for Omar Khadr argue that's a fatal flaw in the government's case and that Khadr can't go before a military commission. If the three-judge appeals court agrees, it could force the Pentagon to redo tribunals for dozens of detainees.

Frankly, I am surprised the government didn't just designate the suspects as evildoers and be done with it.

The Health Benefits Of A Short Ambulance Ride

Category: Seeing Clearly Now

After you read the results of this important study published in a respected medical journal I have an observation to make.

The relationship between distance to hospital and patient mortality in emergencies: an observational study

We aimed to determine whether distance to hospital was associated with mortality in patients with life-threatening emergencies.

Conclusion: Increased journey distance to hospital appears to be associated with increased risk of mortality.

Emergency Medicine Journal 2007;24:665-668

My observation: I suspect the time of the journey may actually have been the culprit and not the distance. Of course, it could have been the speed of the ambulance or its size. But, that would require another study.

Bullet's Path Should End This Matter

Category: Seeing Clearly Now

This news story falls in the No Harm No Foul category. I believe all charges and accusations against both men involved should be forgotten and they should have a beer together to celebrate the good luck that allowed both to live another day.

Trooper under scrutiny for alcohol levels during shooting

CHARLES CITY (AP) -- The state trooper who shot a man for allegedly trying to run him over is being investigated after tests showed he had alcohol in his system during the incident last winter.

Trooper Mark Domino was the key witness in the trial Tuesday against William Filippo Jr. of Cedar Falls, who is accused of driving his vehicle at Domino during a chase Feb. 16 south of Charles City.

Filippo was initially charged with attempted murder after his arrest. Prosecutors changed the charge to assault with a dangerous weapon, eluding and drunk driving, in exchange for Filippo dropping the request for a jury trial. His blood-alcohol level was 0.2 percent, more than double the legal limit.

Officials said the chase began when Domino tried to stop Filippo and question him about a hit-and-run earlier in the day.

During the chase, both vehicles ended up in a snow-filled median along U.S. Highway 218. That's when Domino got out of his squad car and Filippo drove at him, officials said.

Domino fired his gun, one bullet hitting Filippo behind his left ear, and exiting near his right eye. He was hospitalized for about a week.

Doesn't this bullet trajectory tell us these could be two of the luckiest humans on earth? Shake hands, fellas, and go hug your wives and children.

Bacteria Have To Be Laughing At Us

Category: Seeing Clearly Now

I need to mount my soap box for this post.

It may be hard to believe, but Corporate America has been manufacturing and selling a product that serves no useful purpose and is, itself, harmful.

Antibacterial Soap May Render Antibiotics Less Effective And Is No More Effective Than Plain Soap

Antibacterial soaps show no health benefits over plain soaps and, in fact, may render some common antibiotics less effective, says a University of Michigan public health professor.

In the first known comprehensive analysis of whether antibacterial soaps work better than plain soaps, Allison Aiello of the U-M School of Public Health and her team found that washing hands with an antibacterial soap was no more effective in preventing infectious illness than plain soap. Moreover, antibacterial soaps at formulations sold to the public do not remove any more bacteria from the hands during washing than plain soaps.

Because of the way the main active ingredient---triclosan---in many antibacterial soaps reacts in the cells, it may cause some bacteria to become resistant to commonly used drugs such as amoxicillin, the researchers say. These changes have not been detected at the population level, but e-coli bacteria bugs adapted in lab experiments showed resistance when exposed to as much as 0.1 percent wt/vol triclosan soap.

Physician Mindsets Create Greedy Trial Lawyer Mindsets

Category: Seeing Clearly Now

Richard L. Reece, MD, posting at MEDINNOVATIONBLOG, has identified what he calls five Physician Mindsets.

Five Physician Mindsets and Trends

Mindsets work like fixed stars in our heads. Holding on to them, our mind drifting like a ship in an ocean of information, finds orientation. They keep it on course and guide it safely to its destination.

Physician Mindset Number One - Physicians on the ground prefer incremental changes through expanding coverage through tax incentives and market-driven changes rather than through a single-payer system.

Physician Mindset Number Two - Physicians are adapting to downward pressure on their incomes and harassing rules and regulations by becoming hospital employees.

Physician Mindset Number Three - Physicians regard consumer-driven care with skepticism and tend to be reactive rather than proactive in adapting to change.

[For Mindsets Four and Five you will have to read Dr. Reece's original article.]

One Physician Mindset observed by me (and probably every other trial lawyer who has ever deposed a defendant physician in a medical malpractice case) is: Physicians do not believe anything they do is ever a breach of the accepted standard of care. They believe whatever they do or fail to do is just part of this thing called the practice of medicine.

This leads to a Greedy Trial Lawyer Mindset: Greedy trial lawyers believe many defendant docs are arrogant bastards who are incapable of admitting a mistake.

Why You Wait Longer And Get More Prescriptions At Your Doctor's Office

Category: Seeing Clearly Now

If your doctor is classified as a heavy prescriber it is likely 25 drug company representatives a week drop in for a chat bearing gifts. What does this mean for you? Even more pills are prescribed and your waiting time gets longer.

What drug rep visits cost you

Nationwide, there are an estimated 90,000 to 100,000 reps; each calls on eight to 10 physician offices a day. Some practices may get only two to four visits a week. However, in 2005 and 2006, primary care physicians deemed as "heavy prescribers" were called on by an average of 29 reps a week, according to Health Strategies Group, a research firm that tracks the pharmaceutical industry.

How those visits break down hints at the possible strain on physician practice: In 2005, 85 percent were drop-ins, 5 percent were appointments, and 10 percent were lunch dates.

From Medical Economics

AMA Awakens To Insurance Scam Of Unprompt Payments

Category: Seeing Clearly Now

The American Medical Association (AMA) is beginning to believe health insurance carriers are intentionally complicating and delaying the payment of claims. Has the AMA been brain-dead for the last 20 years?

AMA To Congress: Stop Unfair Business Practices Of Health Insurers

"The AMA urges Congress to pass legislation that will:

-- Establish a strong federal prompt pay standard;
-- Protect more robust prompt pay state laws by ensuring the federal standard is the "floor"

"Small physician practices have limited leverage relative to large insurance companies since antitrust laws prevent physicians as a group from addressing payment and other contract terms on a level playing field.

"The ability of physicians to address unfair payment practices continues to diminish with the increasing consolidation of health insurers. In the majority of Metropolitan Statistical Areas, a single health insurer dominates the market.

"The growing disparity in negotiating positions has created an environment where insurers are able to evade prompt payment laws with little, if any, adverse consequence. This has a financially debilitating effect on small physician practices and could limit patient access.

"When one side has all the market power, more efficient market mechanisms are hampered. A common problem confronted by many physicians is insurers paying claims late. Even if a claim includes all the appropriate information, insurance companies often find reasons to delay or deny payment. This is tantamount to small physician practices extending interest free loans to large insurance companies.

"In addition, this, seemingly intentional behavior by the insurer, creates an onerous administrative burden. Physicians and their staff must spend hours on the phone pursuing payment of unpaid claims. In fact, growing numbers of physician practices have been forced to hire office staff dedicated solely to collecting late payments."

Texas Judges See No Need For Tort Reform

Category: Seeing Clearly Now

Judges have a front row seat in the civil justice system. They also are presumed to be impartial as between the plaintiff and defense bar. Their observations about the fairness of the jury system and the need for more tort reform might be worth knowing.

Tort Reform: Straight From the Horse's (or the Judge's) Mouth

For years, Texas residents have been hearing about runaway juries, frivolous lawsuits, and the need for tort reform. But most of the stories in the popular press and thrown around by tort reform groups are anecdotal; there has always been a question of how to best gather data to measure whether jury awards are excessive or suits are frivolous.

...for the last two years, the professors have conducted a survey of Texas District Court Judges to get their views on the "litigation crises." After receiving responses from an astounding 78% of Texas district court judges, the results of the survey were released in the Baylor Law Review in an article titled Straight From the Horse's Mouth: Judicial Observations of Jury Behavior and the Need For Tort Reform.

Because the article is not yet publicly available, we don't want to provide too many details. But we will say that among the results were findings that substantially more judges thought juries had awarded too low of damages than judges that thought juries had awarded too much. And well over 80% of the judges did not think there needed to be additional "reform" to address frivolous lawsuits.

Outpatient Surgery - Do Risks Outweigh Benefits?

Category: Seeing Clearly Now

A surgeon is supposed to inform a surgical candidate of the risks and benefits of the surgical procedure. This information, when provided, enables the patient to give an informed consent to the surgery.

In at least 31% of scheduled surgeries there also is a need for a discussion of the risks and benefits of using the particular surgical facility.

The spotlight grows on outpatient surgery

[R}isks...exist when a patient chooses to have surgery outside a hospital and far from emergency medical services, says Lee Fleisher, chairman of anesthesiology and critical care for the University of Pennsylvania Health System in Philadelphia.

Fleisher has studied those risks and says that as the number of outpatient surgical centers blossoms, it's key for patients to learn the benefits and drawbacks of non-hospital-based surgery. Of the 50 million surgeries performed annually, he says, 31% occur at free-standing ambulatory surgical centers (ASC) where no hospital or emergency department is attached and patients go home the same day

Fleisher is concerned that as more older patients and people with multiple chronic conditions choose surgery at outpatient clinics, adequate postoperative and emergency services may not be at hand.

Minorities and older patients with multiple medical problems are more likely to require postoperative emergency care, several studies show. "We're concerned that as more ASCs perform more surgeries on older, higher-risk groups, those people will not be close enough to emergency services if they need them," Fleisher says.

From USA Today

Since outpatient surgical centers are frequently owned by surgeons, just how often are the risks of using the facility mentioned or properly presented? And, while we are on the topic, just how often is the surgical patient told who owns the facility? Just wondering.

Doctor Errors Are As Common As The Air We Breathe

Category: Seeing Clearly Now

A reasonable assumption is that every doctor has made mistakes in patient care. I mean, if 92% admit making mistakes we have to conclude that the remaining 8% are lying or oblivious to their mistakes.

Doctors are Human, too [Would the better title be, Doctors Are Too Human?]

A report from the AP last week, and reported by the Washington Post, Fox News and others, describes a survey of more than 3,000 doctors in both the US and Canada about their reactions to their own mistakes.

The survey was developed and issued by the Joint Commission (JCAHO), the body that accredits hospitals and other health care facilities. It asked doctors whether they had affected any near misses, minor medical errors, or serious medical errors which may have caused permanent or potentially life threatening harm.

92% admitted they had been involved in errors. And those involved also reported that after they made the errors, they felt increased anxiety about the potential for future mistakes, less confidence in their abilities, they reported sleep problems and a loss of job satisfaction.

The number is huge -- 92% !! We all make mistakes, granted, but our mistakes don't usually cause harm to other lives. That's 92 of every 100 doctors. We know that translates to almost 100,000 deaths per year, too. I don't know how to do that math, but those numbers are huge.

So perhaps the biggest takeaway from this report is that we patients need to internalize is the sheer numbers of doctors who make mistakes. And we patients need to practice defensive treatment seeking.

Because at least 92% of our doctors are making errors and we are the ones paying the price.

Posted by Trisha Torrey at EVERY PATIENT'S ADVOCATE

Malpractice Settlements Fairer To Medical Providers Than To Patients - Honest

Category: Seeing Clearly Now

Our fair and balanced president, George W. Bush, has explained ["I am the Explainer"] how medical providers are regularly extorted into paying outlandish sums to settle meritless malpractice claims:

Doctors and hospitals realize... it is expensive to fight a lawsuit even if it doesn't have any merit. And because the system is so unpredictable, there is a constant risk of being hit by a massive jury award. So doctors end up paying tens of thousands, or even hundreds of thousands of dollars to settle claims out of court, even when they know they have done nothing wrong.

The truth, not surprisingly, is quite different.

The Fairness of Malpractice Settlements

Is this claim [let's call it the Bush Extortion Theory] correct? The strongest empirical support for it comes from the 1996 findings of the researchers who directed the Harvard study of New York hospitals. They concluded that the merits of a malpractice claim have no bearing on the likelihood of a settlement. They even suggested that the entire adjudicative process is "an expensive sideshow" in which settlement is really driven by damages, not negligence.

The widespread reliance of both tort critics and the mass media [and the Explainer] on this single prestigious study is unfortunate. Its findings are decidedly inconsistent with the substantial body of empirical data accumulated over the past several decades.

Those studies demonstrate, contrary to the Harvard study, that settlement outcomes are directly correlated with the strength of the plaintiff's case.

Over the past quarter of a century, more than a dozen studies have collected data on malpractice settlements. With only one exception, they have consistently shown that plaintiffs with strong cases are more likely to receive a settlement payment than plaintiffs with weak cases. When strong cases settle,
the average payment is substantially larger than the average payment in weak cases.

Moreover, the data on malpractice settlement strongly suggests that liability insurers possess a palpable advantage in bargaining power. On average, malpractice claims settle for less than their expected value. The most likely sources of that bargaining power are the defendant's superior risk tolerance,
better access to information, more experienced attorneys and insurance representatives, easier access to expert witnesses, and the incentive to fight low-odds claims vigorously. Defendants probably gain additional bargaining power from trial lawyer awareness that malpractice claims are very hard to win at trial, even with strong evidence of negligence.

The overall performance of the settlement process should be reassuring to those physicians who are willing to listen. Quality of care drives settlement outcomes. To the extent that settlement outcomes depart from the merits, the discrepancies usually favor malpractice defendants. Although physicians may find it hard to believe, it will be hard to design an evenhanded adjudicative process that treats them much better.

From an article by Philip G. Peters, Jr., University of Missouri-Columbia School of Law

Message From Earth To America's Ayatollah

Category: Seeing Clearly Now

David Brooks of the New York Times has just returned from a pilgrimage to the White House where he had an audience with Ayatollah Bush.

I spent the first four days of last week interviewing senators about Iraq. The mood ranged from despondency to despair. Then on Friday I went to the Roosevelt Room in the White House to hear President Bush answer questions on the same subject. It was like entering a different universe.

Far from being beleaguered, Bush was assertive and good-humored.

I left the 110-minute session thinking that far from being worn down by the past few years, Bush seems empowered. His self-confidence is the most remarkable feature of his presidency.

His self-confidence survives because it flows from two sources. The first is his unconquerable faith in the rightness of his Big Idea. Bush is convinced that history is moving in the direction of democracy, or as he said Friday: "It's more of a theological perspective. I do believe there is an Almighty, and I believe a gift of that Almighty to all is freedom. And I will tell you that is a principle that no one can convince me that doesn't exist."

Second, Bush remains energized by the power of the presidency. Some presidents complain about the limits of the office. But Bush, despite all the setbacks, retains a capacious view of the job and its possibilities.

Unfortunately, as is often the situation in theological matters, on the other side of the world are other ayatollah's who are convinced their Almighty has provided other gifts.

If we could get our American Ayatollah to take off his robes and actually perform the job of President of the U.S. it is possible the power of his office could actually accomplish something beneficial during his final year in office.

Deployable Troops To Run Out At Just The Right Moment

Category: Seeing Clearly Now

I have not been to Iraq. I am not a military expert. I have never served in the military. However, I can spot a coincidence when I see one. See if you can spot one too in this excerpt from a New York Times article.

U.S. General in Iraq Speaks Strongly Against Troop Pullout

BAGHDAD, July 15 -- An American general directing a major part of the offensive aimed at securing Baghdad said Sunday that it would take until next spring for the operation to succeed, and that an early American withdrawal would clear the way for "the enemy to come back" to areas now being cleared of insurgents.

Maj. Gen. Rick Lynch, commanding 15,000 American and about 7,000 Iraqi troops on Baghdad's southern approaches, spoke more forcefully than any American commander to date in urging that the so-called troop surge ordered by President Bush continue into the spring of 2008. That would match the deadline of March 31 set by the Pentagon, which has said that limits on American troops available for deployment will force an end to the increase by then.

"It's going to take us through the summer and fall to deny the enemy his sanctuaries" south of Baghdad, General Lynch said at a news briefing in the capital. "And then it's going to take us through the first of the year and into the spring" to consolidate the gains now being made by the American offensive and to move enough Iraqi forces into the cleared areas to ensure that they remain so, he said.

The new American motto: We will fight until we run out of troops available for deployment. This will strike terror in the hearts of terrorists.

Keep Your Eye On The Genome

Category: Seeing Clearly Now

Mankind is still evolving, but not necessarily in the direction of perfection. Any serious presidential candidate or greedy trial lawyer should follow this research.

Recent Changes Discovered In The Human Genome

A Cornell study of genome sequences in African-Americans, European-Americans and Chinese suggests that natural selection has caused as much as 10 percent of the human genome to change in some populations in the last 15,000 to 100,000 years, when people began migrating from Africa.

In the latest study, the researchers identified 101 regions of the human genome with strong evidence of very recent selection. These regions include genes that control proteins that help muscle cells attach to surrounding cells (mutations of this gene lead to muscular dystrophy), receptors that relate to hearing, genes involved in nervous system function and development, immune system genes and heat shock genes.

"It is important to emphasize that the research does not state that one group is more evolved or better adapted than another," said co-author Carlos Bustamante, a Cornell assistant professor of biological statistics and computational biology. "Rather as humans have populated the world, there has been strong selective pressure at the genetic level for fortuitous mutations that allow digestion of a new food source or tolerate infection by a pathogen that the population may not have faced in a previous environment."

My own study of the human race, American subtype, also shows environmental pressure causing genome change. Although my full report is not quite ready for publication I can already say with certainty Americans are evolving in the following ways:

1) Shorter attention spans for anything complicated or nuanced.

2) An emotional need for almost continuous cellphone conversations.

3) More primitive, mystical religious beliefs.

4) Enjoyment of less understandable song lyrics.

What does this mean for those of us who seek to communicate effectively with our fellow Americans? (This applies equally to trial lawyers and presidential candidates.)

It means the most effective vehicle to get a message across would be to do it in a one minute rap-like chant of easily digested but garbled sound bites beginning with the words, Before the Rapture, broadcast to the jury or to every potential voter by Sprint.

Text This To Your Teen Driver: Watch The Road

Category: Seeing Clearly Now

Matt Noyes at Noyes Legal News discusses the multi-tasking habits of teenagers.

Survey Says . . .Teenage Drivers Admit to Risky Driving Habits

Sixty-one percent of teens admit to risky driving habits according to a survey by AAA and Seventeen Magazine. Of that 61%, 46% say that they text messages when driving and 51% talk on cell phones while driving.

Other teens in the vehicle can be a major distraction for teen drivers, and driver distraction is a factor in 25%-50% of all car accidents.

The survey also found that 40% of teens exceed the speed limit by 10 mph or more while driving, and 11% of teens admit to drinking or using other drugs before getting behind the wheel.

The survey, featured in Seventeen Magazine's upcoming August issue highlights the risks teenager drivers experience, but also highlights the risk to others that young, inexperienced drivers impose while engaging in risky habits.

A loose end - how does Matt get advance copies of Seventeen Magazine issues?

Pediatricians Are Rare Targets Of Malpractice Claims

Category: Seeing Clearly Now

Pediatricians may be the most conscientious and competent specialists in medicine.

Do Pediatricians Face A Malpractice Crisis?

Indiana University study provides hard evidence previously lacking.

"We studied pediatricians and malpractice because while the medical malpractice issue is extremely stressful and gets a lot of press, and we all have heard numerous horror stories and anecdotes, there is little actual data reported, especially for pediatricians. So we took a retrospective, comprehensive look at malpractice claims against pediatricians. Surprisingly, we found that from 1985-2005 society hasn't become more litigious, at least not vis-a-vis pediatricians," said Aaron E. Carroll, assistant professor of pediatrics at the IU School of Medicine and a Regenstrief Institute, Inc. affiliated scientist.

"While I don't want to minimize the horror of being sued, the numbers don't bear this [malpractice] out as a problem for pediatricians," said Dr. Carroll.

Although children are responsible for a large percentage of healthcare consumption, he found that pediatricians accounted for only 2.97% of all malpractice claims.

Another explanation for this situation - one that I would accept - is the relationship which develops between pediatricians and families. Surgeons, anesthesiologists and radiologists are usually not able to spend years sharing family experiences with their patients. Many would not recognize their patients at a shopping mall. As many trial lawyers know, clients frequently prohibit even the consideration of a claim against Doc Jones "who has been part of our family for over 23 years."

Appearing At A Hospital Near You - Greedy Medical Providers

Category: Seeing Clearly Now

Surprise! There are Greedy Hospitals, Greedy Doctors, Greedy Laboratories and Greedy Medical Clinics.

NEJM Editor Calls For Health System Change In Chicago Tribune Interview

The Chicago Tribune on Sunday published an interview with Arnold Relman, an editor at the New England Journal of Medicine and a professor at Harvard Medical School who has written a book, titled "A Second Opinion," that calls for reforms to the U.S. health care system. During the interview, Relman said, "What makes medicine in the U.S. more expensive than in all the other countries is the commercialization of our health care system," adding, "It doesn't matter if you're for-profit or not-for-profit, everyone is concerned about maximizing income."

In China, Quality Is Not Exactly Job 1

Category: Seeing Clearly Now

Made in China means Buyer Beware.

Inspectors Say Nearly 1 in 5 Chinese Products Substandard

Chinese government inspectors report that nearly one-fifth of the products they examined this year were substandard. The report follows months of increasing publicity over tainted foods and unsafe products made in China and sold both domestically and overseas. Daniel Schearf reports from Beijing. China's General Administration of Quality, Supervision, Inspection, and Quarantine says in the first half of this year more than 19 percent of inspected Chinese products made for domestic consumption failed national quality and safety standards.

The rate of failure among small manufacturers was even worse, at 27 percent. Small manufacturers account for about 75 percent of all food processing operations.

The inspection agency says it surveyed more than 6,000 companies and seven thousand products, focusing mainly on food and consumer goods.

From the Voice of America

In fairness to the Chinese I wonder what the results would be if the American General Administration of Quality, Supervision, Inspection, and Quarantine tested American-made products. Oh, I'm sorry, we don't have a General Administration of Quality, Supervision, Inspection, and Quarantine. We have the FDA.

Can You Name The Most Addictive Drug In America?

Category: Seeing Clearly Now

"Laboratory experiments confirm that cocaine alters the structure and function of the brain within a day of the very first dose. In humans, cocaine-induced alterations in the brain can trigger addiction with the first use." This would be a frightening finding and virtually everyone would support the public policy that outlaws cocaine's sale and distribution.

Unfortunately, the laboratory experiments were not about cocaine. Nicotine was the subject of the experiments and the sentence actually read: "Laboratory experiments confirm that nicotine alters the structure and function of the brain within a day of the very first dose. In humans, nicotine-induced alterations in the brain can trigger addiction with the first cigarette."

So, why are cigarettes legally sold and heavily taxed?

Just one cigarette can lead to addiction: study

Some young people show signs of addiction after inhaling just one cigarette, say U.S. researchers.

In a four-year study of more than 1,200 sixth-grade students in Massachusetts, 10 per cent of those who smoked were addicted within two days of first inhaling, and another 25 per cent were hooked within a month.

Some young people show signs of addiction after inhaling just one cigarette, say U.S. researchers.

In a four-year study of more than 1,200 sixth-grade students in Massachusetts, 10 per cent of those who smoked were addicted within two days of first inhaling, and another 25 per cent were hooked within a month.

Among the 217 students who had smoked, just over half became addicted.

"Laboratory experiments confirm that nicotine alters the structure and function of the brain within a day of the very first dose. In humans, nicotine-induced alterations in the brain can trigger addiction with the first cigarette," Joseph R. DiFranza, a professor of family medicine & community health, said in a news release.

The study was funded by the U.S. National Institute on Drug Abuse.

Wal-Mart, The Not-So-Grim Reaper

Category: Seeing Clearly Now

Wal-Mart has claimed it has an insurable interest in all of its full-time employees. That means it purchased life insurance, naming itself as a beneficiary, on about 350,000 employees. You have to wonder if the company has obtained life insurance on its regular shoppers.

Attorney: Wal-Mart Collected On Deaths

By ELAINE SILVESTRINI The Tampa Tribune

When Karen Armatrout died in 1997, her employer, Wal-Mart, collected thousands of dollars on a life insurance policy the retail giant had taken out without telling her, according to a lawsuit filed in U.S. District Court.

Armatrout was one of about 350,000 employees Wal-Mart secretly insured nationwide, said Texas attorney Michael D. Myers, who estimated the company collected on 75 to 100 policies involving Florida employees who died.

Myers said the policy payouts ranged from $50,000 to $80,000, depending on the person's age and gender. They were taken out on all full-time Wal-Mart employees who, in December 1993, were between ages 18 and 70 and participated in the medical benefits plan.

He said the company stopped taking out the policies in 1995 but continued to receive payouts on employees who died, even those who had left Wal-Mart.

Even after employees leave their jobs at Wal-Mart they continue to contribute to the bottom line.

Lying Eyewear - Safety Eyewear Does Not Meet Voluntary Standard

Category: Seeing Clearly Now

Seeing Clearly Now is one of the topical categories on my blog. The news today about safety eyewear is, unfortunately, a perfect fit for the topic.

Safety Eyewear Fails Testing

Did you know that over 2,000 work-related eye injuries occur every day in the USA? Eye injuries cost the economy over $300 million annually due to lost productivity, medical expenses and workers' compensation.

New data from the Illinois College of Optometry (ICO) challenges the effectiveness of protection in safety eyewear offered by several leading manufacturers.

The issue concerns a voluntary industry safety standard called ANSI Z87.1. Safety eyewear that claims to meet the ANSI 287.1 standard are expected to withstand a high velocity, high energy impact. ICO researchers tested 75 safety spectacle frames from five different manufacturers. Each frame was fitted with durable polycarbonate lenses by laboratory experts. The eyewear then underwent a series of high velocity, high mass pellet strikes that simulated real-world mechanical forces. The frames from half of the eyewear samples failed the safety tests. Metal frames fared poorest.

Only one manufacturer's products passed all of the tests - A2 frames from Hilco.

Eye safety experts point out that there is no government oversight regarding ANSI standards - it depends solely on manufacturer self-regulation.

From WebMD

What about making it a crime for any manufacturer to falsely claim its product meets a safety standard and allowing the award of punitive damages for any injuries that result from the defective condition of the product? And, a mandatory recall of the product when the false claim is discovered?

The Coming Of The Faith-Based Bar Examination

Category: Seeing Clearly Now

Religions are getting pretty microscopic in the conduct they prohibit. Apparently, one religion now proscribes the answering of bar examination questions that require the applicant to accept, support and promote homosexual marriage and parenting. I suspect the same religion prohibits answering bar examination questions that require the applicant to accept, support and promote family planning, condom use, embryonic stem cell research, habeas corpus for evildoers and working on the Sabbath.

What this country needs is a faith-based bar examination.

MA: Failed Applicant Sues Bar Examiners Over Test Question on Gay Marriage

A Massachusetts bar examination applicant who claims he failed the test because he didn't answer a question about homosexual marriage and parenting is suing the test administration agency, the state Supreme Judicial Court and four individual justices for constitutional violations.

Dunne claims his score of 268.866 on the November 2006 bar exam just missed the passing score of 270 points because he didn't follow the proscribed format for an unlawful question about gay marriage. Dunne said the question required applicants to "affirmatively accept, support and promote homosexual marriage and homosexual parenting." Dunne claims the defendants violated his First Amendment right to exercise his religion and violated the due process and equal protection clauses of the U.S. Constitution. He also claims their actions impose illegal state regulations on interstate commerce.

Dunne failed to mention how insensitive it was of the bar examiners to ask him to think like a lawyer.

Bush Has "Moved The Courts" To Another Planet

Category: Seeing Clearly Now

Emily Bazelon, at Slate, asks the question - What do the liberal and moderate lawyers who supported John Roberts' nomination say today?

Emily's article is posted at Sorry Now? and is worth a read.

The second page of the article raises a concept that needs to be taken to the trash heap of history.

In those preconfirmation days in 2005, there was one more argument for broad support for Roberts and Alito. Benjamin Wittes, a member of the Washington Post editorial board when it backed both of Bush's picks, reminded me of it in an e-mail this morning. He has no regrets about his support for Roberts, because he expected to disagree with him on key votes and thought he should be confirmed nonetheless. "Presidents have a legitimate right to move the courts and the principal check on this power is not the confirmation process but, rather, a certain ideological diversity of presidents over time," he writes.

Because of the life-expectancy and lifetime appointments of Supreme Court Justices some presidents are always going to have the opportunity to "move the courts" whereas other presidents, also elected by the voting citizens of the U.S., never even get to nudge the courts. A president who is eager and able to "move the courts" should be checked by the Senate advice and consent function. Nobody seriously believed the Alito and Roberts appointments were intended to simply fill vacancies with fair-minded legal scholars. These nominees were, despite their statements to the contrary, activists fully intent on making major changes in our jurisprudence.

It may take 20 or more years to see any diminishment of the rightward swing and pro-business agenda of the U.S. Supreme Court because the Senate allowed President Bush to "move the courts". Maybe the nation can survive this judicial relocation; but, as I have said in other articles, the U.S. Supreme Court seems to have moved to another planet.

Take The Pens From Docs And Save Some Lives

Category: Seeing Clearly Now

I propose a ban on all handwritten physician orders in hospitals. From now on all doctors will have to use a computer keypad just as they do when surfing the web, sending email, participating in fantasy football and sending letters to editors complaining about greedy trial lawyers and frivolous malpractice lawsuits. Why take the pen out of the hand of the docs? Because, they don't know how to write so other people know what they mean.

Just What the Doctor Ordered. Review of the Evidence of the Impact of Computerized Physician Order Entry System on Medication Errors

From press release (NewsWise):

Doctors are famous for sloppy scribbling -- and handwritten prescriptions lead to thousands of medication errors each year. Electronics to the rescue: U.S. hospitals that switched to computerized physician order entry systems saw a 66 percent drop in prescription errors, according to a new review of studies.

Thanks to Shirl Kennedy at Docuticker

Alito, Alito, He's Our Man...From Corporate America Songbook

Category: Seeing Clearly Now

It may not be as glamorous as the Academy Award won by former Vice President Al Gore, but Justice Samuel Alito has been awarded the Bloomie as the Pro-Business Champion of the U.S. Supreme Court. President Bush may have a friend in Jesus, but corporations have Alito - for years and years and years.

Alito Champions Business Causes in First Full High-Court Term

In what may have been the most pro- business U.S. Supreme Court term in decades, standing out as companies' No. 1 ally was no small feat. Justice Samuel Alito managed it in his first full year.

As the court term comes to a close this week, Alito has emerged as the justice friendliest to the interests of corporations. He sided with the U.S. Chamber of Commerce, the nation's largest business lobby, in 13 of 14 cases this term, more often than any of his colleagues. He cast votes to limit punitive damages, ease regulation and restrict suits by investors, consumers and alleged victims of job bias.

"On the cases where it's possible to differentiate the justices, he's been on the pro-business side every time," said Roy Englert, a Washington lawyer with Robbins Russell Englert Orseck & Untereiner who won a telecommunications case he argued before the court this year.

From Bloomberg.com.

Why don't we just appoint a corporation or business organization to the court instead of a person? I propose the U.S. Chamber of Commerce.

The Clean Hands Doctrine May Save Your Life

Category: Seeing Clearly Now

Trisha Torrey, posting at EVERY PATIENT'S ADVOCATE, says health care providers in the hospital setting are lax about washing their hands. And, she tells us why we should care.

MRSA: Killing More Americans everyday

APIC (Association for Professionals in Infection Control and Epidemiology) is holding its annual meeting this week, and today published the results of its latest findings on the number of people who die from MRSA (methicillin-resistant staphylococcus aureus) and other HAIs (hospital acquired infections). These are superbug staph infections, usually acquired by hospital patients, but sometimes transmitted in the community as well. Superbugs are called such because they have developed a resistance to drugs -- nothing can kill them.

That means -- once a patient contracts a MRSA infection, s/he usually can't get rid of it. S/he will be infected for the rest of his/her life.

Bottom line? Between 48,000 and 119,000 patients per year may be acquiring these infections. That represents 46 per 1,000 patients. These numbers are much higher than previously believed, and higher than reported in previous studies. In particular, the Centers for Disease Control (CDC) had previously reported only 3.9 deaths per thousand.

If I'm doing my own math correctly, that means that the REAL rate is 120 times WORSE than what we thought?

And the thing that ticks me off about this the most? These infections are PREVENTABLE! If the proper precautions are taken in hospitals, then there is no reason why patients should acquire staph infections in the hospital. None.

And do you know what the proper precautions consist of? In most cases... simply washing one's hands.

By my own observation, I have seen how lax health care providers are about hygiene. Other studies have been undertaken to document how little regard practitioners have for conscientiously keeping their hands sanitized and clean. I'm sure it's a pain in the catoochie to have to wash and sanitize before touching every patient... but... when it can mean the difference between life and death? Seriously.

It might not be a bad idea to bring your own sanitizing liquid into the hospital and insist that each provider use the darn stuff. Tell them Trisha feels it may save your life.

The Best Doctors Are Not The Marrying Kind

Category: Seeing Clearly Now

Errors in medical diagnosis are often the cause of totally unnecessary medical injuries and deaths. The malpractice frequently lies in what one medical blogger refers to as marrying the diagnosis.

Do not marry the diagnosis!

Faulty information synthesis, which includes a wide range of factors, was the most common cause of cognitive-based errors. The single most common phenomenon was premature closure: the tendency to stop considering other possibilities after reaching a diagnosis.

From DB's Medical Rants

I have observed that the hasty marriages which turn out poorly are almost reckless in their passionate embrace. How else to explain the decision to diagnose and treat the least serious condition and the perseverance in the relationship with the diagnosis when treatment is obviously failing. Marriage needs to be reserved for a relationship between human beings. Doctors should only be permitted to have courtships with diagnoses.

The U.S. Supreme Lobbyists

Category: Seeing Clearly Now

Corporate America is enjoying the payoff from twice electing George W. Bush President of...well, Corporate America. I haven't seen the President's approval rating within the business community, but it should be soaring well above the 29% level of approval in the nation as a whole.

High court has been good for business

The Bush administration and corporate lobbyists long have sought sweeping "tort reform" to limit lawsuits and massive jury awards -- without much success. But in the last year, they quietly have been winning much of what they've wanted on a case-by-case basis in the Supreme Court.

With a week to go in their term, the justices have handed down a dozen rulings that sharply limit the damages that can be won in lawsuits or make it harder to sue corporations.

"The Roberts court is even better for business" than the court led for two decades by the late Chief Justice William H. Rehnquist, said Washington attorney Maureen E. Mahoney, who is a longtime friend of Chief Justice John G. Roberts Jr. and a former clerk for Rehnquist. "There is unquestionably a greater number of business cases before the court, and [the justices] are quite willing to limit damage remedies."

Five of the Supreme Court Justices should be required to register as lobbyists for the business community.

Anonymous Physicians Rat Out Drug Company Influence

Category: Seeing Clearly Now

Anonymous physicians on the relationship between doctors, hospitals and drug companies:

Are doctors unduly influenced by drug companies?

Dr. Virus: I don't think that doctors make dangerous decisions because of the influence of the drug companies. But I think we make very expensive decisions. There's an antibiotic for $10 and there's an antibiotic for $150. I had dinner last night with the $150 guys, and it might be theoretically marginally better. There might be reasons that I prescribe it, and one might be that I liked my steak dinner. You'll get well either way on the cheap one or the expensive one, but this way I'll have another steak dinner. It's low-level bribery--there's no question about it. I used to go out to dinner with these guys, and I stopped because I found it too gross for words.

Dr. Lung: I used to be in charge of a department, and I told my unit that I'm not going to support big dinners where they take twenty doctors out. If you're friends with one particular rep, then you can go as friends. But I've always felt that they're expecting something in return.

Dr. Heart2: I am wooed. You know, all doctors are wooed. But the true excess is not in the pens and the steak dinners. It's the relationships pharmaceutical companies develop with hospitals that are much more nefarious than buying a doctor a steak dinner. Companies strike deals with hospital pharmacies to provide their drugs at a low cost to get patients using them. Then they price the drug at a later date any which way they want.

Source: New York Best Doctors - A panel of anonymous physicians coughs up secrets of the trade.

Drug Reps With Spreadsheets Welcomed By Oncologists

Category: Seeing Clearly Now

In my post yesterday, Oncologists Keep Their Eye On Profits, the question was whether oncologists were uniquely focused on profits among all the medical specialists. PharmaGossip provides more evidence for us to consider. When drug company reps are showing up at oncologists' offices with spreadsheets instead of drug samples and clinical studies it is hard to imagine anything but dollar signs in the heads of these practitioners.

Cancer - Big Pharma's (and oncologists') last gold rush

Industry documents that have emerged in a federal civil lawsuit in Boston show that big pharmaceutical companies sometimes calculated to the penny the profits that doctors could make from their drugs. Sales representatives shared those profit estimates with doctors and their staffs, the documents show.

In one PowerPoint presentation from 2000, a Bristol-Myers Squibb executive told employees that oncologists' biggest concern was "Reimbursement Today, Reimbursement Tomorrow, Reimbursement!"

Dr. Robert Geller, an oncologist who worked in private practice from 1996 to 2005 before leaving to join a biotechnology company, said that cancer doctors knew the profits they could make and in some cases would change treatment regimens or offer unnecessary care to make extra money.

"It's clear that physicians stopped making decisions based on what made scientific or clinical sense in lieu of what made better business sense," Dr. Geller said.

While many of the documents in the lawsuit remain sealed, the exhibits used in the first trial are part of the public record. They show that representatives for the companies brought spreadsheets to oncologists' offices to show doctors how much they could make.

The Catholic Church Clears Priest Of Molestations - In Secret

Category: Seeing Clearly Now

The Roman Catholic Church has perfected the investigation and prosecution of priests accused of molesting minors. After reading this report of the process when government prosecutors are not involved, it is apparent that (1) secret trials conducted by (2) fellow priests and reviewed by (3) Rome is the formula to clear the good name of men of the cloth.

Vatican clears former pastor of sex charges

The Rev. William J. Dowd, a popular Bergen County priest who was accused in 2002 of sexual misconduct with minors, has been cleared by church officials in Rome.

The decision means the 67-year-old Dowd can wear clerical garb, celebrate Mass and represent himself as a Catholic priest for the first time in more than five years.

A panel of three priests found Dowd innocent of the allegations in a 2005 closed-door church trial in Newark. That proceeding then had to be reviewed by the Vatican....

Officials in Rome contacted the archdiocese late last week to say they had affirmed the trial.

Not everyone cheered the news. A victims' advocacy group criticized the church's use of closed-door proceedings.

"Historically, people have been very skeptical of secret church proceedings when clerics are clearing other clerics of crimes against children," said Mark Crawford, co-director of the New Jersey chapter of the Survivors Network of Those Abused by Priests. "More and more often, these proceedings are returning the accused predator priest to ministry."

Dowd never faced criminal charges. The allegations were decades old and, as a result, could not be prosecuted under the statute of limitations.

Church officials have released few details about Dowd's case, saying only that a man from Mississippi initially came forward, followed by a second accuser. Both alleged that Dowd had engaged in sexual misconduct with them while they were minors.

The case was presented initially to an archdiocesan review board - a predominantly lay panel appointed by the church - which determined the accusations warranted further action.

That led to the closed-door trial in 2005, with three priests from outside the archdiocese acting as judges.

Dowd was represented by an attorney versed in church law and the archdiocese assigned a "promoter of justice" to present the case.

"It went through a period of months, with evidence being gathered and a number of people from both sides presenting testimony," [Jim] Goodness [a spokesman for the Newark Archdiocese] said. "The decision of the tribunal was that he was not guilty of the allegations."

That decision then was sent to the Congregation for the Doctrine of the Faith in Rome, which reviewed the trial and found it was conducted in accordance with church law.

From NorthJersey.com

Ritalin Use Studied Among Children Of Divorced Parents

Category: Seeing Clearly Now

Ritalin has apparently graduated to the company of toxic chemicals and deadly diseases. Studies are being conducted to determine what circumstances and events increase the risk of Ritalin use. What we have here is a legal prescription drug that may have gone over to the dark side.

Divorce Increases Risk Of Ritalin Use

Divorce puts children at higher risk of Ritalin use compared to kids whose parents stay together, says new research by a University of Alberta sociologist, who cautions that this doesn't necessarily mean that divorce is harmful to a child. [But it does imply that Ritalin is dangerous stuff more likely to be provided to a child after a divorce.] The study appears in this week's issue of the Canadian Medical Association Journal.

Dr. Lisa Strohschein found that there is a "significantly higher" risk of Ritalin use - nearly twice as high - for children whose parents divorce compared to children whose parents remain together. It is the first study to follow children over time and evaluate whether experiencing parental divorce increases the risk for subsequent Ritalin use, a drug commonly prescribed for Attention Deficit Hyperactivity Disorder (ADHD).

Why did Dr. Strohschein select Ritalin as opposed to, say, aspirin for her study?

She was drawn to look at Ritalin usage because prescriptions to children for Ritalin have skyrocketed over the past two decades, leading to concern over whether it is being appropriately prescribed.

G8 Gathers To Plan Good Deeds

Category: Seeing Clearly Now

Rich nations meet again to make themselves feel good.

Don't listen to what the rich world's leaders say - look at what they do

From The Guardian

It is time once again for that touching annual ritual, in which the world's most powerful people move themselves to tears. At Heiligendamm they will emote with the wretched of the earth. They will beat their breasts and say many worthy and necessary things - about climate change, Africa, poverty, trade - but one word will not leave their lips. Power. Amid the patrician goodwill, there will be no acknowledgement that the power they wield over other nations destroys everything they claim to stand for.

The leaders of the G8 nations present themselves as a force for unmitigated good. Sometimes they fail, but they seek only to make the world a kinder place. Bob Geldof and Bono give oxygen to this deception, speaking of the good works the leaders might perform, or of the good works they have failed to perform - but not mentioning the active harm. They refuse to acknowledge that what the rich nations give with one finger they take with both hands.

Rich nations manufacture and market to poor nations products that do far more harm than good. But, hey, it helps the trade balance.

Look at what is happening, right now, in the Philippines. This country has many problems, but one stands out: just 16% of children between four and five months old are exclusively breastfed. This is one of the lowest documented rates on earth, and it has fallen by a third since 1998. As 70% of Filipinos have inadequate access to clean water, the result is a public health disaster. Every year, according to the World Health Organisation, some 16,000 Filipino children die as a result of "inappropriate feeding practices".

These are the deaths caused only by acute results of feeding children with substitutes for breastmilk. A summary of peer-reviewed studies compiled by the campaigning groups Infact and Ibfan suggests that breastfeeding also reduces the incidence of asthma, allergies, childhood cancers, diabetes, coeliac disease, Crohn's, colitis, poor cognitive development, obesity, cardiovascular disease, ear infections and poor dentition. Switching from bottle to breast could prevent 13% of all childhood deaths - a greater impact than any other measure. Panaceas are rare in medicine, but the mammary gland is one.

Both the government of the Philippines and the UN blame the manufacturers of baby formula for much of the decline in breastfeeding. These companies spend over $100m a year on advertising breastmilk substitutes in the Philippines, which equates to more than half the department of health's annual budget. Those who appear most susceptible to this advertising are the poor, who are also the most likely to be using contaminated water to make up the feed. Some spend as much as one third of their household income on formula. Powdered milk now accounts for more sales than any other consumer product in the Philippines. Almost all of it is produced by companies based in the rich nations.

Is He Really A Pediatrician?

Category: Seeing Clearly Now

Children do not select their own doctors. Parents normally do that for them, usually by looking for a competent pediatrician. Apparently, the task may have a sizeable margin of error to it.

Up To 17 Percent Of Pediatricians Not Board Certified By ABP

A study, published in the June issue of the Journal of Pediatrics, found that as many as 17 percent of physicians in a single state who claim to be pediatricians on state licensure files have never been board certified as a pediatrician by the American Board of Pediatrics (ABP). And another 12 percent of physicians who report to be pediatricians did not complete a medical residency training program in pediatrics.

"Residency training in pediatrics and board certification by the American Board of Pediatrics distinguish the physician as having the level of expertise and knowledge to provide the best possible care for your child," says study lead author Gary L. Freed, M.D., MPH, chief of the Division of General Pediatrics and director of the CHEAR Unit at Mott.

He continues, "Our finding that up to 17 percent of those reporting to be pediatricians in a given state are not board certified by the ABP should encourage more parents to find out if their child's physician really has been board certified as a pediatrician, and that he or she has maintained that certification status. Recertification is equally important because medicine is constantly changing, and it is a means to keep physicians up-to-date on the latest medical developments."

Audio Tapes Would Improve Medical Diagnosis

Category: Seeing Clearly Now

You can slice it anyway you want. The conclusion remains the same. The rising number of medical diagnostic errors is related primarily to poor communication skills of the doctor in conversations with the patient.

QUALITY: Are Doctors Asking The Right Questions?

by Rob Cunningham

An M.D. and Harvard professor who writes for the New Yorker, Jerome Groopman is creating a widening public audience for a problem that internists have been worrying themselves about for decades: an apparent decline in physicians' clinical skills, driven at least in part by increasing dependency on high-tech diagnostic tools and financial incentives to see more and more patients.

Much of the evidence comes from studies based on autopsies that reveal morbidities not detected (or treated) in living patients. One such study found major diagnostic errors in 32 percent of patients who died during stays in intensive care. Estimates of the overall rate of diagnostic error fall in the 10-15 percent range.

The bottom line, according to Groopman, is that doctors often don't ask the right questions and don't listen carefully enough when the patient answers.

My suggestion would be to tape-record all physician-patient verbal communications, just as is done "for quality purposes" by many businesses who communicate with customers by telephone. If businesses have discovered the mere fact of a recording tends to improve the communications process why not apply this simple "device" to the medical field. When poor communication skills lead to serious injuries and deaths it would seem a reasonable burden to bear.

Americans Fleeing Major Political Parties

Category: Seeing Clearly Now

America is experiencing MPPAD, (Major Political Party Affiliation Drain). This condition occurs when major political parties exhibit idea atrophy and appear to exist solely to exercise power and to pass out spoils.

Number of Republicans in U.S. Hits New Low, Number of Democrats Also Decline

Source: Rasmussen Reports

For the fourth straight month, the number of people identifying themselves as Republicans has decreased. For the third straight month, the number of people identifying themselves as Democrats has also decreased.

A Rasmussen Reports national telephone survey of 15,000 adults in May found that just 30.8% now say they're Republicans. That's down slightly from last month and down more than six percentage points from the GOP peak of 37.3% during Election 2004. The number of Republicans has been falling fairly steadily since the middle of 2005.

However, the survey also found that the number of people identifying themselves as Democrats has fallen to its lowest level in seventeen months (since January 2006). Democrats gained about two percentage points of support during 2006 and peaked at 38.0% in December of last year. Since actually taking control of Congress, Democrats have given back most of those gains. Today, 36.3% say they belong to Nancy Pelosi's party.

From Docuticker

Americans May Have An ED Problem

Category: Seeing Clearly Now

I was about to prepare a new post but forgot what the topic was going to be. I may be one of those with an ED problem - no, not the ED featured in the television ads. Easily Distracted is the ED of which I speak.

Test Puts Attention on the Easily Distracted

THURSDAY, May 31 (HealthDay News) - Prospective employers may have a new tool to spot people who are too easily distracted while on the job.

Nilli Lavie, a psychology professor at University College London in England says she's developed a method of measuring how easily a person's attention wanders. She says it could be used by employers when hiring workers and could prove especially useful for jobs - such as a bus driver or pilot - where distraction could lead to fatal errors. [I definitely would like advance warning of a pilot who is ED.]

Easily distracted people are more likely to be involved in accidents, noted Lavie.

The computer-based test designed by Lavie measures a person's accuracy and reaction times when exposed to distractions. It was tested on 61 people, and the findings were published in the Association for Psychological Science journal.

Not only did the study find that the test gauges how easily a person is distracted, it also found that all people - easily distracted or not - tend to be far less likely to be distracted when they're doing a difficult task. This is likely because people are so focused on completing a difficult assignment that they have no extra brain capacity for processing distracting information, Lavie said.

Could ED explain why George Bush has been elected twice.

A Bone To Pick About Depression

Category: Seeing Clearly Now

Now, this is something to be depressed about.

Antidepressant Use May Boost Fracture Risk, From Harvard Women's Health Watch

Evidence is accumulating that depression is a risk factor for osteoporosis, reports the June 2007 issue of Harvard Women's Health Watch. A recent study found that people ages 50 and over who regularly took antidepressants called selective serotonin reuptake inhibitors (SSRIs) had double the rate of fractures as people not using such medications. Other research points to depression itself as a source of endocrine changes that can damage bone.

Whether the danger comes from depression, the drugs used to treat it, or something else, doctors are paying more attention to this association. During the 1990s, depression began to emerge as a possible cause of bone loss, rather than a result. Scientists studied women who didn't have osteoporosis symptoms or even know they had the condition. They found lower bone mineral density in those who were depressed. Moreover, the link was found in both younger women and women past menopause. Other studies have found a similar relationship, so investigators have been looking at hormones and brain chemicals potentially involved in both depression and bone loss.

Another reason to stop following the daily news.

Tennessee Says "No Thanks" To Malpractice Tort Reform

Category: Seeing Clearly Now

Missing a train can be a good thing.

Author of Tenn. Malpractice Bill Now Relieved It Didn't Pass

A Tennessee state representative who helped shepherd a bipartisan effort to limit frivolous medical malpractice lawsuits said he was glad the measure did not pass.

House Judiciary Committee Chairman Rob Briley, D-Nashville, said supporters of the medical malpractice bill exaggerated the need for limits on malpractice lawsuits.

"It was premature. It didn't need to pass,'' Briley said during a House floor session. "We didn't need tort reform in this state.''

Briley said he received information last Wednesday from State Volunteer Mutual Insurance Co., the state's largest provider of malpractice insurance to doctors, that insurance rates were dropping an average 4.2 percent this year.

He also said there hadn't been an increase in juries awarding large damages to patients nor was the standard of medical care decreasing, as tort reform supporters have indicated.

Unfortunately, many states have boarded the tort reform train. Maybe, after they arrive at a destination where injustice and malpractice thrive, they will ride the train back to justice for the victims of medical misconduct.

Corruption Of Science And Medicine...By The NEJM?

Category: Seeing Clearly Now

Over at Notes From Dr. RW we are told that discussions of science are corrupted when played out in the arena of public debate.

Tabloid based medicine trumps evidence based medicine

Mere moments following NEJM's release of the Avandia meta-analysis and editorial there were millions of Google search queries for Avandia according to a recent post from Clinical Cases and Images. Malpractice attorney ads began appearing only hours later. Hype spreads more rapidly than nuanced critical analysis. So, long before defects in the paper had a chance to be exposed, the popular media, consumer activists and the trial lawyers had taken over the debate. Within hours Avandia was the new Vioxx. More recently we have learned that the ongoing prospective RECORD trial, designed to look at macrovascular outcomes in patients taking Avandia, is in jeopardy (hat tip to Kevin M.D.) due to patients dropping out as a result of the publicity. Something's terribly wrong with this picture.

Some are accusing NEJM as being like a tabloid and PharmaGossip proposes a new cover style. Is NEJM deserving of the tabloid label? In my considered opinion, yes, for two reasons. First, the journal could have published a more critical, less inflammatory editorial. Even worse was the journal's decision for early open access release of the paper and editorial. Such a tactic might be appropriate for a public health emergency such as the SARS outbreak. This is not SARS. This is not a public health emergency.

Clearly tabloid based medicine has trumped evidence based medicine and done much harm. I have repeatedly argued that discussions of science are corrupted when played out in the arena of public debate. The Avandia controversy is a case in point.

Dr. RW has a valid point. I am sick and tired of all this gibberish about medicine clogging up the media. What this country needs is a separation of scientific discourse (including medicine) from the public. What possible good comes from public awareness and discussion of scientific matters? We should ban any scientific thought and discourse by anyone without a Dr. before his name. And, a similar ban should be applied to legal thought and communications. Ditto, in the areas of military matters and our government. Our lives would be so much better without all the corruption to medicine, science, law, military and government.

Data-Mining For Greater Drug Profits

Category: Seeing Clearly Now

Data-mining in medical prescriptions surfaces in many ways, not all good.

Seattle pediatrician Rupin Thakkar's first inkling that the pharmaceutical industry was peering over his shoulder and into his prescription pad came in a letter from a drug representative about the generic drops Thakkar prescribes to treat infectious pinkeye.

In the letter, the salesperson wrote that Thakkar was causing his patients to miss more days of school than they would if he put them on Vigamox, a more expensive brand-name medicine made by Alcon Laboratories.

"My initial thought was 'How does she know what I'm prescribing?' " Thakkar said. "It feels intrusive. . . . I just feel strongly that medical encounters need to be private."

This is the reaction of one physician cited in a recent Washington Post article.

Doctors, Legislators Resist Drugmakers' Prying Eyes

"We don't like the practice, and we want it to stop," said Jean Silver-Isenstadt, executive director of the National Physicians Alliance, a two-year-old group with 10,000 members, most of them young doctors in training. (Thakkar is on the group's board of directors.) "We think it's a contaminant to the doctor-patient relationship, and it's driving up costs."

The American Medical Association, a larger and far more established group, makes millions of dollars each year by helping data-mining companies link prescribing data to individual physicians. It does so by licensing access to the AMA Physician Masterfile, a database containing names, birth dates, educational background, specialties and addresses for more than 800,000 doctors.

After complaints from some members, the AMA last year began allowing doctors to "opt out" and shield their individual prescribing information from salespeople, although drug companies can still get it. So far, 7,476 doctors have opted out, AMA officials said.

Since at least the early 1990s, drug companies have used the data to identify doctors who write the most prescriptions and go after them the way publishers court people who subscribe to lots of magazines. They zero in on physicians who prescribe a competitors' drug and target them with campaigns touting their own products. Salespeople chart the changes in a doctor's prescribing patterns to see whether their visits and offers of free meals and gifts are having the desired effect.

"It's a key weapon in determining how we want to tailor our sales pitch," said Shahram Ahari, a former drug detailer for Eli Lilly who is now a researcher at the University of California at San Francisco's School of Pharmacy. "The programs give them [doctors] a score of 1 to 10 based on how much they write. Once we have that, we know who our primary targets are. We focus our time on the big [prescription] writers -- the 10s, the 9s, and then less so on the 8s and 7s. . . . We're dealing with individual physicians who might give us the biggest dividend for our investment."

Why don't we just allow doctors to be drug company employees who can push pills to patients in a more efficient and profitable way? Each employee doctor could supply the employer drug companies with much more complete patient information than is presently gathered at great expense by data-mining.

In Maine, Multi-tasking Drivers Must Be Of A Certain Age

Category: Seeing Clearly Now

Driving an automobile while talking on a cellphone, playing a video game or adjusting a portable MP3 player apparently are dangerous activities for teenagers but not for adults in Maine.

Maine Bill to Ban Teen Drivers' Cell Phone Use Advances

A bill to ban teen drivers in Maine from using cell phones and other electronic devices has won unanimous approval from a legislative committee.

The original bill was supposed to ban the use of hand-held cell phones by minor drivers, but it was amended during a work session last week to include other electronic devices like video games and portable MP3 players like the Apple iPod.

"They broadened that (bill) to look at all causes of distractions,'' said Jon Clark, deputy director of the state's Office of Policy and Legal Analysis, who advised the Transportation Committee on the issue.

The amended proposal, which was approved by the Transportation Committee, would expand current law, which bans drivers under 18 with an intermediate license from using a cell phone for the first 180 days.

A separate bill to ban the use of hand-held cell phones by all drivers, including adults, was rejected 11-2 by the committee.

Mature drivers (with years of experience eating fast food, disciplining backseat children, inserting CD's and folding maps while driving) obviously can handle the new electronic devices while commuting on major highways.

Hook, Line And Sinker Rules Should Be Applied To The Loyal Bushies

Category: Seeing Clearly Now

What can we learn from a fishing tournament that may guide us in dealing with those in the Bush Administration who have been lying and misleading us for over six years? Let's visit Missouri where they apparently don't have much use for liars and cheaters.

Angler blackballed after cheating scandal

Poplar Bluff -- An avid angler accused of cheating in a bass fishing tournament last month is finding that fellow fishermen aren't forgiving his transgression.

Gary Lee Jones, 60, of Poplar Bluff, faces a felony count of theft by deception. Just as painfully, perhaps, he faces the ire of his fishermen friends.

"What he did, he did to every fisherman. It's like a brotherhood," said Skeeter Law, owner of a boat shop frequented by Jones. "He's done lost any kind of trust that he had."

Those who know Jones say he was good enough to compete in tournaments.

Fishing is a serious part of life around Lake Wappapello, about 150 miles south of St. Louis.

Competitive fishing -- a race to see who brings in the greatest total weight of fish -- brings big cash prizes.

Cheating isn't new to the sport. Fishermen have been caught using frozen fish, fish hidden in secret compartments, fish tied to hidden lines.

Tournaments use lie detectors to ask winners whether their catches were made that day. Jones passed a lie-detector test at a competition two years ago after placing second. There were rumors he cheated, but his friends stood up for him, the St. Louis Post-Dispatch reported.

Last month, a fisherman and his son told police they had seen Jones on the lake on April 28, the day before the 2007 Angler's Choice/Bass Quest Tournament.

Jones spent his time next to a floating duck blind, raising officers' suspicions.

State conservation agent Mic Plunkett and a state water patrol officer found two live bass with red nylon cords looped through their mouths and tied to the duck blind, Plunkett said. They marked the fish by punching a tiny hole in one fin on each bass.

The next day, as 38 boats pushed off into Lake Wappapello, Jones headed for the duck blind cove in his boat and waited until the other competitors had cleared out, authorities said.

Plunkett and a water patrol officer, dressed in camouflage, waited on shore about 60 feet away. Plunkett lay behind a log with a video camera -- also camouflaged -- poking over the top.

They watched as Jones reached into the water, pulled up the bass, cut the line and placed the fish in his boat's aerated holding tank, according to Plunkett.

At the official weigh-in that afternoon, Jones turned in four bass for a total of 11.55 pounds -- to win second place. He also had a single five-pound fish to take third in the Biggest Bass category. Jones was awarded a silver trophy plaque and his check for $886. Organizers snapped his photo while authorities inspected Jones' catch. They found the marked fish.

As Jones accepted congratulations, he was placed under arrest. Word of the undercover operation quickly spilled through the crowd. Applause broke out. Several fishermen shook the officers' hands.

"I've never had that large of a crowd be that enthusiastic about someone getting arrested," said Jeff Johnson of the water patrol. "That was something different."Jones goes on trial July 17, and faces two to seven years in prison.

Overlawyered And Tort Deform Are Cleaning My Clock

Category: Seeing Clearly Now

Readership, viewership, page views, rankings - these matters keep my greedy body awake at nights. I mean, the competition is tough out there in the blogosphere. My crack team of internet professionals estimate that on any given day an average of 2 people come to my blog. (I believe one of those is me.) The average visit lasts 26 seconds. I am being told any chance for a book deal or made-for-TV movie is out the window at stats like this.

My ultimate goal for Greedy Trial Lawyer is to morph into an entire product line of action figures and shiny men's suits. Why am I sharing this with you today? Well, apparently, some other legal blogs are likely to get to the cash register before me unless I ramp up my numbers pretty quickly.

These numbers for Tort Deform and Overlawyered blow my mind:

Blog Traffic & Hubris: Tort Deform v. Overlawyered

The question of blog traffic is always an interesting one.

How much does your traffic reflect the importance of your discussion or the level of support for your point of view? Perhaps, not at all.

In any event, it's often hard to gauge how much traffic a blog actually has, and I believe that discussion of other blogs' traffic isn't really at the core of the worth of each side's arguments.

Interestingly, Overlawyered.com, our primary tort "reform" counterpart in the blogosphere, has criticized Tort Deform as "unimportant" because, as they saw it, we have a modest readership.

While I say again that I don't believe readership is directly linked to the worth of a viewpoint, given the fact that Overlawyered.com has attacked this site on account of its perception of our readership, and in light of the fact that Overlawyered.com recently made a post praising its own readership, a comparison is in order.

Last month, during its fourth full month in existence, Tort Deform had 127,349 page views.

According to Overlawyered's post on its estimate of its page views it is currently at about 2 million each year. Two million page views a year puts Overlawyered's monthly page views at 166,666. That number puts the current readership of Tort Deform at 76.4% of Overlawyered's.

These guys are ahead of Rush Limbaugh while I am below Mother Teresa.

Patient Warning - Confusing Array Of Complaints Frustrates Doctors

Category: Seeing Clearly Now

I am not sure why this 8 year old medical journal article regarding signs that point to nonorganic back pain is making the rounds on blogs this month. I doubt that nonorganic back pain complaints are suddenly increasing.

Is it malingering, or is it 'real'?

Eight signs that point to nonorganic back pain - P. Douglas Kiester, MD; Alexandra D. Duke, DO - VOL 106 / NO 7 / DECEMBER 1999 / POSTGRADUATE MEDICINE

In any event, in the interest of fairness to patients who are reporting any back pain to a doctor I thought a link directly to the source was appropriate.

This is the preview of the article:

Have you ever become frustrated while caring for patients who present with a confusing array of musculoskeletal complaints and other signs of illness? When routine evaluation does not suggest a diagnosis and you begin to suspect it's "all in their head," how do you identify the underlying cause? And what is the best tack to take when dealing with such patients? Thanks to research by Waddell and colleagues, there is a way to distinguish between physical and behavioral causes. Drs Kiester and Duke explain the eight Waddell signs for identifying nonorganic back pain and offer a practical approach to patient management.

I guess the trick is to avoid frustrating your doctor? Patients with back pain should lead the doctor directly to the underlying cause before the yellow malingering light goes on. Never pull out a confusing array for him to consider.

Bottom Line Of Tort Reform Not A Plus

Category: Seeing Clearly Now

Legal blogger, Bob Kraft, cuts to the bottom line of Tort Reform.

The False Choice: Doctors Or Accountability

The consumer group Texas Watch has produced an excellent article on tort reform in Texas, and specifically about the recent constitutional amendment that essentially took away the rights of Texans to sue medical providers for meaningful damages. The article is titled The False Choice: Doctors or Accountability, The Real Impact of So-Called Tort "Reform" in Texas.

The bottom line, as so many of us tried to warn consumers before the election, is that medical care is no more available now than before "reform," insurance premiums have not decreased significantly, and medical malpractice victims are now barred from recovering full damages in court. The only beneficiaries of Tort Reform are the big insurance companies.

Does anyone believe that the insurance industry worked so hard to restrict the rights of the wrongfully injured in order to make medical care more available and to reduce insurance company profits?

The drumbeat for Tort Reform has been well-orchestrated and financed by an industry that makes its money by denying or reducing claims. Insurance companies could do that the old fashioned way, by defeating each claim in the courthouse, or they could effectively bar the courthouse door.

FDA Announces Brand New Focus

Category: Seeing Clearly Now

There is shock and awe in Washington, and it is not in the Pentagon. It is the reaction to the Food & Drug Administration's announcement of a comprehensive commitment to the safety of drugs and other medical products.

FDA ANNOUNCES PLAN TO IMPROVE DRUG SAFETY

The FDA has outlined a comprehensive commitment to the safety of drugs and other medical products. The FDA report, which also responds to recommendations made by the Institute of Medicine (IOM), details a series of initial steps that aim to ensure that FDA's safety programs are the best possible.

The FDA plans to take action in three key areas:

*Strengthening the science that supports the FDA's drug safety system from premarket testing through postmarket surveillance;

*Improving communication and information flow; and

*Reorganizing operations to improve the review, analysis and consultation related to safety.

Wow! These people mean business - I mean, safety.

Missing Hospital Records, No Independent Autopsy Equal $30 Million Verdict

Category: Seeing Clearly Now

Was it a natural cause or an accidental overdose of painkillers that killed the hospital patient within a day after his joint-replacement surgery? Hint: the hospital says it lost some of the patient's records.

Coroners urged to investigate more patient deaths

COLUMBIA, S.C. (AP) - The 2002 death of a man after joint-replacement surgery - and the $30 million verdict against Lexington Medical Center that followed - has prompted some to call for more in-depth investigations into patient deaths at South Carolina hospitals. A jury found that the hospital and an anesthesiologist were responsible for the death of Dr. Asif Sheikh, 58, who died less than a day after double knee-replacement surgery at the hospital.

At trial, Sheikh's lawyer Geoffrey Fieger argued that his client died from an accidental overdose of painkillers that the hospital tried to cover up. The hospital, which acknowledged it had lost some of Sheikh's records, is appealing.

States differ on their policies of notifying coroners and medical examiners after questionable hospital deaths, said Dr. Joseph Prahlow, an Indiana pathologist and president of the National Association of Medical Examiners.

Big Pharma & Lawyers In Race To Bottom With Wall-to-Wall TV Commercials

Category: Seeing Clearly Now

The legal profession has experienced a drop in public esteem for a number of years. More recently drug manufacturers have suffered the safe fate. There is a common denominator - advertising on mass media. PharmaGossip has the details.

Big Pharma's reputation - how low can it go?

Pharmaceutical firms need to make some drastic changes to the way they do business if they are to regain the public's trust and must be seen to be more interested in medicines than market share to avoid even more damage to their image, a leading industry observer has told PharmaTimes World News.

Peter Claude, a USA-based partner at PricewaterhouseCoopers pharmaceutical and life sciences advisory services group, was speaking as the firm published a report, Recapturing the Vision which highlights the significant differences between the public's view of pharmaceutical companies and the industry's self perception.

Mr. Claude said that "it is difficult to comprehend how an industry that has saved so many lives should be held in such low public esteem," noting that "in the current climate of distrust, the public is questioning the industry's motives and practices from sales and marketing to pricing to drug development."

DTC [direct-to-consumer] advertising needs to be more serious and scientific. A change needs to be made in the way sales and marketing practices are carried out and the industry has focused for too long on the doctor rather than the patient.

This change can be achieved in a number of ways, Mr Claude explained, one of which is to improve the quality of direct-to-consumer advertising on TV and focusing on the serious scientific benefits of the drug.

The legal profession should read Recapturing the Vision before it drops below child molesters in the eyes of the public it is pounding with inane commercials.

The Canaries Are Dying In Canadian Hospitals

Category: Seeing Clearly Now

Would you agree that nurses would probably be the most knowledgeable folks about the frequency of serious medical errors in hospitals? It seems to me they would be at the ground floor level throughout hospitals and most aware of the mistakes that are occurring.

Well, 74% of Canadian nurses think it is likely a patient will experience a serious medical error in a hospital. Yes, that is three-quarters of them.

Canadians afraid of medical errors and environmental factors affecting health

A new poll suggests most Canadians believe a serious medical error might occur at a Canadian hospital.

The poll reveals 60 per cent of Canadians fear an error may be made while undergoing medical treatment.

Sixty per cent of public, 40 per cent of doctors, 62 per cent of pharmacists, 74 per cent of nurses, and 77 per cent of managers think it is likely that someone might be subjected to a serious medical error while in a Canadian hospital.

If 74% of the canaries in coal mines flopped over dead who would be willing to walk into mines? Maybe that's why they no longer use the canaries. But, we can't do without the nurses. (Of course, if they are responsible for most of the errors, we should ban a few.)

Hoax Of Medical Malpractice Crisis Exposed

Category: Seeing Clearly Now

When you name your report The Great Medical Malpractice Hoax you had better have the facts to back it up. Public Citizen has done its homework well. Cyrus Dugger at TortDeform provides this summary:

Public Citizen: Medical Malpractice Lawsuits Not the Cause of Health Care "Crisis," Public Citizen Report Shows

Despite claims by business and medical lobbying interests and the Bush administration, there is no medical malpractice lawsuit crisis in America, according to analysis released today by Public Citizen. The new report, "The Great Medical Malpractice Hoax," dispels oft-repeated myths of dwindling doctors and spiraling insurance premiums used to support limits on the ability of injured patients to seek redress in the courts.

The real problems are a lack of attention to patient safety, the high incidence of preventable medical error and the lack of accountability for a small set of doctors who account for a majority of medical malpractice payments, the report reveals. The report also presents several recommendations for Congress, state governments and hospitals to reduce health care costs and save lives.

"Over the past few years, the Republican-led Congress has repeatedly attempted to curtail the legal rights of medical malpractice victims by capping damage awards and imposing other limits on access to the courts by consumers," said Public Citizen President Joan Claybrook. "This report shows that lawmakers were misguided; in fact, Congress should work to reduce medical errors."

You can read the full Public Citizen Report and decide just how misguided the tort reformers have been.

Medicare Drug Prices Soar Above VA Drug Prices

Category: Seeing Clearly Now

Shirl Kennedy, at Docuticker, provides an excerpt from a report explaining why the Bush Administration and the Republicans in Congress did not want the government to have the ability to negotiate prices with drug manufacturers in the new Medicare Drug Benefit.

No Bargain: Medicare Drug Plans Deliver High Prices

Medicare drug plan prices for the top drugs prescribed to seniors are 58 percent higher than the same drugs provided to veterans by the Department of Veterans Affairs (VA), according to a report released today.

The new report, issued by the consumer health organization Families USA, was released shortly before the House of Representatives was scheduled to vote on a bill to end the current prohibition preventing Medicare from bargaining for cheaper drug prices. The bill is a top priority for House Speaker Nancy Pelosi and her new Democratic majority.

For the top 20 drugs prescribed to seniors, the report examined prices charged by the VA compared to the prices charged by the five companies with the largest enrollment in the Medicare (Part D) drug program. Those companies, UnitedHealthcare/PacifiCare, Humana, Wellpoint, Member Health, and WellCare, enrolled almost two-thirds (65 percent) of the Medicare beneficiaries participating in Part D during 2006.

According to the report, the prices charged by plans sponsored by the five companies are 50-75 percent higher than the VA price for Celebrex; 51-82 percent higher for Lipitor (10 mg); 69-95 percent higher for Nexium; 205-261 percent higher for Fosamax; 435-522 percent higher for Protonix; and 1,066-1,229 percent higher for Zocor (20 mg).

I am having trouble even calculating what the Zocor overpricing means.

Smoking And Global Warming Are Good For You

Category: Seeing Clearly Now

From Politics In The Zeros comes word that tobacco-disinformation tactics and operatives have found a new home.

ExxonMobil's tobacco-like disinformation campaign on global warming

A new report from the Union of Concerned Scientists offers the most comprehensive documentation to date of how ExxonMobil has adopted the tobacco industry's disinformation tactics, as well as some of the same organizations and personnel, to cloud the scientific understanding of climate change and delay action on the issue.

I had thought all of the disinformation specialists had moved to the Bush Administration. Maybe they are jumping ship.

States Give Corporate America Greater Profits By Giving Us Fewer Rights

Category: Seeing Clearly Now

Nathan Newman, at TPM Cafe, details how Corporate America went state to state to accomplish much of its "tort reform" agenda. The accomplishments are enough to light your hair on fire. And, the result - greater profits - was predictable.

Shutting the Courtroom Door: How the Corporate Right Mobilized in the States

The only thing that has changed in the wake of "tort reform" are escalating corporate profits at the expense of consumer and workers' pocketbooks -- a triumph of using lobbying power to rob from working families to benefit the wealthy. And this was done nearly solely with changes in state policy-- highlighting why state politics matters so much for large areas of social justice.

Soon all courtrooms and court systems will be operated by state Chambers of Commerce.

"Nanny-State" Takes On "Big-Fannies"

Category: Seeing Clearly Now

Walter Olson at Overlawyered fires his shot at what he calls the nanny-state in the United Kingdom.

Nanny-state watch: warning labels on larger-size clothes?

The British Medical Journal, already well established as a source of policy recommendations noxious to individual liberty, is at it again:

Clothes made in larger sizes should carry a tag with an obesity helpline number, health specialists have suggested. Sweets and snacks should not be permitted near checkouts, new roads should not be built unless they include cycle lanes and food likely to make people fat should be taxed, they say in a checklist of what we might "reasonably do" to deal with obesity.

(Nigel Hawkes, "Larger-size clothes should come with warning to lose weight, say experts", Times Online (UK), Dec. 15).

The report referenced by Walter was put together by Laurence Gruer, director of public health science at NHS Health Scotland, and Sir George, who is emeritus professor of medicine at Newcastle University. The recommendation regarding clothing is actually Printing helpline numbers for advice with all clothes sold with a waist of more than 40in for men and 37in for boys, women's garments with a waist of more than 35in or size 16 or above, and more than 31in for girls.

British citizens live in a society which provides a universal health care plan that must deal with the many diseases associated with obesity. In the United States, where our continued reverence for individual liberty has resulted in over 40 million uninsured citizens and the most costly health care system in the world, we look at obesity and its causes as just a "living big" lifestyle choice. Walter apparently feels freedom-loving Americans would be repulsed by an effort by our government to inform its obese citizens of available help for a condition that is killing them and costing the rest of us billions of dollars a year.

Next week, Walter may be putting the spotlight on those ridiculous warnings on cigarette packs, the overly wordy package inserts provided with prescription drugs, the stupid warning labels about alcohol consumption during pregnancy, the nagging "buckle up" buzzer in our automobiles, the nutritional information on food product packaging, the flame-retardant effort in children's sleepware, the choking hazard labeling of children's toys, the annual flu-vaccine programs and the child immunization vaccines.

Thank God, someone is going to crusade against the Made In China labels. [Talk about the ultimate nanny-state infringement upon individual liberty.]

The Circle Of Life - Big Pharma Version

Category: Seeing Clearly Now

The circle has been completed by Big Pharma. Massive marketing campaigns now cause far greater use of a drug than would be warranted from a purely medical standpoint. As a result, more complications are occurring. Some of the complications are the very ones the drugs were designed to avoid.

From Pharma Watch comes the success story of the Cox-2 inhibitors.

More ulcers seen after Cox-2 inhibitors launched

The whole point of introducing COX-2 inhibitors was to prevent the nasty GI side effects of NSAIDS. The net effect however, has been to increase the number of ulcer and GI bleeding problems. This is because all the hype over Celebrex (and Vioxx) has persuaded doctors to use them in a lot more people - including people who they might not have used an NSAID.

In other words, we spend billions on Celebrex etc, and end up with more ulcers, not less. Good on you Pfizer, you've done it again.

Nurses May Be Their Own Worst Enemy

Category: Seeing Clearly Now

Wow!! I just read what amounts to a scathing indictment of the nursing profession and its leadership. It is posted at Universal Health. You may need to wear protective clothing to approach this "bedside."

Nurses: Prostituting for the Healthcare System Pimp

Nurses, who by social contract, are supposed to serve as patients' advocates, have prostituted themselves for the health care system pimp. As long as nurses continue to be violent toward fellow nurses, the public will continue to pay with its health.

The Bible Made Me Use It

Category: Seeing Clearly Now

Does this research mean marijuana use will be increasing among smoking Christian fundamentalists?

Weed Enhances Fertility of Tobacco Inhibited Sperm

A reproductive medicine specialist at the University at Buffalo has shown that a new compound may improve the fertility of tobacco smokers who have low sperm count and low percentage sperm motility.

The sperm from male smokers were washed with a synthetic (cannabinoid) chemical called AM-1346. After incubation, there was a doubling in the fertilizing capacity of sperm from poor quality semen, results showed.

"Human sperm carry the cholinergic receptor, which responds to the neurotransmitter acetylcholine," noted Burkman. "Nicotine mimics acetylcholine and binds to the cholinergic receptor." In earlier research, Burkman and colleagues also showed that human sperm contain cannabinoid receptors, which respond to marijuana, as well as natural cannabinoids occurring in the body.

Lani Burkman, Ph.D., and colleagues presented the findings at the 2006 meeting of the American Society of Reproductive Medicine held recently in New Orleans.

"Based on our previous data and published literature, it is clear that most tobacco smokers will exhibit a small or a significant decline in fertility," she stated. "Nicotine addiction is quite powerful. The best solution is to stop smoking and then wean yourself off of all nicotine products. But for smokers who can't quit, the in vitro use of AM-1346 may significantly improve their fertilizing capacity."

I can see the full page ads: No Sperm Left Behind. Or, Give Your Sperm A Fighting Chance.

It's The Building That Is Causing Medical Errors

Category: Seeing Clearly Now

Guess which workplace is worried about hospital-acquired infections, medical errors and operational failures? Hint: many of the employees wear white uniforms and carry stethoscopes.

The Role of the Physical Environment in Promoting Health, Safety, and Effectiveness in the Healthcare Workplace

There is an urgent need to address the inherent problems in the healthcare workplace that lead to staff injuries and hospital-acquired infections, medical errors, operational failures, and wastage. The physical environment plays an important role in improving the health and safety for staff, increasing effectiveness in providing care, reducing errors, and increasing job satisfaction.

These improved outcomes may, in turn, help in reducing staff turnover and increase retention -- two key factors related to providing quality care in hospitals. However, it has become increasingly clear that efforts to improve the physical environment alone are not likely to help an organization achieve its goals without a complementary shift in work culture and work practices.

Source: The Center for Health Design

Bottom Line: (1) injured and unhappy hospital employees cause many of the medical errors experienced by patients and (2) hospital employees get the same poor care when they become patients. Conclusion: It's the building, stupid!

Blue-Ribbon Bucks Fund "Get Government Off Our Back" Committee

Category: Seeing Clearly Now

Sometimes blue-ribbon committees have special blue-ribbon funders. The Tortellini tells us about one this week.

Following the blue-ribbon money

New York Times columnist Floyd Norris has a great post on his blog about the money behind the blue-ribbon Committee on Capital Markets Regulation that's pushing to relax corporate governance regulations. Turns out that the panel's biggest funder is none other than Hank Greenberg, the former and longtime CEO of the world's largest liability insurer, AIG.

I Nominate Perry Mason For Sainthood

Category: Seeing Clearly Now

Thank God for Perry Mason.

Michael Asimow on Our Enduring Faith in the Adversarial System

Michael Asimow, University of California Los Angeles School of Law, has published "Popular Culture and the Adversarial System" in the Loyola of Los Angeles Law Review for 2007. [From the abstract.]

This article addresses a puzzle: lawyers are the most distrusted and despised of all American professions, whereas the public has a much higher opinion of judges. Yet Americans believe strongly in the adversary system in which all the important procedural decisions during civil or criminal trials are made by lawyers....

However, the article suggests another possible reason: the influence of popular cultural portrayals of the trial process. Dating back to the days of history's greatest teacher of trial tactics - Perry Mason - media consumers have been taught that the adversary system delivers the truth. We can count on a great lawyer's cross-examination to reveal the identity of the real killer. Even though we hate and distrust lawyers, we want a good one by our side when we're in trouble or an aggressive one prosecuting the crooks. Countless films and television shows since Perry Mason's day have conveyed the same basic message, although in more sophisticated form.

Hypocrisy - Another Name For Lie?

Category: Seeing Clearly Now

The topic today is hypocrisy. Ted Frank apparently sees less hypocrisy in the world than I do. When you are Greedy Trial Lawyer by choice you tend to wish others would be equally straight-forward. Maybe we all need to select one or two adjectives to place before or after our names.

Mike at Crime & Federalism picks up the story. Go for it, Mike.

What is Hypocrisy?

Ted Frank, blogging at Overlawyered, has an interesting post on hypocrisy. Check it out.

My take: I'm suspicious of a person whose words and actions are incongruent. If a person claims to be a tort reformer, but himself files frivolous lawsuits, then I wonder if the person really supports tort reform. So while the person might not be a hypocrite, his actions would make me wonder what ulterior motive he has for "supporting" tort reform.

A person's words and deeds should generally overlap.

So while I'm not sure it's appropriate to call an alleged tort reformer who files lawsuits a hypocrite, it is appropriate to question that person's motives for "supporting" tort reform. If a person really cared about fixing a problem, why would he work to make the same problem worse?

The answer, of course, is this: Most politicians "support" tort reform because they have been paid off by big companies. Most politicians who "support" the poor do so to get elected - and thus accumulate personal power. When a person cannot obtain more power with the tort-reform or support-the-poor gig, then he will find another way to serve his interests.

To that last paragraph I say, Amen, Brother!

We Deserve Better Than Medical Tourism

Category: Seeing Clearly Now

Is there anyone out there who doubts that high medical costs and pathetic health insurance coverage in America need immediate attention? When foreign countries are advertising medical tourism as the alternative to our broken healthcare system have we not sunk below absurd.

Medical tourism: India is 'nation of choice' for medical tourists

Medical tourism: India is 'nation of choice' for medical tourists: "India's minister for tourism and culture, Smt Ambika Soni, has highlighted the need for the country to promote itself as the emerging medical value travel destination for overseas patients.

Speaking at the launch of the new Incredible India brochure on Medical Tourism, Smt Soni said that both private and public hospitals needed to combine their efforts in order to promote the country as the medical destination of choice and to assure tourists of the best quality treatment at competitive costs.

I'm thinking educational tourism can't be far behind.

High-Speed Police Pursuits Should Be Limited To Video Games

Category: Seeing Clearly Now

You can call them police chases. You can call them police pursuits. You can even call them high-speed pursuits. What we should do is call them off.

Head-on crash victim files suit against city of Oakland

OAKLAND -- Patricia Messner's memory of her head-on collision is sketchy, but she remembers a big bang.

Messner, who said she has just begun walking again with help from a cane, sued the city of Oakland and the police department Oct. 6, claiming that police "caused the colliding vehicle to be traveling the wrong way on the interstate, with no headlights, at a recklessly high rate of speed."

Messner's suit highlights the dangers and thorny legal issues that arise when a police chase results in injury or death. California law essentially grants immunity to law enforcement agencies and cities from lawsuits filed when bystanders killed or injured during high-speed pursuits.

Messner is one of thousands injured in police pursuits throughout the state. Last year, law enforcement was involved in 7,942 pursuits that resulted in more than 1,200 people getting injured and 32 killed from collisions, the California Highway Patrol reported.

California leads the nation almost every year in injuries and deaths incurred as a result of police pursuits, according to data from the National Highway Traffic Safety Administration. In 2004, the last year statistics were available, only Texas recorded more fatalities.

Bring Your Checkbook When Applying For A Federal Judgeship

Category: Seeing Clearly Now

The checklist for judicial appointments during the Bush Administration probably gives bonus points for political contributions to Republicans or to the President himself.

Money trails lead to Bush judges

A four-month investigation reveals that dozens of federal judges gave contributions to President Bush and top Republicans who helped place them on the bench.

At least two dozen federal judges appointed by President Bush since 2001 made political contributions to key Republicans or to the president himself while under consideration for their judgeships, government records show. A four-month investigation of Bush-appointed judges by the Center for Investigative Reporting reveals that six appellate court judges and 18 district court judges contributed a total of more than $44,000 to politicians who were influential in their appointments. Some gave money directly to Bush after he officially nominated them. Other judges contributed to Republican campaign committees while they were under consideration for a judgeship.

From Salon.com

The Rule Of 9 Is The Only Sensible Way To Go

Category: Seeing Clearly Now

The punitive damage tobacco case argued before the U.S. Supreme Court this week has brought us a mystical connection between acceptable punitive damages and the number 9. An L.A. Times editorial is wild-eyed over the size of the $79.5 Million punitive award and appears to support a cap on punitives of 9 times compensatory damages. To the Times the cap would be a good general rule that makes sense.

While we are at it, I believe the salaries and bonuses of corporate officers should be capped at 9 times the company's average employee. And, the charges for newspaper ads should be capped at 9 times the cost of the Sunday edition. Now, we are making some sense. The world is so much more sensible if we use the "rule of 9."

Torts gone wild

WHEN LAWYERS say, "hard cases make bad law," what they often mean is that a sympathetic plaintiff or an unattractive defendant can induce judges to depart from a general rule that makes sense. The U.S. Supreme Court should resist that temptation in ruling on an Oregon jury's decision to order a tobacco company to pay $79.5 million in punitive damages in a case involving a lifelong smoker who died of lung cancer.

In a landmark 2003 ruling, the justices suggested that punitive damages should be capped at nine times the amount of actual damages.

Has anyone else noticed the fact that there happen to be 9 Supreme Court Justices?

Nursing Home Mistakes May Kill Us All

Category: Seeing Clearly Now

When you only learn about less than 1 out of every 20 errors made by the staff you are supervising should you call yourself a supervisor? In fact, why shouldn't you be fired?

Mistakes In Nursing Homes Often Not Brought To Light, USA

The issue of nursing home quality is getting more attention as baby boomers age. It is estimated by the U.S. Census Bureau that 35 percent of the total population will be older than 65 by 2020. A recent study by a University of Missouri-Columbia nursing researcher found that a shift in attitude is needed to improve the quality of care in nursing homes.

According to the study, preventable errors in the healthcare system are the eighth most common cause of death. The study suggests that medication errors could be a large part of the problem. In nursing homes, administering medicine is viewed as a routine task. However, because most nursing home residents are frail and elderly, even minor medication discrepancies can have very negative outcomes, according to Jill Scott-Cawiezell, assistant professor in the MU Sinclair School of Nursing.

In broaching the subject of medication errors and ways to correct them during the study, Scott-Cawiezell said she was surprised by her experiences working with 'front-line staff' who often faced so many demands and were so stressed they didn't even want to know about their mistakes. Her study suggests that nursing home leaders are aware of fewer than 5 percent of the errors in the system, but that staff members are aware of all of them.

More Nurses Good; Less Nurses Bad

Category: Seeing Clearly Now

Some studies merely confirm what any rational person would have thought in the first place.

Link Between Nurse Numbers And Patient Mortality

Patients staying in hospitals where there are fewer nurses on the wards are more likely to die or experience complications, according to a major new study launched at the Royal College of Nursing (RCN). The independent study - the first of its kind in the UK - mirrors the findings of US research by establishing a direct link between the number of nurses working on wards and patients' chances of recovery and survival. The research also finds that nurses working on wards where nurse to patient ratio are lower are much more likely to experience "burn out."

Goodbye To "Stay The Course" And "Cut And Run"

Category: Seeing Clearly Now

Now that Stay the Course has been retired by the White House because it is, supposedly, not an accurate expression of the complexity of what the Administration has been doing in Iraq, I propose the White House also retire Cut and Run. I humbly suggest the latter is not an accurate expression of the complexity of what those who urge withdrawal of American military forces have been proposing.

This would go a long way toward ending public "debate" over the war in Iraq by slogans. I know slogans are useful shorthand in political campaigns and elsewhere. But, there is something pathetic and tragic about using them to discuss an ongoing military conflict.

Praise The Lord And Pass The Perks

Category: Seeing Clearly Now

I must have been taking a long nap because I missed an editorial in the New York Times almost a week ago.

Faith-Based Profits

Mary Rosati, a novice training to be a nun in Toledo, Ohio, says that after she received a diagnosis of breast cancer, her mother superior dismissed her. If Ms. Rosati had a nonreligious job, she might have won a lawsuit against her diocese (which denies the charge). But a federal judge dismissed her suit under the Americans With Disabilities Act, declining to second-guess the church's "ecclesiastical decision."

I do not have the hesitancy of a federal judge about second-guessing the church's "ecclesiastical decision." At the pit of my greedy stomach I feel the decision is unworthy of the Catholic Church.

The editorial continued with other perks that we provide for organizations which claim to do God's work.

Ms. Rosati's story is one of many that Diana Henriques told in a recent Times series examining the fast-changing legal status of churches and religious-affiliated institutions. The series showed that the wall between church and state is being replaced by a platform that raises religious organizations to a higher legal plane than their secular counterparts.

Day care centers with religious affiliations are exempted in some states from licensing requirements. Churches can expand in ways that would violate zoning ordinances if a nonreligious builder did the same thing, and they are permitted, in some localities, to operate lavish facilities, like state-of-the-art gyms, without paying property taxes.

In its expanded form, this principle amounts to an enormous subsidy for religion, in some cases violating the establishment clause of the First Amendment. It also undermines core American values, like the right to be free from job discrimination. It puts secular entrepreneurs at an unfair competitive disadvantage. And it deprives states and localities of much-needed tax revenues, putting a heavier burden on ordinary taxpayers.

After Texas exempted religious day care centers and drug-treatment programs from state licensing, a study found that the "alternatively accredited" facilities had 10 times the rate of abuse and neglect of the others, and several were investigated. In 2001, the Texas Legislature, no enemy of organized religion, did the right thing and ended the exemption.

I do not recall God saying we should treat those who choose to do his work better than those who do the other work required in our society. Maybe I should be Brother Greedy Trial Lawyer.

Mold To Become State Flower If Crist Becomes Florida's Governor

Category: Seeing Clearly Now

Mold has been injected into a political race in Florida in a most ironic way. Thanks to The Tortellini for bringing this item to our attention.

A Moldy Campaign?

For years, big business has linked arms with Republicans to tar Democrats as beholden to trial lawyers and enemies of personal responsibility for their opposition to tort reform. But what happens in a race where the trial lawyer candidate is a Republican? [How can a trial lawyer be a Republican?]

That's the scenario facing Florida Republicans right now. Business groups that spent eight years winning a host of restrictions on lawsuits under Jeb Bush are in a bit of a tizzy after state Republicans nominated Rep. Jeff Kottkamp as their candidate for lieutenant governor. Not only was Kottkamp the only Republican house member to vote against tort reform last year, but he's also a plaintiff in the kind of lawsuit that makes tort reformers apoplectic.

A few years ago, Kottkamp nearly died after bypass surgery when a mold infection developed in his chest. Florida now caps damages in suits against public hospitals at $250,000, so Kottkamp instead sued the hospital construction company he alleges created the moldy conditions that led to his infection. Perhaps the most disturbing thing to business groups is that it looks like Kottkamp and running mate Charlie Crist are likely to be elected...

The Crist Campaign has tried to insulate itself from the criticism of the Republican base by making some unusual promises. If elected, Crist and Kottkamp have vowed to put damage caps on personal injury awards against Florida construction companies. Or, if that is not possible, to declare mold the state flower.

Picture Button Justice For Accused

Category: Seeing Clearly Now

I never thought of having to try a medical malpractice case involving a nursing error with the spectator section of the courtroom full of nurses in crisp, white uniforms. Or, presenting a case against a police department before a packed courtroom of police officers.

Either scenario would strike me as creating an environment prejudicial to the injured plaintiff's cause. My assumption would be that the jury would get the impression that the community favors the defense. Or, that a defense verdict would be the best outcome.

These thoughts came to mind when I read about this argument before the U.S. Supreme Court:

High court considers buttons' role in proceedings

The Supreme Court on Wednesday debated whether a murder victim's family prejudiced the trial of an accused killer by wearing buttons to court bearing a picture of the slain man.

The justices waded into issues of defendants' rights, struggling with the question of whether the buttons visible to the jury in Mathew Musladin's case denied him a fair trial or were a harmless expression of grief. The state of California is seeking to reinstate Musladin's conviction, which was thrown out by the 9th U.S. Circuit Court of Appeals.

I do not know about the constitutional rights of victims, the families of victims or criminal defendants. But, I do know what impact the picture buttons would likely have on the minds of some jurors.

Don't Provoke A Trial Lawyer

Category: Seeing Clearly Now

Don't provoke me - I am a Type A personality. This may be the required warning label on the chest of many trial lawyers.

Aggressiveness And Irritability Found To Be Associated With Aggressive Behavior

Specific personality variables, such as anger or irritability predict the tendency to either engage in aggressive behavior willingly or to engage in aggressive behavior when provoked, according to a recent meta-analysis in the September issue of Psychological Bulletin, published by the American Psychological Association (APA).

[The study] examined the association between personality variables and aggressive behavior, under provoking and relatively neutral conditions. The following personality variables were identified: trait aggressiveness, trait irritability, trait anger, Type A personality, dissipation-rumination, emotional susceptibility (tendency to feel inadequate or vulnerable), narcissism, and impulsivity.

Persons identified as having an aggressive and irritable personality were more likely to engage in aggressive behavior regardless of whether situations were provoking. "This may suggest that these persons have the capacity to engage in cold-blooded style of aggressive behavior, reacting harshly as a result to little or no agitation" said lead author B. Ann Bettencourt.

The review also found that personality variables, and the level of provocation, interact to influence aggressive behavior. For instance, people who are Type A personalities, have a tendency to express anger (trait anger), have self-destructive tendencies and mull-over upsetting situations, are emotional susceptible, narcissistic and for the most part impulsive were more likely to behave aggressively only under provoking conditions.

The Newest Tort Reform Strategy

Category: Seeing Clearly Now

I suspect the Tort Reform effort has moved into a new phase. Studies and articles like the one below are starting to crop up. The common theme is the unimportance of money. Next, there will be scientific evidence that uncompensated injured persons and unsuccessful trial lawyers are the happiest people on the planet.

Expert: Money can't buy happiness

Money can't buy happiness, but happiness can buy you money, according to a U.S. psychologist who says happiness is genetic, attitude and circumstance.

"Happier people seem to have more initiative and productivity at work, and their customers and bosses are more satisfied, which can lead to a raise in pay," said Dr. Michael Frisch, a professor of psychology at Baylor University, who co-authored a study with a University of Pennsylvania psychologist and three students.

People who are more materialistic and place being rich as a high value tend to be more pessimistic and unhappy.

If there is any truth to this study it explains the attitude of most doctors. The only thing that can save them from the grumps is socialized medicine.

Analysis Of The "Medicine" In $217 Million Verdict Not Productive

Category: Seeing Clearly Now

Over at Kevin M.D. the medicine behind the $217 medical malpractice verdict in Tampa, Florida, is being reviewed.

The medicine behind the Navarro stroke case

More details are emerging from the record breaking malpractice case. Let's look at the medicine behind the case:

On Aug. 9, 2000, Navarro, who was a professional basketball player in his native Philippines, entered University Community Hospital-Carrollwood with a headache, nausea, dizziness, confusion and double vision. He described a personal medical history of hypertension, diabetes and elevated cholesterol plus a family history of strokes to the triage nurse. A different nurse than the triage nurse also noted he was unsteady on his feet.

When Navarro spoke with Herranz in the examination room, he mentioned the sudden onset of a headache earlier that day and that he had felt a "pop" in his head.

According to the 2005 second amended complaint, Herranz did not complete an adequate medical history of Narvarro, nor did he do a complete or adequate neurological exam.

Navarro spent about 5 1/2 hours at UCH-Carrollwood, during which time he had two CT scans of his brain and was diagnosed with "sinusitis/headache" by Austin, prescribed Vicodin for the pain and an antibiotic by the doctor and sent home. He was not told to watch for any stroke symptoms.

I have commented, as follows, on Kevin's blog:

I realize the effort in this article is to examine the medicine behind the verdict. The medicine only provides the factual basis for the jury to conclude malpractice occurred. As in all malpractice cases it is a yes or no decision. You can slice and dice the facts all week, but, trust me, these facts are not special or unique to lawyers who review missed or delayed diagnosis cases.

The medicine, however, does not provide a good explanation for what is obviously unique - the jury felt the need to award punitive damages and, as a consequence, to be certain the compensatory damages were truly adequate. By their dollar awards in this case the jury is communicating disgust with someone or something (likely multiple someones or somethings). The level of disgust is likely related to the size of the punitive damage award. I would say this jury was about as disgusted as one can get and not yell obscenities.

Since I was not in the courtroom it is difficult to isolate the fuel that ignited the jury's reaction to the case. I have my suspicions, but they could be well off the target.

There is one observation I feel confident enough to express - the probability of an award of punitive damages and a bleed-over into a large compensatory damage award should have been assessed very carefully by the defendants, the insurance company and the defense attorneys. It is extremely rare for a judge to permit a jury in a medical malpractice case to even consider the award of punitive damages. This judge concluded the evidence justified the jury instruction on punitive damages and the arguments of counsel on the subject. Alarm bells should have been ringing very loudly at that point and, probably, well prior to that point.

The fact is that judges have been insulating medical providers from larger medical malpractice verdicts for years by denying the victims the opportunity to seek punitive damages for grossly negligent, reckless or willful misconduct.

One of my suspicions is that some aspect of the defense of the case before the jury was perceived as disingenuous or dishonest. Maybe the jury thought the defense was entirely fair and honest but still awarded over $100 Million in punitive damages. But, more likely, the cock crowed three times during the defense summation.

And, The Leader In Filing Frivolous Lawsuits Is....Corporate America

Category: Seeing Clearly Now

Cyrus Dugger at Tort Deform has alerted me to my major competitors in the filing of frivolous lawsuits. Corporate America appears to have clogged up the civil system even more than greedy trial lawyers.

Businesses More Likely to Sue - More Likely to Sue Frivolously

Ironically, a report by Public Citizen demonstrates that despite their opposition to lawsuits by individuals (often filed against corporations) corporations were found to have filed more lawsuits, and more than that, to have filed more frivolous lawsuits than individual people.

"A recent study by Public Citizen found that in 2001 in Arkansas, Mississippi, Cook County Illinois., and Philadelphia, corporations were 3.3-5.8 times more likely to bring a lawsuit than individual tort plaintiffs. The study also found that when these corporations did file lawsuits, they and their attorneys were 69% more likely than individual tort plaintiffs and their attorneys to be sanctioned by federal judges for filing frivolous claims or defenses."

Medical Error Climbing The List

Category: Seeing Clearly Now

On the other side of the world it appears that medical error is working its way to the top of the list of the causes of preventable deaths.

Death By Medicine

Here in New Zealand it has been claimed that medical error, including adverse reactions to drugs, claims over 3,000 lives per year making this the 3rd leading cause of death after heart disease and cancer. That the very distant 4th placeholder (road smashes) gets so much attention while medical error receives so little, is a mystery to me and bordering on being downright scandalous.

With the ageing population and the increasing medicalisation of the healthy, I predict it will not be long before medical error becomes the leading cause of preventable death in the developed world.

From where I sit medical error may already be at the top of the list because most of the heart disease and cancer deaths are not presently preventable. Errors, on the other hand, are entirely preventable

Some Drug Advertising Campaigns Boost Sales Of Another Company's Drug - A Bitter Pill To Swallow

Category: Seeing Clearly Now

Even Big Pharma sometimes wastes its advertising dollars on a campaign that fails to increase sales of a particular drug. Even worse, sometimes a campaign results in increased sales for a rival company's drug of the same class. That is when the drug manufacturer takes two aspirin and goes to bed.

Unexpected Effect Of Direct-to-consumer Drug Ads

Television ads for prescription drugs are everywhere, enticing people to ask their doctors for this drug or that one, but the effect this type of ad has on American healthcare may be more complicated than simply inducing patients to choose one brand or the other, according to a team of researchers.

The researchers found that the direct-to-consumer advertising of Vioxx and Celebrex had positive effects on patient flow, increasing the numbers of patients seeking treatment for osteoarthritis.

The researchers report that "the effect of Vioxx direct-to-consumer advertising was consistently positive, increasing the proportion of osteoarthritis patient visits for which a prescription was written for Vioxx."

The Celebrex advertising was, however, associated with higher rates of Vioxx prescribing, but was not associated with significant changes in prescribing for Celebrex. Possibly, strong efforts by Pfizer drug representatives marketing Celebrex to physicians had already grown the Celebrex prescription base. Another possibility is that the heavy advertising by Pfizer for Vioxx embedded that brand in people's minds early on and Celebrex ads simply reinforced the class of drugs rather than a specific brand.

The researchers did find that direct-to-consumer ads for Vioxx and Celebrex influenced doctors' prescribing and patient behaviors.

"These ads convinced more people to visit their doctor's for treatment of osteoarthritis," says Kleit of Penn State. "Interestingly, the Celebrex ads were not very good at getting people to ask for or prescribe Celebrex, but did influence visits to the doctor and Vioxx prescriptions, exhibiting a class effect."

Post Medical Error Suffering - Together We Can Lift This Burden

Category: Seeing Clearly Now

A special thanks today to This Makes Me Sick for bringing to our attention the tragedy of Post Medical Error Suffering (PMES). Finally, this affliction will get the attention it deserves.

I commit to redoubling my personal efforts to bring more medical errors into the light of day and to provide more doctors and nurses the opportunity to compensate their victims. Healthcare professionals, I feel your pain. Help is on the way. Along with you, I curse those risk management and defense instructions to keep your mouths shut.

The Great Untalked About in Med-Mal

The media often talks about the pain visited upon patients and families by medical errors (which is very real), but rarely do they talk about the pain and suffering experienced by medical professionals after medical errors. Sure, there are those healthcare professionals who are cold and callous and truly don't care, but the vast majority of doctors and nurses suffer greatly after a medical error. They beat themselves up and literally grieve.

The situation is made worse when risk management and defense counsel tell the doctor or nurse to shut up and abandon the patient/family. Healthcare professionals being told not to heal patients and families who have been hurt only makes a bad situation worse. There are countless stories of clinical depression, ruined careers, divorces, and even suicides among healthcare professionals after medical errors.

Big Pharma Big Fan Of Medicare Drug Benefit

Category: Seeing Clearly Now

Guess who is doing quite well with the Medicare drug benefit.

Drug Benefit 'Boosting' Revenue for Pharmaceutical Companies

The Medicare drug benefit "is boosting prescription volume and revenue for drug companies," the Philadelphia Inquirer reports.

According to IMS Health, Medicare prescription drug plans cover about 12.4% of all U.S. prescriptions. As a result, the Medicare prescription drug benefit "has had a pronounced effect on pharmaceutical companies' financial results, with a majority of U.S. pharmaceutical revenues in the second quarter exceeding Wall Street expectations," the Inquirer reports.

If You Had A Hammer Would You Perform Angioplasties?

Category: Seeing Clearly Now

We have an article posted last month by Fixin' Healthcare to thank for this lesson in medical economics:

The Lifestyle Chronicles - Heart And Soul

Should we be surprised by the news that angioplasties are performed at four times the national rate in Elyria, Ohio? Not really. Researchers at Dartmouth have reported for some time now the variation between different parts of the country for procedure rates.

That it is Elyria and angioplasties are specifics in a data base that describes our health care system very well. All anyone has to know about this particular situation is that the North Ohio Heart Center employs 31 cardiologists.

Don't be surprised that someone does what they are trained to do, particularly when it is lucrative. When you are a hammer, the whole world is a nail.

Thirty-one cardiologists clustered together will result in the care for a lot of hearts or a lot of care for as many hearts as might be available and paid for. Saturation bombing will do no good. They will disperse and move to other clusters or form new ones.

The Pope Was Not Available So "Judge" Martin Issued The Vioxx Vindication

Category: Seeing Clearly Now

The Wall Street Journal is blogging over the issue of how to address former judges. Should the world still call them Your Honor or Judge? Or, should we get back to the customary Mr.?

In the article on the WSJ Law Blog, however, the specific former judge and his proper title is far from a matter of courtesy. Merck carefully selected The Honorable John S. Martin, Jr., to supposedly issue his report concerning the handling of Vioxx by Merck. The very fact that the name of the former judge is the top line in the title of the report reveals the importance Merck and the Debevoise & Plimpton LLP law firm place on the prestige of the former judgeship. If Merck had been able to land the Pope as the front man for this corporate ploy, the title would have been: The Report of HIS HOLINESS, POPE BENEDICT XVI...

Should We Call Former Judges "Judge"?

Here was the title page of the 179-page outside investigative report ordered by Merck's board that largely exonerated the drug maker's handling of Vioxx:

Report of The Honorable John S. Martin, Jr.
to the Special Committee
of the Board of Directors of Merck & Co., Inc.
Concerning the Conduct of Senior Management in the
Development and Marketing of Vioxx

Also on the cover page, on the bottom right-hand corner: Debevoise & Plimpton LLP. That's because The Honorable John S. Martin, Jr., is a former federal judge who stepped down from the bench in 2003 to practice law at Debevoise. In its opening page the report states, "Judge Martin and a team of lawyers and paralegals from Debevoise spent over 53,000 hours conducting an investigation over a period of approximately 20 months."

Now we know it's common practice to continue to refer to judges as "judge" long after they leave the bench.

...is it unbecoming for Merck and its lawyers to trade off the fact that John Martin once wore a robe?

Is it unbecoming for Judge Martin to allow his judgeship to be cheapened by this PR effort?

I Am The Greatest

Category: Seeing Clearly Now

Out there in medical offices, hospitals and clinics there is a subset of clinicians who appear, either by training or personality, unable to judge themselves. In other words, they overestimate their skills. Nobody would care except that they practice these imaginary skills on patients.

Doctors Often Overestimate Their Expertise

TUESDAY, Sept. 5 (HealthDay News) -- Doctors often have a falsely exaggerated view of their own capabilities, a new study suggests.

In fact, physicians who were judged by outsiders to be the worst performers in a given area often gave themselves especially high marks, researchers report.

"There is a subset of clinicians who appear, either by training or personality, unable to judge themselves," said study lead researcher Dr. David Davis, a professor of health policy management and evaluation at the University of Toronto, in Canada.

His team published its findings in the Sept. 6 issue of the Journal of the American Medical Association.

In their review, Davis and his colleagues in Canada and the United States decided to see what the accumulated data had to say about the accuracy of physician self-assessments. To do so, they focused on 17 studies comparing doctors' self-assessments against those of an objective, external reviewer.

"In two-thirds of those studies, it appears as though physicians, without any outside means of observing their behavior, misjudged their competence," Davis said.

In many cases, doctors thought they were very adept in certain tasks -- detecting signs of sexual abuse in patients, for example, or delivering joint injections -- but were typically deemed to be poor performers by outside experts.

Doctors Asked To "Remember The Alamo"

Category: Seeing Clearly Now

Eric Novack, MD, posting at This Makes Me Sick is in his full manly battlefield mode. See if you can spot the references to military matters in what should logically be a rational discussion of important issues to physicians. General Novack, I mean, Dr. Novack, addresses his troops (whoops!) in the manner of George S. Patton. Slapped any patients around, lately, General?

'Is The Crisis Over?'

The issue of medical liability reform appears to have lost some of its front-page appeal to doctors and the media over the last several months. The big question is why?

The real issue is that physicians are coming to realize that the greater threat to them is the prospect of going out of business due to the double whammy of decreasing reimbursement combined with greater regulation and diminished bargaining clout with the private insurance oligarchy. So, while the battle for medical liability reform remains an essential front in the war on medicine, the focus has shifted to the real battleground: physician autonomy and reimbursement.

Physician groups need to continue to be vigilant about not being portrayed as 'tilting at windmill's when it comes to medical liability reform. But, we must recognize that the issue of tort reform would be a pyrrhic victory indeed if autonomy and reimbursement go the way of the Alamo.

Go the way of the Alamo. Now there is a really helpful image for us all to ponder. Remember the Alamo - the new rallying cry of the medical profession.

"Do No Harm" Is Manufacturer's Duty

Category: Seeing Clearly Now

Chris Rangel, at RangelMD.com, discusses whether large verdicts against negligent or reckless corporations have an impact upon their future conduct - a fair discussion to have.

But, Chris takes a bridge too far when he says, Ensuring that as few people get hurt as possible is not part of the job of a company.

It appears massively simplistic to believe that corporations would "think twice" before developing a dangerous product. Ironically, corporations not only think twice, they have entire risk and prediction analyses about the potential liability of every consumer product. If the risk is too high then they stop. If the sales from a product are likely to exceed losses from any successful litigation then they proceed.

Companies don't really care if a few people get hurt using their products as long as profits are not hurt as well. Ensuring that as few people get hurt as possible is not the job of a company, as bad as that sounds. It's the job of regulatory agencies in government.

Since Chris is an M.D., I'll put it this way: First, do no harm. Chris learned this in medical school. It applies to every individual and every corporation in America. No new product should expose its users to an unreasonable risk of harm. Just as no competent physician should place a patient in the path of an unreasonable risk.

I do not believe it is solely the job of regulatory agencies to protect medical patients, and I do not believe it is solely the job of such agencies to police the marketplace for dangerous and defective products.

AMA Labels The Medical Liability System As Awful, Awful, Terrible And God-Awful - Sounds Like Some Doctors I Have Sued

Category: Seeing Clearly Now

The President of the American Medical Association, in an exclusive interview, has announced the results of his analysis of the U.S. medical liability system - awful, awful and terrible.

Interview: An 'awful' tort system, AMA

WASHINGTON, Sept. 1 (UPI) -- In an exclusive interview with United Press International, William Plested III, president of the American Medical Association, says that limits on medical tort "pain and suffering" damages are not enough without comprehensive reform of the medical liability system.

Q: Medical tort reform at the federal level failed to pass earlier this year in the Senate. Are limits on medical tort "pain and suffering" damages going to be an issue for each state to decide from now on?

A: That's kind of a sad commentary on our federal government that that hasn't happened, but that's exactly what we're seeing. But the changes (at the state level) that we've seen are temporary fixes. The $250,000 (damages) caps that we've passed in the state of California stabilized (medical malpractice) premiums somewhat, but we still have this awful, awful system. This is a terrible system.

At the end of the exclusive interview, as William reached for one more grenade, he revealed his most damning description - god-awful.

Q: [Ken Suggs, head of the Association of Trial Lawyers of America] said there is no medical malpractice "crisis." Any comment?

A: Well, do you want (a crisis)? If the message to American physicians is, this god-awful system will never be changed until you give us a crisis, what do you think we're going to say? We can't beat our heads against the wall trying to protect your ability to get care.

There you have it. A man of science presents his findings.

Doctors Are Practicing "Defense-of-Income Medicine"

Category: Seeing Clearly Now

A special thanks to Doc Advocate for a better explanation for defensive medicine. In its recent post we are reminded that the Congressional Budget Office has suggested that its studies do not support fear of frivolous lawsuits as the true cause of supposedly unnecessary testing. Rather, the CBO nominates income generation for doctors as a more likely cause.

What we have, apparently, is defense-of-income medicine.

Medical malpractice reform has been the source of heated debate, but there's little data about the impact of frivolous lawsuits on health care costs -- though they're frequently cited as a major cause of health care cost inflation.

The powerful American Medical Association, which represents doctors, cites statistics indicating the fear of malpractice claims has caused nearly 80 percent of doctors to order tests they otherwise wouldn't have.

But the Congressional Budget Office (CBO), the General Accounting Office and the Kaiser Family Foundation say there is little evidence to support that claim.

"Defensive medicine may be motivated less by liability concerns than by the income it generates for physicians or by the positive, albeit small, benefits to patients," the CBO said in a 2004 briefing.

"On the basis of existing studies and its own research, CBO believes that savings from reducing defensive medicine would be very small."

Honesty Apparently Not Taught In Medical Schools

Category: Seeing Clearly Now

If doctors are not honest about medical errors (the conspiracy of silence) why should we expect them to be honest about the reason for the conspiracy of silence?

Lawsuit fears aren't reason for docs' silence on errors

As debates over medical malpractice raged in Washington and across the country, many doctors have blamed a litigious system in the United States for discouraging doctors from openly admitting mistakes to patients. Those same doctors have held up the Canadian system, which drastically limits liability and discourages lawsuits, as a model.

But it turns out that it's not the risk of lawsuits that zips doctors' lips but rather the "culture of medicine" itself, say leading researchers on the subject.

Canadian doctors are just as reluctant to fess up to mistakes, said Dr. Thomas Gallagher, a University of Washington internal-medicine physician and co-author of two studies published Monday in the Archives of Internal Medicine. They are the first to compare attitudes about error disclosure among doctors in the two countries.

In fact, Canadian and U.S. doctors' attitudes about disclosure were "very, very similar," Gallagher said. "Even in settings where doctors worry less about malpractice, disclosure is still difficult for doctors."

The results strongly suggest that the medical-malpractice environment, long believed by many doctors to be the "root of all evil," is not the prime deterrent to doctors' disclosing errors, Gallagher said.

Does this make the culture of medicinee the root of all evil?

When A Doctor Is Likely To Disclose Medical Errors

Category: Seeing Clearly Now

Parallel Universes posts on the subject of revealing medical errors to patients. You can read the statistics. Apparently, an error has to be both serious and obvious to assure it will be disclosed.

Don't Tell The Patients

Doctors are less likely to reveal major medical mishaps if the error is not obvious to the patient, new research has found. A study of almost 2700 American and Canadian doctors has found that 65 per cent would definitely disclose a serious mistake made during treatment.

But the medics varied widely in when and how they told patients an error had occurred. A doctor confronted with a obvious error was far more likely to impart the news to their patient than one faced with a less apparent mistake.

You can read the abstract of the study published in the current issue of the Archives of Internal Medicine here, and the results are:

64 percent of the doctors agreed that (medical) errors are a serious problem;

50 percent disagreed that errors are usually caused by system failures

98 percent endorsed disclosing serious errors to patients;

78 percent supported disclosing minor errors;

74 percent thought disclosing a serious error would be very difficult;

58 percent had disclosed a serious error to a patient;

85 percent were satisfied with the disclosure

Grow Up Americans - Stop Suing Corporate America

Category: Seeing Clearly Now

Blogging Things Daily espouses the Tort Reform line: Americans need to stop suing manufacturers. We need to grow up and simply make better choices and leave corporate America alone. If we don't, the world as we know it will come to an end.

I agree with the concession in the article that we live in a society where numerous unhealthy products are created, manufactured, distributed and sold to consumers.

Freedom of choice - we have a distinct CHOICE whether or not to use certain products - I also recognize and value.

How we get from unhealthy or dangerous products and freedom of choice to granting immunity to corporate America, however, is a mystery to my greedy brain. I certainly choose to drive my car each day, to obtain medical care, to have prescriptions filled, to fly in airplanes, to ride on buses, to lower my fanny into lawn chairs, to crank up my chairsaw, to eat at restaurants, to walk into supermarkets, to breathe continuously and to be a responsible citizen who does as little as I can to put anyone else at risk.

Apparently, because corporate America does not drive a car, obtain medical care, get prescriptions filled, fly in airplanes, ride on buses, sit in lawn chairs, use chainsaws, eat at restaurants, walk into supermarkets or breathe it is licensed to injure and kill us humans. It is up to humans to stay out of its way.

The Lawsuit Matrix

According to an article written by Michael Weissentstein, A New York Jury awarded $20 Million in punitive damages to a smoker's widow (after a jury deliberation of over two days).

Let's take a long and very deep perspective of the grand effects this ruling may have on corporate America:

...the phenomenal repercussion of this landmark decision may create extreme, adverse effects.

...would it not only be right and justifiable that ALL persons who have died from lung cancer due to smoking should be awarded equal amounts as well?

[Then follows a parade of defective products which have caused injuries.]

The fact is, we live in a society where numerous unhealthy products are created, manufactured, distributed and sold to consumers. The point being that we CANNOT hold every company responsible for OUR OWN ACTIONS...The nice thing about America, is that we have a distinct CHOICE whether or not to use certain products. When our overuse, misuse or general use of a product comes with repercussions, we must choose to accept our own fate and learn from it.

I leave you with one piece of advice: Live. Learn. Prevent. Suing industries for our own choices, is a travesty to America and will ultimately lead to irrevocable circumstances.

And The Winner Is...Dr. Rock Solid, Witness For The Plaintiff

Category: Seeing Clearly Now

I propose a national campaign to honor the expert witnesses who testify on behalf of patients in medical malpractice cases. It could be called Doctors For Justice and would even announce annual awards for the witnesses who best represent the guts, competence and communication skills required. Why do I make this proposal? Read the RedOrbit article below.

Fear of Discipline Can Chill Potential Medical Experts

A medical malpractice lawsuit sits on Steve Sanders' desk. And he knows of a great witness that would help his case.

The problem is the witness refuses to talk.

It's frustrating, said Sanders, a Northland attorney who was not surprised by a doctor's reluctance to testify against his colleague.

Sanders' situation is not unique to lawyers who represent plaintiffs in medical-malpractice cases. Doctors fear they will be retaliated against if they provide expert assistance in a plaintiff's case, Nancy Kenner of Kenner & Kavanaugh said.

Kenner began her career defending doctors accused of malpractice. Then, she didn't have any difficulty finding doctors to testify in the defense of her clients.

It was very simple, she said. Switching to the other side several years ago was very difficult.

We look for legitimate, credible, practicing doctors to testify, she added. We are still able to do that, but we have to look hard sometimes.

In some parts of the country, doctors who testify for plaintiffs find themselves in trouble with their licensing organizations or medical societies. Some have termed it a national campaign by medical societies to discipline doctors who testify for plaintiffs.

Litigation In The Public Interest - Enforcing The Te