Friday, November 12, 2010

Physicians and Surgeons: You're Guilty Until Proven Innocent

The title may sound an exaggeration, or an attempt to attract the attention.  Unfortunately, it is 100% accurate, if you see how the consequences of being guilty will be suffered from early on.  Let's say you are an excellent doctor.  Let's say your patients love you.  Let's say you have great bedside manners.  Let's say you keep yourself well-informed of new medical literature.  Let's say you treat your patients as if they were your own family.  Let's say your results are better than your peers.  Then something happens.  Somehow, a peer review is initiated against you.  While you ponder what's happening, and you start putting a lot of hours and effort to respond to the allegations, the powers decide that, allegedly because of "concerns", and to protect the patients from you, you are placed on suspension.  Believe it or not, you will, from now on, suffer the consequences as if you were actually "guilty", even though it is all unproven. Here is how it works.  The hospital has to report to the National Practitioner Data Band (NPDB) that you are suspended, and such a report should be filed within thirty days (in California, only 15 days and electronic filing is being implemented).  Hold on, what are we reporting here?  The doctor has not been proven guilty of anything.  It gets worse, and still the physician is not proven to deserve any restriction of their practice.  An investigation by the hospital may be initiated, and may take for ever, while the physician is unable to earn a living, being on suspension.  The doctor cannot work elsewhere either, because the NPDB report effectively made the physician not employable.  Bad .. eh?  It gets even worse.  There is no high-standard "due process".  The entire process is allowed to be driven and directed by the very people who are being hostile to the doctor.  The peer review process may very well end with a verdict that revokes the doctor's privileges in that hospital, which is the death sentence to the physician's career.  Throughout the process, the doctor has been enduring the consequences of being guilty (losing ability to practice medicine, having a negative report to the NPDB, being unable to find a job, being labeled as incompetent) before any fair process has ever started.  For many physicians, the process will never be fair, since the laws are extremely biased against the physicians, and will be completed with the definitive destruction of the career.  Even though the title says "You're guilty until proven innocent", it is quite possible that you'll never be able to clear your name with the current state of affairs.  If you can afford litigation, that is probably your only chance to defend your reputation. 
Those who aspire to be physicians need to know those very true facts about practicing medicine in the USA. You will be under the mercy of others.  You may be lucky to practice in a good environment.  Or, you may be not ......

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