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Wednesday, August 5, 2009

A Doctor's Great Fear


As of this past June, I have finished 11 years of work as an anesthesiologist. For a physician, one the worst things that can happen to potentially destroy a career is the dreaded lawsuit. Up until last Friday, there had been just one hiccup that seriously made me question my desire to continue in this career.

The first occurred in 2002 in an attempt at a frivoulous lawsuit concerning a patient who was mad at the surgeon and hospital for the overall care he received for elective surgery. I was also named as part of the suit when the opposing lawyer noticed that a paramedic student was in the OR with me and had been given a chance to place the patient's breathing tube for surgery and had cut the patient's lip slightly with the metal laryngoscope. Lip lacerations don't happen too often, but it is not a big deal. Just like when your lips are chapped in the winter and they can split - that is usually what a lip laceration is like and it heals in a few days without any permanent damage or scar. The patient claimed he had no knowledge that the paramedic student was going to be in the operating room as part of the anesthesia team and thus, the lawyer accuseded me of negligence, malpractice, intent to harm, etc. Fortunately, the main hospital I work at is a teaching institution and every patient signs papers and consent forms when they are admitted that clearly inform them that as a teaching institution, there are students, residents, and so forth, will be part of the patient's care. Prior to surgery, they again sign consent forms for surgery and anesthesia that again inform them of the same. By signing these papers, they give their permission that this is normal practice for our hospital and that this is ok with them. After giving depositions and over a year's worth of worry and time wasted, the suit was dismissed just before it went to court. What a feeling as a huge weight of pain and torture was removed from my being. The lawsuit was gone... forever. It was great news, truly... but the experience of personally receiving a certified letter via courrier, and then seeing a law firm's name on the envelope, and having to open the envelope knowing full well what is inside, then having to read your name on legal documents declaring that you are being sued is one that you never want to experience. The immediate feeling is a immediate deflating of spirit, a pain and fear within, an intellectual "why me?", anger at our legal climate and the lawyers that encourage patients to sue out of the lawyer's greed at seeing the potential windfall if they win, and a deep sadness and questioning and double-guessing of professional ability, competence, and judgement. Thinking back to those years, I recall the loss of joy in going in for work, the constant fear in the back of my mind that if I didn't practice defensive medicine another lawsuit could just as easily be upon me, seeing every patient encounter as a potential lawsuit rather than as an opportunity to care for them and do what God has called me to do... I recall the loss of my passion and heart for my career as a physician. Frivoulous though the lawsuit was, it clearly was a defining moment. Like the loss of innocence we as children feel when despite our parent's best efforts to protect us, eventually our exposures in the real world show us how evil the world really can be... so too, the first lawsuit a physician receives alters him/her forever. I think even now, I can even rationalize it if I really did do something wrong and made an error. However, when frivoulous lawsuits are encouraged, for no obvious reason but to extort windfall jury awards against physicians and their insurance companies... gone are lofty ideals of why physicians ever enter the field of medicine. The ideals and mantra of "wanting to help people" becomes secondary to "how can I keep from being sued by this patient?". It is amazing that a part of our society and legal profession thrives on this.

So that brings me to two weeks ago, when again another envelope arrived by courier for me. I cannot talk about the case obviously for legal reasons. But yet again, it amazes me how a niche in the legal profession preys on physicians because they feel we theoretically have "deep pockets", being well insured. The merits of the suit in regards to myself are even more unfounded, in my opinion. So, it is with a heavy heart that I must endure yet again the legal process and the entire nauseating ride of emotions I will once again experience until the truth yet again prevails. I have grown in my maturity as a physician and this time around I understand "the system" a bit better. No matter the outcome, I know there is no guilt within me. Tragic though the case, the blame lies elsewhere and I am at peace with that knowledge. I know I have questioned my job in the past, but I do believe that I am where I am and doing what I am doing in order to accomplish God's greater plan. Even if I stray, I know in my core that Romans 8:28 holds total truth... "that God causes all things to work together for good to those who love God, to those who are called according to His purpose".

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