

A spectacular failure of a state medical board - tokenadult
http://scienceblogs.com/insolence/2013/09/20/patients-endangered-by-failure-of-medical-boards/

======
fsckin
The $250,000 limit on medical malpractice suits in Texas is bullshit.
Protecting doctors from frivolous lawsuits is fantastic in theory, but if make
a grave mistake, you should be held accountable. 'License to Kill' isn't that
far from the truth. It's expensive, but you can literately kill people and get
away with it.

Here's my story:

We saw two doctors in Texas, both were convinced that my wife had advanced
bowel cancer. The second doctor confirming the diagnosis was the Worst Day in
my life.

We had no idea the doctors had colluded behind our backs, negating the
exercise of getting a 'second unbiased opinion'. We had gone to a separate
chain of hospitals and got the first diagnosis regurgitated to us.

She went in for a laparoscopic bowel resection surgery and woke up with:

* A nasty scar from pelvis to belly button

* Temporary ileostomy bag (her worst nightmare, requiring another surgery to remove, more nasty scarring)

* Hysterectomy (Sterilized, no kids yet)

* News that the previous diagnosis of cancer was incorrect.

* New diagnosis: Endometriosis (Can be treated without surgery in most cases)

The doctor was practically in tears when he broke the news to me.

The doctor was paid $60,000. The anesthesiologist and hospital split the rest,
and our insurance paid in excess of $150,000 for the first surgery that wasn't
medically necessary. The ileostomy reversal was performed in another state and
cost another $40,000. Insurance is still paying for emergency room visits a
few times a year.

We eventually consulted with several lawyers, and none would take the case,
even the scummiest bastard I've ever met who would probably take candy from a
baby if given a chance to do so. They all came to the same conclusion:

"There is no question that you have been severely and permanently wronged. Due
to complications, you will need regular emergency medical attention for the
rest of your life. If we took this case to court, we would win it every time.
Unfortunately, it is not worth it to us due to the $250,000 limit. There is
zero chance they will settle, there is no incentive for them to do so. A trial
will be long, drawn out, and eventually, you could owe us more than the jury
awards."

Thanks, Republicans.

~~~
mikeyouse
Tort Reform (essentially limited liability) is in direct conflict with the
only corrective mechanism in the 'free market'. I've never understood why
republicans support it so earnestly.

~~~
masklinn
Because republicans only care about free market for the votes and the ability
to destroy governmental processes and rollback social progress it gives them.

They're as plutocratic as the democrats if not more so, and they're even more
shameless about it.

~~~
derleth
If you look at the evidence, especially the Gini coefficient, Republicans are
a lot more plutocratic than Democrats:
[http://www.zompist.com/liberalism.html](http://www.zompist.com/liberalism.html)

~~~
talmand
You know, it's sad to see a well-thought out and researched document that
makes many excellent points be totally ruined by a never-ending series of
rants and name-calling against the opposition that also predictably ignores a
few inconvenient facts.

I was dissecting the problems but it was turning into a wall of text. I'll sum
it up easily enough in a smaller wall of text:

Since the 1930s:

\- All bad things that have happened are because of the evil Republicans going
out of their way to screw the little guy. After all, Republicans never do good
and only make mistakes.

\- All good things that have happened are because of the courageous and
saintly Democrats cleaning up the messes of the Republicans. After all,
Democrats always do good and never make mistakes.

\- If a Republican President spends an incredible amount of money to win a
war, it was bad. If a Democrat President spends an incredible amount of money
to win a war, it was good. Never mind the fact that Congress spends the money,
not the President who only presents a wish-list.

\- If something bad happens: Republican is President means mention it,
Democrat is President means ignore it. Republicans control Congress means
mention it, Democrats control Congress means ignore it. If something good
happens: swap first set of rules.

\- If something bad happens: Republican President and Democrat Congress, blame
President. Democrat President and Republican Congress, blame Congress.
Republican President and Republican Congress, blame Republicans. Democrat
President and Democrat Congress, blame Republicans. If something good happens:
swap first set of rules.

For the problems we see in today's world created by government, I blame the
Republicans and Democrats involved. For the good things created by government,
I credit the Republicans and Democrats involved. Only a fool goes with the us-
vs-them mentality.

------
tokenadult
It looks like this doctor hires one of those reputation management firms, as
most Google search results from searching his name are just medical
directories that don't point to any of his surgical mistakes or the belated
regulatory sanctions he has recently encountered. It's remarkable how well
quacks can protect their reputations online even after patients die.

AFTER EDIT: As suggested by another comment in this thread, if you'd like to
learn all the gory details of this quack surgeon's career, see the original
Texas Observer reporting on him,

[http://www.texasobserver.org/anatomy-
tragedy/](http://www.texasobserver.org/anatomy-tragedy/)

which ought to rank higher in a Google search on his name than it does.

~~~
Echo117
That link currently ranks at #4 for me in a Google search of Christopher
Duntsch, no quotes.

------
coldcode
Yet another reason to avoid Texas. Sadly I live here. I think our politicians
probably go elsewhere for medical care.

~~~
npsimons
This is why every time someone here says "hey, move to Texas, it's better!" I
just have to shake my head. Sure, nowhere is perfect, but between the school
boards in Texas and the medical board, plus the unconstitutional laws still on
the books against electing atheists, I just can't see myself living there.
Yes, I know Austin is a tech mecca of the midwest, but there's a cultural
problem in the whole state that stories like these point to.

~~~
angersock
"unconstitutional laws still on the books against electing atheists"

Point to any recent cases where that's been used to actually prevent an
election. Every state has stupid laws on the books, seldom enforced.

As for the school and medical boards, while there are some mistakes that get
made, coverage like this makes it more likely, not less, that things will get
fixed.

"cultural problem in the whole state" is painting in really, really broad
strokes, and inaccurate ones at that.

~~~
npsimons
_Point to any recent cases where that 's been used to actually prevent an
election. Every state has stupid laws on the books, seldom enforced._

And yet Texas is one of a dozen states out of 50 that still have a law banning
atheists from office; sure it's not enforced, but it sends a message: atheists
aren't welcome here.

 _As for the school and medical boards, while there are some mistakes that get
made, coverage like this makes it more likely, not less, that things will get
fixed.

"cultural problem in the whole state" is painting in really, really broad
strokes, and inaccurate ones at that._

So you get some school boards that mess up every once in a while in every
state; medical boards too. You don't see it happening, though, again and
again, as in Texas. Oh, and I completely forgot about things like the death
penalty and shutting down of Planned Parenthood and abortion clinics. Need I
go on?

I'm sure there are plenty of nice people who live in Texas; I'm just not too
keen on joining them until they sort some things out.

~~~
angersock
_" And yet Texas is one of a dozen states out of 50 that still have a law
banning atheists from office; sure it's not enforced, but it sends a message:
atheists aren't welcome here."_

It's things like this that give atheists such a bad name: willfully taking
offense at something that is clearly just vestigial legislation.

Much as I enjoy seeing our legislature inaction, I prefer they don't waste
precious cycles on updating such clearly antiquated codes until they become an
issue, for real, in practice.

As for the others, you probably just haven't _heard_ of them yet. Terrifying,
no?

------
wging
I recommend reading the source article for this blog post, instead. It's well-
written and far more detailed.

------
w1ntermute
I'm sure Texans are happy to allow the free market to sort this problem out.

~~~
jerf
That doesn't sound like an unregulated system.

That sounds like a system where the regulation didn't work.

One of the reasons I'm much less gung-ho about regulation as the answer to
everything is that I acknowledge that case exists, and must be considered
carefully rather than unconsciously assumed away. Regrettably, this
complicates things compared to a world in which we could just assume the
problem away, but we don't live in that world.

Those who could have stopped it had their ability to do so regulated away:
_The board’s mandate, spelled out in the Medical Practice Act, recognizes a
doctor’s license as a hard-won, valuable credential. Doctors’ rights are to be
protected at every step of the process. The board can’t revoke a license
without overwhelming evidence, and investigations can take months, with months
or years of costly hearings dragging on afterward._ (Quote is trimmed a bit; a
justification follows, but is a prime example of how regulation failed to
consider an edge case and then made damned sure everybody else was obligated
to fail to consider it as well.)

~~~
masklinn
> That doesn't sound like an unregulated system.

> That sounds like a system where the regulation didn't work.

No, it's a system where all regulatory authority and ability has been
willfully destroyed over the last decade.

[http://www.texasobserver.org/anatomy-
tragedy/](http://www.texasobserver.org/anatomy-tragedy/)

> But in the past 10 years, a series of conservative reforms have severely
> limited patients’ options for holding doctors and hospitals accountable for
> bad care. In 2003, the Republican-dominated Texas Legislature capped pain-
> and-suffering damages in medical malpractice lawsuits at $250,000. Even if a
> plaintiff wins the maximum award, after you pay your lawyer and your experts
> and go through, potentially, years of trial, not much is left.

> The Legislature has also made suing hospitals difficult. Texas law states­
> that hospitals are liable for damages caused by doctors in their facilities
> only if the plaintiff can prove that the hospital acted with “malice”—that
> is, the hospital knew of extreme risk and ignored it—in credentialing a
> doctor. But the Legislature hindered plaintiffs’ cases even more by allowing
> hospitals to, in most cases, keep credentialing information confidential. In
> effect, plaintiffs have to prove a very tough case without access to the
> necessary hospital records. This is an almost impossible standard to meet,
> and it has left hospitals immune to the actions of whatever doctors they
> bring on. Hospitals can get all of the benefit of an expensive surgeon
> practicing in their facility and little of the exposure. This has freed
> hospitals from the fear of litigation, but it’s also removed the financial
> motivation for policing their own physicians.

> The medical malpractice cap and the near-immunity for hospitals snapped two
> threads from the regulatory web. What remained was the Texas Medical Board.

> But the Medical Board wasn’t designed to be an aggressive enforcer. It was
> mostly designed to monitor doctors’ licenses and make sure the state’s
> medical practitioners are keeping up with professional standards. The
> board’s mandate, spelled out in the Medical Practice Act, recognizes a
> doctor’s license as a hard-won, valuable credential. Doctors’ rights are to
> be protected at every step of the process. The board can’t revoke a license
> without overwhelming evidence, and investigations can take months, with
> months or years of costly hearings dragging on afterward. The protections
> make some sense. The Legislature doesn’t want the Medical Board taking a
> doctor’s license—and livelihood—unnecessarily or based on flimsy or
> frivolous claims. But the result is that unless a doctor is caught dealing
> drugs or sexually assaulting patients—or is convicted of a felony—it is
> difficult to get his or her license revoked.

> What all this means is that the Texas Legislature has committed the state to
> a policy of medical deregulation—a free-market system in which doctors can
> practice as they please with limited government interference. Only their
> consciences, and those of their fellow doctors, limit them.

~~~
dec0dedab0de
That sounds like regulation is working, just in favor of the doctors over the
patients.

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rickmatt
Okay, who else correctly guessed the state?

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mtdewcmu
> With the exception of pain management clinics and anesthesiologists, the
> board doesn’t have the authority to inspect a doctor, or to start an
> investigation on its own.

Somebody's watching the medicine cabinet; they forgot about the knife drawer.

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Buttons840
Are there any resources for investigating doctors? Is there no ways for
patients to save themselves from the next Hannibal Lecter?

------
auctiontheory
One of my favorite words: iatrogenic.

