Damn lawyers
 

Who besides doctors is required by law to provide free interpretation services that cost far in excess of fees collected? Stuff like this pisses me off.

http://www.law.com/jsp/article.jsp?id=1202425326286

Why does the doctor have to provide interpretation services? I would think that it is the responsibility of the patient to do so.

Yeah, one would think that if one were rational. Unfortunately, we're leaving this thinking to attorneys.

This requirement significantly impacts my work and irritates me to no end.

And to think we just elected a ticket with two attorneys.

We?

I had nothing to do with that. I voted for the Naval pilot and the babe.

Notice how in the article, the physician was found liable for $400K (a year's income) while a lawyer guilty of a similar offense had to pay a whopping $1K.

Damn lawyers.

Interesting, isn't it?

I wonder how many attorneys have to purchase malpractice insurance for their errors? Do they go before a panel of physicians to determine the quality of their work? Don't worry, we'll ask a few attorneys how well you did and then take their testimony to a group of jobless high school dropouts for the final decision. I mean, really, how hard can it be?

The frustrations physicians experience in malpractice are understandable, but the magnitude of your errors, literally concern life and death. Now many professionals don't experience the same professional malpractice that physicians do, but historically large accounting firms were sued in securities cases for egregious errors to a point where the firms ceased doing certain types of work.

Lawyers purchase malpractice and it runs roughly what a family practitioner pays.

Fellas, you're shooting the messenger. This is an Americans with Disabilities Act case. You can thank congress for that one. If you don't like how a judge is applying that law, or think it is beyond the scope if its intent, you should be calling your congressman. Seriously.

Also, just for educational value, in my state you are not required to carry malpractice insurance but you appear on a list of "uninsureds" if you don't. As a practical matter we ALL carry malpractice insurance, think and discuss frequently our exposure in various situations, and must take at least twelve hours of continuing education, three of which must be ethics. There is a move to require everyone in my state to carry insurance and I support it.

In addition, we are subject to discipline for unethical behavior including loss of license. Here is the public record for my state on this: http://www.vsb.org/site/regulation/d...ystem-actions/

Now I won't argue that my insurance is as expensive as yours. Its not. The reason is that for the most part on my worst day I can do as much harm (or good of course) as a doctor can. We also, on average, don't make remotely as much as you do. There are exceptions, of course.

Last, as much a MD's hate malpractice, that area of the law is nothing more or less than regulating whether the standard of care is observed. Lawyers have zero to do with where that gets set. It is set by you in every day as you practice. And of course in every case it is one of your brethren who must say you deviated from it. Every case must have an expert Dr. who says you did it wrong. Yes there are professional witnesses out there, but let me tell from experience that anyone is has a very large part of their income derived from giving testimony gets raked over the coals for it and loses a great deal of credibility.

Don't get me wrong, I think the out come of that case does sound silly. I'm just trying to persuade you that your ire is misplaced. (How'd I do?) :-)

It's not the practicing lawyers I blame as much as the lawyer legislators, lobbyists, and judges for this stuff. You guys protect each other and would just as soon let doctors burn.

For the federal government to require a physician to pay an interpreter $200 in order to see a patient for which the government will reimburse the physician $50 is patently ridiculous.

Cue Mike Waters (if he were still around) saying "Nobody is forcing you guys to accept Medicaid or Medicare patients." My responses:

1. Not true for emergency room patients. We see these patients regardless of insurance status for ethical and legal (EMTALA) reasons.
2. Many specialties (internal medicine subspecialites, for example) have a median patient age of almost 70, making it impossible to avoid the Medicare population.

I have devised methods around that for my clients. That side effect is an unintended consequence and the ADA should not be seen as a mechanism for full employment of death interpreters. Welcome to the world according to Obama though.

I'm not about to enter into another malpractice debate with attorneys (last time, this ended with Cali educating me on how to diagnose head injuries, lol) but I have to make a couple of points:
1) I'm not sure the interpreter requirement is an ADA issue. In this case, it may be, but the much more common case is that of the patient who doesn't speak English. I don't speak Spanish (besides limited medical spanish), so this is a daily frustration for me. Usually, we have someone around who speaks Spanish and can translate, but occasionally, we don't, and we have to provide an expensive translation service. This takes literally twice as long to see the patient (a serious issue when we're busy) and if anything's lost in the translation process, I am liable for any bad outcome that results. If a patient's only language is Swahili, it's the hospital's (or clinic's) duty to provide adequate translation. If the government is going to require us to see everyone who walks through the doors, and if the government values this type of provision, they need to reimburse the clinician for it.
2) Not all doctors are rich. I would wager that the rheumatologist in this discussion makes less than most of the attorneys on this board. Malpractice premiums shouldn't have anything to do with wealth anyway.
3) No thinking physician wants to do away with malpractice. I would guess that I am more irritated at poor medical care than the average patient is. These are my colleagues who are putting a bad name on medicine. My beef is with how the breach of standard is care is determinied. There is very little that is black-or-white in medicine. I'm in one of the more protocol-driven fields, and yet even in my field, I'm constantly dealing with probabilities, and there is usually no clear-cut answer on what should be done next. This is probably the most misunderstood aspect of healthcare. The average person feels like there are tests for every disease and it's just a matter of ordering the test; in reality, we're constantly dealing with prior probability of disease and and every test only alters that prior probability, and very rarely to 100% (or 0%). We understand Bayes better than pelagius. We're always guessing (with varying degrees of confidence). The nuances of medical decision-making are just too complicated to hand over to a bunch of jurors with no prior education or exposure to the field. This is why I would favor some sort of professional juror system, or some independent and unpaid (at least by the sides involved) physician review panel to determine the breach.

I'm totally fine with providing deaf interpreters when the government is willing to reimburse me; they need medical care too, and they have no better alternative. I'm not fine with providing interpretation services to illegal aliens or those who haven't taken the time to learn the language.