Giving Lawyers the Treatment

News from the AMA convention:

A doctor's proposal asking the American Medical Association to endorse refusing care to attorneys involved in medical malpractice cases drew an angry response from colleagues Sunday at the annual meeting of the nation's largest physicians group…

Last week, the daughter of a Mississippi legislator said she was denied treatment by a plastic surgeon because her father opposes limits in damage suits against doctors.

Dr. Michael Kanosky said he referred Kimberly Banks to other plastic surgeons to have her burn scars removed because he had lobbied on the other side of the issue and saw an ethical conflict.

More on this.

Comments

[WLC]

I remember a few months ago, Illinois doctors protested in Springfield about the legal abuses in Madison County. Not ALL abuses--just medical malpractice. Not ALL frivilous lawsuits, just those doctors deem "frivilous" (suing fast food joints may be acceptable). There was a great picture in the Peoria paper: a doctor reaching over and ripping up a counter-protester's sign.

And so, the "professional" behavior continues. Lawyers and doctors--a marriage made in a trailer park.

[Stephen Fetchet]

It's pretty hard for a lawyer to file a malpractice suit, if there isn't a plaintiff looking for money...

[db]

And to think that these two professions were once considered the most prestigious in the U.S. How many people have had their grandmothers ask them what they want to be when they grow up, only to be told that they should rather want to be a doctor or lawyer for whatever reason (money or respect, depending on who you ask?)

[TWC]

Jesus Chrysler, Fyodor, if you think a few flippant comments about lawyers makes libertarians look bad you certainly haven't been reading the comments on this blog during the Reagan 'era' last week (or any other portion of time).

Personally I am of the opinion that comments that include 'fuck you' and 'kiss my dead dad's paraplegic ass' are far more likely to make libertarians look bad. This place is a cesspool at times, doesn't that bother you just a bit?

Aside from that the legal system in the US is pretty much without any redeeming qualities. Lawyers and judges are pretty much in charge of the system and therefore deserve heaps of scorn.

Aside from that the comments are tongue in cheek.

[TWC]

The point missing here is that the doctor refused to treat the daughter of a lawyer based on conflict of interest. He was right to do so given that he lobbied on the opposite side of the issue from the woman's lawyer-father.

That is pretty much a textbook conflict of interest.

[Dan]

Look at this from Kanosky's perspective. If something had gone wrong during the plastic surgery, he would have been fucked. You know the woman's lawyer would have been selling the jury on the idea that Kanosky deliberately botched the surgery to get revenge on the woman's father.

In any case, shouldn't doctors have the right to decide who they treat? If they don't want to treat malpractice attorneys, I don't see a problem with that. Why treat someone you know will be looking for any available opportunity to rob you blind?

[db]

Agreed. It would be the same if a lawyer were asked to represent a doctor in a malpractice case if the lawyer had made significant contributions or legal counsel to an anti-malpractice-law-reform group. The lawyer would be well within his rights not to represent the doctor.

[fyodor]

In case all you talking about the doctor's "right" not to treat someone are talking to me, allow me to ask, what part of "I fully defend the *legal right* of a doctor to refuse treatment to anyone" do you not understand?

TWC, well sure, libertarians like any group say all sorts of stupid things that can make them look bad, so of course this let the lawyers rot haw haw stuff ain't the only thing one can criticize that's said in these parts. But I didn't appoint myself guardian of all that's true and blue and right in libertarian cirlces. I'm commenting on this because I'm moved to. If something else said here could potentially make libertarians look bad but doesn't move me to comment on it, that's my prerogative. Lambasting politicians (dead or alive) is an age old pastime of all politcal persuasions and if some people get overly snarky or juvenile about it, I usually just choose to ignore it. I'm not saying this stuff here is necessarily worse, just something that interests me more. I need no other justification. I don't claim to be a "professional" blog commentator; I have no oath to uphold.

[fredH]

Joe:

Let's look at some actual numbers. Here in South Carolina, the annual insurance cost for a neurosurgeon has gone from $13K to $65K over the last five years. The cost for most other specialties has also quadrupled or quintupled. Do you really think that all of that money is going to Republican politicians? At that rate, they should have an election war chest in the multiple billions. BTW, I am neither a doctor nor a lawyer, thank God.

[Rick Laredo]

So much for the Hippocratic oath. /R

[joe]

WLC, people in trailer parks don't generally act as entitled as doctors and lawyers.

fredH, no, as usual, the companies that pay off the Republicans keep most of the money for themselves.

[Ironchef]

Joe

Lawyers stop representing doctors? Right. Not as long as the cash flows.

[WLC]

Joe,

You are correct--I do apologize for that connotation. My only (admitedly feeble) defense is that I'm from lower middle-class stock myself and I rattled it off without thinking how it would be perceived.

My contempt for two formerly distinguished professions, who should know better than to squabble, squeal, and carry on as they have, remains.

[Gary Gunnels]

fredH,

In part its a function of the insurance companies trying to re-coup their stock market losses from the collapse of the bubble.

The problem with this issue is that its much more about "so is your mother too" reasoning that its almost intractable. To be blunt, malpractice attorneys may be in part to blame, but they are hardly the whole reason for increased insurance costs.

[twc]

Fyodor,

Oh. 🙂

[twc]

Denying medical treatment to lawyers?

Whatta concept. That would avoid some need for legal reform. At least in the latter years.

Or maybe docs should do surgery for lawyers on spec, sort of like lawyers do. If legalman lives, 40% of his fees (in perpetuity) go to the sawbones. If he dies on the table, reclassify it as pro bono medicine.

[Shakespear's Son]

Deny medical treatment to all the lawyers.

[Mark S.]

No... shoot them on sight.

[fyodor]

When folks around here complain that opposing the drug war makes libertarians look bad, I scoff. If we're not going to stand on our principles and point out when liberty and rights are being violated, what the hell's even the point?

OTOH, when crap like this is applauded, even perhaps in "jest," I just shake my head over how cartoonish and juvenile this makes us look.

[Highway]

An interesting phenomenon. That some doctors think they have been pushed this far by a single class of people, so much so that they feel they need to retaliate, is somewhat telling, IMO. The USA Today story had a bit more information about the associated anecdotes.

It would seem to me that, in non-emergency cases, doctors would be well within any ethical questions to deny treatment to a class of people. While it opens up charges of 'discrimination', I don't really have a problem with that. Seeing as how I think individuals should be free to discriminate generally (while suffering social consequences of that discrimination), I don't really see a conflict. It's rather cheap how the nurse lost her job, tho, since there was no indication of unprofessional conduct stated in the article, just an 'unwritten rule'.

[Highway]

fyodor,

I wonder if this really falls into the realm of 'crap'. You have an industry (malpractice lawsuits) that has latched onto another industry (health care), and in the legitimate pursuit of 'correcting mistakes' and weeding out bad doctors has also put a terrifically high burden on the healthcare industry through less justified suits. Insurance companies are also somewhat to blame, but the needs for malpractice insurance are driven by the lawsuits. The next corrective practice by the doctors is legislation, but in that direction, they run headlong into the very same people who are causing them the trouble (the lawyers). The desperation of this situation has caused many doctors to leave states, to retire, or take other severe measures to limit their liability.

I'm not necessarily 'applauding' their actions, but I can definitely see their justification for the idea.

[mark]

1. she wasn't denied treatment for what was apparently a non-emergency, she was referred to another doctor.
2. as far as I know, the doctor may not perform the procedure she needs or desires
3. there is no 'class' of people invloved, only 1 doctor and 1 patient.
4. if the doctor is uncomfortable treating her due to his past political lobbying, I see no reason to force him to do so, given the there are plenty of plastic surgeons available across the country.

[Patriot]

I tend to side with Highway on this one fyodor. It's a personal ethical choice for a doctor to refuse care to anyone. And it should be their choice.

It's pleasant to see that the idea was shot down, however. It's scary to think your profession would warrant having to find black market medical care.

[joe]

As soon as the Bar Association tells its members to stop defending physicians, the docs will run the white flag up the pole and we can put this silliness behind us.

[fyodor]

Okay, okay, let's parse this down. I fully defend the *legal right* of a doctor to refuse treatment to anyone. Whether it's an ethical thing to do is another matter. And claiming "not to applaud" something yet to "see its justification" is the kind of moral weasling most folks here would likely not let someone get away with if it were a matter of, say, rioting over racial injustice.

Anyway, I wasn't really thinking about that part of the blog post so much as the part about the proposal to the AMA to make such treatment (or should I say nontreatment) official MD policy, plus the first two flip comments. I hate to sound moralistic, but retribution of this sort is juvenile and, yes, unprofessional. It ain't gonna go anywhere and best to leave talk of it to folks who just want to make themselves look bad. And before you think it's noteworthy that they're so mad, take care to consider whether you want anger and passion to be considered meaningful when the shoe's on the other foot.

[greg]

On a side note, i would just like to point out that in NYC there is case law that says that landlords can refuse to rent to lawyers solely on the basis of them being a lawyer. It stems from a case where a few law students moved in then refused to pay rent for over a year by simply applying the landlord-tennant law of NYC to the letter. My wife were hung up on a number of times as soon as they asked what we did for a living.

As for a doctor refusing to treat a particular patient well, this is america and all, I think highway has it right. And, like the rent thing, it sounds perfectly legal. Anyway, who would want to go to a doctor that doesn't want to treat you?

And as for the last comment, the bar association will never tell its lawyers to stop defending doctors, as this type of law constitutes probably the single largest source of income for their lawyers, Med Mal insurance defence. There are countless firms that do nothing but this type of work. They would sooner eat their own hat and start seeing quack doctors before they gave up defending them in med mal actions. When doctors keep complaining about their outrageous insurance premiumns where do you think that money goes?

[greg]

On a side note, i would just like to point out that in NYC there is case law that says that landlords can refuse to rent to lawyers solely on the basis of them being a lawyer. It stems from a case where a few law students moved in then refused to pay rent for over a year by simply applying the landlord-tennant law of NYC to the letter. My wife were hung up on a number of times as soon as they asked what we did for a living.

As for a doctor refusing to treat a particular patient well, this is america and all, I think highway has it right. And, like the rent thing, it sounds perfectly legal. Anyway, who would want to go to a doctor that doesn't want to treat you?

And as for the last comment, the bar association will never tell its lawyers to stop defending doctors, as this type of law constitutes probably the single largest source of income for their lawyers, Med Mal insurance defence. There are countless firms that do nothing but this type of work. They would sooner eat their own hat and start seeing quack doctors before they gave up defending them in med mal actions. When doctors keep complaining about their outrageous insurance premiumns where do you think that money goes?

[joe]

"When doctors keep complaining about their outrageous insurance premiumns where do you think that money goes?"

Doctors -> Insurance Companies -> Republicans (and Joe Lieberman)

That's where.

[fyodor]

"I've seen how you can be 100% wrong but still get your way without ever going to trial, if you have enough money to intimidate the other side."

Liberals see the same thing only draw the conclusion that they should hate rich people. But it's all just part of the imperfect morass called life.

[Highway]

No, I can imagine that I wouldn't get away with that kind of argumentation, if we were talking about race riots, or violence, or any other denial of basic rights. But we're talking about an elective (from both sides) doctor-patient relationship. I also don't think it's a good position for the AMA to adopt, but if individual doctors want to adopt this policy, then fine. Again, they will face the social consequences, whatever they are, presumably including the denunciations that they are immoral. I am only saying that I can understand the points they use as justification. As to whether that justification is valid is a question to be hashed out.

[JRW]

I am a plaintiff's lawyer, albeit not medical malpractice. There are a number of false assumptions, however, that appear in the discussion. First, personal injury plaintiffs almost invariably lack the money to hire an attorney at an hourly rate. Before taking a case on a contingent-fee basis, even an unethical lawyer (who hoped to stay in business) would have to confirm that the plaintiff had suffered significant damages and there was reasonably clear evidence of liability. Otherwise, it would be foolish for the lawyer to invest hundreds of thousands of dollars of time and litigation costs into the case. The legal marketplace weeds out such fools very quickly.

Second, there is an implicit assumption that somehow the evil "trial lawwwyers" are able to summon the forces of evil, beguiling juries and persuading them to adopt irrational results. Even if such lawyers did exist (I have never met one), one should be asking why insurance companies with billions in assets would not be the ones hiring them. In fact, plaintiffs in malpractice actions are almost always outgunned and outspent.

As for the doctors' claimed right to refuse service, why not? If doctors wish to reduce the social standing of their work to that of waitresses and plumbers, I see no reason to protect them from themselves.