06/24/2020
#8—The substantial factors that are evidence of the
disintegration of the medical profession
These facts and admonitions are not only proof of the pending demise of the medical profession, but also serve to illuminate that fact that nothing is being
done to alleviate the increasing barriers which ultimately result in destruction. If anything is being done, the efforts are being hidden in the deep state.
Proof of this issue can be easily be found in thousands of places. So let’s talk about a few of those.
1. Burnout
This word has become the leading key word for articles, publications, discussions, and personal planning throughout the medical profession
and most of the supportive tributaries surrounding the profession. The problem is not what’s being debated, but what never reaches the eyes of most medical patients and the public.
At present, the public commonly is unaware of how serious of a
problem this is for themselves and even the physicians themselves.
The public rarely pays attention to what happens to all those “rich” doctors. The public is ignorant of the numbers of physicians that are quitting medical practice annually in our nation.
Physicians rarely go public with the issues they have and how they
feel about them, even to their friends. Divorce rate is a bit higher than average in our population.
Suicides (about 400 doctors per year) is kept quiet. That number is about the amount of one medical school (all four years of classes) annually wiped out. Stress is a great component of that tragedy.
How about the stress of medical malpractice suits that have the capacity to completely wipe out a physician’s finances, family,
reputation, and career? There is no way to predict when or if that will
happen during any physician’s practice. Most of those malpractice suits result from unintended treatment results, so physicians must live with that possibility daily in their careers.
Do you think that any error, complication, outcome is an intended process by any physician, knowing that all hell will come down on his or her head promptly? All physicians believe that the power of the elected attorneys in our government will never permit any revisions in the malpractice law as it is today.
That means runaway jury verdicts into the multiple millions of dollars with no cap placed on the “Pain and Suffering” segment of the verdict
will continue forever.
How would you like to be in a profession where the prejudice of the legal profession (most are lawyers) working in congress enables them
to prevent such verdicts from destroying the whole medical profession--and they purposely do nothing? It's more than bias, it's terrorism.
Only God can correct the problem, apparently.
Is it any wonder that physicians are suffering from burnout?
2. Loss of medical practice for financial reasons
Yes, it's the lack of business knowledge and the tools that would enable any physician to get out of financial problems. Of even more importance is that these business principles alert any person in a
business of any type of pending financial failure and allows the
prevention of and recovery from potentially financial disasters.
Medical practice is a real business. Doesn’t it seem sensible that anyone that wants to succeed in business needs to know how to run the
business efficiently and profitably. Because 99% of physicians graduate
from medical school business ignorant, how is it possible that they could
ever earn enough money to stay in their medical business.
When they recognize they are failing and finally see that their income is dropping rapidly, they have no knowledge about how to reverse
the process.
Of course, no one talks about the fact that medical schools refuse to even offer or provide a business education, with rare exceptions
recently. Why? Do they believe that physicians should not succeed? Do
they believe that physicians will succeed anyway, which runs contrary to every business principle taught in business schools today? Or is this a matter of tradition—for a century or more physicians have not required a
business education and got along OK.
Someone forgot to tell the medical schools that we live in a different world today where physicians require far more than a medical knowledge to survive.
Beyond all this is the obvious fact that all medical schools are actually promoting the business ignorance of physicians. That weakness inherent to medical education and career success is the perfect weakness that allows the congress and politicians to openhandedly continue the destruction of the medical profession, including private medical practice.
The fact is that the leadership in the medical profession are still living in the last century of thinking and are arrogant enough to avoid doing anything to make the issue go away. And that is what breaks my heart. Essentially all physicians today deny that they have been taken advantage of by their medical schools.
They simply take what is offered to them. Physicians have lost the instinct to care enough about themselves and their careers to take control of what happens to them during their medical careers. Even when the truth is told to them, they deny it. Isn't that something Christ said in the Bible? Is business ignorance a disease that they can never recover from?
It is astounding how much any physician can earn, can improve their skills and knowledge, can provide far more updated medical care, and can treat their families with all obligations they deserve when they have a business education and use it in their medical practice.
3. Arrogance and confidence play a primary part in reaching one’s maximum potential as a professional--and are also a vulnerable weakness that can be abused.
It's all about standing up for yourself, your beliefs, your expectations, and the lifestyle you deserve.
I admit that this was part of my own problem in my medical career.
It’s the reason that I was forced to quit each of the three healthcare platforms (military-HMO-hospitalist) that I practiced with and where I had no control of my own career.
In all three, my situation for practicing medicine was dictated to me.
In all three, membership/association/job retention “dictates”
significantly prevented my ability to advance my skills.
In all three, I was seriously restricted from applying/using the more
advanced skills, talents, procedures that I had earlier extensive
practice experience using and applying in my medical practice.
These are a few of the undesirable characteristics embedded in all medical practice platforms other than private medical practice. The purpose of those dictates is to control each individual physician’s
activities regarding medical practice.
Think of it as a way to maximize the profits, money saving strategies, and production efficiencies necessary for the financial survival of the ruling/controlling entity—certainly not for the financial benefits of the physicians they employ.
The freedom to practice medicine as doctors choose; the eternal fixation every physician “dreams of” is today becoming exactly that.
If you want to know what has been destroying the medical profession over the last five or more decades, you just read some of the reasons.
4. The consequences of the political/government plan of “rounding-up” the medical profession…
When cowboys round-up the cattle, they can control the cattle activities, their productivity, and their assets. It’s a well-known plan
that works every time, even with humans.
For years now the government has been involved in strategies that
seem logical, voluntary, and agreeable. By very cleverly squashing the physicians in private practice to the point of extreme frustration and anger, they are left with one sensible alternative. They go find a job to remain in medical practice and continue their career. GO-HMO!
If that isn’t rounding them up, what is? The government gets a pass
on doing that because the process paints a picture of it being a voluntary
choice by physicians. It isn't.
Now carry that idea up another step. Strange as it may seem to the
public, physicians are now called “healthcare providers.” You know, the same label that also is given for nurses, midlevel providers, and other medical care people. Do you catch the drift?
The emotional part of this issue for physicians is being downgraded.
No longer are the value of, status of, and reputation of physicians recognizable—except perhaps that they are all rich. They have become part of the herd. Of course, any respect, trust, reliance, and appreciation are also downgraded along with their value. You see it daily in the news media and when you’re being treated by physicians, generally speaking.
So, after all those years of education to become a physician, you are called a healthcare provider on a level with all the non-professionals.
You can bet that this downgrading is a segment of the
government plan—"tear their arrogance out by the roots.”
5. What happened to all the American college seniors who used to apply for and fill up all medical school classes?
This should jerk your head around. Why is it that the men in
college have lost their passion for considering a medical career. Do
they know something that the educators don’t?
It’s no big deal today because medical school classes are quickly filled up with women and foreigners for the most part. Shall we give
the medical schools a “pass” on that? Somebody is missing the ball here. Something is very wrong here.
Does it matter if you can’t quite understand what your physician
has been telling you?
Does it matter if half of the women physicians practice part time?
Could it be important that men physicians practice full time? Could that mean that there are less physicians practicing full time and are seeing increased numbers of patients because they have to?
If there are lots more medical schools being constructed and
producing many more doctors, then the numbers would even out.
But, that’s not the case.
Forcing physicians into the herd where all these physicians can be controlled, results in consequences for patients as well.
6. The destructive force of uncapped medical malpractice verdicts …
Uncapped verdicts mean there are no legal limitations to the extent of acceptable punishment for violations of the laws. Physicians
aren't suggesting that medical malpractice be legally eliminated, just not
be left completely open to the outrageous whims of a jury.
There are several segments of a malpractice verdict that juries make decisions about. Over the years the single segment of the verdicts that
have been permitted by the rule of law to gradually take on a life of its own is named "pain and suffering." The emotions that arise throughout
a medical malpractice trial are purposely ignited by prosecutors.
Prosecutors know that if they can suggest, demonstrate, or prove that a doctor has viciously violated the malpractice laws causing harm to a
medical patient, the passion of that violation(s) usually draws a higher
monetary verdict for the plaintiff. And the harder the jury needs to
punish the physician.
There are several problems with such a process...
a. The medical malpractice laws of each state are quite different from other states. This permits plaintiff attorneys leeway in what they show to the jury and what they purposely withhold from the juries.
b. The medical malpractice laws on the books were written in such general terms that the courts have to interpret what the law is saying are violations of medical practice in each case.
To list the thousands of violations that should be considered in each case is impossible, so each violation is a matter of interpretation as to whether it is a significant violation and then how bad a violation it is relative to the implied damage done to the medical patient.
c. The worst of the problems is what the jury thinks is deserving of punishment and how extensive they should make the punishment. In essence, the jury must be educated by the attorneys well enough to make reasonable decisions about punishment.
d. There are no legal or other restrictions in each state that limits or maximizes verdicts of juries for pain and suffering unless a "cap" has been placed on verdicts being considered. Of the several states that have placed caps on pain and suffering, juries are held to reasonable limits, especially concerning the amount of money allowed in verdicts.
e. Run-away verdicts in medical malpractice cases have often been in the range of 7 to 10 million dollars, or more. Those verdicts, when approved, are a certain death sentence to any physician's career because they are impossible to recover from.
The United States Congress could easily resolve this practice destroying element but refuse to do so. The primary reason is said to
be to protect their "cash cow" (huge income source) for attorneys that manage medical malpractice cases against physicians across the country.
Receiving an attorney fee of 25% or so of a $7,000,000 jury verdict certainly sucks hundreds of attorneys into the medical malpractice litigation business.
California seems to be the best example of such consequences. In the 1970s run-away jury verdicts reached the point that all medical malpractice insurance companies quit providing malpractice insurance
to medical doctors in California. I was in private medical practice in California at the time.
The malpractice insurance premiums became so high that physicians
were not able to afford insurance, so physicians were forced either to practice without any malpractice coverage or move to another state where premiums were much cheaper.
I chose a third option. Using arbitration agreements with patients worked for me, at least up until the physician groups created their own malpractice insurance companies that nearly all doctors signed into.
After a couple years California passed a new law capping the jury verdicts. Then medical practice went back to normal as the
malpractice insurers returned to California with reasonable premiums.
At the time about 7 other states passed "capping" laws later on, leaving the rest of the state medical malpractice laws unchanged.
Such medical malpractice cases that also occur in Managed Care practices can sidestep trial options because they have the necessary funds to mediate the case (out-of-court) directly with the injured
medical patient. It keeps the cost of litigation down and results in a reasonable amount of money being paid to the plaintiff.
Private practice physicians rarely have the funds to fight for fairness
in their litigation springing from their errors or complications their patients suffer from. Malpractice insurance companies found insurance premiums paid by physicians increasing again. They had to do something
to stem the increasing problem--they modified their tactics for managing claims.
What happened to physicians was again an attack on their weakness.
When physicians are facing severe restrictions on their incomes (government plan working), there is no way to pay high court costs and attorney fees. Bankruptcy is not the best answer.
The modification that the malpractice insurance carriers gave physicians, essentially removed any ability of the physician to make decisions regarding the management of the claim against them. Previously, physicians were given a say about management of their
legal cases.
Now a physician has two choices...
1. Agree to hire private malpractice defense attorneys to
handle the claim process and pay for it all out of their
own pockets, which in most cases is not affordable.
This is especially true when the actual malpractice
incident is deemed to be obviously a matter of
incompetence or neglect of the physician(s) involved.
Under these circumstances a trial is the only
reasonable method for the doctor’s attorneys to keep
the eventual jury award to a minimum and to be more
affordable for the insurance carrier to cover the costs.
This choice is a gamble at best.
2. Permit the malpractice insurance carrier to decide the
method for and financial settlement figures necessary
to settle medical malpractice claims outside the court.
In such cases it enables the insurance attorneys to
negotiate directly with the plaintiff attorneys on behalf
of plaintiff patients to settle the claims outside the
courtroom for an amount of money sufficient to avoid
trial costs.
The advantage for the physician(s) is that he or she
avoids having to admit that they are responsible for the
malpractice incident. This effectively prevents the legal
records from showing this incident as a malpractice claim
against that physician(s).
Why is that important? Every medical malpractice
verdict recorded against a physician has very serious
consequences for any physician. Some of these are…
*These malpractice records are not only filed with the
State Medical Board where the physician is licensed,
but also are filed with the State Medical Boards where
the physician also has a medical license.
So, if a physician moves to another state to practice,
the records follow that doctor.
*Medical Boards have legal leeway to punish physicians
In any manner they choose with very few limitations.
Personal Biases of Board members are well known
inside the medical profession. Board members are
appointed by state governments and usually include
individuals not in the medical profession as well as
medical doctors.
*The reputation of the physician is compromised in many
ways, even by each hospital medical executive
committees of doctors. They can restrict a physician’s
hospital privileges, surgical privileges, among others.
The local community finds out about this problem
rather quickly, which keeps patients away from this
doctor. Often their practice incomes diminish a
significant degree.
Local doctors stop referring patients to this doctor.
I'm elaborating here on the weaknesses of private medical practice
that the government uses to undermine the medical profession and force all physicians into their controlled environment.
Would you choose to become a physician if you knew all of these factors beforehand--factors that are stacked against you and are increasing?
If you read newspapers, listen to news, or watch the trends of important issues being discussed daily today, you may now be aware of the pending and predictable increase in litigation burning up the airwaves and fogging up the court system. The Covid-19 pandemic has ruined many businesses and lives.
Most people likely never consider what is happening to private physicians during this pandemic. Yes, they were forced to close their practice businesses the same as other businesses. Physicians earn no
income during those months, lose employees, lose patients, go into debt.
Because they make money only when they care for patients, it takes years to build up their patient load and incomes.
Members of congress are now proposing passing a law that protects the government employees and elected officials from law suits related to the pandemic management.
Our congress is now facing potential litigation against them and may well create a law to prevent it.
Physicians have been waiting for years to have laws passed to protect them as well and for the same reason.
For example, if the government politicians put a cap on malpractice jury verdicts in 50 states, it would open a new world of medical practice
interests, especially in the specialties that attract the most severe malpractice claims--ones that physicians have avoided going into for decades. But don’t worry! Patients can still be treated by those thousands of foreign doctors that seem to have no fear about those issues.