Proud members of the Vast Right Wing Conspiracy. We strongly believe in personal freedom, responsibility, and gun rights. We also believe in the 90/10 theory. That means that 10% of the people have 90% of the talent. Unfortunately, we are not in the 10% category. However, the rest of us are still better than 90% of the politicians.

Wednesday, July 4, 2012

Medical costs

If you've been reading this blog for long you're fully aware that I have a very long list of patients who don't follow their doctor's advice.  This is not unusual, no matter the type of practice.  As a matter of fact, it's my bet that quite a few of the rugged individualists who read blogs like this one are non-compliant.  It's built in to that personality type.  Of course, there is a difference between simply fudging a little to suit your lifestyle and out-and-out stupidity.

This guy was not smart.  That's a given.  Seeing a doctor for high blood pressure, shortness of breath and an irregular heartbeat and not following his advice doesn't come anywhere close to smart on the meter.

 after examining Mr. Martinez, Dr. Gangasani recommended follow-up cardiac testing, and he offered Mr. Martinez an appointment for the next day to have the testing performed. Mr. Martinez refused, and instead he scheduled the testing to take place one week later. Dr. Gangasani also specifically told Mr. Martinez not to engage in any strenuous activity

That's fine, it is always the patient's choice.  So putting off getting his heart that was acting up checked out until the day after his date to have a three-way with a buddy and a woman not his wife, must have priorities.

Perhaps he didn't regard it as strenuous activity.  Nonetheless, he died of a heart attack during the action.

Now that would be just a sad story, but his widow sued the doctor for negligence.  And won.  3 million dollars, knocked down from 5 million because the jury decided that Mr. Martinez was partially responsible for his own behavior and health.

Partially responsible.  And yet what could the doctor have done?  He offered earlier testing and gave proper advice.  Mr. Martinez would have survived to get the testing had he scheduled it for the next day as his doctor suggested and paid attention to the stricture on physical activity.

I've often had to say to a patient that they could put off testing (or being admitted, or go home), but I don't think it a good idea.  My job is to offer the best advice I can for their situation, however, the choice is theirs.  I don't have the power or authority to hold them prisoner for their own good and I don't want it.

No matter, another court decision like this one won't make a huge difference, but all of us in this country who pay for malpractice insurance, medical care, or medical insurance will take another hit because a jury didn't think a man with a long history of non-compliance (something that surely contributed to his poor condition) should be regarded as responsible for the consequences of his decisions.

That's life, and death, in a land that's been trained to blame the guy who might have some money.

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