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A Trial Lawyer's and Patient's Perspective on Doctors and Health Care

February 17, 2023

"Molière saw through the doctors, but he had to call them in just the same."

"It is not reasonable, to expect doctors in private practice to be impartial when confronted by a strong pecuniary interest."

- George Bernard Shaw


As one who has had either the fortune or misfortune of being a personal injury litigator, depending on one's altruism or lack thereof for over 43 years, I have reached some inevitable conclusions concerning the individuals who could stand the sight of blood and therefore embarked upon a course of deriving a benefit from the maladies of others.


How this exalted professional status has struck social observers over the years varies with the intensity of their individual experiences. George Bernard Shaw's outlook was somewhat malign toward the medical profession, observing that, in the "Doctor's Dilemma,"


"...when doctors as competitive tradesmen were replaced by a medical profession that had been brought under responsible and effective public control. Until this body of men and women were "trained and paid by the country to keep the country in health it will remain what it is at present: a conspiracy to exploit popular credulity and human suffering".


In other words, Shaw was looking forward to the creation of a National Health Service." These words were written in 1903.


Not that lawyers are not calculating; however, they are constrained by the law and by their profession itself to simply presiding over the transfer of wealth from one party to another, providing the oil for the cogs of either justice or of criminality to function or not. Many are just as greedy as anyone else, but generally, people's lives do not depend upon their behavior. Their fortunes, yes, their freedom, often, but, except in rare criminal cases, not their lives.


Much of the angst that Doctors suffer, depending upon their conscience, individual character, or profit motive, fear of being sued, or other governmental intrusion upon their fiefdoms depends upon how motivated they are by greed. Often the ones who are greedy usually occupy large private medical groups and are judged within that group by how many patients they see, or how much revenue they generate. Usually the ones affiliated with Universities and are academics are somewhat less motivated by such obsessions. Some doctors are so greedy that they refuse to write prescriptions for patients who do not come in for a visit at which time they can be prescribed almost anything they want, as long as the doctor can bill either Medicare or a private insurer for an office visit.  If a patient calls and asks for a renewal, the doctor insists that they visit or get no prescription, blaming the government in most cases, of non-existent governmental scrutiny. Some will not even fill out a form without a fee being charged to the patient. Patients resemble a stack of Benjamin Franklins to them. Questions concerning such matters with the doctor often evokes an aggressive, "find another doctor" rebuke.  Such an enormous ego or insecurity does nothing for the doctor-patient relationship. One doctor was offended by my asking for test results after waiting 10 days. No concern for the patient's anxiety evident at all. "That's normal for this office, if we are not meeting your needs, find another doctor."


In addition, my individual experiences with doctors who testify in court enjoy more popularity if they are the most convincing witness no matter the mendacity of their testimony. Some doctors who specialize in forensic medicine, charge highly extravagant fees, based upon the rationalization of loss of net patient visits when they are obliged to visit the courthouse or to give deposition testimony. Every fundamental lesson of cross-examination of these doctors requires questions of how much they are paid for their testimony, what percentage of their practice is dedicated to treating patients, and how often they are in court (often more than in the office) and for which side they testify, how many patients they actually treat, etc.


 Some have robotic administrative staffs specifically geared to make sure the doctor is or will be paid before he or she even consents to treat a suffering patient.  They have insufferable office managers trusting no one, their jobs set by the culture of the office promulgated by the greedy doctor rather than the needs of the patient, affirming the 1903 Shaw philosophy that doctors should be working for a National Health Service. Illness should not be profit driven and insurance companies whose motives to collect premiums and not pay claims remain insidious affronts to a decent society. The same rule should apply to physicians who run their offices as though they were branches of the Bank of America.


Some argue that health care needs physicians profit motivated to make decisions concerning the patient's health and that it attracts people of quality to this profession. Studies in European nations like Sweden debunk this notion. Compounding this error is the health insurance industry, stories about which circumlocutions to a avoid legitimate claims are often featured by investigative reporters and on "60 Minutes."


Doctors who seek fabulous wealth should be in business, not clinicians; they deserve to earn a good living commensurate with their hard work and training. But a profit motive for a clinician simply works to the detriment of the patient. And a profit for a health insurance company is the same evil on steroids.


No possibility of great change in this system is possible unless the public is disabused of the notion that clinical medicine is a business. Clinicians perform great service to society, but usually perform no research and development. If they do, they are entitled to patents for their work.

Then they can reap the rewards of entrepreneurship.  Otherwise, let them earn a good salary, live in a nice home and stop acting like they do not belong to a noble profession, dedicated to their patients, and not to large boats and McMansions. Leave that to the titans of industry, or as Theodore Roosevelt aptly put it, to the "Malefactors of Great Wealth."

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By Engage Team February 17, 2023
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By Engage Team February 17, 2023
"A house divided against itself, cannot stand..." - Abraham Lincoln From California to New York, from Oregon to Florida, a frightening division has descended upon our country. From rural to urban America, people wonder whether the nation and its institutions can survive this polarity. There have been times in American history that the nation was divided, never more so than in 1860. Throughout that history, there had been bitter partisanship and division. From the heat of the constitutional convention in steamy 1787 Philadelphia, the founders fought bitterly to a compromise that actually welded two nations into one in a constitution which just ninety years later devolved into a insanely bloody civil war, brother against brother, father against son, family against family. A partisan press with countless newspapers and pamphleteers spewed hatred and vituperative allegations against their countrymen both at the founding and throughout the years leading to the Civil War. Twitter has nothing on them. A rural south, an industrializing north, both parts of which employed slavery, regarded Negroes as inferior, abetted involuntary servitude and a racist ethos, challenging even the most enlightened of our citizenry. During the time between the founding and the Civil War forged compromises kept the Union together. The Missouri compromise (1820) and the Kansas-Nebraska act (1854) failed as attempts to reconcile admission to the Union of new states as either slave or free. 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By Engage Team February 17, 2023
Passion seems to be bestowed as a blessing on few people but seeking it is a not inconsiderable chore conferred on the many. I am not officially retired, but it seems that way. The clients call less and the work I did as a trial lawyer has become less and less appetizing. Business has diminished, not only because I am seventy-nine years of age, but because I have zero desire to market myself like a snake oil salesman. I leave that particularly odious practice to well-funded and battle stationed Morgan and Morgan and others, whose legions of paralegals, investigators, paid experts and well-staffed soldiers battle with insurance companies, and “fight for you,” its overworked lawyers all the while complaining to their colleagues and family that they hate what they do. Fifty years at the bar, and I do not mean Flanagan’s, is enough, so I leave the task of transferring wealth from one party to another and taking a piece of the action the alleged passion of the many. I do still consult with clients, if I can be of help them. I wonder if I can achieve a modicum of mastery the piano, considering that when I took violin lessons as a youth, the bandleader working at my dad’s upstate New York hotel, a Catskill fiddler by the name of Billy Rogers (nee Rosenberg) who, admittedly, was not a music teacher, told my father, that I was the “dumbest, most tone-deaf child he had ever met.” But then again, he was no Isaac Stern nor even a music teacher. Music teachers do not scream at their beginning ten-year-old students. The sole reason Dad asked him to teach me was because a guest had left a violin in one of his hotel rooms. Before my dad’s discovered violin aspirations for me, I had expressed neither the interest nor the inclination to play the most difficult, annoying instrument, or torturing everyone within hearing distance. “Press the strings until your fingers bleed and you develop callouses,” said Billy. I do not recall what happened to the violin or Billy, although he was aged in 1952. Dad either sold the violin or most likely, gave it away. Another serial disappointment from his son, I guess. After becoming a lawyer, I decided I would learn to play tennis. And I loved it. I was addicted. I became reasonably competent, starting at the age of 35, and playing regularly until I hit 70 and had spine surgery laying me up a few years. I was never the best, but I was pretty good, had a good serve and tried to play again a few years ago, losing to a younger fellow who had been playing just a few years. I had beaten him soundly before. Never fast on my feet, my molasses-like movements said, time to hang up the sneakers. Life is a series of things being taken from you. At 55 I had taken up golf. I think I have a pretty good swing, but athletically, I needed time to learn, ( a nice way to say I am a slow learner) and time is running out. Although that would not stop me, if I had some agreeable companions with whom to play. Many of the friends whose company I enjoyed have died or fallen away. There is nothing worse than spending 18 holes with someone monumentally annoying. “Nice putt,” they said, as my ball sped past the hole. Plus, most golfers do not share my politics and, inevitably, an afternoon of enjoyment turns into a dumpster fire. Most players who are Republicans, cheat. The shoe wedge or miscounting the score is a frequently insufferable habitude of the right-wing selfish, individualist, “let them eat cake” crowd. Now, when my days are not consumed by interminably long doctor’s visits or some new ailment appears, I am seeking something to do with my spare time. Going to the hospital or delivering goodies to the ill and infirm is too depressing, since I already am depressed about most people walking past me as though I did not exist. I have become irrelevant and invisible, both not particularly enviable results of my wrinkles and weathered skin and increasingly whitening hair. A grey ghost. I suppose I should take comfort that a geezer like Joe Biden could be president, gaining inspiration from him. But he seems so delicate, so frail now, that a stiff breeze would blow him over or he might stumble coming down the stairs of Air Force One. It is frightening to behold. Still, Joe beats the alternative--the orange-colored crook who is still peddling the big lie. The country is in the worst crisis since the great depression, and Joe is not FDR.  Which brings me back to the piano. I asked a neighbor who is a music teacher at an exclusive private school, “Is learning the piano at 79 doable?” He replied, “definitely, it will be good for your mind. Always keep two hands on the keyboard and learn musical notation.” I replied that I had purchased a book that said I will be able to play a Bach prelude within six weeks if I practiced 45 minutes per day. Encouraging. I guess I will find out if it can be my new passion.
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