|
When he went out on strike last January,
Dr. Robert Zaleski had his 15 minutes of fame. The
Wheeling
,
W. Va.
, orthopedic surgeon was one of two dozen surgeons to walk off
the job in January to protest his state's high costs of
malpractice insurance. Arguing that "frivolous
lawsuits" were driving up insurance premiums and forcing
physicians to leave the state, Zaleski and his colleagues
threatened to stay out for 30 days unless the legislature passed
a bill that would cap non-economic damages in such suits at
$250,000. As the walkout turned into a national story, Zaleski
became one of its most visible faces, making the rounds of TV
news shows and telling CNN, "I would certainly jump in
front of a bus if I could to continue to serve my patients as I
have for 23 years." Just a few weeks later, Zaleski's mug
shot appeared with those of five other doctors in The New
York Times Magazine, where he claimed to be "on the
brink" of moving out of state because of high insurance
rates and lawsuits.
Zaleski and his colleagues are the leading edge of a much
broader movement. All across the country, doctors like him are
telling reporters, legislators, and even their patients that
frivolous lawsuits are driving up insurance costs and driving
doctors out of practice and out of state, threatening access to
care. They've mobilized around state legislation to limit
malpractice lawsuits and linked arms with President Bush and
Republicans in Congress who have been pushing similar bills in
Washington
. Indeed, Zaleski himself was even personally invited to attend
a speech President Bush delivered in
Scranton
,
Pa.
, where he railed against the threat to patient care posed by
out-of-control lawsuits.
Upon closer inspection, however, it appears that Zaleski may
be more a source of the problem than a victim of it. Between
1987 and 2002, according to the West Virginia Board of Medicine,
patients filed 14 lawsuits against Zaleski, eight of which
resulted in payouts that together came to $1.7 million. By
contrast, according to a Public Citizen study, only 1 percent of
the state's doctors made five or more malpractice payouts over
the past decade. And while Zaleski says the settlement figures
are misleading because they also include defense costs, his
record is hardly squeaky clean. In a 1985 lawsuit (one not among
the 14 reported to the Board of Medicine), he admitted in a
deposition to being addicted to prescription painkillers for a
substantial part of the time that he was operating on people in
the early 1980s. Not only was he a drug addict, but to maintain
his Percodan habit, Zaleski allegedly wrote prescriptions for
other local addicts, who filled them and kicked back some pills
to the doctor, according to court documents that include copies
of the prescriptions and depositions from some of the addicts.
Yet even though a suspicious police officer reported him to
the state medical board, Zaleski was never disciplined by his
fellow physicians. (He says he does not remember the specifics
of the case, and while he acknowledges a past substance-abuse
problem, insists that he has been clean and sober for 21 years.)
Given this history, the real scandal may not be how high
Zaleski's insurance premiums are, but the fact that he can get
insurance at all. Zaleski's malpractice record may have been
extreme, but it was not unusual among the doctors who walked out
of
West Virginia
hospitals in January. According to a Charleston Gazette report,
nine of the 18 doctors striking at
Wheeling
Hospital
, including Zaleski, had cost their insurers more than $6
million in malpractice settlements and judgments. At least some
of the suits don't seem to merit the adjective
"frivolous." In one case, a doctor had left a clip on
an artery, eventually forcing the patient to have a liver
transplant. In another, a surgeon cut into his patient's stomach
wall during surgery, causing a massive, fatal infection. Indeed,
a number of those doctors leading the protest movement include
former drug addicts, felons, doctors whose licenses have been
revoked, and many, many others who get sued a lot--and far more
than most of their colleagues.
Not all the physicians angry about malpractice lawsuits and
high insurance rates have such checkered histories as Dr.
Zaleski. Many ethical and responsible doctors say the system
invites frivolous litigation, subjecting them to considerable
hassle and anxiety. One result, they argue, is an increase in
"defensive medicine"--when doctors schedule too many
tests, just to be safe--which contributes to higher health care
costs for everybody. But even the respected General Accounting
Office (GAO) has recently concluded that there's little evidence
to back the striking doctors' main claim, which is that lawsuits
are forcing many of them to abandon the practice of medicine or
to avoid high-risk procedures. And while there's no doubt that
malpractice insurance is getting more expensive across the
board--about 30 to 40 percent, on average, during the last three
years--this increase is largely due to the ailing stock market
and poor business practices in a virtually unregulated industry.
As a result, there's no reason to think that capping jury awards
would bring premiums down, a fact the insurance industry itself
acknowledges. Robert E. White Jr., president of First
Professional Insurance Company, the leading medical malpractice
insurer in
Florida
, told the Palm Beach Post in January, "No responsible
insurer can cut its rates after a [medical malpractice] bill
passes." The one surefire way to bring down the number of
big-payout lawsuits is to reduce the number of those doctors who
inspire most of them. But state medical boards--which are run by
doctors--have been notoriously reluctant to aggressively police
their own.
The doctors' protests aren't about good policy. They're about
good politics. Although the malpractice strikes look like a
natural outgrowth of physician frustration, they are, in fact,
the product of a sophisticated lobbying campaign coordinated by
Republican operatives and underwritten by business groups with
little interest in the practice of medicine. GOP leaders view
malpractice lawsuits as a pivotal issue for the 2004 campaign.
With health-care costs skyrocketing on its watch, the GOP is
eager to shift blame onto the Democrats, who have long enjoyed
greater public trust on the issue. And doctors, who enjoy great
credibility among voters, are the key. By linking rising
health-care costs to frivolous medical lawsuits, Republicans can
use doctors as a cudgel against trial lawyers, the Democratic
Party's second-largest funding base and one which could be
paralyzed by lawsuit caps. Once bills to restrict malpractice
lawsuits are on the table--in Congress and in the state
legislatures--Republicans can slip in much broader legal relief
for corporations under the guise of bringing down health-care
costs, especially for senior citizens. Frank Galitski, a former
Bush campaign staffer who works with the doctors as head of the
Texas Alliance for Patient Access (TAPA), a coalition of
insurance companies and health-care corporations, puts it
bluntly: "This is a great issue for the president,
particularly in the key battleground states of
Pennsylvania
,
Michigan
,
Ohio
, where they have an aging population." Indeed, if the
experience in
West Virginia
is any indication, the GOP has found itself a winning formula.
The perfect storm
The doctors who walked off the job last January were
primarily from the
Wheeling
and
Weirton
areas of
West Virginia
, right in the heart of steel country and on the borders of
Ohio
and
Pennsylvania
--the only solidly Republican section of historically Democratic
West Virginia. Nestled in the
Ohio
Valley
,
Wheeling
is a relic of the Industrial Revolution. Once home to a bustling
steel, glass and even tobacco industry, the area today offers a
rusting landscape of smokestacks and the dying steel mills which
are an endangered species in
America
. Downtown
Wheeling
is nearly deserted, its once grand Victorian architecture
blackened from years of neglect. A "Coffee Shop" on
the main drag is actually a video poker hall with a single
coffee pot to provide an occasional pick-up to the pasty,
overweight gamblers glued to video poker machines and smoking
cigarettes in dark rooms.
Like much of
West Virginia
,
Wheeling
and the surrounding
Ohio
County
rank among the poorest places in the country. Thanks to the
closing of the steel mills,
Ohio
County
has lost 30 percent of its population since 1968, leaving it
with one of the oldest populations of any county in the country.
Today's residents are thus heavily dependent on the local
hospitals, which also happen to be the area's largest employers.
Wheeling
Hospital
, where most of the doctors went on strike, employs some 3,000
local residents.
Thanks to the health-care-based economy, doctors make up the
area's upper crust, and their patients are mostly poor folks
reliant upon government health-care programs like Medicaid and
Medicare. As trial lawyers are quick to point out, with its high
rates of poverty and uninsured residents--as many as one in
five--
Wheeling
is not exactly a magnet for medical talent, especially because
it must compete with the highly-acclaimed University of
Pittsburgh Medical Center only 60 miles away.
As a result, many of
West Virginia
's striking doctors were foreign-born and -trained, and even
some of the native doctors were trained in places like
Guadalajara
,
Mexico
. At the same time,
Ohio
County
has an unusually active and talented trial bar, lawyers who
honed their skills through decades spent suing coal companies
for workers' cases of black lung. The tension between the two
groups has been brewing for years, and by 2001, when malpractice
insurance companies imposed stiff premium increases on doctors,
conditions were ripe for the perfect storm.
While the jury verdicts aren't nearly as outrageous as the
doctors make them out to be, there have been a few whoppers in
Ohio
County
--albeit usually in cases involving egregious malpractice--and
these seem to be what really riled the doctors. The case that
really sticks in their craw is that of Dr. Fred Payne. Like his
colleague Robert Zaleski, Payne had been sued a dozen times over
the past decade, and had paid out settlements of at least $7.3
million, according to the
Charleston
Gazette. In 1998, Payne operated to repair a minor spine
injury on a spry 76-year-old World War II veteran who had fallen
out of a tree. On his way to the operating room, he ran into a
medical-equipment salesman who encouraged him to try out a new
type of clamp. The patient hadn't consented to the procedure,
nor had Payne ever even seen the tool used or studied its use;
but he tried it out anyway. After Payne left the hospital, a
nurse paged him to let him know that the patient wasn't doing
well in recovery. An examination found that the clamp had
slipped into the spinal canal and paralyzed the man from the
neck down--a hideously worse injury than he had initially
sustained. He died a year later. A lawsuit over the case, which
charged that the man didn't even need surgery in the first
place, was settled for $4.6 million.
The
Ohio
Valley
Medical
Center
agreed to pay $3.5 million of the settlement, but insisted that
Payne was responsible for the rest. But Payne's minimal
insurance didn't cover the balance, so the judge on the case,
Fred Risovich II, insisted that he use his personal assets to
pay his share of the settlement, a rare move in a malpractice
case. "The negligence was so gross, and the injury so bad
that justice required that he pay something," says Risovich.
Payne has not practiced medicine since.
Doctors in
Wheeling
had not been particularly politically active before this, but
they were outraged by the case--not by Payne's behavior, but by
Risovich's. The doctors organized to oust him in a nasty
campaign that would foreshadow the tenor of the battle over
malpractice suit caps two years later. According to Risovich and
people in the local medical community, during the 2000 judicial
race, anonymous flyers appeared on the windshields of cars at
the local supermarket, accusing Risovich of beating his wife and
being a racist. Risovich says one night someone set fire to his
campaign materials in his front yard and urinated on his stoop.
"Someone sent investigators to call my children at college,
asked my stepchildren if they'd ever been molested. It was
horrible," says Risovich. Dozens of Republican physicians
changed their party affiliation so they could vote against
Risovich in the Democratic primary, and many today take credit
for his crushing defeat.
Claim adjustment
Just as the doctors were becoming politically energized, the
malpractice insurance industry went into a financial tailspin.
St. Paul Companies, once the nation's largest malpractice
insurance firm, pulled out of
West Virginia
and other states in 2001, leaving 1,000
West Virginia
doctors without insurance. Doctors in Charleston--apparently not
averse to lawsuits when these suit their own purposes--filed a
class action against the company, alleging that St. Paul stiffed
the doctors after pursuing a business strategy designed to
enrich top executives with more than $45 million in bonuses,
salaries, and stock options. The suit alleged that
St. Paul
raided $1.1 billion in reserved doctors' premiums to
artificially inflate its earnings in 1999 and 2000, a move that
helped executives to $5.2 million in bonuses and increased the
value of their stock options to $28 million.
Despite evidence of insurance company shenanigans, though,
doctors put the blame for their insurance woes on trial lawyers,
malpractice suits, and juries. They had some help in staying
focused: Between 1995 and 2001, Medical Assurance, a large
company which provided medical malpractice insurance to doctors
to cover their legal costs and damages in lawsuits, paid the
state medical association at least $115,000 to lobby on the
company's behalf, according to a story in the Charleston
Gazette by Lawrence Messina. Medical Assurance offered
members breaks on their insurance premiums for attending
"White Coat Day" at the legislature and provided the
glossy brochures and information on "meritless
lawsuits" and "outrageous" damage awards that
doctors used in their talking points with reporters and elected
officials.
Similarly, the PR materials on "lawsuit abuse" and
patient petitions that began to fill doctors' offices last year
came from the West Virginia Care Coalition; the coalition was
actually a project of Maple Creative, a Charleston-based PR firm
with close ties to the Bush administration. Those groups footing
the bill for Maple's services included, not surprisingly,
several with a direct stake in medical issues. The state HMO
association and the local hospital association, according to
Wheeling Hospital CEO Donald Hofreuder, gave the Care Coalition
more than $200,000. But other business groups with a broader
agenda of lawsuit restrictions also pitched in, including the
West Virginia Oil and Gas Coalition, the state chambers of
commerce, the
West Virginia
Building
and Industry Coalition and the Business Roundtable.
Once corralled behind malpractice caps, doctors came up with
their own innovations. At one point, physicians in
Wheeling
began adding a "tax" to their bills, $5 or $10 above
and beyond what insurance would pay for, telling patients it was
intended to cover their outrageous malpractice insurance
premiums. Predictably, older people on fixed incomes were
outraged and flooded their elected officials with calls for
lawsuit restrictions.
All in all, claims about a "lawsuit abuse crisis"
proved remarkably effective in
West Virginia
--and resistant to contradictory evidence. In February 2001,
responding to the doctors' allegations, the Charleston
Gazette undertook a computer-assisted analysis of more than
2,000 medical malpractice claims reported to the West Virginia
Board of Medicine. The paper determined that far from being in a
state of crisis,
West Virginia
ranked 35th in the country for median malpractice payouts. The
paper also found that both the number of malpractice claims and
the dollar amounts of the settlements and verdicts had actually
declined between 1993 and 2001. Nor was
West Virginia
suffering under an epidemic of "disappearing doctors."
Last August, the Gazette's
Messina
attended a rally at which the
West Virginia
medical society set out 37 empty chairs labeled with the names
of local doctors who supposedly had been forced out of practice
because of insurance costs. He discovered that at least two of
the doctors named were indeed not practicing--because they were
dead. Another two were still actually treating
Wheeling
patients. A Public Citizen study of the state medical board
records later found that the number of doctors in
West Virginia
increased by more than 350 between 1997 and 2002.
This fall, the GAO reached a similar conclusion: of five
states identified by the American Medical Association (AMA) as
malpractice "crisis" states, including West Virginia,
it found that "many of the reported provider actions taken
in response to malpractice pressures were not substantiated or
did not widely affect access to health care … some reports of
physicians relocating to other states, retiring, or closing
practices were not accurate or involved relatively few
physicians." Nor, in those same states, could the GAO
"identify any major reductions in the utilization of
certain services some physicians reported reducing because they
consider the services to be high risk."
Lawyers' trial
As doctors and insurance companies in
West Virginia
mobilized to impose caps, Republicans in
Washington
began to ramp up their own campaign for lawsuit restrictions. In
July of last year, the Bush administration kicked off the effort
with the release of a report called, "Confronting the New
Health Care Crisis: Improving Health Care Quality and Lowering
Costs by Fixing Our Medical Liability System," which
claimed that the "critical element" for expanding
health insurance to uninsured Americans was "curbing
excessive litigation." Soon after, in mid-July,
congressional Republicans launched a hearing titled
"Harming Patient Access to Care: The Impact of Excessive
Litigation." The supposed travails of
West Virginia
doctors made a perfect case study. Rep. Shelley Moore Capito (R-W.Va.),
a close confidant of White House adviser Karl Rove, personally
escorted a
West Virginia
doctor named Dr. Samuel Roberts to the House floor to testify.
Roberts, one of only three doctors who testified, told the
committee that he could not afford the insurance to continue
delivering babies, and claimed that this year, "I will have
to stop, leaving seven counties around me with no family
physician delivering prenatal or maternity care."
As with so much of the malpractice campaign, Roberts's
testimony omitted some critical facts that might have explained
some of his insurance woes: In 1987, he pleaded guilty to five
counts of cocaine possession and was sentenced to five years
probation, according to the Charleston Gazette. In response, the
state suspended his medical license for a year, though it later
reduced the penalty to five years of supervised probation.
(Incidentally, a year after his dire warnings to Congress,
Roberts is today still delivering babies, according to his
office.)
Nonetheless, the campaign gained steam, and in July 2002,
Bush gave a major speech on medical malpractice in
North Carolina
, home state of trial lawyer and Democratic presidential hopeful
John Edwards. "Healthcare costs are up because docs are
worried about getting sued," the president declared. Before
the speech, Bush met privately with AMA president-elect Donald
Palmisano, who told The Wall Street Journal that Bush had
counseled him to "get out the grassroots" if he wanted
caps on malpractice damages. The
West Virginia
doctors took his advice. When they staged their strike in
January, it coincided perfectly with Bush's State of the Union
address, in which he raised the malpractice issue before a
national TV audience.
The
West Virginia
strike did inconvenience a few patients, but its real sting was
felt--as intended--at the statehouse. Joe DeLong, a delegate
from
Weirton
--where some of the surgeons walked out--views the doctors'
strike as a form of extortion. "When I grew up, a strike
was a sacrifice," he says. "The doctors' livelihoods
were never at stake. This was a movement to inflict pain on the
sick and the elderly." He recalls being flooded with calls,
including one from a 96-year-old woman in tears because she was
dependent on a state transportation program to get to her
doctors. The shuttle wouldn't cross state lines to take her to
Pennsylvania
or
Ohio
if doctors in
West Virginia
quit practicing; she only calmed down when DeLong offered to
drive her should it prove necessary.
Such calls sent the legislature into a frenzy. "It's an
emotional issue for them," DeLong says, noting that the
doctors have done a good job of turning their insurance problems
into an anti-lawyer issue. Aside from the trial lawyers, there
has been very little organized opposition on the other side. In
March, state legislators, most of them Democratic, voted
overwhelmingly in favor of a sweeping malpractice bill. (DeLong
was among them.) Gov. Bob Wise practically begged to sign it.
Thanks in part to the ripple effect of the
West Virginia
strike, the national campaign by protesting doctors has been a
smashing success. In state after state, doctors have had only to
threaten walkouts to win promises of damage caps from local
legislators. Shortly after the West Virginia doctors went on
strike, for instance, doctors in Scranton, Pa., sat down to talk
strategy with Frank Galitski, the former Bush campaign
worker--who admits that "there is some coordination"
between the doctors' protests and the White House. Which makes
sense: At the national level, Republican-led efforts to impose
restrictions on medical malpractice lawsuits have helped unite
otherwise disparate elements of the health-care industry behind
a broader effort for lawsuit restrictions. A malpractice bill
passed by the House in March with backing from the AMA, for
instance, would completely exempt not just doctors but also drug
companies, medical-device manufacturers, nursing-home operators,
and HMOs from punitive damage awards for reckless conduct. The
Senate just rejected a similar measure, but the GOP plans to use
the issue during next year's election--and for good reason.
Limits on malpractice suits have proved to be a powerful
inducement to the medical community at a time when frustration
with managed care has been alienating this once-reliably
Republican constituency. (Lawsuit-prone doctors like Zaleski
have proven especially eager to lead the crusade against trial
lawyers.) After the
West Virginia
success, the AMA pledged to spend a whopping $22 million this
year on the malpractice issue alone, establishing a nationwide,
state-level grassroots operation that will come in handy during
the 2004 election--a figure nearly eight times larger than the
entire budget of the Association of the Trial Lawyers of
America. And so far this year, Bush's reelection campaign has
netted more than $750,000 from doctors.
Error reports
It's worth noting that the walkouts would never have proved
so effective had the media taken a closer look at the doctors
involved--and the interests backing them. Aside from a few
skeptical reporters in
West Virginia
, most of the press has taken the doctors' claims at face value,
rarely challenging their evidence and anecdotes. In June, for
instance, Time magazine devoted an entire cover story to
"disappearing doctors," complete with data supplied by
the AMA--the same data that previously had been challenged by
consumer groups around the country and later was authoritatively
debunked by the GAO. Reporters have also abetted the campaign by
portraying wealthy doctors as the impoverished victims of
"lawsuit abuse" and the often poor and injured
plaintiffs as the greedy pawns of billionaire trial lawyers. Yet
as with the AMA's data, that image doesn't hold up under
inspection.
Take Dr. Rajai Khoury, a striking
Wheeling
cardiovascular surgeon who told a local TV news interviewer in
January, "We're hurting, our patients are hurting, the
community is suffering." It's no secret in Wheeling that
Khoury recently built a 12,000-foot mansion with a five-car
garage, a pool, and a lovely view of the countryside from
"Pill Hill," the ritzy neighborhood that's home to
many doctors. (According to county building records, the house
is valued at close to $3 million, in a town where houses go for
as little as $19,000.) Even Zaleski seems to be doing pretty
well, despite his claims on television. He says his malpractice
insurance of $150,000 a year is about 30 percent of his income,
which would net him $300,000 annually. "I'm not
starving," he admits.
Dr. Greg Saracco, the telegenic surgeon who became the
unofficial spokesman for the
Wheeling
walkout, defends his profession, saying, "I don't think
it's really an issue how much a doctor makes. Who says we have
to do this for free?" In an interview, Saracco rails
against the "outrageous jury awards" given in
Wheeling
, offering the story of a local man who violated company rules
and safety guidelines on the job and used a broomstick to
unstick some kind of machine, which then cut his arm off.
Saracco says the man then sued the company for safety
violations, and a jury awarded him $4 million for his stupidity.
"Is somebody's arm worth $4 million?" he says with
amazement. Alas, the story may be apocryphal, as many
"frivolous lawsuit" stories often are. Verdicts over
$1 million are rare in
West Virginia
(there were none last year), and none of the trial lawyers I
spoke with in
Wheeling
could recall such a case. They suggest Saracco may be confusing
it with a similar case--lost leg, not arm--but the suit was
against an insurance company, a very different issue.
When asked whether he's ever been sued, Saracco says he just
settled a "crappola" suit for $25,000. In that "crappola"
suit, James Westfall, a man in his mid-50s, came into the
hospital for a hernia repair surgery, performed by Saracco and
his partner, Dr. Robert Cross. According to the lawsuit, during
surgery, Saracco pierced Westfall's bowel while stitching him up
and sewed it into his abdomen. The wound closure later tore and
created a hole in Westfall's bowel, causing it to leak. Cross
failed to respond to nurses' reports of complications until
Westfall was in critical condition--too late, as it turned out.
Westfall died a miserable death two days later. The lawsuit was
ultimately settled with Cross and the hospital for well over a
million dollars.
Bad medicine
Saracco suggests that most of the people who suffer from
"malpractice" usually have themselves to blame, like
obese people and the smokers he says are getting money from
asbestos lawsuits. The solution, he insists, is a cap on jury
awards like the one passed in
California
during the '70s--the law all the doctors' talking points refer
to as proof of the efficacy of such caps. But Saracco and his
fellow physicians have a short memory.
California
passed its law in 1976, after malpractice insurers, blaming
out-of-control lawsuits, suddenly hiked doctors' premiums by
more than 300 percent in a single year. Some years after the law
took effect, insurance premiums had shown no sign of going down.
California
doctors ended up suing Travelers' Insurance Co., alleging that
it grossly overcharged in the name of a non-existent malpractice
crisis. (Here, too, the plantiff's bar came in handy: A trial
lawyer won the doctors a $50 million refund.) The state
ultimately passed strict insurance reform that kept a lid on
future premium increases.
There are, however, other solutions that might help reduce
insurance rates that Saracco and his colleagues never mention.
Studies have repeatedly shown that only 5 percent of the
nation's doctors are responsible for more than half of all
malpractice payouts. Yet those lawsuit-magnet practitioners
generally pay the same insurance rates as doctors who've never
been sued, the equivalent of giving drunks the same car
insurance rates as soccer moms with perfect driving records.
This practice exists among malpractice insurers partly because
many of them are owned by doctors themselves, but mostly because
they make their money on investments, not on claims management.
As a result, the insurers have an incentive to sign up as many
doctors as possible so they can invest their premiums in the
stock market--a strategy which ensured that, when the economy
went south they would have to begin hiking premiums sharply. The
use of experience rating, like that employed by auto insurers to
weed out the dangerous drivers, would reward better doctors and
price those who attract the most lawsuits out of business rather
than subsidizing them.
Better regulation of health care would likely reduce the
number of malpractice lawsuits simply by reducing the number of
medical injuries. In 1999, the Institute of Medicine (IOM)
reported that preventable medical errors kill as many as 100,000
people a year--and cause a tremendous number of lawsuits. The
IOM recommended a national mandatory public error-reporting
system, along with stronger requirements that doctors regularly
upgrade their skills as a condition of maintaining their
licenses. Error reporting would allow better data-mining that,
in turn, would help the health-care industry combat mistakes
more systematically by detecting problem areas and suggesting
remedies. Research has already shown that surgeons who do a
large volume of high-risk procedures such as bypass or delicate
spine surgery make the fewest mistakes, since practice makes
perfect. That's why the IOM also has recommended that such
procedures be restricted only to experienced doctors at
high-volume specialty facilities rather than letting any
neurosurgeon in
Wheeling
,
W. Va.
, try his hand at it now and then.
Yet striking doctors aren't advocating any of these
proposals: Their organizational lobbyists have indeed vigorously
fought such measures, even simple protocols such as marking
surgical sites with a pen to avoid, say, amputating the wrong
foot, as did a doctor in Florida in 1995. These days, the only
solution that doctors seem to offer for any of the nation's
myriad health care problems is limiting the patients' right to
sue. And the Bush administration is just fine with that.
|
