patrick.net

How else can nature teach us all a hard earned lesson about greed

Who says Nature is not morally neutral?

This blog has made me feel less homesick. I left my adult children there and my base (friends). I'm hoping the So Cal market shakes out alot next year. I use to live in the Claremont area.

Home of the Claremont Colleges cute little town near the San Gabriel Foothills. With a eastern Ivy League feel.

Trial lawyer here (though I'm an entertainment lawyer -- I don't do medical malpractice) -- I have to stick up for my profession.

First of all, medicine is the profession that I admire and respect more than any other. People always view doctors and lawyers as roughly equivalent, but the truth is that they aren't. There is no comparison. Lawyers aren't responsible for people's lives. I've never been working frantically to save someone, only to see them die while my hands are inside them. I've never had to tell a family that their loved one has a terminal disease and isn't going to make it. Doctors have to do those things, however.

Also, medicine is a profession that, by and large, helps people and contributes something of real value to the community. The same, unfortunatley, cannot always be said of lawyers. i am proud of the cases I handle, and i have never done anything that I am ashamed of. But let's face it -- there are a lot of sleazy lawyers out there, and many are basically parasites who contribute nothing of value to our society. And to the extent that the legal system is one of the three branches of our government, sleazy lawyers don't just bring shame on the legal profession -- they bring shame on our entire society. But aside from a few quacks pushing diet supplements, natural remedies, etc., there really aren't too many sleazy doctors out there.

I also have a great deal of sympathy for doctors from a financial standpoint. I myself still have $130k in student loan debt, so I know what that burden feels like. And I also know that, like lawyers, doctors don't make nearly as much as people think they do. And I know that a lot of this is a fairly new development -- over the past 20-30 years, doctors' incomes have not kept up. The same is true for lawyers.

And as a member of another learned profession, I know that people sometimes make mistakes. When you are dealing with enormously complex subjects, like law or medicine, it is impossible to get the right answer 100% of the time. Especially when you have just a few seconds to find the answer. I cannot guarantee that I will win my clients' cases, and doctors cannot guarantee perfect operations, deliveries, etc. Yet whenever somethign goes wrong, some people are ready to sue.

But it's the repsonsibility that doctors are forced to shoulder whcih makes the job so hard. I wish doctors made a lot more money, althoguh no amount of money can ever truly compensate someone for the emotional toll that dealing with someone who has just become paralyzed takes on you. That is why I admire doctors so much. You really do have to be a special person -- frankly, a superior person -- to shoulder that burden. I am in awe.

That said, I have always been skeptical of arguments that lawyers are responsible for all of the problems that plague the medical profession. I don't want to get into it too much on this forum, as this discussion could go on for days, but suffice it to say that there are very few medical malpractice lawyers out there, and it is suprsingly hard to win med-mal cases. The idea that there is all sorts of "frivilous" litigation out there is something I just do not buy.

This is also why I am skeptical of "special" courts, consisting of doctors, for medical malpractice cases. I can be sued for malpractice, and I don't get that sort of special treatment. Why should they? Also, while I beleive that the medical profession does generally try to maintain high standards, we all know that there are plenty of quacks out there who nonetheless manage to keep their medical licenses. If doctors were reguarly forced out of the profession -- for committing malpractice, not for doing things like having sex with patients or abusing drugs -- I might have a little more faith in the idea of "self-regulation."

Caveat: there is one group of doctors that really do get hit with a lot of frivilous litigation. That is obstetricians. The reason for this is becuase medical malpractice cases against OB/GYNs involve the world's most sympathetic plaintiffs -- injured and crippled children. Juries tend to let their sympathy overcome their reason when they see some kid with CP twitching in a wheelchair, and as a result there really is a med/mal crisis re: OB/GYNs. But one of the reasons why you always hear about the OB/GYN crisis is becuase it's a special case, one that the tort reform groups are always trotting out as their example. But dermatologists don't pay nearly as much for their malpracitce insurance, and they aren't leaving the practice of medicine due to litigation costs

But I think the problems of medicine are due to a lot more than frivilous lawsuits. Medicare reimbursement rates. Administrative costs. The growth of the uninsured population. Drug costs. PPO's and HMO's. These things have a lot more to do with the problems doctors face than the handful of med/mal lawyers out there.

Finally, as a lawyer, I think that a lot of doctors frankly have a sort of irrational hatred for my profession. I don't know why, but I've noticed this about my doctor friends -- they are always bashing lawyers. I think lawyers have sort of evolved into the all-purpose bogeyman of the medical profession. Everything that goes wrong is attributed to us.

I have a theory as to why. People alwyas accused doctors of having a "God" complex, but I don't think that is fair. But if you are an attending physician at some suburban hospital, you sort of are God. There are hundreds of people at the hospital whose sole purpose is to carry out your orders -- instantly. Your patients are from all walks of life, which means that most of them never second-guess or question you. Yes, you have to report to the hosptial staff if something goes wrong, but most days, you don't have to. You are pretty much the ultimate authority all the time. No one ever talks back or sharply questions your competence. Let's face it, after 20 years of this, your ego is affected. How could it not be?

But if you are sued for malpractice, all this suddenly changes. Not only is the plaintiff's lawyer more than willing to second-guess you and question your competence, he's actually trying to make you look bad. Suddenly you experiencing things you haven't had to deal with in years, like someone accusing you of doing something wrong, questioning you, and pressuring you. Your deposition is one of the worst experiences of your life, as some slick, arrogant lawyer makes you look like you didn't do the necessary tests. The fact that this experience is so jarring makes a lot of doctors who have gone through it really hate lawyers, especially if they believe that they did nothing wrong.

Anyway, this is just my $.02 worth of amateur psychiatry.

In closing, I would very much like to once more express my admiraton and thanks for doctors. They're better men and women than I am and their job is a million times harder. If I didn't have student loans of my own I'd gladly pay more for medical services if it meant that doctors would have higher salaries.

I think we have a few economic colonies out there, just not sure how much MORE we can steal from them.

China, for one, is our economic colony. They subsidized their export to such an extent that they can only recoup the incremental cost of production. For example, recently the shipping charges of Chinese companies serving the inbound and outbound China routes are quoting NEGATIVE shipping charges, you heard me right, negative (well, they still charge some port stocking fee). They will pay YOU for keeping their ships running. However, I think we have repetitively challenged their limits of subsidizing our consumption, so I am not sure if we can steal much more incrementally in the upcoming crisis.

Japan, to a certain extent, is also an economic slave of the US. By manipulating their Yen at a "comfortable" bound vs USD, they are essentially subsidizing our lifestyle with their exports. They just didn't build up such an excess capacity as China because at least their stuff can command higher premium. Can we steal more from Japan when we head into crisis? Not so sure, because Japan is apparently ramping up their export share to Europe (perhaps they sense something, huh?).

i suppose there's both economic and cultural imperialism in the form of banana republics as an instance of the former and saturating the world with coca-cola and mcdonalds and hollywood output as the latter...

OO,

China tries to get more export to Europe and Asia, the problem is that the main business drivers are still ethnic Chinese business people out Taiwan and Malaysia. I'm beginning to think that Mainland China will be more resilant than I've thus far given it credit for. They seem to actually comprehend the need to diversify and build up the internal market. The new CCP politburo appears to be a collection of pretty astute people - they might actually make some good economic decisions that'll really show itself in another 5 or 10 years.

But then, I read about the absurd construction projects posed by their water and electric bureau and it's like WTF. Those guys make the army corp of engineers look like genius auditors in comparison.

Time has a very different value for those in the high 6 & 7-figures club.

I saw a GP for a consult the other week, and when he learned I work in IT, asked me how to install Office or similar on his PC at home. I said 'just put in the CD and wait for the setup routine to run and follow the prompts'. He said 'wait a minute. slow down, that sounds a bit complex', heh. Note that children can do this. And 10 years of med training isn't complex? Maybe I should start that PC servicing business over here for doctors... (I should point out I currently do general sys admin work across s/w and h/w, including Oracle, Unix, M$ products, an ERP and so on)

Joe Schmoe, the # of frivolous lawsuits is significant. The mere threat of a lawsuit changes the nature of practice. I have some contacts ( I would hate to call them friends) who are exactly these pitbull malpractice attorneys. They have little to no regard for the medical profession and purely interested in the $. This is a profession? Juries? They routinely poll juries after malpractice cases. Guess what? The jury was either not listening or unable to comprehend the issues. Typical responses from the "jury of our peers": "I just didnt like the way they argued with each other". Does the ABA ever admonish the trial lawyers to bring forth legitimate cases? No. And I know lawyers that are on state legal boards. they couldnt care less about a cases legitimacy. When people tell me "My daughter is in law school", I say "where do you think you went wrong?"