A doctor’s compensation, for the most part, has nothing to do with medical excellence or healing patients.   A doctor’s earnings are, for the most  part, contingent on only one thing:  The quality of forms and paperwork sent to third party payers such as private insurance companies and Medicare.

Whether or not you are cured is really very much beside the point.  Indeed, you can drop dead five minutes after exiting a doctor’s haughty office on Park Avenue, and your doctor will still get paid if the forms are in order.  Very simply, doctors don’t have much of an incentive to do anything good or right.  Of course, many of them were filled to the brim with benevolence when they were young, but a) the crassness of the profession, b) the need to make oneself cold so as to avoid becoming emotionally involved in a case, c) the millions made by wall street executives in the course of screwing people over (What is the essence of the Capitalistic Act?  Taking a piece of junk worth twenty dollars and convincing some poor shnook it is worth fifty dollars), d) the torture endured by young doctors in hospitals, and e) the very understandable tendency to get sick and tired of stupid patients who call the doctor about every little thing (I knew a woman who called her doctor on every Tuesday.  Tuesday was the day the science section of the New York Times came out.   Invariably, there would be some cutesy little article which said that garlic or some other seasoning was salubrious, and invariably this woman, while stuffing her face with strawberry shortcake, would ask the doctor, “So, answer me this:  Is it really true than ginger ale can get rid of wrinkles”), make doctors SICK OF THEIR PATIENTS.

Accordingly, the average doctor older than thirty-five is a son of a bitch.   His altruism has withered away.  He just wants to make the bucks, and the bucks are made not by curing people – Blue Cross and Medicare couldn’t care less if you are alive or dead or enduring hundreds of bed sores, lonely and forgotten in a hospital ward – but by sending the insurance companies and their ilk good paperwork.

You think this is all imaginary?   Then why do 100,000 Americans die every year of nosocomial (Hospital acquired) infections.  Because the sons of bitches are too damn self-centered to wash their fucking hands.    You think I am paranoid?  If a surgery goes awry because of blatant medical error, do you think the patient knows about it.  He was unconscious during the  surgery.  (Indeed, most of the time people don’t even know they were hurt by doctors.  A Harvard study – admittedly somewhat old as I heard about it in Law school and I was graduated from law school in 1985 – said that for every medical malpractice action initiated in New York State, 20 valid actions were not started)  Do you think it’s easy to bring a suit for malpractice?  Do you have any idea how hard it is to find a doctor willing to testify against another  doctor and how much he’ll charge you if he will consent to testify?

The cases of malpractice, and of really egregious and astounding malpractice, are ubiquitous, but I don’t think most people have any idea of what is going on.  Just as Alexis de tocqueville said that Americans are so certain that they are free and fine that they rarely question whether they are free and fine, Americans are so certain that we have the greatest medical industrial complex in the world that they’ve never taken a look to see the dead bodies in the machine.   About once every two weeks or so, I see a story in the New York Times which documents the atrociousness of doctors, but that story is on page 16 or so, and what proportion of Americans read,  or hear of, or even know what page 16 of the Times looks like.  The Americans are listening to Fox or CNN.  CNN will cover the news all the time, but they simply repeat the same superficial things every ten minutes or so.  Metternich said the masses were inert, and they are, and let’s not forget that they are grotesquely stupid too.  If you have any doubt, just examine the pea-brain discussions that dominate the presidential elections.

In any event, we need to make it easier for Plaintiffs to bring medical malpractice actions because medical malpractice actions are the most potent incentive to encourage the responsible practice of medicine.

Copyright, David Gottfried, 2012


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