Sunday, October 19, 2008

Unfunded mandate = unfunded liability

A physican was recent sued and had to pay $400,000 because a patient claimed that because the physician did not hire an interpeter they did not understand the risks of the medication that they were prescribed. In this case the patient was deaf and the risks were printed on the information they received from the pharmacy. Even so, they sued the doc because Medicare mandates that a translator be available at all times. Of course Medicare does not pay for the translator. If you do get a translator, the translator will of course state that they are not responsible if the patient misunderstands the instructions and your hospital attorney will tell you that you are ultimately responsible. So here you go, a pateint comes into the ER, you have to see them by law regardless if they can pay, you then have to pay out of your own pocket what ever it costs to have an interpeter and even then, they can still sue claiming that they didn't understand the instructions. Then of course you must see them in follow up so you do not get sued for abandonment and must hire the interpeter every time they come to the office. (Because, even then it is your not the patient's responsibility to have an interpeter.) Something tells me that they will always be able to find an attorney as attorneys by law dont have to hire an interpeter.


SeaSpray said...

It would seem the jury was reading from the Obama handbook..."share the wealth" and all that.

I am not married to a physician, nor do I have a physician in my family and yet when I read these inane judgments and all the other new/erroneous regulations forced upon the medical profession ... it really bothers me. It's insane! I guess you just have to see it as business as usual these days.

I feel sorry for that doctor. I wonder why he didn't insist she see someone else... or why she persisted with a doctor that she felt couldn't communicate or had the resources to communicate effectively.

Also...could she or her life partner READ?????????? I believe they could.

Is it not logical that a person would be adept at compensating for their disability... or that the people surrounding them would be equally attuned to their loved one's special needs and so therefore assist them with their vulnerable area????

Is that asking too much????

And even if the patient was developmentally disabled (which they weren't)why is it the provider's responsibility to lose money to make things more convenient for said patient? That's WORSE than universal/socialized health care!

What about being self accountable...responsible for yourself and your own actions?

And I don't get... why one person's disability is another person's "responsibility...particularly financially? That thinking is just flawed!

These things boggle the mind! Maybe she was after money all along and set him up.

It seems his mistake was "allegedly" insulting her. I completely understand his frustration and why he lost it...but I guess that is a fundamental lesson in why a physician matter what...with patients has to keep his cool. And I'm not saying there aren't jerk doctors out there who haven't been mean to patients and undeservedly so. My girlfriend was treated terribly by a few docs when she presented to ERs with symptoms that looked like panic attacks. It got worse as she would relay the experiences she had and what appeared to be a line up of doctors not finding anything wrong with her.

But that was back when the prerequisite to diagnosing Lyme disease was that you had to see 10 doctors first!

It was actually her 9th doctor that made a diagnosis of neurological lyme disease. After a month of treatment she was back to herself. She was fortunate because I've seen people left with heart damage and neurological damage so profound that they were permanently disabled. The neuro case-the guy looked like he had cerebral palsy and it was bad.

She has been bitter toward docs and the idea of medicine ever since. There are people that would sue for that. I know ED docs get testy when they think a patient is wasting their time... particularly if they think it is psychological. But after reading these things...doctors just have to be careful.

It bothers me...just because these lawsuits are wrong and it also seems to me that potential lawsuits are the catalyst for over regulation, which then compromises the very goal of the medical give quality care to the patients.

And that bothers me as a patient for two reasons..maybe more.
1.) It could have a negative effect...possibly causing me or people I care about harm or needless suffering and more expense if things go wrong because the med professionals are too busy documenting and making phone calls instead of actual hands on with patient care.

2.) I read these med blogs... I read about the collective physician discouragement to the point of they leave their profession.. or practice as they know it to go off into an area they feel they have more control.

So... it bothers me because I worry that my docs might opt to leave their profession. One of my docs knows my case inside out, knows me and I trust him immensely. I actually feel safer when he is around or I hear his voice. I know that probably sounds weird but I have been through some things that really scared me and he was the one that fixed me and the one with all the knowledge and I know he knows things about me so that he might not waste time on one thing... or absolutely know something works best for me that another doc might not realize. If something were to go wrong...I know I can count on him to give me the best care or see to it that I will get the best care.

I am at the point that I can talk with him about anything... and I do mean anything and you don't get there overnight. I think our chemistry is good and he listens to me and I believe respects and takes me seriously. I am just so grateful to know that if I have any concern he is on top of things and I feel heard by him.

I think I told you that I read somewhere that one of the best ways for a physician to avoid a to listen to the patient.

I'll tell you something else that bothers me that I learned from the medblogs. The fact that there are doctors who don't want to take on complicated cases because they worry about lawsuits. Again...I don't blame them... but who gets hurt? The patient. Stupid lawsuits!

I have also read many patient blogs/comments and most are very grateful for their good doctors.

And I read where doctors actually appreciate/enjoy their good relationships with their patients.

And I think when that works BOTH ways... well right there...the doc has an added benefit toward facilitating healing in the patient because of the good communication and less chance for miscommunications... and of course the patient benefits from that. It's a win-win! :)

I really do feel bad for doctors that just want to give their patients quality and compassionate care, but all these other things take up their time or concerns.

I really hope my docs and all the doctors out their have magnificently fun ways (even if it is just doing nothing)to relax, recreate (literally recreate within themselves)and just enjoy their private lives without interruption when not on call.

Too bad the doctor can't counter sue for irresponsibility or the people that instituted that law!

On a lighter note... when you have a chance if you haven't already seen it... go to the Independent Urologist and check out his current post. HILARIOUS and what a terrific idea!!! :)

mercydoc said...

Just one more reason to drop Medicare until it is reformed! I wonder if it would discourage lawsuits if physicians had patients sign waivers saying, "I waive my right to have an interpreter, and will not sue this clinic or the provider for any misunderstanding that may result from this." signed:____________
(of course they could argue that they didn't understand what they were signing because an interpreter wasn't there, so I guess I answered my own question) :-(