1. doctorblue
    November 11, 2009 @ 4:50 pm

    I added a link to this article in My Favorites on my blog site http://doctorblue.wordpress.com. I became disabled unnecessarily at age 50 while insured by Cigna HMO because Cigna providers did nothing more than refer me from one test and specialist to the next despite testing positive for various infections and physiological abnormalties. Cigna refused to take my complaints about its providers seriously despite its much touted Code of Ethics “Patient’s Bill of Rights,” which claims that patients have the right to “be heard” and have their care concerns addressed. Now on SSDI and Medicare, I am continuing to seek competent medical care. I am also in search of an attorney who can advise me on setting up a cyber begging site so I can raise the $25,000+ in expenses to hire a medical malpractice attorney on a contingency basis. I believe my case would qualify for Virginia’s continuing care statute of limitations that tolls the statute until treatment ends.


  2. A Land Harris MD
    November 11, 2009 @ 5:56 pm

    I agree that doctors are making more mistakes now than they did when I began to practice medicine, 20+ years ago. It is THE main REASON that I am for EXPANDED and IMPROVED MEDICARE for ALL AMERICANS!

    It is THE ONE reason that I have declined to accept patients that might at some time need to be hospitalized, where the insurance companies and the hospital CEO’s routinely pressure physicians to discharge patients before it is safe for the patient to be discharged. It is why I do not “accept insurance”, except from one local plan, and I require my patients to pay me directly on a patient determined sliding scale basis.

    I do not have to employ a large staff that would be needed to keep up with all the ways insurance companies continually devise to cheat physicians out of reasonable reimbursement for the work they do.

    I am lucky. I do not have children to raise and educate, nor do I now have relatives that are dependent upon me for support, and I am fairly modest in my needs, which my practice has luckily provided to date.

    Because I was trained at a medical school dedicated to graduating good Family Practice physicians, I know how good Family Practice CARE was practiced 20 years ago. I subsequently continued my education with additional training for a specialty that allowed me to design my practice so I do not have to compromise the quality of care I give my patients.
    Fortunately, I have been able to stay clear of the frantic treadmill that has been created by the rise of Medical Insurance companies’ power.

    If I had stayed in primary care, I would have had to hire a large staff dedicated to trying to figure out how to collect payment for my services as the “rules” created by the insurers constantly change, and they create more and more ways to refuse to pay anything at all.

    Contrary to popular belief, physicians who practice as sole providers, CAN NOT TAKE OFF deductions on their taxes for any of their uncollected fees (nor for any associated costs), despite the time, overhead and work they have already expended in caring for that patient.

    What does this have to do with BAD DOCTORS??? In my experience of 30 years in the medical world, I have known very few doctors who were inept, or callous, or lazy, or dishonest.

    I think the premise of this article, that “Lack of doctor accountability is at root of medical malpractice woes”, is fundamentally wrong. For that reason, the solution presented is not a solution to the problem of the increase in “medical malpractice” & poor patient outcome in the last 20+ years.
    I strongly believe, her solution will do nothing but drive many more primary care physicians out of medicine or into plastic surgery/dermatology/etc. We already have a shortage of the primary care physicians.

    Primary Care Medicine is TIME INTENSIVE. It depends on the relationship and interaction between the patient and the doctor to work well. Of all physicians, primary care physicians HAVE TO take the TIME to give their patients quality patient care, or patient care suffers.

    I strongly believe primary care physicians, who are the basis of any good medical system, are trying to practice the best medicine they can, under the circumstances, which have gradually changed for them as they run faster and faster to try to stay upright.

    It is not unlike the experiment with frogs…if you put them in a pot with hot water, they will jump out….if you put them in a bath of cool water and gradually raise the temperature, THEY WILL STAY THERE & BOIL TO DEATH.

    I consider this an appropriate analogy. The practice of medicine, in my opinion, is now in the VERY VERY HOT WATER stage & the physicians are becoming disoriented and fragmented as they try to do the best that they can, under the circumstances…and the result is the decline in the quality of medical care that most primary care American doctors can achieve.

    This has led many primary care physicians, who expected to work for many more years, as many older physicians did until recently, to close their practice much earlier. They used to love to practice medicine, when they had the TIME to do it to the BEST OF THEIR ABILITY…. before the insurance companies got control of the tread mill.

    To survive in the “insurance age” primary care physicians have had to shrink the 30-50 minute patient visit that was “usual and customary” when I graduated from medical school down to the current “whirlwind 7 minutes & 1 symptom per patient”.

    To support the overhead necessitated by the insurance company shell game, 7 minutes per patient is the most time that can be alloted to a patient “encounter” in a Family Practice setting. This includes all of the paperwork necessitated by the patient’s visit.

    This 7 minutes is all the time they have to listen to & talk with the patient, examine the patient, educate the patient, fill out the forms necessary for the tests the physician thinks are indicated, fill out the prescriptions to give to the patient with appropriate education needed to understand & take the medicine correctly, fill out the note in the patient’s chart, fill out the insurance claim form, and move on to the next patient, among other things.

    A physician also has to set aside time for phone calls with patients, labs, other medical professionals as necessary & time to obtain continuing education.

    ALL OF the above were stressed as NECESSARY to PRACTICE QUALITY MEDICAL CARE for the best outcome for the patient in my Family Practice training.

    By that definition, no one is getting Quality Medical Care now, in my opinion, unless they have the money to contract with a physician on “a yearly retainer”. This is a system where the patient pays, out of pocket & up front, thousands of dollars each year to their primary care physician to be available to them if needed that year for whatever illness occurs. This arrangement does not cover anything but the primary care physician’s time for consultation and routine medical care.

    Without the retainer arrangement, the current office based primary care physician (in order to make enough income to support the physician, his or her own family, & the additional staff dedicated solely to the goal of getting the physician paid) has had to expand their overhead exponentially.

    This overhead is necessary to try to deal with the insurance companies’ continually changing delays & denials of payment for the care already given by the physician to their patients.

    The additional overhead covers:
    1) salaries of the staff dedicated to trying to get the physician paid for the work that they have done, &
    2) the extra staff to help the physician do some of the paperwork etc needed because of the time crunch &
    3) the staff’s families’ medical coverage,
    4) the extra space & equipment & computers etc for the expanded staff,
    5) & the ongoing billing staff training to try to make them aware of the continually changing “requirements” & shell games that each of the many insurance plans of the many “insurance” companies devise solely to CHEAT the physician OUT of ANY payment for the work they have already done.

    I am sure I have left out other costs directly related to the insurance con game, but I hope you get the picture.

    As you can see… IN THIS SYSTEM, CONTROLLED BY THE INSURANCE COMPANIES’ RELENTLESS DRIVE FOR PROFITS, the physicians are racing the clock, & patients & physicians are losing.

    THIS I believe is the reason that many more shortcuts are taken, & less well trained staff are relied on to do things physicians did previously themselves. Currently “medical care” is a rat race, created by the private insurance corporations who are ONLY interested in their PROFITS.

    Insurance companies DO NOTHING TO PROVIDE HEALTHCARE to patients!

    SOLELY because of this rat race for obscene profits for the CEO’s and stock holders in the Mega Insurance companies (WHO DO NOTHING AT ALL TO PROVIDE ANY ASPECT OF HEALTHCARE, other than SUCKING THE SYSTEM DRY on a regular basis)….overworked and very stressed physicians make many more mistakes in current medical practice…and most primary care physicians are running as fast as they can just to survive.

    We now have very few medical students going into the “primary care” branches of medicine (Family Practice, Pediatrics etc). WHY WOULD THEY????

    The magic of having the honor & the awesome trust of another human being who puts their health into your hands is a blessing, IF you have the time and ability to justify that trust. There is nothing like making a positive difference in your patients’ lives.

    Being a physician in America no longer the same.

    If America cuts the leeches out of the system and moves to an EXPANDED and IMPROVED Medicare for ALL Americans, the system can be phased in over time to retrain the workforce that is now dedicated to cheating Americans out of decent healthcare as employees of the “insurance leeches”.

    The program can be phased in to include ALL AMERICANS & adjusted to be fair for patients and physicians again, and the health of America will improve greatly for ALL Americans.



  3. Carolyn
    November 11, 2009 @ 7:03 pm

    Did you send this to all of our Congresspersons in both houses?
    Many Drs. aren’t taking Medicare patients. What do we do?
    They must increase not decrease Drs. payments.
    Right now my medicare and supplemat are fantastic. I’ve been a patient at Mayo since they opened. They have cut medicare from some of their facilities. If they cut the main one, what will I do. I called about 12 local drs. and none would take medicre.


  4. A Land Harris MD
    November 11, 2009 @ 7:59 pm

    If we get expanded improved medicare for all Americans…the reimbursement will need to be adjusted to come into line with what is reasonable. But there are lots of docs who prefer to take medicare because they at least get paid something and they can count on it…If we got Single Payer/Medicare for all then there will be only one system to work on and that will enable us to make it better for patients and for doctors.

    Right now medicare and medicaid are working on a shoestring ( overhead something like 3%) with the oldest and the sickest of patients and the cast offs of the FOR BIG PROFIT insurance companies and on “Medicare Advantage” the for profit companies are defrauding the government right and left and have lost a number of court cases to that effect…the policing of medicare is hard as the funds are so low…but if they had the whole thing they could cover all and save the country lots of money…it would take time to phase in…. but Now Americans are sending their hard earned money to the Corporate CEO’s for their mansions (30-40% pure profit) and getting nothing in return.

    Glad you are covered…good luck!
    Land Harris MD


  5. A Land Harris MD
    November 11, 2009 @ 8:02 pm

    Ps…no…it needs editing…and I am tired tonight…but perhaps I should send it off after that…thanks for the inspiration.
    L H.


  6. New report on medical errors is wake-up call; White House should focus on improving patient safety to reduce medical costs « CitizenVox
    December 24, 2010 @ 1:53 am

    […] to a crisis of medical errors in hospitals. Today, we learn that nothing has changed and that patients are suffering needless injuries and deaths from preventable medical mistakes. The Inspector General’s office of the Department of Health and Human Services (HHS) has […]


  7. Al Neustadter
    October 17, 2013 @ 9:21 pm

    I can tell you that when it comes to the death of elderly in hospitals, the goal of everyone involved is to defend the doctor(s) at all costs. Records and discharge summaries are falsified as needed, and state regulatory agencies will decline to investigate. I suspect the feeling is that old people will die soon anyway, and you don’t want to cost a doctor his career. And doctors know that they enjoy this kind of protection, which empowers them. I speak from experience (see HolyCrossHealth.com).


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