Tuesday, August 24, 2010

Tort Reform -Why Doctors Can't Say They're Sorry

Lately I’ve been doing some reading about the myriad of things in our healthcare system that we could be doing much better and as always tort reform comes out close to the top.

Looking at it, the problem doesn’t only lie in our rising medical costs due to malpractice insurance and doctors practicing defensive medicine (ordering probably unnecessary tests and treatment out of fear that they might get sued). It also erodes the trust present in the doctor-patient relationship and the integrity of the doctors forced to practice in a litigious atmosphere.

Doctors aren’t allowed to say “I’m sorry”. It’s a malpractice thing, kind of like the warning on the back of your car insurance card that says, in event of an accident don’t apologize. Apologies imply guilt, you see, and guilt means you lose in court.

The strange thing is that, they found (in a study I can’t lay my hands on right now), that if the doctor had only apologized, most of these lawsuits wouldn’t have happened. These lawsuits are brought to court by people in pain. People that have just lost a loved one, or a leg. People who believe that the doctor should be made to pay for what they’ve done since they so obviously have no remorse.

Can you imagine? I’m sure it’s happened to most physicians at one point or another, whether as a near miss or a true tragedy. One day you screw up. You’re too tired and you make a mistake during surgery, you misdiagnose a condition because the alternative just didn’t occur to you, someone dies or is horribly disfigured. And you can’t say, “I’m so sorry. I was tired. I didn’t think. I was human. There’s no way I could ever make up for your loss.”

What does that do to them as people? Doesn’t it make them feel like a monsters to cause a tragedy by making a mistake and then have to consider something so ridiculously pragmatic as whether or not the family will sue? How hard is it to go against their first instinct to try and ease these people’s pain and lock it down so that they can pray they don’t get sued. It’s a challenge with a million dollar price tag if they fail.

What does it do to the doctor-patient relationship when there’s a bad outcome and you know that even if your doctor was in the wrong they wouldn’t tell you? It sure makes it easier to assume that there was a mistake and a cover up or even true malicious intent, doesn’t it?

How did we get here? To place where people in pain use the legal system to punish people in pain? Who can fix this, really? What can we do? I don’t have the answers to any of these questions. Maybe someday I will. But for now I think we need to start by asking the questions.

Sunday, August 1, 2010

It's Hard To Get Into Med School

I’m shocked, aren’t you? It’d be more amusing except that really I am, kind of. I thought that all you needed were good grades (really good, like 4.0 good) and a decent score on your MCAT (the SAT’s of med school). It turns out that this is not so. You also need a good amount of physician shadowing, 500+ hours of volunteer work (yes over five hundred. Yikes!) in a clinical setting and “well rounded extra-curricular activities”.

So basically I have to get a 4.0 in a “well rounded” (not just sciences) degree, ace my MCAT, convince several doctors to let me follow them around for a while, offer myself up for ten hours a week of indentured servitude for a year, and join, ugh, clubs.

All I have to say, is that they must really want to make sure that you really want to be a doctor. And that you handle pressure well. As far as I can tell, the schedule imposed by the volunteer work plus school and school related activities (classes, homework, clubs, and work study) AND the care and feeding of my spouse and four children will leave me with approximately six hours a week of free time to do things like, you know, read a novel or poop. Did I mention that medical school and residency are supposed to be much worse than this? I think that they have about this same schedule only without sleeping during the week.

I’m glad I found the Flylady system which works uber awesome for me. It’s the only way I have a prayer of keeping up with school, getting my homework done and keeping my house from being condemned. I strongly suggest that everyone check it out. Just be sure to take some of the over-the-top sappy messages with a grain of salt. I, for one, can’t help but snicker at terms like, “weekly home blessing hour” (that’s when you do things like change your sheets) and quotes like, “Nothing says I love you like a clean toilet to throw up in!” You should definitely check it out, just don’t drink the Kool-Aid.

In unrelated news, my brother got married yesterday in a beautiful ceremony that just made me wish harder for one of my own. Fortunately my divorce (from a man I separated from nearly a decade ago) should be final by the end of September which means that I can finally marry the wonderful man that I cohabitate with, although I still don’t get a gorgeous ceremony or a pretty dress. Such is life I suppose.

I’ll post pictures of the ceremony regardless, because, well, I’m pretty proud of myself for finally having the courage to get divorced. It took me a long time. Heck, starting school, getting divorced, VBACing my fourth baby. This year seems to be all about courage for me. It’s certainly filled with new experiences.

Well, I should probably run along and put an end to the Wrestle Mania going on in my living room. Be sure to tune in… well, tomorrow to read about the awesome volunteer job I nailed over at our local hospital.