Posted by Bill Sandweg on 28 February 2022.
In the movies, the wild west is always portrayed as a lawless place in which the sheriff was either outgunned or corrupt and citizens were at the mercy of the bad guys. You had to protect yourself because there was precious little help available from the people who were supposed to be helping you. At least as far as medical treatment goes, that is pretty much where we are today. The people and organizations that are supposed to be protecting the public from fraud and malpractice are either impotent, lazy, or corrupt or some combination of all three.
Turn on the television, listen to the news on the radio, read a newspaper, if you can find one. If you do these things, it won’t be long before you come upon a story of a doctor misbehaving in a way that harms patients. It is often the same old story that we have seen over and over again. A doctor gets terrible results in surgery with many badly injured patients. That doctor is asked to leave the hospital, or even the state, and off she or he goes to the next hospital or the next state with no one bothering to warn the new landing spot about the risks presented by the surgeon.
And it is not just dangerous and incompetent surgeons who get this “hear no evil, see no evil, speak no evil” treatment. Sexual predators are allowed to go from place to place taking advantage of patients, sometimes for years before they are finally reported to the authorities. Fraudsters, who fake bills or perform unnecessary medical procedures often get the same treatment. Where are the people who are responsible for protecting the public? For many hospitals, it is better to just show the miscreant the door and pretend that nothing ever happened. After all, who needs bad publicity? Move along, folks. Nothing to see here.
Sometimes the doctor taking advantage of the public is treated as a hero. Performing expensive, aggressive, and perhaps not really needed surgeries and using surgical products in which the surgeon has a financial interest may not be good for the patient but it looks great on the hospital’s bottom line. If you expect a hospital to look critically at surgeons, or any other doctor, who adds substantial value to the bottom line, you have not been paying attention. In today’s world of big medicine, money talks and lots of money talks very loudly indeed.
Medical boards don’t have the financial incentive to pretend nothing happened but they are a lot like the sheriff in the movies who doesn’t want to offend the big shots in town and who is just looking for a nice quiet job. If you are caught abusing drugs or alcohol, you can expect firm treatment from your state medical board. Malpractice a little here or there, or sometimes even a lot, and you will find the medical board a little more lenient. After all, the doctor didn’t mean to injure the patient and, as we all here at the medical board know, medicine is complicated. And the doctor has offered witnesses to say she did nothing wrong. With all that in mind, how can we take her license away? Maybe just a letter of concern will fix the problem, especially if she volunteers to take some additional medical education.
Medical boards that get very aggressive and discipline lots of doctors, even if the doctors deserve it, are going to ruffle feathers. Doctors have money to pay for lawyers. Doctors have money to make political contributions. Doctors work at hospitals that don’t want to see their doctors disciplined. Complaints will be made to the politicians who appoint the members of the medical board and less aggressive members will be appointed to the medical board in the future.
In the wild west of today’s medicine, you need to protect yourself. You can’t count on anyone else to do it. Do some research into your condition and into the doctor who wants to treat it. Ask questions. If the doctor is offended by your questions, move on to someone with thicker skin who doesn’t mind answering questions. There are a lot of tools out there for patients to assist them in making good choices. Use them.