Damn lawyers - Page 2 - cougarguard.com — unofficial BYU Cougars / LDS sports, football, basketball forum and message board

Archaea · 11-10-2008, 03:34 AM

Quote:

Originally Posted by CardiacCoug

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.

ERCougar · 11-10-2008, 12:48 PM

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.

ERCougar · 11-10-2008, 01:12 PM

Quote:

Originally Posted by Archaea

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 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.

11-10-2008, 12:48 PM	#12
ERCougar Senior Member Join Date: Oct 2007 Posts: 1,589	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.