On The N.C. House-Select-Committee-On-Tort-Reform's CRAPPY Notions Of "Reform"

Related to this Housecalls post of three days ago, North Carolina legislative committees work quickly when their "debate" is based on "business-friendly" sound-bites . . . and those of us who've done the dirty work aren't even invited to the discussion.

(Kevin MD had a pseudo-related post up on Monday, but I'm pretty-much ignoring the little weasel-gone-sponsor-happy because of his indiscriminate deleting of comments - and apparent banning of commenters - not just me - for no other reason than they dare talk back to social media's "leading physician voice".  Indeed, this post composed largely of what I can remember of the comment that would not post at Kevin's.)

Firstoff, I don't really have a problem with caps-on-certain types of damages.  North Carolina's doctors have lived with the threat of John-Edwards-syle "jack-pot" justice hanging over their heads for too long. 

I also think "losers" should pay . . . as a deterrent to the ambulance-chasers . . . and liars.

But I do have a problem with special immunity ONLY for Emergency Room physicians.  And I can have a problem with it because, in my many adventures as a Locums, I've worked in a Pediatric Emergency department in the great big city.  I've also been unsuccessfully sued for malpractice (see ambulance-chaser reference above).

You cannot base that kind of immunity simply on location.

And the same thing will happen here that has already happened with the immunity that hospital peer review committees currently enjoy.  It's simply another legally-immune way to act in bad faith and cover up malpractice and CRUSH anyone who might blow-the-whistle.

You know, like what happened to me in Asheboro.  The opinionated/homegown lady Pediatrician who rescued the Cone-owned Family Practitioner-who-did-not-have-a-clue-what-he-was-doing got fired, SLAPP-sued and swindled . . . for doing her duty. 

The Cone-owned darling who screwed-up and nearly killed an infant with his arrogance and ignorance went on to become Chief-of-Staff at Randolph Hospital.

Let me put it another way:

I currently work as an independently-contracted Pediatric hospitalist at a rural/far-Eastern facility.  For long blocks of time (huge chunks of any given month), I take 24-7 call for any Pediatric emergency that may stroll or land in my particular hospital.  In my case, right now, I'm the ONLY MD for three or four counties consistently providing on-call inpatient Pediatric coverage.  For several years, the private docs who live in the area, haven't wanted anything to do with it.

For those who would sneer and spit at the private MD's for shirking their "duty", I say, WIPE THE SMIRK OFF YOUR FACE AND SWALLOW YOUR SPIT.  These doctors, already running practices-that-are-busting-at-the-seams were on-called to death.  Their hospital privileges became a burden they could not bear and stay sane/healthy/have any kind of life.

It has something to do with burn-out . . . something the non-medical lay-person simply cannot understand.  I know all about that too . . . because it was my life in Asheboro . . . providing 24/7 back-up call for physicians who clearly did not appreciate it.

Allow me to explain what call means in my day-to-day life/practice.  For all of the time that I am contracted to cover call, I am usually less than 10 minutes from the hospital-in-the-middle-of-rural-nowhere . . . and at NO time more than 30 minutes away.  I cannot go anywhere or do anything that might get interrupted.  Some days (like today), things are slow . . . other days/nights I am SLAMMED . . . but while on-call, I am constantly "on" (a kind of a higher-state-of-awareness-but-not-in-a-Charlie-Sheen-way).  I consult in the ED.  I admit patients.  I stablize and transfer them out if they're deemed too sick to stay on our floor.  And I attend/"rescue" any and all of the disasters and potential disasters that can happen on the OB unit at any hour of the day or night . . . situations where bad outcomes can happen that have NOTHING to do with my management of the baby . . . but instead what was wrong in the first place.

The one saving grace in this arrangement is that I'm not answering all of the routine "Mommy" calls for the local practices (otherwise, I would go insane).  They have their own rotating call schedules for that.

OBTW, unlike doctors working in hospitals in the big city, while managing these cases, I have limited ancillary support.  Don't get me wrong, this particular hosptial staff does a FANTASTIC job with what they have.  And you could not ask for better people - who know how to come together for a sick kid in a crunch.  But it's not a children's hospital.

Because I do answer the call and do come in . . . more often-than-not for people/patients I do not know/have never met . . . using local/rural resources that are sometimes stretched . . . and do my job to the best of my ability/knowledge/training as a Pediatrician (specialist) . . . I can have a legal target on my back for up to 19 years in North Carolina.

It's absurd.

(And DO NOT EVEN even get this "dime-a-dozen" Board-certified Pediatrician started on what the over-paid, over-rated, assholes-with-MBA's running Randolph Hospital did to me for doing my job the way it was supposed to be done.)

In terms of what I do, especially on the OB unit, I am NO DIFFERENT from an ED physician.  I show up when I'm called.  I see the patient in front of me - no matter how sick they are.  And I do my best by him/her.

Under the logic behind this proposal, how is it FAIR for an ED physician to get special immunity from "jackpot justice" - but not me (functioning as a specialist) - based SOLELY on location of the service provided?

With all due respect, much like the pseudo-socialist farce that is Obamacare, the N.C. House Committee's "solution" proposal for tort reform is a CRAPPY solution . . . intrinsically unfair to both doctors and truly-wounded patients . . . loaded with unintended consequences . . . doesn't begin to address all of what needs to be addressed . . . and is a CLASSIC example of lawmakers acting on behalf of special interests (there's a lot of hospital money behind ED physicians - notsomuch behind Pediatricians) proceeding without thinking-what-they're-doing through.

I am forwarding this post to Craig Jarvis at the Raleigh News and Observer . . . as well as the N.C. Coalition for Patient Safety . . .

. . . and I stand ready to answer my "representative", Harold Brubaker's, call . . . since/because/you-know, being a Republican in scandal-ridden Raleigh, he's so very concerned about accountability and real healthcare reform.