Slashdot Mirror
Doctors Sue Patients for Online Complaints
Carl Bialik writes "'Several Web sites have sprung up that encourage patients to post anonymous reviews of doctors and dentists. Some frustrated patients have even created entire Web sites to criticize specific physicians. The Wall Street Journal Online is reporting that some doctors are, in turn, defending their reputation by suing the online critics."
Awww, they should toughen up. Spending time posting on Slashdot should help out with that as no interesting or informative post here goes without some sort of pain.
Seriously though, if the patients are reporting on their experience, then that is not slander. Just stick to the facts and they should be fine. However, when you start crossing the line into statements that cannot be substantiated, then that is dangerous water. It is of course important to have resources like Slashdot where comments past a certain date cannot be modified. They become a part of the historical record that documents both protection for and against issues of speech.
Visit Jonesblog and say hello.
Well, IANAL, but doesn't this somehow interfere with getting out the Truth(tm) and that whole Free Speach(tm) thing that everyone is always getting worked up about? I realize that this may be hurting their business, but if they suck so much that people feel the need to complain, don't they have the right to complain?
That reminds me. . . I'm not entirely satisfied with my family physician.
Doctors are already a protected class of citizens, who have enormous power over the average person. They've got sanctioned monopoly powers, have a huge amount of leeway in treatment quality, and generally don't come close to the quality of service that they did a generation ago.
It is in everyone person's right to criticize bad service, and the threat of libel lawsuits should not be as powerful. When you have a State-sanctioned power to treat others, it shouldn't stop you from giving your best, especially in life or death situations.
I have a great doctor who has been retired for probably 15 years. He's old school and treats me and my family with respect and friendliness. He's available 24/7 by phone (home, office, cell, pager) and he's called me back at bizarre times when I've had problems. All my friends are blown away by the stories I have of his service.
I've been to other doctors and wish I had the time to complain. Dirty exam rooms, gossiping about other patients, staff that works more like DMV workers than health professionals.
I guess these people should just shut up and take what the State spoonfeeds them. Just wait until we have Nationalized Healthcare if you really want to see things get worse.
The American Dental Associations is no better.
First Amendment restrictions on our Federal and State governments should be re-visited. "No law" means no law. Especially when a doctor is free to blog their side of the story. I'm not sure why it is in anyone's power to curb the speech of others on a private or public forum.
I'm always late to a doctor's "appointment". Why should I have to wait for them after I already made an appointment?
Also, fact is that there is little difference between a doctor and someone that makes up mnemonic rhymes to monty python songs for 4 years and a doctor. Granted, there are decent doctors out there, but I've never been too impressed with your average doctor.
I welcome websites and/or other means of communication to bring doctors to our level. To me they are basically a non-technical auto mechanic that works on people instead of cars.
Sue your customers until they love you. It's working for the RIAA, after all!
See what I've been reading.
...I plan to file suit against any /.ers that disagree with my posts.
Dark Reflection
Remember the last election? We had "free speech zones." People who disagreed with the politicians' (both Right and Left) point of view were told to go somewhere else to protest. And furthermore, it was illegal for the press to enter those areas.
We no longer have real free speech in our country. Sure we can open a titty-bar. Sure we can show boobies on HBO. But if the status quo doesn't want the truth to be said, be it the government or the medical establishment, they'll stomp it out. Get used to it. The 60s are over folks.
If someone says he and his monkey have nothing to hide, they almost certainly do.
Sounds like more states need anti-SLAPP laws.
"It's the height of ridiculousness to say for those 9 lines you get hundreds of millions."
Anonymous comments are tolerated here, and there's even the potential to defame.
Not too many people complaining, though.
If the "slander" is determined to be fact, then there is no liable (read: defamation of character) that the poster/blog/web site can be sued for. In this case, the onus is placed on the offended (doctors) to prove that the offending statement is untrue. Without that proof, there is no recourse for the Doctors.
It wasn't that long ago that there was a big stink over a doctor-run web site that blacklisted malpractice plaintiffs so that doctors could deny them future coverage, regardless of who won the case. Google cached link I guess it's not so funny when someone does it to them.
I didnt know there was anyhting illegal about posting on ones experience. If a patient does not post false information and made up facts about the person and it is all just their opinion then these Doctors have a moot argument.
GL HF!
Before i see a dentist or a doctor i like to get some opinions on who I should or shouldn't go to. Which can be difficult if you are new to the area. If it's constructive critism I see no reason why it shouldn't be posted online, but not outright slander. Last thing I want is some hack fixing my teeth or prescribing me meds.
For an average of $300 per year, just about anyone can get Umbrella Liability Insurance. Such insurance shields you from many things including slander and libel claims.
That way, the evil corporation or incompetent doctor that wants to shut you up with a frivilous lawsuit will really be suing your multi-billion dollar insurance company. $1 Million worth of coverage is typically around $300 per year. Multi-million policies are frequently available for not much more.
I'm a big tall mofo.
The reason the doctors' are suing is this: true, you do have free speech, but you have to be responsible with it. If you slander (I guess in this case it would be libel) someone, they have the right to sue you. You would need to have disclaimers galour on the web-sites and all sorts of legal rhetoric to protect your backside. Case in point is the site bestbuysux.org. He has been sued a couple of times and has had to reorganize content and post disclaimers.
As long as you act responsiblly and have your backside covered you're good. If you make you make everything look legit but it is really just a flame page because you don't like someone's bedside manner; well, someone with their career on the line may just come after you.
I eat Karma for breakfast, lunch, and dinner. That's why I don't have any.
Be it a blog, a forum or just a plain old web zine. Remember, just because someone wrote it on the web, doesn't mean jack that it's even vaugly true. Remember people, one thing people love to do on the web, is exagerate, boast and inflame. And just because it involves doctors doesn't mean it's any diffrent.
Some of the complaints may be true, but on the Internet, accountability is zero, so you don't know if a post is true or fabricated. ONe person can falsely generate thousands of complaints against a doctor or, appeal to only those who wish to complain about a doctor and provide steeply one sided evidence against the individual.
I know a lot of people here may not like Doctors and the fortunes they apparently gain. But it's not without cause and things like this aren't making it any easier for them. No I don't want to give them a free pass but don't judge everything by it's cover people. Be weary of complaints and get a second opinion before you start marching along side the vocal minority.
Sentack
Without exhausting existing avenues for complains against Physicians/Surgeons, posting directly on the Internet should be discouraged.
Not, it is not a issue of free speech, but if the Physicians will have to constantly watch their back against disgrunted people posting online, their quality of service might suffer.
I know this as a Physician myself.
As an alternative one can always report to the licensing boards and ask for review by a panel of experts and specialists instead of setting up a novice 'peoples' court and run a witch hunt.
Most Importantly, if a patient visits a doctor, they enter automatically into a non-disclosure agreement although no legal documents need to be signed.. by virtue of visiting a doctor, a patient agrees to put himself/herself under that doctor's care. The burden is on the patient to find a physician whom he can believe.
If Patients who may be not be satisfied due to a combination of myriad factors start using the Web primarly as a means to get back at the doctors, what is going to stop the Doctors to retaliate likewise by releasing confidential health details about their patients if they are not satisfied with the patients for example?
My end point is that this is a delicate issue and must be handled according to set protocols and procedures. Wild West tactics might only backfire on the general population.
The core problem, in the age of the internet, is that anyone can say anything about anybody and be potentially accessible on a world stage. Thus, what some patient posts about a doctor can have a significant impact on that doctor. If I Google a doctor's name and some thisdoctorsucks.com entry pops up, I'm not going to visit that doctor.
As it stands, doctors have no recourse (except for lawsuits) to put in their side of the story. I'd bet that many cases of malpractice are actually cases of "malpatients" -- the patient's own stupidity, irresponsibility, lack of candor, or failure to follow the doctor's recommendations contributed to or even caused the problem. Add to that the simple problem of mismatch of social styles and one person's "uncaring" physician is another person's efficient doctor.
My point is that any system that potentially inflicts damage on a person's reputation should have a "due process" mechanism that lets that accused defend their actions or tell their side of the story. To avoid costs, this system needs to be automated so that if the patient can post their allegations online, the doctor can reply with their side of the story.
Two wrongs don't make a right, but three lefts do.
The defendant may plead and establish the truth of the statements as a defense.
This is just unfair. Look at it this way: what if it were your career? If you work a service job, what if managers from companies worldwide in your industry started manager forums to talk about your performance and possibilies for hiring. Its way too unreliable. If you work a professional job at a desk-- same deal. And if you're a manager, what if clients all started forum-ing about your business? Plus, is there any check for truth in comments? Perhaps I'm just a malignant troublemaker and decide one afternoon that it would be fun to ruin the career of a respectable practicing doctor. Is phone calling and talking too slow? The old heard-from-my-friend-he's-bad [or good] seems fine to me. Phone calling and gossip are tried and trued methods.
Doctors are the only field that doesn't compete on either price or quality. Yet, we wonder why it is expensive and the doctors make so many mistakes.
This is my sig.
If what they are saying is not factual then it should be very clearly presented as nothing more than an opinion. The free flow of information like this is an integral part of capitalism.
IANAL but while I believe that the doctors can sue for false information posted online that can be shown to cause damages they would have to file a suit, prove that the information posted online is false and not solely an opinion. They have no grounds to prevent people from posting their comments and can only file a suit after the fact (that is, prior restraint is not allowed). Imagine if M$ decided to sue for every "Windows Sucks" or other anti-M$ comment on slashdot.
Unfortunately, lawsuits are expensive, but the most likely result will be some sort of disclaimer or the site simply removing the offensive (whether true or not) comments.
So let me get this (lewrockwell.com) straight. What you're saying (lewrockwell.com) is that (lewrockwell.com) doctors (lewrockwell.com) are pure evil (lewrockwell.com)?
This is not a Dupe to my knowledge but this seems familiar like for a website where students report on their teachers. So that future students and maximize their investment in education and get professors who are actually competent, speak your language, and are not so full on them selves that they can't teach any material that isn't about their PHD. Then some Profs. Got mad at the site. How did that turn out, and probably the same will happen here.
But doctors have more money then college profs do so they might be different. But when you get the name DR. in front of your name some think it is an abbreviation for Divine Reasoning, and they figure because they spent more years in school they know more about everything then anyone else.
If something is so important that you feel the need to post it on the internet... It probably isn't that important.
Bad programmer. He gets fired.
Bad Doctor. Nothing. But insurance rates go up.
Yah, the system seems fair.
IANAL, but I've seen actors play them on TV
Can someone please explain to me how this is any different than someone posting a bad review for a book on, say Amazon.com? Or is it that Amazon does in fact receive subpeonas to remove those reviews that can be categorized as libel or slanderous and we, the public, don't hear about it?
I have a great doctor who has been retired for probably 15 years. He's old school and treats me and my family with respect and friendliness. He's available 24/7 by phone (home, office, cell, pager) and he's called me back at bizarre times when I've had problems. All my friends are blown away by the stories I have of his service.
Guess what - your doctor is probably behind the times and you'd get better outcomes if you were being treated by a whippersnapper from a good medical residency program with a couple years of practical experience.
the major advances in civilization are processes which all but wreck the societies in which they occur - A.N. White
I think these doctors have every right to sue, and win the cases against many of the online commentators. Sites like lasikfraud are misleading to the public and could lead to poor healthcare decisions. However, I ( and hopefully the judicial system ) have no problem with, and encourage, intelligent reasonable feedback on doctors and hospitals; that is useful to everyone. It seems most of the lawsuit targets are just unhappy people who start flames which intentionally mislead and unfairly damage reputation. Such things are definately and correctly NOT protected by the first ammendment.
-- Checking emails and kicking cheats `till the day I die.
As an alternative one can always report to the licensing boards and ask for review by a panel of experts and specialists instead of setting up a novice 'peoples' court and run a witch hunt.
Doctors overseeing doctors? Why is that not the fox guarding the henhouse?
If Patients who may be not be satisfied due to a combination of myriad factors start using the Web primarly as a means to get back at the doctors, what is going to stop the Doctors to retaliate likewise by releasing confidential health details about their patients if they are not satisfied with the patients for example?
As a doctor, I'm sure you're aware of HIPAA and the serious penalties for violations.
Wild West tactics might only backfire on the general population.
So back in the Wild West days, if someone was accused of something, they didn't lynch them in the town square, but ran back to their bunkhouses and blogged about it? Not even in the same ballpark.
Where does the school board find them and why do they keep sending them to ME?
It's bound to come up, so let me head this question off at the pass:
Q: Why don't the physicians post their side of the story and let the public decide who is more correct?
A: The docs cannot simply post their side of the story on a patient's blog in response to the complaints. HIPAA's privacy provisions generally prevent physicians and their staff from doing so.
In the court of public opinion, only patients have a voice. It's little wonder that some docs might choose to reply via the official court system, because they have no other recourse.
With reasonable men I will reason; with humane men I will plead; but to tyrants I will give no quarter. -- William Lloyd
... except by peer reviews. The only other way is to try out the services first, and some may want to view the reviews of others before 'trying' out a doctor's services.
Especially for expensive, risky or important procedures.
A bad haircut won't do you too much harm, but an incorrect diagnosis could be dangerous. Especially, if they are going to charge high rates and make you wait hours to see them for five minutes.
I'm not a lawyer, and I'm not a doctor, but I'm pretty sure that the Non-Disclosure agreement is entirely a one-way contract.
The Doctor is bound to not disclose information to 3rd parties (except within the pre-defined bounds of their privacy policy). The patient is certainly free to discuss the details of his or her healthcare with anyone they wish.
I really don't understand what non-disc agreement would ever be in place that would stop a patient from discussing his medical care with 3rd parties. The patient OWNS that information.
"Especially when a doctor is free to blog their side of the story."
Breaching patient confidentiality is far worse for business than an unhappy patient with a blog.
doctor sues you!
In some states (USA) there are anti-SLAPP statutes that permit a defendant to dismiss quickly and receive attorney fees and costs.
The anti-SLAPP motion (generally) requires the case be brought as a result of a right to petition (ie. complaint to a court or government) or an issue of public concern and that there is not a great likelyhood of success. For more information go to www.casp.net or http://www.barbieslapp.com./
SLAPP stands for Strategic lawsuit against public participation.
Fight Spammers!
I had a doctor that was *always* late to see me. But we're not talking 5, 15 or even 30 minutes. We're talking almost always more than 45 minutes to a couple of hours!
So yes, I understand they have to see other patients, but if they're always late, maybe this just means that they should accept less patients in the first place. People have to work, and our time is just as valuable.
- sigs are for wimps.
>>Doctors overseeing doctors? Why is that not the fox guarding the henhouse?
Nope, that analogy is wrong.
Only a board of specialists can determine whether a particular doctor's actions, judgements are correct, done in good faith and do not amount to gross negligence and incompetence.
How else would you want it to be? Judgement by a Jury with popular vote? Most of the time, decisions made by physicians/surgeons are complicated and depend on many factors.
When we have peer reviewed Journals in every scientific fied, why would you object to peer-judged and peer established standards?
``some doctors are, in turn, defending their reputation by suing the online critics.''
To me, that sounds like fighting for peace or fucking for virginity.
Please correct me if I got my facts wrong.
Yeah, I was going to make note that I was linking to a site that contains many different authors, editors, and third party articles all on their site. Forgot to mention it.
LRC definitely has a political bend to it. So do doctors suing their patients for expressing their right to speak freely.
That's an interesting correlation. The more the government has gotten involved in health care and health insurance industries, the worst the quality of the service has gotten.
It is in everyone person's right to criticize bad service, and the threat of libel lawsuits should not be as powerful.
Luckily for We, The People, libel is notoriously difficult to prove. The malicious intent to misrepresent and damage must be demonstrated. This is tough to do when frustrated people are just bitching. Even if what they are saying is WRONG or misleading, if they're saying it honestly, they're mostly in the clear.
When you have a State-sanctioned power [lewrockwell.com] to treat others, it shouldn't stop you from giving your best, especially in life or death situations.
And yet, the greater your actions are governed and sanctioned by the state, the greater your propensity to do a shitty job.
I've been to other doctors and wish I had the time to complain. Dirty exam rooms, gossiping about other patients, staff that works more like DMV workers than health professionals.
An interesting comparison - health care to the various incompetant sectors of public service.
"I have never won a debate with an ignorant person." -Ali ibn Abi Talib
If no legal documents are signed, then how does a patient's entering a doctor's office obligate the patient to nondisclosure?
The confidentiality that doctors owe patients is different.
And these experts and specialists are physicians, no? Hmm. . . So people can only protest bad medical care to medical professionals?
Really? When I gained 50 pounds at the age of 25, was told by numerous young doctors to get on Lipitor and other drugs for blood pressure and choleserol, and was having bouts of emotional frustration and told to get on an anti-depressent "temporarily" by 5 different doctors, I said no.
My elderly doctor said lower my carbs. I did. 6 months later, problems were all solved. 5 years later they're still fine.
Doctors used to make housecalls. Most won't. Doctors used to see you the moment you walked in the office. Most won't. Mine does.
Keep telling me about these kids who have government subsidized educations and also a great Congress who works extra hard keeping the amount of doctors graduating to a minimum -- helping every doctor charge that much more.
While I don't think ranting on the web is the answer to these problems, I really wish there was a better means of finding honest, competent doctors. I have dealt with a lot of quacks in the past few years, but that may be my area (South Florida.)
I don't think blogging about it does much except make both parties look bad.
I wrote an Amazon.com book review for a programming book that was less than flattering. I posted the review under my real name.
The author of the book Googled me, found my email address and then contact me to complain. I found that a little strange.
"if the Physicians will have to constantly watch their back against disgrunted people posting online, their quality of service might suffer."
If physicians know that their patients have limited access to recourse against them, I am certain that quality of service would suffer.
"If Patients who may be not be satisfied due to a combination of myriad factors start using the Web primarly as a means to get back at the doctors, what is going to stop the Doctors to retaliate likewise by releasing confidential health details about their patients if they are not satisfied with the patients for example? "
Ethics, and public outcry over lack of them.
How long do you think it would be before major news outlets report on a doctor releasing private medical information of a patient?
How long after that will it be until the doctor is penalized or has their license revoked by their state medical board?
'Most Importantly, if a patient visits a doctor, they enter automatically into a non-disclosure agreement although no legal documents need to be signed."
Not true at all. A treatment agreement != a non-disclosure agreement. There is no NDA unless it is expressly agreed. While a state medical board may require physicians to protect patient privacy, the patients themselves are under no such obligation. Many doctors' offices require you to sign an NDA before they'll treat you (often not each time, but rather, a blanket NDA to cover all visits). Also, these NDAs may not cover truthful criticism of a doctor's practice. I, for one, would never sign an NDA requiring me to keep my mouth shut if I have a bad experience.
If, as a physician, you believe you have an NDA covering all aspects of your practice with any patient you treat, you should get some legal advice.
"My end point is that this is a delicate issue and must be handled according to set protocols and procedures."
Often, a patient can have a bad experience with a doctor, even though no sanctionable behavior occurred. The patient should still have the right to inform others of their experience -- this is, after all, what word-of-mouth is.
Perhaps patients should not be allowed to recommend doctors to their friends and family? Instead, patients should have to check for formal commendations of good service.
Libel is still illegal, and is subject to prosecution. But honest communication of experiences, not covered by an NDA, are legal, just, and necessary for best consumer protection.
"Trolls they were, but filled with the evil will of their master: a fell race..." -- J.R.R. Tolkien on Olog-hai
I sued and lost. Judge ruled I didn't have a leg to stand on.
I'm not sure if you were being sarcastic, but it IS an interesting correlation.
I hate to keep linking to lewrockwell.com but they do have great opinions that are covered by a lot of facts they point to. It is scary how the AMA is an arm of the government AND a lobbying group. It is scary that Congress limits the amount of doctors that graduate, keeping costs high. It is also scary that doctors are so heavily licensed, keeping natural healing methods at an uphill battle (although I'm not a fan of most natural healing methods).
He stuck his finger up my ass for only a $25 copay.
A hooker would charge much more than that!
He was not talking about an NDA type of contract, but a contract of agreeing to be under the doctor's care. You might want to re-read the doctor's note...
Often wrong but never in doubt.
I am Jack9.
Everyone knows me.
My wife's a pediatrician and all the talk recently was about a spate of recent studies that prove statistically that newly minted doctors give better care than doctors out of residency for ten years plus (especially those not in a university affiliated setting).
the major advances in civilization are processes which all but wreck the societies in which they occur - A.N. White
I'm not sure why it is in anyone's power to curb the speech of others on a private or public forum.
.let me come in agian).
So long as we leave out issues of criminal libel it isn't. Speech remains free as in speech, as the government cannot exert any force of prior restraint or post facto criminal prosecution (ok, leaving aside copyright/trademark issues as well. .
Speech that is deemed libelous is not, however, free as in beer. You can say it, but it's going to cost you.
Yeah, yeah, I know. God help you if you can't afford to pay to show that your speech wasn't libelous, which is the angle these doctors are using. They're chance in court is nil and they know it.
No doubt in future our paychecks will be simply direct deposited into the accounts of the lawyers.
KFG
KFG
Oh great. If some asshat has this insurance and decides to tell lies about me, there's nothing I can do about it.
>>> I really don't understand what non-disc agreement would ever be in place that would stop a patient from discussing his medical care with 3rd parties. The patient OWNS that information.
Yes, the patient OWNS that information...but does that necessarily mean that he is always free to discuss it or reveal it to third parties in a manner that will affect the doctor's ability or oppurtunity to treat other patients?
When the patient approaches a doctor,and when a doctor accepts the patient for treatment, they mutually enter into Two Implied Agreements .
1. That the Doctor will hold the patients' information confidential unless under legal santion or request by a court of law and that the doctor will exert his best efforts towards the relief, health of the patient, etc etc, etc... there are many liablities of the doctor towards the patient,
2. That the patient agrees to follow the Doctor's instructions, etc etc etc and at last agrees to approach a suitable court or body for arbitration in case of negligence or failure on part of the doctor to effectively discharge his duties..
Now, the question is: whether forums and blogs do make a valid and competent avenue to seek arbitration or whether its best to seek it under legal and professional bodies?
Now I re-read it and look like an ass. Let the AC trolling begin.
Often wrong but never in doubt.
I am Jack9.
Everyone knows me.
And the other side of the coin is that one shouldn't have the power to ruin an innocent persons reputation. e.g you're a child molestor! Rape! Rape!
So if I called rapist on you, why would people believe me? Words alone won't skew too many opinions unless they are backed up by more concrete evidence.
Canada. Europe.
Exactly. Some of the worst health care there is. I've been to both, have had friends in both with medical problems, and they're terrible. Add in the fact that "free" health care costs consumers more than free market health care, and you've got a sinking ship. Government's solution to the terrible "free" health care problem: more money!
. If it's never taken to court then no one will know what is smear, and what is legitimate. A blog is no substitute for a court of law (court of slashdot maybe).
Except Tort Reform problems and the high cost of litigation makes it difficult to sue your doctor. I know, I've two friends who had no choice other than to hire ambulance chasers as the real lawyers wanted way too much per hour to even take the case.
"When we have peer reviewed Journals in every scientific fied, why would you object to peer-judged and peer established standards? "
Because peer-determined standards of care are not the only issues that patients can have problems with.
Furthermore, if a doctor does adhere to peer-determined standards of care, and the patient publishes material that says the doctor didn't treat them properly, etc, then that patient is committing libel, and is prosecutable.
If a judge or jury does determine that the doctor met those peer-reviewed standards, then the doctor is vindicated, the complainer is fined, and the material is not allowed to be published. If the material is particularly damaging, then the doctor can file an injunction to have it removed pending consideration of the libel case.
"Trolls they were, but filled with the evil will of their master: a fell race..." -- J.R.R. Tolkien on Olog-hai
If one could create bonded pseudonymous accounts that were not traceable back to the owner of the account, one could have anonymity with accountability.
- None can love freedom heartily, but good men; the rest love not freedom, but license. -- John Milton
Studies by whom? AMA? I hope so. When my wife was in the ER a few months ago, it was all young doctors who were overworked and offered no reasonable opinion as to what was wrong with her. The two doctors we were referred to were even worse (young as well).
I'm sure there are GOOD doctors out there, but if I find a bad one, why isn't it my right to speak out to the world about it?
First of all, $300/year is not chump change. My motorcycle insurance was less than that - for full coverage.
Second of all, how much protection does it really offer for slander or liebel cases? Or are there escape clauses that make the policy useless when you really need it?
Avoid Missing Ball for High Score
Actually, the courts have ruled in earlier instances and *even if* no documents were signed, there is an IMLIED CONTRACT.
>> So people can only protest bad medical care to medical professionals?
[ Reply to This ]
Sorry, one has to protest to the courts and the courts set up SPECIALIST bodies just like a Jury, but only with those who have competence to understand the issues at hand to ADVICE the courts.. the Judgement is upto the Courts anyways!! The Specialist Doctors only advise the court, not deliver judgements. They make the issue understandable to the Judges.
"You can't have meaningful, productive free speech with perfect anonymity"
You can't have real free speech without anonymity.
If only because people speaking anonymously are often speaking anonymously because the other party/person is significantly more powerful.
You don't have freedom of the press if you can't anonymously criticize the government. Think about it... a thoughtful, representative government doesn't care, a corrupt one will crush anybody who says something they don't like.
If I put up a website that says my Chevy-Ford sucks, here's all the repairs its has, and don't buy one. Chevy-Ford may threaten to sue me. And because our legal system is geared heavily against individuals, I really have no forum unless I can be anonymous.
When one of my profs talked about it in class he said: "The site said that I was a bitter old man, but I'm not that old!" Awesome prof, by the way.
Not to mention all the review sites that currently exist about things like movies and tv shows.
So, if there is a precedent set where you can bitch about a bad movie, or prof, but not about someone who could very well have your life in their hands, then there might be a more important legal battle than software patents coming up. (well, at least one that concerns me more anyway)
I'm all for sites that allow users to post reviews from either a positve, negative or neutral perspective. It still may not be fair to the person, but at least different sides of the stories can be seen under similar context. (rather than having to go to the forums to see the retort of the accused, compared to just the negative being on the main page)
Then again, I doubt Bill Gates has the time to reply to each and every one of the sites bashing him and his company (/. included)
Am I open minded towards open source, or closed minded towards closed source?
I was going to mod spadefoot up but thought I would point out that if you automagically signed a non-disclosure agreement when you visited a doctor getting a second opinion would be illegal. Since that obviously is not the case the premise is false. QED.
I could probably argue this case from either side.
...but put yourself in the doctor's shoes and ask yourself what would you do?
Doctors do have to put up with a lot of crap as it is. Patients seem to expect them to come in like magical paladins who can cure anything with a few magic words. A lot of patients don't even take their advice anyway... who hasn't thrown away the last few pills in the bottle because they're already feeling better? Take it on a full stomach? Don't take it with alcohol? Those warnings are for other people, right?
And that's just the small stuff. Your doctor tells you to start eating right, quit smoking, and exercise. But those Twinkies look so good, and there's a Mork and Mindy marathon on tonight. A few weeks later, cardiac arrest... but hey, the doctor should give a guy some warning next time!
Let's face it, folks... becoming a doctor requires a huge amount of time, money, and dedication. It truly is a lifetime commitment. And when you finally get there, it isn't particularly pleasant work. Sure, the money is decent, but there's also the constant threat of multi-million-dollar lawsuits and now these internet complaints. Most of us simply don't have what it takes to be a doctor, much less a magical awesome doctor who never makes mistakes.
On the other hand, I firmly believe that free speech is wonderful and lawsuits suck.
Andrew Lenahan http://www.starblind.com/
"Folk who bring libel suits often have something to hide. Robert Maxwell successfully supressed criticism of his theft-in-progress of the Mirror group pension fund using libel writs."
I agree that libel suits can mean someone has something to hide and if that is the case then they should be fought against and people fighting against them should be encouraged and supported.
Another possibility of being able to comment without being sued into submission is Freenet. Although I don't like the idea of hiding, for some people who cannot afford a lawsuit this maybe a viable option.
Ah yes, clearly it's the fault of the government.
It'd never be because of everyone going to med school because they heard they can make six figure salaries by cutting people up, rather than because they have a serious desire to help people. Take a look at the glut of shitty programmers for an analogy. Please, share with us your wisdom of how reducing government interference will make the thousands of monkeys who took CS from their local college because they heard it would make them rich into better programmers.
Sadly enough, the reason so many doctors suck it here is because the oversight that exists is barely enough. I have here the Spring 2005 edition of the Texas State Board of Medical Examiners bulletin. The Spring quarterly contains all of the disciplinary actions against doctors for the prior year, and in it are juicy tidbits like one doctor sexually assaulting a patient under anesthesia for which he was awarded a temporary suspension of his license, after the DNA tests came back positive. At least the doctor did the right thing and voluntarily gave up his license. Another gave false information to the board, "forgot" to tell the board that he was manic-depressive, assaulted his wife with a gun, and eventually ended up getting up close and personal with the Dallas SWAT team. He also got a temporary suspension. Another was put on probation (his suspension was "stayed") for practicing while drunk... in all, there were 187 doctors facing discipline in the year prior, for anything from rape to failing to maintain their required education.
Less regulation is going to make that better? Are the bad doctors (who are in it for the money) going to step forward and give up their cash cow out of a sudden discovery of the goodness in their hearts? Or maybe they'll put up a sign and let their patients know: "Welcome to Dr. Craptacular's Surgical Practice! In the past 5 years I've raped one woman, shown up to an appendectomy while drunk twice, and was arrested for possession of cocaine three times, but my rates are 10% lower than the guy across the hall's rates!"
If I have been able to see further than others, it is because I bought a pair of binoculars.
It is about time that the medical community was put in check. As far as I can tell there is a culture of protected ineptitude in the medical profession. There are many great doctors, and there are many poor doctors, and there isn't much a patient can do to determine which is which. The medical boards are more akin to a union or religion, and don't help to protect the public at all.
Most doctors I've seen practicing in recent years prescribe whatever new drugs that are promoted to them, usually in the form of free office pens and advertising leaflets. There doesn't seem to be much understanding of the patient or the underlying causes or anything like that. Maybe I'm confusing medical research with medical practice here, but there seems to be a bit of a disconnect. Some doctors I've encountered seem incapable of figuring things out. They can't explain their thought process or answer questions clearly. They're about as sophisticated as an average car mechanic. The medical community must be able to be improved.
If you have a terrible experience and you can't talk about it, then how will this ever get sorted out? If the claims were truly libelous (damaging and false) then the doctor's suit is reasonable... but I have a feeling that some doctors would like to avoid valid criticism. Sorry, but I think the patient's right's trump the doctor's. Hopefully enough of these anonymous sites can be successful that it shakes things up.
Cheers.
I've dealt with quite a few non-disclosure agreements, and you are missing one key point. They are one way documents. The doctor is the party which cannot disclose any information, under penalty of legal punishment and retaliation. This is for the safety, privacy and protection of the patient.
BUT, if a patient wants to go around and disclose to the world their own health problems, and the treatments they have been given, then that is their personal freedom to do.
It's a one-way privacy statement. Sorry but the patient has every right to talk about the doctor, and the doctor does not have the opposite right.
I do agree with you though that choosing a doctor whom you trust is very important, but it can quickly get difficult for a patient with a sudden health issue that sends them to a variety of specialists. When your health is in trouble and time is a leisure you don't have, there is not time for an average person to investigate every medical provider that they come in contact with. And what if you are addmitted to a hospital via the ER? You have little or no choice then in who treats you.
Often, a patient can have a bad experience with a doctor, even though no sanctionable behavior occurred. The patient should still have the right to inform others of their experience -- this is, after all, what word-of-mouth is.
Quite right, Physicians still rely on word-of-mouth as advertising channels because they are discouraged from advertising their services as comodities or commercial offerings....
but you see, there is a delicate but important fineprint matter here regarding posting on the Internet..
On the Internet, you cannot control to whom your advice, remarks, opinions about a particular doctor reaches.. personally recommending or telling somebody to stay away from some xyz doctor is perfectly alright, but putting it on the web is totally a different matter altogether... That information on the web might affect someone's judgement and thus jeopadice NOT The doctor, but the patient himself from receiving potentially proper care... got my point? The issue is about control over the opinions.. even before we know that the opinions might be right or wrong.
>> Not true at all. A treatment agreement != a non-disclosure agreement. There is no NDA unless it is expressly agreed
Sorry for making it sould so simplistic.. anyway, there are many court precedents which rule that a NDA is implied on part of the doctor even without expressly agreed (although its necessary for successfull defense).. just because a patient did not or MORE IMPORTANTLY couldn't sign a NDA doesn't mean the doc can go ahead and disclose the patient's information...
>> Also, these NDAs may not cover truthful criticism of a doctor's practice. I, for one, would never sign an NDA requiring me to keep my mouth shut if I have a bad experience.
Ah.. you got me all wrong.. I am NOT against critisism... feedback is necessary to improve quality of service.. both good and bad feedback, but to COMPLAIN, one must follow procedures, not just post to a blog. Thats my point.
Generally negligence is excluded. This means that if you consciously or unconsciously lied, they can deny coverage.
Simplified, negligence is when you do something wrong. Gross negligence is *knowingly* doing something wrong.
Umbrella liability is not a license to be an asshole. It's frankly not worth it in my view. It makes you a target since you now have deep pockets. First thing a lawyer is going to want to know is the policy limits on the target of a lawsuit. If he/she hears about an umbrella policy, they'll be gunning for the whole amount.
HBI's Law: Frequency of calling others Nazis is directly correlated with the likelihood of the accuser being Communist.
"Slashdot, where telling the truth is overrated but lying is insightful."
What happens when they complain that the doctor sued them about the complaint? Will the doctor then sue them about the complaint about the lawsuit about the complaint?
http://www.popularculturegaming.com -- my blog about the culture of videogame players
Sites like this can be useful for frank discussion of the merrits/failings of a person or company, but they are also frequently abused.
My partner is a professor. He has complained to me about ratemyprofessors.com, where students who are disgrunteled for getting bad grades can write very derogatory and misleading things about their teachers. The site makes no attempt to assess truth, and there's no opportunity for the professor to respond.
This pattern of website gives a sense of anonymity and can be more about freedom from responsible speech rather than freedom of speech.
Yes, my partner could probably find out who made which comment and sue for slander or libel, but that seems like such an extreme measure. Maybe people should sue though. Many people would not post the things they do if they thought they would actually be held responsible for their comments.
Yes, it is government's fault, partially.
When government sets the licensing standards, of course the wrong people will get a hold of a license to practice medicine. Why not allow independent licensing boards (as was the case in the past) offer licensing of their doctors? Underwriter's Laboratories does a great job of making sure lamps and toasters are safe, why can't Doctor's Underwriters compete with United Doctors League in licensing their members as "safe?"
A licensing board is only as good as its members. If the board doesn't revoke the license of a member for an error or a crime, the board is useless. Government licensing is much harder to revoke. I've been to my state licensing board (actually had a hearing today regarding a sales tax payment short I made a year ago) and I couldn't believe how easy it was for me to walk out of there with no penalty and no worry. They were so busy with other mundane problems that I just fell through the cracks.
Honestly, do you want the same people that take your driver's license photo be the people that hand out licenses to your doctors? Do you really think good doctors will give up their practices to be the licensing committee with government pay?
why would people believe me?
Because people are stupid. See also: pediatrician getting lynched because long words are just too damn confusing to mobs.
If I have been able to see further than others, it is because I bought a pair of binoculars.
I had a friend who went to the dentist and ended up with a bunch of problems. He went to another dentist and the second said "Oh my god, WHO worked on YOU?!". He submitted a complaint to the dental board, complete with records from the second dentist. Outcome? "Not sustained."
I told him not to expect anything -- the medical community self-polices not because it does any good, but because it provides great insurance against real legal sanctions and problems. I don't know for a fact, but I would almost bet that in many states the self-policing medical boards have to sustain a complaint before any further review of the doctor's case or punishments can be meted out.
I think what he should have done is threatened a lawsuit but have been willing to accept a cash settlement of $5k along with an agreement to not discuss the outcome. It would have more than covered lost wages, additional dental procedures and pain and suffering, and he probably would have gotten it.
They are one way documents. The doctor is the party which cannot disclose any information, under penalty of legal punishment and retaliation. This is for the safety, privacy and protection of the patient.
Yes, you're right.. I actually did not make it sound right in my first post.. but the point i was trying to make wasn't about NDA's at all.
Sorry but the patient has every right to talk about the doctor, and the doctor does not have the opposite right.
Right again, but the The point is: If a patient has a complain.. maybe a valid one.. it might be true, so posting it online might NOT be a libel or slander.. but he/she should FIRST USE THE standard procedures like approaching the court if its serious, or approaching the administration of the hospital/city/municipality etc.. before going ahead to the net.
BECAUSE there is NO benefit to gain from the net.. It might be in good faith to warn others.. but how can one differential between the good faith posts and malafide ones?? and who is going to determine that?
I hope I made myself clear now.
i would add one to this: the concept of need. Lateness on the part of a patient is more inconsiderate than lateness on the part of a doctor.
I had to wait hours once for my neurologist, who ran very, very late. When he came in, he apologised profusely.
I told him what my mum always told me: Never to mind waiting in the doctor's office, because they take the time that is needed with their patients. A doctor who has made you wait will make sure that you get the care that you need, and if YOU'RE ever the one who's in need of the extra time, you'll be glad that they'll disrupt the schedule for it.
In this case, my neurologist had been treating- on an emergency basis- a stroke victim, and couldn't just walk away to pick up a phone. I didn't mind, because if i ever need the emergency care, i'd be glad to know that it was there for me.
"I'd say 'Have a good time,' but arson is still illegal.
Libel is written, Slander is spoken.
My wife's a pediatrician and all the talk recently was about a spate of recent studies that prove statistically that newly minted doctors give better care than doctors out of residency for ten years plus
Great. Let's see some links to those empirical articles published in accredited, peer-reviewed journals. And hopefully they haven't been done by doctors, or the husbands of doctors.
Max
My god carries a hammer. Your god died nailed to a tree. Any questions?
Given that insurance companies say that most malpractice cases are filed against the same of doctors I wonder how many of these complaints represent the same pool or a similar percentage?
If the doctor is suing for injunctive relief, it's not the insurance company's problem.
Knowledge is how to play a game, intelligence is how to win, wisdom is knowing what game to play.
In most states, you can search for your doctor and see their list of malpractice suits, medical board disciplinary actions, and a record of any crimes for which they've been convicted.
Facts, not hearsay.
"The advanced societies of the future will be driven by competing systems of psychopathology." -JG Ballard
So, doctors shouldn't be sued by patients, but patients should not be allowed to sue doctors.
Gotta love the hypocrisy of the conservative agenda (tort reform).
The truth is, if it came down to a choice, I'd vote for the little girl who will need $15 million in medical care to keep her alive for 40 years over a doctor who's upset by a bad review. But I suppose a $250,000 cap on punitive damages that keeps her alive for.. a few months.. is good enough.
If conservatives truly cared about lawsuits and the medical community, they would work with Democrats to allow drug reimportation and bring drug prices down, which would create a more competitive market and lower the needs of those types of patients.
The truth is, $15 million is a lot. But believe it or not, that's how expensive our system is.
But of course, it's the health care industry and drug companies that contribute mostly to conservatives, so we need to make sure they make billions --- even if it's at the cost of people in need.
Sorry, doctors, my ears are plugged on this one.
The next comment I write will be ready soon, but subscribers can beat the rush and see it early!
There probably is a correlation, but that does not imply that there is a direct cause relation (i.e. more government involvement leads to worse quality).
I think that the link here is that USA's government previously have had a low involvement in public health care and the industry is exploiting the profit possibilities that now show up combined with inexperienced (in this matter) politicians.
The health care system in most European countries have heavy governmental involvement and are working reasonably well. There are of course variations, but I think most people agree on that those health care system works better than the one in USA. For an extreme comparison look to Cuba which has one of the worlds better health care systems with only governmental involvement.
PS Yes, in this post I state some opinions that I do not back up further, and while this generally is bad I think that they should be clear enough.
When you are sure of something, you probably are wrong (search for "Unskilled and Unaware of It").
uhh... the Red Cross advertises on tv.... And mabye you just had a shitty doctor, being human they can't all be perfect.
Get a free Ipod!
If a doctor is always an hour behind...
Thats the point.
If someone is always late paying bills, showing up, or whatever, that is a psychological problem, obviously not a money problem or a time problem because if they are always behaving that way then the money and the time is a constant and the only variable is the person.
"Only a board of specialists can determine whether a particular doctor's actions, judgements are correct, done in good faith and do not amount to gross negligence and incompetence"
You can't be serious.
Imagine if Microsoft said "You can't make any kind of competent review or criticism of our products because you need to be a data processing profession to determine if our judgements were correct and don't amount to gross negligence and incomptence".
You'd laugh out loud!
A doctor provides a service like any other professional and is entitled to the same amount of respect that I would give a lawyer, plumber, programmer or musician.
Just going to school for a long time and passing a test doesn't give anyone special insight or immunity from public critism.
You were mistaken. Which is odd, since memory shouldn't be a problem for you
A physician you may be, but a lawyer clearly you are not.
I defy you to point out any example of a circumstance where any party is "automatically" entered into an NDA (or other agreement) without documents needing to be signed. Certainly patients do not enter into verbal NDAs with doctors; besides written agreements, what other forms of agreements are there?
Implicit NDA - as if!
If they are stating *facts* or clearly stating that its a personal opinion, it should be clearly legal to post the information.
If the doctors prevail, its one more strike against freespeech.
Now, if they are *lies* then more power to the Doctors.. and no, i couldnt get to it to read the article.
---- Booth was a patriot ----
Of course only medical specialists have the requisite competence, but do they have the requisite honesty?
And how are such judgments publicized, if at all?
Seriously.
Ever since my physician completely dropped all HMOs, he's been much more accessable, and the quality of the care has increased tenfold.
The HMO zombies can't properly treat their patients. Period. End of story.
On the other hand, I agree with nationalized healthcare on principle, but am sternly opposed to it for the simple reason that I know that it will be terribly terribly screwed up if we try to implement it, given our current track record.
Anyone who disagrees hasn't been to the DMV recently.
-- If you try to fail and succeed, which have you done? - Uli's moose
Many variables! Here's my hypothesis: It may be that "newly minted" doctors on average give worse "care" but are more knowledgeable and up-to-date about the best, modern medicines to prescribe for various conditions, and know more about various conditions etc., and maybe on average this means better outcomes for patients but doesn't necessarily mean that dada21 isn't correct - because as I said, there would be MANY variables covered in such a study, and the study would clearly not isolate any of the variables. It might well be that if you combine new knowledgeable doctors with 'proper care' that you would get even better outcomes.
My own (anecdotal) perception is that doctors in "modern" practices don't have time to give proper care to patients ... they are run like factories / assembly lines where the goal appears to be to push as many patients through as possible, so each patient has perhaps ten or fifteen minutes and then you're pushed out again with a prescription in your hand before you've even had a chance to really explain what the problem is - and most of the time, my problems DON'T end up being solved AT ALL, the doctors effectively give a "don't know" shrug and push you off to the next "specialist" because their are ten people still in the waiting room behind me. Eventually you give up and literally just live with health problems because it's costing so much and nothing is changing (btw if I don't come back and complain would that count as a "success" in that study you cite?). You can't properly troubleshoot problems in any field without giving proper time and care to each problem case. I know as a programmer even to debug programs you really have to take your time and "get into it". I think this is the biggest difference between 'old-school' doctors and new doctors - fewer patients and more time per patient.
"On the Internet, you cannot control to whom your advice, remarks, opinions about a particular doctor reaches.. "
Which is why the information is considered to be published, and is governed by libel laws.
"anyway, there are many court precedents which rule that a NDA is implied on part of the doctor even without expressly agreed (although its necessary for successfull defense).. just because a patient did not or MORE IMPORTANTLY couldn't sign a NDA doesn't mean the doc can go ahead and disclose the patient's information"
But the concern here is whether patients have the right to disclose information about their treatment, not whether patients have the right to privacy.
If a patient wishes to file a formal complaint that results in legal sanctions against the doctor, they may do so. But if the patient wishes instead to inform others of their experience, without pursuing legal action, they may also do so. Protection from libel in published sources already exists, and applies to blogs.
"Trolls they were, but filled with the evil will of their master: a fell race..." -- J.R.R. Tolkien on Olog-hai
Mike
"Not an actor, but he plays one on TV."
Dr. Henry Levin, DDS is a technically excellent dentist.
But his office manner and communication with patients leaves much to be desired.
How dare they file suit against people expressing an honest opinion.
From http://dictionary.reference.com/search?q=fact
2.
a. Something demonstrated to exist or known to have existed: Genetic engineering is now a fact. That Chaucer was a real person is an undisputed fact.
b. A real occurrence; an event: had to prove the facts of the case.
c. Something believed to be true or real: a document laced with mistaken facts.
Emphasis mine. There are other nuances of the definition which suggest that a factual statement does not have to be true.
Do please check the definition before you say anything is "by definition".
It's rare that you're presented with a knob whose only two positions are Make History and Flee Your Glorious Destiny.
"If Patients who may be not be satisfied due to a combination of myriad factors start using the Web primarly as a means to get back at the doctors, what is going to stop the Doctors to retaliate likewise by releasing confidential health details about their patients if they are not satisfied with the patients for example?"
the law.
one is legal and the other is illegal.
take a guess as to which is which.
the burden is on the physician, who is licensed by the state to provide quality health care, to provide good service.
why should these people be licensed if they cannot even meet the minimum requirements?
in other words, why is it up to the patient to find a competent doctor? doesn't the license guarantee some level of competence?
or maybe it's time to see physicians as software....
full of bugs and since your health is involved, can be quite deadly.
Science : Proprietary , Knowledge : Open Source
DR.Oogle http://doctoroogle.com/ has over 19,000 dentist reviews for 50 major metropolitan locations across the US. Only 13% of those reviews are critical or negative in nature. Considering that a dentist visit can, and often is, a scary experience - 13% is LOW! Yet, WSJ chose to concentrate on the "juicy" stuff - subpoenas, threats, lawsuits etc. while ignoring the fact that the bulk of the patient feedback is positive.
How about an article that references The Annals of Internal Medicine?
I'm curious about your criteria, by the way. Who is the peer in "peer-reviewed" who would review a medical journal who isn't also a doctor?
the major advances in civilization are processes which all but wreck the societies in which they occur - A.N. White
From a different site:
100 years of Medical Robery
Real Medical Freedom
On a different note, I'm a big fan of Osteopathy (D.O.s, not M.D.s). It's kind of hard to find an osteopath who specializes in Osteopathy (most D.O.'s practices are no different than an M.D.'s), but if your structure is screwed up, it's certainly worth the trouble.
See Andrew Weil's _Spontaneous Healing_, Chapter 2 for his experience of the Miracle Healing Power of ten-fingered medicine.
Learn the rules so you know how to break them properly.
www.teslabox.com
If you could get the perfectly compassionate and polite physician who teaches whippersnappers at a med school that would be perfect, but given a choice betwee putting up with a rude overworked young 'un from a top program and an older doctor who graduated many years prior from the same program but is no longer affiliated with a university, you're probably better off with the whipersnapper, even if they piss you off.
:)
But there are indeed many variables. My wife is of course the perfect doctor and is infinitely compassionate and knowledgeable
the major advances in civilization are processes which all but wreck the societies in which they occur - A.N. White
I'm sure there are GOOD doctors out there, but if I find a bad one, why isn't it my right to speak out to the world about it?
No reason I can see. Just make sure the complaints are accurate and I'm all for consumer info websites on doctors. However, I would suggest that if you publicly complain about a specific treatment program that you should allow the doctor a response and a limited HIPAA waver to release enough information about the specific incident to mount a reasonable defense in the court of public opnion.
the major advances in civilization are processes which all but wreck the societies in which they occur - A.N. White
You need a little history lesson. The regulation of doctors is done through licensing -- the AMA. The AMA started in 1898. Their goal was to limit the number of medical schools and limit the number of students admitted to each medical school. They claimed this was to insure higher quality of health care, but its own clear effect was to limit the supply of doctors in America. Hopefully you know enough about economics to realize that limiting supply while demand stays constant will increase price. Anyways, by 1910 the government introduced legislation that closed all non-AMA medical schools. The number of medical schools in the US dropped from 163 in 1906 to 69 in 1944.
But wait, it gets better. Medical schools wanted to increase their class sizes in the great depression. They found themselves in the position of turning back qualified students even though they had space for them. Clearly the AMA was not going to like an increase in the supply of doctors. So what did they do? Well most (if not all) medical schools also operate or are associated with a hospital. The AMA threatened to revoke the licneses of their hospitals if they increased the number of medical students they admitted.
So you would think that all these high standards and licensing would at least increase the quality of health care in the US, right? Nope. America's cost per capita for health care is the highest in the world at $4662, yet we rank 42nd in life expectancy, 37th in infact mortality, and more than 100,000 patients die each year in hospitals from accidents and medication errors. Here's a great article on that.
You see, licensure basically creates a government backed monopoly. You have some group with a vested interest (current doctors) who are able to limit compettition (by saying who can offer medicine and how it must be offered) with the backing of the federal government. Microsoft's monopoly is nothing in comparison! There's no law against you installing Linux...
Finally, the other thing that regulation/licensure causes is a hinderance to technology. There was a great article from a guy at Harvard Business (couldn't find any free links to it) about how health care is ripe for disruptive technologies. It's an industry where specialization is more and more common. This requires much more education/training, but allows for higher profit margins. However, specialization is needed by less people. So what you wind up with is that most people see doctors who are way-over-qualified to treat whatever is wrong with them. Yet these doctor's must recover the costs of the extra education needed for their specialization. Hence the high cost of health care in the US. This kind of thing has been seen in countless other industries, and it usually leads to a disruptive technology. The disruptive tech is something that is not as good as what it competes against, but is good enough for most people and much cheaper. Over time the disruptive technology becomes better and better. Think Solaris vs. Linux if that helps.
So why haven't we seen something like this in health care? The answer is simple: licensure. People with vested interest are able to protect their position at the expense of the public. They can stop compettition that would otherwise increase the quality of life of the public and decrease the economic drain.
So you see, more government regulation may not be the answer. The people doing the regulating will have to have medical training. So we're right back in the position of people with a vested interest having even more people to control their industry. This hasn't worked in the past, so there's no reason why it would would now. If anything, it will likely limit supply (how many doctors) even more (in the name of increasing quality) and thus make doctors even less accountable for their actions (combine that with legislation to limit malpractice lawsuits.) It will also make sure
Knowing people who live in Europe and deal with their health care system, they only like one thing about it: it's mostly hassle-free. Yeah their taxes are insane but if you need something done you just go to the hospital or whatever, and don't have to deal with insurance claims and what not.
My friends and distant relations in Canada spin another tail. Most of them carry modest insurance to get work done in the US due to the logjam in the Canadian system.
I don't LIKE our health care system, but I enjoy its relative alacrity and flexibility. I enjoy the freedom to make my own decisions, for the most part, about what I get done, and when.
For an extreme comparison look to Cuba which has one of the worlds better health care systems with only governmental involvement.
Yeah, but I don't like the other stuff you have to put up with to get it, like living in utter poverty unless you're involved with the government, or being jailed and/or executed for disagreeing with the wrong people.
I think nationalized medicine can work, but we're kidding ourselves about what it'd cost in America. With as many people as we have hauling around the mass equivilent of entire additional people in their asses, guts, and thighs, I cringe in terror at the thought of what it'd cost us (as in, you and me) to finance a public health care structure that has to deal with these fatties. It's not a matter of "could we do it" it's a matter of "would it be any better than what we have now?" I'm not sure that it would, and I'm even less convinced that our political leadership knows either. It'd just "be nice." Sort of like Bush's prescription drug thing. Nobody really thought seriously, "What is this going to cost us in the long run?" Or even the short run. Pure political philandering. PS Yes, in this post I state some opinions that I do not back up further, and while this generally is bad I think that they should be clear enough.
"I have never won a debate with an ignorant person." -Ali ibn Abi Talib
Who is the peer in "peer-reviewed" who would review a medical journal who isn't also a doctor?
Fact is, any "study" published in a medical journal tooting the horn of, well, *medical professionals*, done by those same medical professionals, deserves a healthy amount of skepticism.
But that isn't what your link talked about. In fact, it doesn't address the actual skill of the doctors in question at all. According to the article, the complaints are summarized as:
"63 percent found that older physicians were less likely than younger doctors to conform to current standards."
and
"14 of 19 studies (74 percent) looking at performance found that older physicians were less likely to adhere to therapeutic standards compared with younger doctors."
In other words, older doctors are less likely to rigidly follow practices exhorted in medical school, and instead do what they think is best. Which apparently seems to be some sort of heretical idea, at least where younger doctors (or Harvard Medical School) is concerned.
Also note this piece of fucking silliness:
" One study found that patients were more likely to die of a heart attack if their physician had been in practice for more years."
The "study" which is being referred to was thoroughly debunked as soon as it hit the journals. Why? Because what the study failed to mention is that *older doctors tend to have older patients*. Of *course* older doctors have more patients that die of heart attacks; their clientele is older and more at risk!
Given that at least one of the sources of the meta-study you linked to was proven to be a crock of horseshit right from the get-go, I remain firmly skeptical of the results of the meta-study, as well as their interpretation of those results (i.e., "doctors who don't rigidly follow practices taught in med school are worse than the fresh, wet-behind-the-ears puppies who do").
Gotta wonder if this is just bad science, or if someone is promoting an agenda.
Max
My god carries a hammer. Your god died nailed to a tree. Any questions?
Not true at all. The US spends more on healthcare as a share of our GDP and we're less healthy as a whole than Western Europe and Canada.
This is the best link I could find on short notice: http://www.csmonitor.com/2004/0505/p02s01-uspo.ht
The free market is the panacea that you believe.
Doctors are like Investigators, sometimes they get things wrong because lack of experience. Sometimes they get things wrong because too much experience. The problem with investigative fields is so much of what can ensure a correct diagnosis is different from case to case.
I've said this a million times, it's the same for the support field in the IT industry. Luck has so much to do with it. It's pointless to condemn people when they give you a wrong diagnosis.
Some human conditions have the exact same symptoms but entirely different treatments. At times, exclusion diagnosis won't even work. Doctors sometimes must use their best guess. Sometimes a lot of experience can help this, and sometimes it can distract from the obvious. So, it should be no suprise when doctors, or technicians, of all shapes and sizes are wrong. People shouldn't condemn them for mistakes anyone could make, regardless of disposition or experience. But, they do because they figure a Doctor, just like their view of a Tech should be able to resolve any problem, and more specifically the client's CURRENT problem.
I laugh when I hear people complaining about "waiting for another set of test results" from their doctor when the doctor is just trying to ensure a correct diagnosis in a confusing field.
Feel lucky your doctor is relying on the tests, in some cases a test may not EXIST and the doctor has to fall back on their best guess.
Doctors, like Techs are encouraged to always look and sound confident no matter what the case. If they're entirely truthful and let you know they're not sure what the diagnosis is, you will question their credentials and possibly go to the competition.
Boy, you don't read too well. I specifically said that both the Right and the Left used free speech zones.
If someone says he and his monkey have nothing to hide, they almost certainly do.
Just this week, for example, we had some woman come in to the hospital complaining of depression. Normally, we'd just screen her for depression and treat it. If we told her to go to hell, that would be one thing. We didn't. The problem was that we had to address her rampant drug problems because we can't diagnose her with depression while she's strung out. She promptly goes off on a tear about how "all we want to talk about is her drug problem" and so on.
Now, if she posts a balanced review and people would read it, nobody would care. The problem is that if she were to post one, it would be one-sided by nature, inaccurate, and full pretty basic lies. Then worse, other people with about as much knowledge read the thing, or just count some dumb "good/bad" review count metric. Given that people don't tend to post good reviews about anything (cars, doctors, whatever) compared to the number of bad reviews that get posted, it turns into a mess.
It's analogous to someone buying a computer from you with a copy of Windows XP, not having any clue how it works, then blaming you for everything from their spyware problem, to their virus problem, to their slow Internet connectivity, to not being able to find a copy of some obscure song on Kazaa. Of course they're idiots, and you know they're idiots, and I know they're idiots, but the other idiots don't know they're idiots because they're idiots too. So now it starts to negatively impact your business when you've done nothing wrong, and they're simply posting misinformed falsehoods somewhere.
Instead of any kind of informed opinion, most of these sites are probably filled with "Dr. Smith prescribed me Vioxx! He's an incompetent doctor!"
That's when it becomes a problem. "DrSmithsucks.com" or "farmerssucks.com" aren't a big deal to anyone credible so long as they're posting correct information. Hey, if you screw up or you legitimately piss someone off, bash away. But when you're posting that Ford sucks because you were drunk while driving (and conveniently leave that bit of vital information out), expect Ford to sue your ass.
Are patients allowed to "badmouth" their doctors online? How is this different (apart from scope) from "word of mouth"?
Are doctors not allowed recourse to protect they "good name", particularly those with private practices where this would essentially equate to their livelihood?
There is merit to most of the comments made above.
However, keep in mind that there are many factors that are not immediately obvious to many of the posters here:
1) Medicine *is difficult*. You cannot become a doctor simply by memorising rules for 4 years (or 6 years in most countries). Unfortunately, human minds and bodies refuse to obey fixed rules and often there are more exceptions than there are rules. While many illnesses may be both straightforward and easy to diagnose and treat, invariably one has to deal with patients where things are not clear, where the diagnosis is not obvious, where the standard treatment for specified condition may do more harm than good; being supremely skilled at invasive procedures does not guarantee that a patient may not come to harm from a complication.
There is no "black or white", no definitive test to diagnose everything, not golden therapy to treat everything.Situations like these can only be dealt with using knowledge and drawing from personal and collective experience. That does mean unfortunately that it's not always possible to get it right - wrong diagnoses are made, wrong treatments are given, complications may occur from a procedure - but that does not necessarily make a doctor "bad". For the patient though this may be catastrophic, something which doctors are acutely aware of.
But if an error occured in good faith, should that doctor be splattered on a web page?
2) As with any profession, there are people in it for the money only and will stop at nothing to get it. However, in most cases this is not what affects patients. In many european countries (i can't speak for the USA) doctors are put in a position where they have to deal with rare and serious conditions outside of their expertise and/or are made to do so in extremely stressful environments (long hours, being paged by 6 different people simultaneously etc). Medical and para-medical staff do their best to cope, in most cases successfully, but occasionally problems will arise from this.
Just think: If you were trying to calculate your taxes after working for 36 hours and people kept phoning you and knocking on your door and your 3-year old kept screaming - how well do you think you'd do?
3) A surprising number of patients seek medical attention without any real physical disease; anxiety is a common theme and can lead to great problems in the patient-doctor relationship. It is tough for medical/nursing staff to deal with very anxious people, as they are treated as emotional punching bags and it can be tough for these patients as anxiety often cannot be "talked away"; they really feel unwell and cannot understand why. At the same time this does not mean that there is nothing wrong with the patient. To put it bluntly - just because they're mad doesn't mean there's nothing wrong with 'em.
But not infrequently it is people with high degree of anxiety that are the most vitriolic against medical staff, in spite best efforts from both nurses and doctors.
These are just a few points from a medical perspective. One of the greatest problems in patient-doctor relationships is communication. Problems here are what frequently will lead to litigation for various reasons. But the problem may not necessarily lie with the doctor, as communication is a 2-way street (for example, i make it common practice to repeat myself ad nauseam as it can be startling what some people just don't retain or refuse to take in [denial]).
Of course, there are doctors not up to the task and perhaps should not be practising medicine for whatever reason. But I believe that these should be investigated by a professional body to assess their
They had a fan site for a local shopping mall. The mall developers tried to shut them down (for some inexplicable reason), so as part of defending themselves they registered several "sucks" domains including http://www.taubmansucks.com/ (Taubman is the name of the developer).
/. my hits from them are higher than normal :)
The guy was trying to defend himself for a long time and started to get dug into a hole, but eventually he found pro-bono representation and ultimately they won. Maybe there's some useful ideas for you in there.
Yup. I've done lots of research about gripe sites because of that C&D.
On a side note someone at farmers reads
-nB
whois gawk date unzip strip find touch finger mount join nice man top fsck grep eject more yes exit umount sleep dump
any "study" published in a medical journal tooting the horn of, well, *medical professionals*, done by those same medical professionals, deserves a healthy amount of skepticism.
This study doesn't "toot the horn" of medical professionals. It compares two groups of medical professionals. If anything, the bias of the Annals would be in favor of older doctors.
In other words, older doctors are less likely to rigidly follow practices exhorted in medical school, and instead do what they think is best.
Science advances. Mortality and morbidity rates drop because we learn things about treatments. Not keeping up with what is the current recommended procedures is the best way to guarantee your patients a worse outcome than other doctors who are current with the latest science.
The "study" which is being referred to was thoroughly debunked as soon as it hit the journals.
Oh no, you don't. Link the refutations. You asked me to find a link and I'll demand the same of you.
the major advances in civilization are processes which all but wreck the societies in which they occur - A.N. White
Agreed. So based on your post, I have to assume that you were hypertensive and had dyslipidemia.
Had the doctor not prescribed a statin and antihypertensive medication, he could have been sued for gross incompetence for not doing so. Even years later when you drop dead of a heart attack at age 45. Then you're depressed, so he's going to prescribe an SSRI for you. Both those interventions are well within the standard of care. In fact, they are the standard of care, in addition to telling you to lose the weight. If you go in there and say that you aren't going to take the medications, you're noncompliant. If you don't like it, find another doctor. That's your right.
It isn't your right to go bash that specific doctor for prescribing, say, Lipitor, metaprolol, and Prozac. And if you do, he has the right to sue you for damages if you call him a quack without bothering to mention that your LDL and triglycerides were through the roof, your blood pressure was 150/110, and you were borderline suicidal.
That's the root of the problem, really. Because the doctor can't retort, even if he had the time and found your complaint, because of privacy regulations, his only resource is to sue you for libel if you happen to leave out the crucial information that your blood pressure was high, you had high cholesterol, and wanted to off yourself with a lamp cord.
If you win in a suit against said asshat, you still get money. That's why they call it insurance.
Granted, it may be a bit harder to win, depending on if they provide for legal services to defend against the lawsuits.
tasks(723) drafts(105) languages(484) examples(29106)
Canada. Europe.
Exactly. Some of the worst health care there is. I've been to both, have had friends in both with medical problems, and they're terrible.
Is the average care in Canada/Europe worse than the average care in the US? Possibly. But that isn't the point. The point is that ANY care is better than the care level that millions of Americans without insurance get, namely no care at all.
My girlfriend has needed to get her wisdom teeth pulled for at least 3 years. Since she cannot afford any health insurance except the University's plan (which won't cover her condition), she has had increasingly severe headaches for those 3 years. Attempting to pay out of pocket for the surgery would certainly bankrupt her.
Add in the fact that "free" health care costs consumers more than free market health care, and you've got a sinking ship.
If that was anywhere close to true, America's healthcare costs would be much lower per capita than any country's costs. Of course, everyone gets care there, while we have ~40,000,000 who have to choose between seeing the doctor or eating. Furthermore, those without insurance often use emergency rooms as primary care providers since they may not turn anyone away. These hospitals often never get paid by uninsured patients, so everyone else ends up paying more to subsidize the uninsured anyway.
Now I respect your opinion on the matter (as it seems you have different priorities regarding health care), but free-market health care can be summed up in this sentence:
"If you can't afford to pay, you deserve to die."
If that is your position, then more power to you. Otherwise, the only possible way to ensure everyone gets the care they need is via socialized health care (insurance, medicine, etc.).
I disagree. I sought out numerous doctors and all the young ones wanted me on drugs without doing ANY extensive tests. It was ridiculous that every single one I consulted with did JACK.
The two older ones I went to (on recommendations of other males my age who experienced the same problem) ran tests, asked me more in depth questions, and realized it was a dietary problem that many Americans and world citizens face: too many fucking carbs.
Face it, look around and you see FAT adults everywhere. They all have doctors. These doctors are happy to prescribe anything they can because they have a monopoly on prescriptions, and most prescriptions require that you come back.
The older doctors I saw noticed the correlation between too many sugars and starches and high blood pressure, triglycerides, and lack of mental focus.
I doubt I'll die at 45 because of what you quoted. I go in every 6 months to get my blood work ups and everything is better than it was when I was 18 (and chomping down every pizza, burger bun, and ice cream I could). Now I live healthier, feel healthier, and the tests prove it.
My wife also has had numerous problems with "prescribe and go" drive thru doctors. She also is using an older doctor who has found better methods of dealing with her asthma, not just drugs.
Yes, but which is the cause and which is the effect?
To me, it seems that as US healthcare has gotten worse and worse, the government has reluctantly been dragged into trying to do something about the problem, where previously it was ideologically opposed to any kind of intervention.
Same alleged facts, different interpretations.
GCHQ Quantum Insert installed. If only our tongues were made of glass, how much more careful we would be when we speak
I would soundly say you are absolutly wrong. Most of the times, the problems you or I have are typical things that don't need any specialized knowledge. If this doctor gets stumped, I would trust him to send me to a proficient specialist. To scorn an old doctor who treats his patients like gold simply because he is old is crazy. Give me a doctor who treats me right rather than an arrogant pissant recently out of medical school any day.
I miss the Karma Whores.
Huh? These times are perfect for people who work normal office hours! Indeed they make it possible to see a doctor before/after going to work, without the need to take a morning or an afternoon off.
PS Yes, in this post I state some opinions that I do not back up further, and while this generally is bad I think that they should be clear enough.
I think we have a new slashdot signature.
Fly me to the moon Let me sing among those stars Let me see what spring is like On jupiter and mars
"Only a board of specialists can determine whether a particular doctor's actions, judgements are correct, done in good faith and do not amount to gross negligence and incompetence"
I agree with that, for the most part. How many people go to a doctor and hear what they want to (ie 'You'll get better') instead of hearing their ODDS of getting better with certain treatments which in turn have side effects of varying severity. Few patients listen, even fewer have enough medical knowledge or comprehension of statistics to truly understand what a doctor is doing or has done.
A doctor treats you, you get side effects (you were warned!), you complain, the meds are changed, you aren't getting better (but the side effects have changed)... now you complain about the doctor, thinking he doesn't know what's going on. In reality, you may simply be in the 5% who don't recover from Diseaous Miscellaneous.
You don't have to like it, but peer review of a doctor is the only fair way to judge their performance.
I think you're interpreting this incorrectly. What is more the case is that older doctors are very carefully following what they were taught in medical school.... 30 years ago. What was current and good practice 30 years ago isn't necessarily so today. In fact, a lot of practices common 30 years ago have since been proven to be ineffectual or even harmful. Medical knowledge and treatment changes over time, and if you don't keep up with it you're going to be left behind (anyone feel like bloodletting is still a good treatment for cholecystitis, please raise your hand).
"No, no, no. Don't tug on that. You never know what it might be attached to."
Let's use my example of MS again.
They gave us IE.
It had bugs, so they patched it.
It had more bugs so they patched it.
It had even more bugs so they patched it some more.
Now they patch it about once a month.
Is a layman able to say "Gee, that must be bad code", or is it a case of where this would happen to any browser?
Can you or I judge? Or is it a case of only peer reviewed code by another computer professional is the only fair way to judge?
It's the same question in either case: doctors are seem unwilling to have their performance judged by their customers.
You were mistaken. Which is odd, since memory shouldn't be a problem for you
A lot of times insurance companies pay off claims because they evaluate that wiggling out of the responsibility by using the terms of the policy is unlikely to work. Not because they couldn't find a reading of the policy terms that favors them.
An insurer has a responsibility to defend their insureds vigorously - it's one of the tenets that gets hammered into your head. After conducting that vigorous defense it is hard to say you aren't paying.
HBI's Law: Frequency of calling others Nazis is directly correlated with the likelihood of the accuser being Communist.
Medical malpractice and legal malfeasance would go way down if patients and clients had an online repository of commentary to go by. Doctors and lawyers should sue people who comment against their "reputation". When the professionals lose because the comments were true, they should pay damages for infringing free speech with frivolous lawsuits, which proceeds fund the online repository. Lawyers who get a few strikes for frivolous lawsuits (whether as plaintiff or counsel), or for malfeasance, should be disbarred and pay extra fines. Doctors who keep losing like that should probably be forced to donate extra organs, like kidneys and lungs, or that heart they're not using.
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make install -not war
Heck, if it's simple, I can go to a pharmacist and get something for a headcold. I want a doctor who'll catch that cancer one visit earlier or run that extra test to rule out a possibly fatal disease, or know that there's a better drug for me than the one he used to prescribe.
The best possible option is to get a middle-late career doctor who also teaches and works at a good medical school/research hospital. They have to keep up with the latest and greatest and have the experience to evaluate the material.
the major advances in civilization are processes which all but wreck the societies in which they occur - A.N. White
I go to a doctor who is neither old nor young. He gave me typical diabetes and high blood pressure meds when I first went to him, then worked with me to help me eat healthier.
I'm now a few pounds lighter, my blood pressure is back in normal range, I need half as much diabetes medication as I did two years ago, and I may have yet another prescription cutback soon.
Next step: a doctor-encouraged 20th or 30th try to quit smoking. I told him I'd tried and failed before. "So?" he said. "You're a writer. How many stories did you have to write before you made a living at it? Don't give up just because past tries have failed!"
What are you talking about? The patient visit is protected by some of the strongest confidentiality laws in the country. Any breach in that confidentiality without the permission of the patient is a grievous violation of both medical ethics and the law. Of course, there are exceptions for things that must be reported (ie. a case of tuberculosis or child abuse), but overall a physician has no ability to air feelings or statements about a patient in a public forum. They can lose their license, their practice, and their reputation, which is everything. Confidentiality laws are designed to protect patients, not physicians.
People say things anonymously because they fear reprisal or punishment. I have posted here anonymously, when it seemed risky or inappropriate to do so. I have no problems with anonymity, but even Amazon recognizes that an anonymous opinion is worthless.
Recently, at a practice I'm familiar with, a patient pulled a knife on a physician who refused to prescribe him unnecessary pain killers (read: narcotics). They were arrested, of course, and thankfully no one was hurt, but this person is free to post whatever they want anywhere they want, under as many usernames as they want, to try to get revenge. One person, if they are dedicated, could shatter that physician's career.
I would venture to say that 99% of doctors aren't out to screw people. If you don't get along well with you physician, find another one. If you think impropriety or malpractice was involved, file an official complaint. Review boards are ITCHING to remove doctors from practice. Because it increases public trust, and decreases the number of quacks out there. If that doesn't work, there are always lawsuits and the internet, but I'm afraid most people skip to the end of the process, and careers are destroyed far more often and far more inappropriately than is commonly known.
IM(not so)HO
They can stop compettition that would otherwise increase the quality of life of the public and decrease the economic drain.
So you're going to take the "Dr. Craptacular" route. Where out of the goodness of their hearts without any organization or government entity to compel them and despite the fact that the shitty doctors want everyone to give them thousands of dollars, they're going to let the patients know that they're shitty doctors so the patients can make educated choices so that competition can occur?
If I have been able to see further than others, it is because I bought a pair of binoculars.
"In latest news, after years of frustration and fear of losing their careers from lawsuits over their screw-ups, disgruntled doctors are now taking the offensive and hitting right back..."
Nuts!
That would be like me getting sued by a half retarded lawyer because I called him an idiot in my weblog. Oh....
This signature has Super Cow Powers
but doctors are not free to blog their side of the story.
Hipocrates put it quite well, and although there are constant efforts to erode confidentiality, the one area it has not been eroded in, at least round here, is in presenting an account of events relating to a patient's condition and management.
Don't look at this as getting revenge on doctors, look at it as an opportunity to do your homework before you put your personal health in the hands of another person. Yes, any reasonable reader should be skeptical of any review he reads on the Internet, aside from possible fake reviews people are more likely to post if they are upset than if they are satisfied. But that doesn't mean looking over the reviews can't be helpful to a potential patient.
" Most Importantly, if a patient visits a doctor, they enter automatically into a non-disclosure agreement although no legal documents need to be signed.. by virtue of visiting a doctor, a patient agrees to put himself/herself under that doctor's care. "
Actually, no. Patients are perfectly free to seek second opinions or disagree with their doctors. And doctor/patient privilege protects the patient's privacy to talk to be honest with their health issues. It doesn't protect the doctor's right to do a poor job.
"The burden is on the patient to find a physician whom he can believe. "
How, if they are not allowed to learn anything before they visit?
"If Patients who may be not be satisfied due to a combination of myriad factors start using the Web primarly as a means to get back at the doctors, what is going to stop the Doctors to retaliate likewise by releasing confidential health details about their patients if they are not satisfied with the patients for example?"
Other than the law?
On the net I can read reviews on CDs, books, electronics, software, apartments, etc. It hasn't destroyed those industries.
Mathematics is made of 50 percent formulas, 50 percent proofs, and 50 percent imagination.
Granted, it may be a bit harder to win, depending on if they provide for legal services to defend against the lawsuits.
If there is a million dollars or more on the line, you can bet that the insurance company is going to be providing lawyers of their own.
One way contracts are generally unenforceable, unless you can invoke the right to promissory estoppel. However, that would probably not be the case in a NDA with a doctor & patient.
All legally enforceable contracts are required to be two-ways. In that offer, acceptance, and consideration (something of value) must flow between both parties.
The examples are usually pretty obvious. In a Non-disclosure agreement usually both sides agree not to disclose information about each other. This intangible benefit, of not losing control to outsiders, of information is promised to each party of the contract. Offer is obvious: the offering either explicit or implicit of a contract and acceptance is also usually on its face either going along with it or making it so obvious (ie, signing a writing).
Another obvious contract anaylsis is a car sale. I agree to sell you my car for $4,000 (consideration). Your acceptance of my offer is usually the writing of a check for the consideration amount and the flip side to the contract. Contracts need to be analyzed through the "mirror" rule of consideration flowing to both parties. IE one party gets the car and the other $4,000.
This rash and bad cough I have? No, I'm sorry I can't tell you what it is or if I am contagious, or my doctor may sue me.
Mathematics is made of 50 percent formulas, 50 percent proofs, and 50 percent imagination.
I thought you could not (successfully) sue for libel or slander if what was said was true? (and isn't there also a window of opportunity for posting opinions, as long as they are plainly stated as opinion and not statement of fact?)
I work for the Department of Redundancy Department.
I don't see how this is any diffrant than an unhappy customer posting their story at some website like BankofAmericaSucks.com
"Only a board of specialists can determine whether a particular doctor's actions, judgements are correct, done in good faith and do not amount to gross negligence and incompetence"
You can't be serious.
Seriously, thats the way its is all over the world.
Health and IT are two very diverse fields and comparing them are like oranges and apples.
In *every* nation, doctor's actions are subjected to review ONLY by a panel of other doctors which then advise a court which in turn pass judgements. That advisory panel is mandatory to determine the nature and scope of the doctor's work.
You can't just try to 'imagine' microsoft and stuff like in this regard.
A doctor provides a service like any other professional and is entitled to the same amount of respect that I would give a lawyer, plumber, programmer or musician.
Just going to school for a long time and passing a test doesn't give anyone special insight or immunity from public critism
WHO is talking about RESPECT here?? This isn't about respect... you got it wrong.
Again, no body is against positive critisisms, but the issue is about how to go about recording those critisisms so that it is effective in its aim to improve services instead of downgrading into a flighfest fight of accusations and counter accusations etc..
My point was that there are certain procedures to be adopted since this is a delicate issue which *cannot* be compared with mundane daily software/harware issues..
Should have had a CT scan done within 6 months. If you have an H.H.O. consider yourself lucky you aren't dead yet. Otherwise, the doctor is at fault.
Gotta wonder if this is just bad science, or if someone is promoting an agenda.
That is the core of the problem...
Previous generations of doctors were trained as scientist 1st and then went to medical school. When modern doctors are trained in sciences they are trained the the results of science but not scientific principals.
Words alone won't skew too many opinions unless they are backed up by more concrete evidence.
Canada. Europe.
Exactly. Some of the worst health care there is. I've been to both, have had friends in both with medical problems, and they're terrible. Add in the fact that "free" health care costs consumers more than free market health care, and you've got a sinking ship. Government's solution to the terrible "free" health care problem: more money!
Hey, Mr. "Words alone won't skew too many opinions unless they are backed up by more concrete evidence." could we see some concrete evidence as to exactly how bad the Canadian and European health care systems are compared to the US? I want real concrete evidence, not your bullshit anecdotal "I spent a week in Amsterdam smoking dope and getting blowjobs in the RLD and my buddy who was with me who got anal clap from being assfucked with a dirty strap-on didn't get good health care" stories.
This is a horrible thing to say but then I am a total bastard, I would love to see you get sick, really sick, chronically ill, and then have to deal with your private health insurance company. Yeah, you'll be singing the virtues of the free market right after they say "hey dude, you're really sick, we don't want to pay for that, it will fuck up our profit margins and we won't be able to pay the CEO as much." Go talk to people who have lost a limb and are trying to get their health insurance company to pay for a decent prosthetic, you'll learn a lot more than you will if you just wank off while reading mises.org and lewrockwell.com.
Except Tort Reform problems and the high cost of litigation makes it difficult to sue your doctor. I know, I've two friends who had no choice other than to hire ambulance chasers as the real lawyers wanted way too much per hour to even take the case.
Uh oh, you've gone off the reservation, if you're a good little Randite and Lew Rockwell reader then you should know that the real reason health care costs too much is that it's too easy to sue doctors. Sounds like you need to go back to talking point central and get reprogrammed.
cheap labor conservatives - they want to keep you hungry enough to be thankful for minimum wage.
Most people in the USA have private insurance, either by themselves or through work. Socialism is when the state pays for medical care, with tax money. This is what we have in Canada and believe it or not the state does take a keen interest to ensure that it (i.e. the taxpayers) is not being overbilled. Double-dipping or fraudulently billing doctors do not get off lightly.
I trust you're not saying that people should have to pay for medical care out-of-pocket. That wouldn't lead to people seeking "value for money", it would lead to most people not seeking medical care at all. In the Chinese countryside, the peasants have to pay cash for care, and most of them just don't go to the doctor, because even the most basic treatment costs them years of their savings (source: personal anecdotes from a Chinese co-worker). Believe me, that is not the kind of situation you want here in the "free world".
Freedom: "I won't!"
My father is a doctor. Several of his patients posted great reviews on some websites and he ended up getting a lot of new patients thanks to them. So allowing patients to review doctors on the internet can be a great thing for doctors (that are good and have happy patients).
And everyone becomes an expert in medicine, because they have watch srubs and ER. (Just like everyone is an expert in forensics, because they watch CSI).
A good friend is a long practising OBGYN. A few years back, a woman came to him part way through her pregnancy. She had a drug habit, and continued to smoke (tobacco) through her pregnancy, against his repeated advice. Her Baby was born nearly a month premature, and barely made it - that he survived was a credit to the experience of said medico. Said woman, tried suing the doctor for malpractice, because her baby wasn't healthy.
Way too many folk base defamatory accusations (on the web or otherwise) on their own inadequate knowledge, or lack of willingness to listen to sound advise from professionals.
More and more often these days, I have seen doctors, medical centers, and hospitals grousing about high malpractice insurance. The problem is not that some doctors are being unfairly punished by malpractice litigation, but that ALL doctors within a given specialty within a region face the same rising liability premiums. IMHO, it is really their own fault because they would rather "band together" against public disclosure of malpractice suits, medical board judgements, etc.
/. poster indicated that however bad the practice of medicine is within the USA today, that nationalized healthcare would be worse. Yet some of my personal experiences with the USA's medical profession would tend to indicate that it couldn't get much worse. Without time and money to pursue the "bad apples" in the medical profession through the legal system, many patients are treated little better than the "human lab rats" of the Nazi or Manchurian Nippon concentration camps of World War II.
Another
If the state medical boards cannot be convinced that it is in the best interests of their good medical professionals to "weed out" their incompetent or corrupt "brethern", then the states or the national legislatures need to force new laws that create publically available websites that can be used by prospective victims^H^H^H^H^H^H^Hpatients to avoid the bad practitioners. And since it is so easy for a doctor to scoot across state lines and establish a whole new set of victims, a national database would be the better solution.
Thankfully we don't have this problem in the technical professions.
The readership here is too varied for me to clearly identify this as sarcasm, but that's my guess.
The technical professions have the same problem. As a development manager I get many resumes that are loaded with certifications and academic credentials and then they fail the simplest interview.
But there's two big differences 1) in many client-doctor relationships an interview isn't possible, and even if it were the client isn't knowledgable enough to properly distinguish the doctor's expertise. 2) most technical professions are not so life-and-death sensitive as being a doctor. Yes, being a doctor is friggin' hard. But they need to be friggin' good.
All I'm saying is that there needs to be some kind of shake-up in the medical community.
Cheers.
Sorry, the quality of service is suffering.
;)
I know this as a patient myself.
'As an alternative one can always report to the licensing boards and ask for review by a panel of experts and specialists'
Umm.. yeah, good luck finding all the info I need to do this, let alone asking my doctor for his info. I'm sure he's going to be real pleased to give it to me. How long will the review take while this guy rips another hundred patients off? Will I even be informed of the outcome? I sincerely doubt it.
Wild west? What was up with the doctor site that listed all the people that had brought malpractice suits?
Regardless, this is going to happen, whether you and your colleagues like it or not.
Your ideas of a 'non-disclosure agreement' are unfounded and purely wishful thinking on your part.
If you act the way you're supposed to, your name won't be posted for anything negative.
This happened a few years back with the ratemyteachers.com site. There's nothing you can do about a society that wants to be more informed.
We *will* rate you.
Insurance companies not only insure yuo against monetary losses, they also must provide a reasonable defense. So, yes, they will "defend" you. More importantly, if they try to defend you too aggressively (i.e. by not settling a valid claim within the policy limits, which results in a judgment against you in excess of the policy limits), you can then sue the insurance company for handling the claim against you in bad faith.
Essentially, the "bad faith" claim is there to protect the insured from the insurance company from betting with someone else's money. For instance:
Joe Negligent has an auto policy with a $100,000 limit for liability. Joe hits Wally Whiplash. Wally's suffers facial scarring and he is young and unmarried. Wally goes to Larry Lawyer who sues Joe Negligent.
Idiot Insurance is notified by Joe Negligent of the claim. Idiot Insurance analyzes the claim and figures the case might be worth about 90,000. Larry Lawyer sends in a demand letter for the policy limits. Idiot Insurance refuses to pay.
Larry Lawyer tries the case, and a jury comes back with a $125,000 verdict for Wally Whiplash, which exceeds Joe Negligent's policy limits. Joe is on the hook because Idiot Insurance gambled (and lost) on the value a jury would assign to the claim, and Joe Negligent suffered as a result, since Wally Whiplash was willing to settle for the policy limits but Idiot Insurance refused to do it.
Joe Negligent can then sue Idiot Insurance for "bad faith." Alternatively (and this is what usually happens) He assigns his claim to Wally Whiplash to settle his case with Wally (Joe Negligent is frequently judgment-proof), and Wally Whiplash sues Idiot Insurance, who must then pay the excess in virtually all cases.
In any case, that's an overview of a "get sued and have insurance company defend it"-gone-bad scenario.
GF.
Lots of petrified grits
It would be something around $5,000.
To put that inperspective, since we are college students, together, we make about $10,000/yr.
Something that is socialized is not run for the "collective good". A socialized system is a system run for the entertainment of the person that runs it, sort of a massive toy for a few funded by a general public.
That is only your opinion. I live under a semi-socialist system and yeah, our politicians can be jackasses just as yours are (google "canadian sponsorship scandal") but the system IS run, by and large, for the collective good. Medicare is specifically designed so that all citizens get an equal (quite high) standard of care. It is not easy to pay for it as a country but our tax burden here is not onerous.
That's the ideology anyway.
You've got it completely backwards. The collective good is the ideology, abuses are the unfortunate reality (in any system).
Blue Cross has delivered to me a better standard of medical care than most European governments would deliver to their citizens and certainly exceeds what Canada does for its. I get to see any doctor I want to for my wife and myself and my kid, whenever I want to see that doctor, When my wife was pregnant I got ultrasounds out the wazoo and soon as her blood pressure went up a bit they induced her and gave her a c-section. When I want to talk to a doctor, I have one on call 24/7. In terms of health care, I really do have it all.
Everything is paid for except a small ($10) copay, and I don't have to do a thing. Blue Cross is the best of American health care, if not the world, but it is expensive. I pay probably more for that level of service than Europeans pay in taxes. And every year it costs me 10% more, and I can't eat that indefinitely. Either that, or I have to go get more money.
So you get good medical coverage, but you have to pay through the nose for it. What about the people who CAN'T invest as much as you can (not just the Medicaid covered ultra-poor but the lower middle class etc.), do you deny they would fare better under a socialized system? And how would you fare worse? You would still get good care, and you would have a lot more money to spend on other things.
Freedom: "I won't!"
Doctors overseeing doctors? Why is that not the fox guarding the henhouse?
If someone is to determine whether or not malpractice existed, I can think of nobody better qualified to do it than doctors. Who would you appoint? Lawyers?
A peaceful, non-disruptive protester (or group or protesters) should be able to express their opinion on public property, regardless of the content.
I've seen lots of protesters doing their protesting. I've never seen any that were peaceful and/or non-disruptive.
I don't even believe it's possible to protest and be non-disruptive. Peaceful, sure, but when protesters are throwing things and trying to shout louder than those who disagree with them, then it really can't be called that.
I agree with the use of free-speech zones, mainly because I generally think these protesters at these events are idiots with too much free time. If they were indeed peaceful and non-disruptive, then sure, they could get closer. But they never are.
- Give a man a fire and he's warm for a day, but set him on fire and he's warm for the rest of his life.
I have gone to two dental clinics in the city of Levis, Quebec, Canada, my visits timed apart by, like, a year, and the hygienists have drilled into my teeth even though I had no cavities.
The first time it happened was in 2004 at the Clinique Dantaire Patrice Russell. The hyienist has used a rapidly-spinning metal tool with a sharp point to drill between my two up center teeth. She has slid the tip the electric tool on my teeth and buried it in my gum. She has set the side of the elctric tool on the tip of my gum. I vaguely remember that white powder was flying from my teeth when the electric tool she was using touched them.
The second time was in February 2005 at the Clinique Dentaire Claude Lemieux. The hygienist used a metal-edged electric tool which grated on the surface of my teeth. She used it to flatten my upper frontal teeth and shorten them, leaving vertical grooves 2 mm wide. She also cut into the tips of two of my lower incisives, leaving one tip shaped like a triangle. In the other, she cut two holes at the top a millimeter in diameter.
I have gone to the Levis police station. The policeman said that he saw a flattening, and suggested to find a lawyer. Instead of doing that, I have written a letter to Claude Lemieux, in which I explained what had happened and asked if his clinic offered compensation to victims like me. We talked on the phone; Claude Lemieux said "hygienists don't dig into teeth. First, they have no access to the tools...." I interrupted him saying "I still have the traces on the teeth." He asked, "can you come to the clinic?" I said "yes". He said, "come to show me that."
I arrived at the Clinique Dentaire Claude Lemieux in the morning of the second day after the phone conversation. I sat in the waiting room. Claude Lemieux said, "come with me." I answered "I'm ok here". He repeated "come with me" and I repeated "I'm ok here." Claude Lemieux then said, "I shall not examine your teeth in the waiting room." I followed him. He went behind a chair of which the back was tilted backward and said, "sit here." I did and I saw him put gloves on his hands. I said, "I don't want my teeth dug again." He said, "if you don't let me examine your teeth, the examination is over." Claude Lemieux put his hand in my mouth without my permission and pushed in the lower-left corner of my up central right tooth, which was painful to me (now there's a vertical surface crack on that tooth). He did this at least twice; I vaguely remember three times. Eventually, Claude Lemieux pretended not to understand that I was showing him that my teeth had been flattened and vertical grooves were still visible, and said "Your theeth have cracks, but they have no holes." Before leaving, I said "I have gone to the police station, and the policeman suggested that I find a lawyer." Claude Lemieux said, "Do what you want, my friend. You shall find no dentist to say your teeth have been dug."
I am not a lawyer or a doctor. However, I do plan on being a lawyer at some point.
I see a lot of posts here taking the patient's side. Why is that? Think about the last time you forgot to use your turnsignal. Now think about the last big mistake you made at work.
Chances are, you probably cost the company some money, got demoted, or even fired. But a doctor does not deal in paperwork or machinery. He deals with something that's grey area is infinite. The machine that he repairs walks a very thin wire between working right, and being dead. Even if that doctor tries to put it out of mind, sometimes his hand may make a living person a dead person.
Why do people not understand that? I dont really agree with these doctors suing back, but medical malpractice lawsuits are outrageous. You cannot put aprice on human life. That means even a billion dollars will not do. There is, however, a value to human life, and most doctors STRIVE FROM THE BEGINNING to uphold that value. When Smith stuck his hand in the machine at work, he took the machine out for the day and cost the company $100,000. His boss screamed at him, and that was that. When Smith's anesthesiologist accidentally gave him an overdose of the general anesthesia, he didn't just get yelled at and then went on with his way. He had to tell Smith's family. He had to deal with the fact that his mistake ended a human life. A malpractice lawsuit could end his career, not just his job.
Removing tartar doesn't have anything to do with drilling teeth. And bits of tartar were the "white stuff" you saw flying.
http://en.wikipedia.org/wiki/Calculus_(dental)
To drill a hole in a tooth, a "metal tool" won't do. Tooth enamel is the hardest substance in the body. You need a ceramic/diamond coated drill bit to do that.
Yup, sounds right to me. Not that I was saying it's unwaivable, just that it's a 2-way contract like all contracts.