After more than a year of conspiratorial planning that would make Francis Underwood proud, California’s trial attorneys got a number assigned to an opaquely worded ballot initiative on Drug and Alcohol Testing of Doctors. Medical Negligence Lawsuits Initiative Statute. As a result, “Proposition 46” could give California voters an unwitting hand in doing what this attorney group has been unable to accomplish after 40 years of inept legislative lobbying and dubious court challenges: undermine the state’s Medical Injury and Compensation Reform Act, or MICRA.
MICRA was passed in 1978 by a Democratic-dominated legislature and signed into law by then-governor Jerry Brown in response to the collapse of the state’s medical professional liability insurance market. MICRA didn’t change the right of injured patients to obtain unlimited economic damages for all medical costs, lost wages and lifetime earnings. What it did was limit was non-economic “pain and suffering” damages to $250,000. Up until 1978, California’s trial attorneys had used this highly speculative class of damages to rake in a third of the multi-million jackpot jury awards. That made California physicians’ malpractice insurance unavailable at any price, leading many doctors to close their practices and leave the state.
That ended with the passage of MICRA. The market stabilized and in the decades that followed, billions in health care savings from lower professional liability costs were passed through to California’s patients.
Early last year, California’s physicians had heard rumors that a ballot initiative to undo MICRA’s non-economic cap was being planned. Little did they know that California’s trial attorneys would take their cue from political consultant-bully Chris Lehane by opening their campaign with a mass mailing of anti-MICRA cadaver toe tags. That was quickly followed by the neighbors of pediatrician and then California Medical Association President Paul Phinney receiving deceptive postcards implying he was a drug dealer.
Months later, the ballot initiative – that was 100% underwritten by the trial attorneys and their allies at a cost of $2.85 per signature – landed on California Attorney General Kamala Harris’ desk. The initiative’s authors cleverly disguised its quadrupling of the MICRA cap to more than $1 million (“to account for inflation”) and cynically camouflaged it between two conversation-changers: 1) mandatory physician drug screening and 2) mandatory uploading of the narcotic prescription history of every California patient to an online database. Naturally, Ms. Harris rewarded her trial attorney donors by making a mockery of the state’s single-subject rule and okayed it.
Even Breaking Bad’s Saul Goodman would blush at this cynicism. California’s legal community has been at the forefront of employer-related tort claims over abusive employment drug screening and, until the initiative was filed, was conspicuously silent on the subject of drug testing for doctors. In addition, concern over the threats to patient privacy had previously led the trial attorneys to oppose implementation of clunky and defective databases like CURES. When these tenets became inconvenient, both were thrown under the inconvenient-fact bus when a trial attorney operative confessed to the LA Times that poll testing showed that the two drug provisions were “sweeteners” to get the Proposition’s anti-MICRA provision to pass.
Unfortunately, Proposition 46 is another sad example of a deep-pocketed special interest hijacking a well-meaning ballot initiative process. While the trial attorneys would have us believe that MICRA prevents Californians from litigating their way to perfect patient safety, their true intent is clearly aimed at getting a place at the trough of what Proposition’s summary describes as “increased health care costs ranging in the low tens of millions to hundreds of millions of dollars annually.”
While readers of The Health Care Blog may think this is an interesting political battle in a corner of the country that deals with a small slice of health policy, every person reading this should be aware that if MICRA’s non-economic provisions are compromised, the likelihood of tort reform in every state will be rocked back on its heels. Increased professional liability insurance costs from increased numbers of suits combined with larger awards would be ultimately passed thru to the health care consumer just when health reform is getting off the ground.
California Doctor is a California Doctor. Due to his prominent position and potential issues facing his employer should his identity to be revealed, he has asked to remain anonymous.
Categories: Uncategorized
Whew…some sanity injected here. Thank you. And what about the inevitable false positives? Q: do we not call it the ‘Joint Commissin’ now?
I regret that I didn’t come upon this post and thread (much too long and detailed for me to read thoroughly) before I voted. Today is Election Day. I am very impressed by how articulate and clear you are in your writing, especially in your replies. Thank you for taking a stand. The best to you. Anne
Re-positioning this old post is a transparent click-bait ploy timed to election day.
That’s how it goes. My best!
No on 46. That was my mailed-in vote.
“ambulance-chasing hack that you are”
Copy that.
YES on Prop 46 will make the Dr. slow down and spend more time on the patient. Prop 46 will hold the Dr.. accountable when they’re careless. Prop 46 will require doctors.to be drug/alcohol tested, ensuring our safety. The days of the 5 minute appointment, tossing out a plethora of prescriptions without proper diagnosis is coming to an end!! The days of marginalizing our loved ones is ..coming to an END. Finally, this white coat, God like complex and arrogance is coming to an END! I look forward to this becoming a law! * I am a parent who lost his 24 year old daughter, a new mother of just 4 months to a local doctor who carelessly gave her 2 medication that put her to sleep permanently and you want me to be accepting? Not so much! This health and safety initiative reaches into each of our homes, providing that very necessary added layer of security for our families. For those thinking this is about the attorney’s…..Keep in mind that this is the only door open to you when you seek justice and want to hold a Dr. accountable.
The only door!! ~ In fact, the moment you learn of a death from a patient of yours, you contact your attorney, circling the wagons, while we are in shock. Don’t even go there with me. YES on 46 ~
BTW…nice canned speech you cut and pasted on this blog…right off your own website. How impressive that you also have a real estate license.
Sell out, ambulance-chasing hack that you are. And to think I almost went to Lafayette College myself…
Congratulations. You are a true credit to your (former) profession by using your legal degree to stab them in the back! May you have to rely on the skills and competence of those you seek to destroy some day…and wind up with a poor outcome.
Vote “NO” on Prop 46!!
Esquire…(since your last set of comments fly in the face of you being empathetic to the overwhelming majority of *good* doctors)
To you, I have only this to impart:
“Logic clearly dictates that the needs of the many outweigh the needs of the few… Or the one. ”
So we should ALL, as a profession, suffer for the missteps and botched cases of the few by choking on a 4-fold increase in premiums? (rhetorical)
Witch hunt!!!
Eric…
Get a grip. You obviously have a HUGE ax to grind and want to paint ALL doctors out to be demons. I’m guessing you don’t have a job…based upon the extensive amount of time and research you pour into your posts. You are exceedingly based in emotionality, and are clearly on a crusade to bring your loved one(s) some form of justice that they will never feel or profit from. You are that ONE guy on YELP who wants to trash the reputation of a restaurant for making “the worst meatball sandwich ever”. Yes…it sounds like your life has been touched by a few bad outcomes. And you are right to cop to the fact that you’re NOT an attorney. For if you were, you would know definitively that a bad result in medicine does not always equate to doctor incompetence or “malpractice”….for there are myriad reasons for poor outcomes…not the least of which are patient non-compliance and the variable responses that real live human tissues are capable of. But because you’ve suffered the loss of a loved one…or happen to know others who have also been affected by a poor outcome, we should ALL be penalized, right? (rhetorical) For those of us that are doing right by our patients, we empathize with your personal connection to these tragedies…but still RESENT some of the implications that you are making, and the misplaced universal aggression towards medical professionals in general. I’m hoping that you never become a judge…to be painting in such broad strokes so as to assassinate and sully the integrity and reputations of those of us who have dedicated our lives to the healing of others. Had I known that one day, doctors would be SO easily vilified by people like you, I might have stuck with that garage band back in the day rather than go into suffocating debt obtaining my medical degree! Peace out, Sparky…
As a medical malpractice attorney AND physician, I found it difficult to read most of this thread without rolling my eyes… there is so much rhetoric and drama from both sides, it’s really a very simple issue when boiled down.
Physicians are not held to a standard of perfection or even to the standard of being the best or even almost the best in their field… They are held to the standard of care for their community and peers. The California legislature has made the legal procedures and rules for medical malpractice cases different from other areas, and done so with a purpose – that purpose being protection of doctors… and while there are many who see protecting doctors as a bad thing, it is not in and of itself really so… some doctors should be protected while others should not get the extra legal shield afforded by the law. Physicians provide an extremely valuable services to the public and one that requires an enormous amount of skill and brain power to provide correctly – all in a field which is not black and white science but science and art combined – lives are at stake, opinions vary, advancements in science abound, no two patients are alike, etc. In addition, medical malpractice cases are extremely expensive and difficult to bring (properly, that is… anyone can slam together an unintelligible complaint and pay the filing fee). To make a suit “worth it,” there needs to be significant damages – and damages that would not have occurred otherwise. As a generalized example, a one month delay in treatment, that is just as effective one month later as it would have been earlier is not going to provide significant damages.
The current law makes bringing frivolous or even low dollar suits economically destructive for an attorney… as it stands now, those of us who know what we are doing will only take the high dollar cases… the hard costs of suit are enormous (as medical experts now regularly charge upwards of $800 an hour for testimony).
One other thing to consider as well is that MICRA is absolutely discriminatory in its effect… the limit on pain and suffering of $250,000 is very often the limit of the entire case when it comes to the elderly and more often than it should be when it comes to women and minorities… Punitive damages?There are no punitive damages in medical malpractice cases… Lost wages? People over 65 are retired and women and minorities earn less than white males. Medical Costs? People over 65 have MediCare so there is none, and people on MediCal have none either. People, think before you vote. This law hurts the elderly and women and minorities and the poor… the very people who seem to NOT get the best medical care in the first place.
As for people who figure this is someone else’s problem… I hate to remind people that the victims of medical malpractice never thought they would be victims before they were… they were plain old people who trusted doctors and such prior to their “incident” (as defense counsel like to callously call it). Their lives are ruined and they deserve fair compensation… since medical injury cannot be undone, all the courts can offer is money.
– Paul
Paul J. Molinaro, M.D., J.D.
Attorney at Law, Physician
http://www.888MDJDLAW.com
nn9NdZ http://www.QS3PE5ZGdxC9IoVKTAPT2DBYpPkMKqfz.com
It seems that there has been no cost of living adjustment on the 250k since 1978which is ludicrous! The caps must increase to present value. There needs to be motivation for bad docs to get out of practice and let the hood ones care for us. No attorney will work on a contingency basis on a loser case aka a frivilous case. There is too much blood, sweat and tears in the practice of law to waste resources.
You sir have no idea what you’re talking about. You do not know your ass from your elbow when it comes to physicians.
Lets put video in the jury room and then all you Einsteins can see what complete bologna all these arguments are.
Unfortunately, JAD, unlike the criminal justice system, doctors seem to be judged guilty until proven innocent just by virtue of being sued.
Really, if we want to improve patient safety and weed out plain bad doctors, or re-educate doctors who need it, the current tort system is not working.
wow quite an interesting dialogue. I have a unique interest in “defensive medicine”, a topic I believe is at the forefront of this issue. I have a particular beef with the article cited about that “PROVED that doctors don’t do more tests in fear of lawsuits!”
http://www.aboutlawsuits.com/unneeded-tests-not-due-lawsuits-48389/
Full disclosure, I am deeply invested in patient safety and am a member of our hospital’s safety committee, but I am opposed to prop 46 for multiple reasons, foremost of which is increased costs to the already incredible expensive health care system. I have thoroughly read both the original language of the proposition and the independent analysis of financial costs and the results are alarming. While the review shows potential savings in some areas, the overall costs will increase in the scale of hundreds of millions each and every year.
Mr. Andrist, after reading your previous commentaries above, while you are clealy quite passionate about this issue and have no problems making personal attacks on individuals who are engaging in an otherwise interesting debate, I see you have no formal medical education, no health care education, no legal education, are not familiar with any of the many regulatory agencies overseeing hospitals, and have a goal to sue hospitals and doctors as quickly as possible. None the less, I will try and explain why the article you posted that you claim “PROVED” doctors don’t do more tests due to fear of lawsuits is biased, weak, and contrary to much better and larger studies that show quite the opposite.
1. First off, it is widely accepted by practitioners, researchers, and our government that we have a huge problem with doctors ordering too many tests in fear of being sued- what we call “defensive medicine.” Large, powerful studies by many institutions have showed this relationship. More on this later.
2. It is generally not academic to quote a second hand source of a research study as your rationale for supporting or rejecting the study. This article is, after all, is the opinion of the person who wrote the article, Irvin Jackson in this case, not the authors of the original study.
3. Even with this in mind, the article is incredible narrow in scope: it compared a single VA center to other non-government centers doing a single test-myocardial perfusion imaging in this case. This is one study, in one center out of thousands of studies and hundreds to thousands of centers across the country. Hardly a powerful study as the n value is 1.
3. Also, look at the site it is posted on-“AboutLawsuits.com; News and Information about Personal Injury Lawsuits.” Could it be that this study was cherry picked to prove a point? There is so much data available on the internet, you can find a “study” proving dang near anything if you look hard enough. The skill is interpretation and analysis of each study, a practice we as physicians must employ in every day practice to ensure the best treatment for our patients.
4. Here is an example of citing original research as i mentioned in #2-in this study, a large group of orthopedic surgeons were surveyed and their practice habits analyzed and the “defensive medicine” costs quantified-
http://www.amjorthopedics.com/fileadmin/qhi_archive/ArticlePDF/AJO/041020069.pdf
This was subsequently published in a large orthopedic surgery journal and is just one of many, many such studies. To play the other side of the issue, here is analysis of survey data from my collection that is from a group not keen on tort reform, yet the results are the same: higher costs associated with fear of lawsuits
http://www.jacksonhealthcare.com/media/8968/defensivemedicine_ebook_final.pdf
In conclusion, the only thing your article you article “PROVED” is that there exists some incredibly small and weakly powered study that maybe shows that the trend in ordering of one very specific cardiac tests does not differ between government and non-government based facilities, but we don’t actually have the study to verify or critique.
What has been shown for years is that defensive medicine plays an enormous role in the costs of medicine and, most unfortunately, rarely benefits the patient. I have mixed feelings on tort reform, but what I try and demonstrate is that increasing the speculative damage cap on MICRA will invariably increase lawsuits (yourself an example) ,increase payouts (obviously), and will increase the practice of “defensive medicine”, which in turn, based on powerful data already published, will increase health care costs.
I practice defensive medicine every day. I know it costs everyone more as my patients are almost entirely Medical/Medicare, but I fear going to court like the plague. I haven’t been sued yet, but it is shown that around 75% of cases go in favor of the physician, but what they don’t tell you is when a physician gets sued, they always lose. Even if I win, am I compensated for lost time, lost productivity, legal fees endured, or are my patients better off for having to see me at a later time because I am in court/with attorneys for weeks? At my institution, defensive medicine it is so common we call it “CYA” medicine-cover your rear end medicine.
Thanks for reading!
I still do not have “competent medical care for Severe Obstructive Sleep Apnea” that “I” had to diagnose on my own because EVERY DOCTOR I WAS SEEN BY WROTE FALSE OR INCOMPETENT MEDICAL RECORDS and were unable to write 3 “classic symptoms” for this illness and now after over 14 years of no medical care and no oxygen to brain the STATE WILL BE PAYING THE BILL FOR MY CARE AT A NURSING HOME BECAUSE DOCTORS ONLY CARE ABOUT LIABILITY NOT ABOUT WRITING CORRECT FULL MEDICAL RECORDS. I learned this from gossip that Kaiser nurses informed my pharmacist father and largest salesman for Eli Lilly in Los Angeles, Ventura , Riverside counties in the 60’s & 70’s and after his heart attack he would not be taken to a hospital because he was afraid they would KILL HIM FROM MISTAKES.
Until the law is changed in California the doctors will continue to “omit” all complications as my surgeon Dr. Paul Nottingham, Walnut Creek omitted when he messed my disk surgery and damaged a major nerve coming from my spine. Contra Costa county was forced to file SSD for me because I was never able to return to work. Cost to Federal gov. along with OxyContin Rx and loss of taxes for a woman at age 42. Major complications unable to move or feel my leg and surgery became over 8 hours when it was to be only 4 hrs. unable to use my left leg for six month. None of these complications or what ACTUALLY TOOK PLACE AT THE SURGERY OR HOSPITAL WAS EVER WRITTEN TO ANY MEDICAL FILE. THEN I LEARNED HE DAMAGED MY THROAT AS WELL WHICH CAUSED THE THROAT MUSCLE TO EVENTUALY COLLAPSE WHEN I SLEPT. I CANNOT GET MY MEDICAL RECORDS FROM A SINGLE DOCTOR THAT I HAVE BEEN SEEN AND INCORRECTLY BEEN TREATED SINCE I HAD TO REQUEST A SLEEP TEST WHICH CORRECTLY DIAGNOSED THE ILLNESS AND DAMAGE TO MY THROAT.
I NOW VOICE RECORD ALL MY MEDICAL VISITS AND SENT TREATMENT CONFIRMATION LETTERS BECAUSE DOCTORS FAIL TO WRITE CORRECT FULL ACCURATE MEDICAL RECORDS SO THEY CAN PROTECT THEMSELVES FROM COMPLAINTS OR ACTIONS BY MEDICAL BOARD. CALIFORNIA MEDICAL BOARD IS A JOKE! I will be now dying in from of their office in Sacramento to show all who receive incompetent medical care that is mal-practice and every doctor should be punished for failing to write correct medical symptoms and what a patient “truly discusses”. Looking for False Claim lawyer. My pain management doctor, Integrated Pain Management, Walnut Creek refuses to provide my medical records since I discovered they are all false as they wrote I was receiving CPAP medical care and writing 360 tablets of 80 mg. OxyContin when the truth was I had not been able to find a sleep specialist or received any CPAP yet. Then the Bi-pap that was ordered by Dr. Karin Cheung of Walnut Creek failed to help and she failed to write a correct medical record by refusing to immediately retest after 90 days of absolutely no improvement and getting worse. Violated my HIPPA writes and sent my entire incorrect medical file to the PCP who I fired for incompetence and she was delivered by hand letter of “firing of my PCP for failing to discuss my sleep tests or refer to a specialists after no test was ever put into my medical file. Doctor protect each other so no bad doctors are removed from the profession. I now refuse to trust a single doctor and nicely inform them I will be voice recording to provide a copy to the medical board as the board never bothered to investigate ANY of my documentation of certified signed receipt letters or faxes to my doctors about all the errors I was having to correct regarding wrong med info my to Medicare Rx insurance company and failing to provide billings to me for charges they had made. I was forced to write FOIA to get true charges these incompetent medical doctors had charged to Medicare for NO SERVICES RECEIVED and false med record written that they will not release to me or amend on every page per California law . Now my pain management doctor is afraid I will DROP DEAD AT NIGHT BECAUSE I STILL HAVE NOT FOUND COMPETENT SLEEP SPECIALIST AS AN ENT THAT WAS CONSULTED INFORMED ME ONLY A TRACHEOTOMY SURGERY WOULD HELP BECAUSE OF ALL THE PROBLEMS HE FOUND. HE WAS SENT A SURGERY CONFIRMATION LETTER AND DID NOT RESPOND WITH ANY CONTRADICTIONS. When I returned to have him perform the surgery he didn’t remember who I was, what he had diagnosed , what exam he had performed and had no medical file. He threw away my three sleep studies that he consulted and also did not any record of my office visit. Then he tries to sell me a dental appliance when we previously had agreed my TMJ was an extreme problem and my flat palate prevented any kind of surgery. We even discussed previously medical journal reports I had printed and discussed when bi-pap had completely failed. Then off the top of his head he recommends turbinate surgery WITHOUT FIXING THE DEVIATED SEPTUM HE DISCOVERED I HAD BUT HE FAILED TO WRITE A MEDICAL FILE SO HE DIDN’T REMEMBER ANYTHING. These kind of doctors have no business in the medical profession. Dr. Sassan Falsafi is disreputable and thank God for social media where at least harmed patients can publish the incompetent harmful medical care they received so they will not care for another patient because the California Medical Board is a JOKE. I had voice recordings and documentation regarding what my true medical records should be and they NEVER bothered to read and did not bother to contact me to get. I told them I was severely disabled and would be sending them but they don’t want any doctor to be punished. THOU SHALT NOT SPEAK ILL OF ANOTHER DOCTOR. Just try to correct the damage the incompetent doctor made. Gladly talk to any person about my case after 2 p.m. 925-787-5412
That couldn’t be FURTHER from the truth! Do you have no shame in not doing any research before you speak?
Lawyers won’t take 90% of the medi-mal cases because they don’t make any money for them! Further, most medi-mal cases are won by the doctors, which means that since the lawyers take the cases on a contingency basis, they would lose every cent they put into it if when the case is lost. So what lawyer is going to accept a case that’s not got great chances to begin with, and risk losing every dime they put into it? Cases cost anywhere between $100,000 and $1 million just in court costs!
So how in the WORLD could this be a money grab for lawyers, let alone rich ones?
Where is WHAT money going to come from? It’s coming from you now! A majority of the time when a victim of medical negligence can’t get a lawyer or loses their case, their health expenses, which are sometimes astronomical, become a burden to the state and the taxpayers! All because a doctor was negligent and a stupid 39-year-old law prevented them from getting to court and holding the doctor accountable! Do you realize how many people are now disabled and reliant upon your taxes because of negligent doctors and hospitals?? There are upwards of 440,000 deaths from medical error every year in this country, and an even higher number of people that are harmed. Do the math!
A recent study PROVED that doctors don’t do more tests in fear of lawsuits! Check it out: http://www.aboutlawsuits.com/unneeded-tests-not-due-lawsuits-48389/
What insurance company is going to pay for extraneous tests when they often won’t cover the cost of the tests in the first place? It’s a myth!
You think the lawyers are spending a lot of money on the campaign, take a look at the other side….they’re the ones running scared! The medical and insurance industries, which are rolling in the profits as it is, are planning on raising upwards of $80 MILLION to fight this proposition. Your NO vote not only means you’re approving of doctors being negligent, but also allowing the insurance companies to continue rolling in the profits! Less than 2% of their profits get paid out in lawsuit claims!
Sure, why not?! Make them richer on the backs of patients being harmed and killed. You could be next and then you’ll change your tune!
When you make this just about lawyers, you ignore all of us victims who have already been harmed by medical negligence. FOR SHAME!
Prop 46 is a MONEY grab for RICH lawyers. That’s all this is. Where is the money going to come from? ME AND MY FAMILY. And the other tax-paying californians. My doctor will order MORE AND MORE tests just so she doesn’t get sued. That is, if she doesn’t leave the state all together.
Think lawyers would have spent over TWO MILLION DOLLARS bringing this proposition to a vote if it weren’t to make them MILLIONS AND MILLIONS of MORE DOLLARS so they can buy a THIRD HOME in the hamptons or beverly hills?
Come on, they don’t care about us Californians. They want another Porsche and who better to get it from than us innocent taxpayers.
Ridiculous.
No surprise I guess that NO ONE trusts nor likes lawyers or politicians (usually one and the same anyways.)
And here’s my video debunking it all. http://youtu.be/dvZqXAsj7jY
Opponents to Proposition 46 have posted a video on YouTube that addresses many of the comments above:
http://youtu.be/nqyIP9NaLYg
@Eric
Good for you. When you’re done, why don’t you come to Colorado and see if you can pull off a hat trick?
Now, THERE’S science for ya.
I see your point Talos, but what’s even scarier is considering the 87 year old male dying of pneumonia is an adverse event. But I could see that happening in these situations.
I have concerns over:
What is an incident? a death? or just an unexplained/unexpected death?
5 doctors and how many ancillary personnel treated this patient?
What if a nurse forgot to push the antibiotics when ordered?
What if the &*()%$ EMR system didn’t tell someone they were supposed to push the antibiotic?
On another note, I love the fact that all these entities are pushing for med students, NPs and PAs to be out providing primary care but yet
“There’s no doctor shortage!”
And by the way, testing with a 5 panel drug screen may turn up some potheads (and yes, medical marijuana users, there’s a lawsuit now from a marijuana positive PA in New Mexico for wrongful termination),
and some cokeheads. But the real problem we’re seeing in Ohio and probably nationally is the oxycodone and hydrocodone that aren’t picked up on the 5 panel test. Seems to me if you’re going to test at all you might want to consider those.
I don’t think so. From the legal online dictionary:
or conj. either; in the alternative. It is often vital to distinguish between “or” and “and.” Example: Title to the Cadillac written “Mary or Bill Davidson” means either one could transfer the car, but if written “Mary and Bill Davidson,” both must sign to change title.
I don’t think so. I just posted this in our Facebook group (of victim/advocates) and only one out of 28 responders had heard of it.
Average person: no.
Average person on a healthcare blog discussing hospital safety:Yes
Average person on a healthcare blog discussing hospital safety and who is involved in an alleged hospital safety campaign and has a lawsuit against a hospital for the last 2 years: Most definitely.
Verdict: troll or droll.
Either way, I am done.
May justice be served.
“…hospitals shall conduct testing for drugs and alcohol on physicians as follows: (2) immediately upon the OCCURRENCE of an adverse event on physicians who were responsible for the care and treatment of the patient DURING THE EVENT or who treated the patient or prescribed medication for the patient within 24 hours prior to the event.”
In legal logic, “or” is inclusive, meaning that every group named has to be included in the testing. If “and” is used, it means that it is exclusive, that a group has to meet all the requirements to be tested. If we use your definition of “or”, you would see everyone pointing the finger at everyone else, so Prop 46 mandates testing of every provider involved, every time.
Seriously? You otherwise present yourself here as someone thoroughly versed in just how lethally bad the acute care space is, and what to do about it, but when you get challenged with respect to relevant particulars, NOW you are just some ordinary schmoe?
Glad I amuse you.
Why in the world would the average person know what the JCAHO is????
@Talos –
“You keep citing the 440,000 and yet you have not educated yourself on JCAHO.”
__
I found it priceless that he didn’t even know what JCAHO is. Who needs ANY sort of basic knowledge when you’re angry and aggrieved? His is the “just ’cause…” argument methodology.
It may very well be based on what a provider is expected to provide, but your assumption that doctors are going to give up their practice or move away because of Prop 46 is unrealistic. It’s the same type of propaganda that the California Medical Association is trying to swindle voters with and it’s not based in reality. We have other states that have banned their tort reform laws and the doctors didn’t pack up and leave in droves!
Thank you for your long presentation on the pneumonia patient, but unless I’m wrong, the only doctor that will be tested is the one accountable for the incident. So the physician that sees the patient, the radiologist, the replacement physician, etc., will not be tested unless they were directly involved with the incident that harmed the patient or killed them. If the ED Physician #1 killed the patient by giving them penicillin when the chart clearly reads that the patient is allergic to it, the radiologist is most certainly not going to be drug-tested!
If each and every one of those doctors was involved in the incident, why shouldn’t they all be drug tested???
The proposition clearly states: “…hospitals shall conduct testing for drugs and alcohol on physicians as follows: (2) immediately upon the OCCURRENCE of an adverse event on physicians who were responsible for the care and treatment of the patient DURING THE EVENT or who treated the patient or prescribed medication for the patient within 24 hours prior to the event.”
It doesn’t say AND, so it’s one or the other. If it’s clear how the patient was harmed, only the doctors involved in the incident itself will be drug tested. I assume if it’s unclear, they will all be tested, as well it should be to come to a clear conclusion as to who was responsible. Each doctor tested who tests positive should be relieved when they are excluded!
To answer your question about marijuana, Section 4, Article 14 of the Business and Professions Code states: (d) “drug” does not include drugs prescribed by a licensed third party for a specific medical condition if the manner in which the physician uses the drug is not known to cause impairment.”
I didn’t say the doctor shortage was bogus, don’t put words in my mouth. I said that passing Prop 46 would not lead to a doctor shortage.
I honestly don’t have time right now to educated myself on the JCAHO…I apologize. I barely have time to answer these posts and work on my social media campaign to get the word out on Prop 46. I’m also preparing for the first deposition in my sister’s medical negligence death case. She died over 2 years ago and I’m having to refresh my memory on a lot of documents.
I can assume, though, that the JCAHO is just as lax as the California Medical Board about issues such as this. A quick google search produced this…I did not read it, just the headline caught my attention: http://docsontheweb.blogspot.com/2008/04/how-to-be-annoying-and-useless.html
I apologize for not having the time to research all you’d like…normally I would. I will make note of these things and try to get to them. If you’d like to stay in touch, my email is stopmicra@gmail.com
If Prop 46 passes, I’m sure efforts will be under way to make drug testing national.
“Your scenario of 300 people not receiving any care is not based in any kind of reality.” Its 3,000 and its based on the average panel size of a primary care provider. This is the number that that a primary care provider is expected to provide care for (some a little, some a lot) over a year. If the doctor is not there, then care cannot be provided.
As to you only encountering one physician within the hospital, I would find that unusual in this current era of hospitalists, intensivisits, and the such. Let take a simple example of pneumonia presenting at the ED:
1. 87 yo male presents with pneumonia to ED. ED physician #1 sees the patient, starts the work-up, orders oxygen (considered a medication) and IV fluids. Sent to X-ray for films.
2. X-rays are done and read out by Radiologist #1, information and patient returns to the ED. 1 hour has passed.
3. ED physician #1 checks out patient to ED Physician #2 and goes home. ED Physician #2 evaluates x-rays, orders antibiotics, inhalers, and admits the patient.. 4 hours since admission.
4. In-house hospitalist #1 picks up the patient, does intake history, assesses patient, and writes orders for more medications to keep patient comfortable.
5. 8 hours later (13 hours total), In-house hospitalist #1 turns patient over to In-house hospitalist #2. In-house hospitalist #2 notes that patient is breathing a little worse, orders chest x-ray and increases the oxygen.
6. Chest x-ray is read by radiologist #2 and shows worsening pneumonia. In-house hospitalist #2 transfers patient to ICU and to intensivist #1.
7. Despite best efforts, patient’s condition continues to worsen, and intensivist #1 feels a chest tube is needed. The chest tube is placed and, unfortunately, the patient dies at that point, suffering an adverse event.
Right there is 5 doctors in less than a 24 hour period that will need to be tested to undergo alcohol and drug testing, and possibly 7 if you include the radiologists depending on the interpretation of the word “treated”. I would wonder how Prop 46 would treat a team of residents and their attending caring for a patient?
Just wondering–California has medical marijuana dispensaries, so if a provider has a prescription from a doctor for medical marijuana and tests positive for marijuana, are they impaired or just under treatment?
As to the California doctor shortage being bogus, I look forward to your explanation of why Gov. Brown thought it necessary to sign a bill on 7/18/2014 accelerating the development of doctors in the state “…On Friday, Gov. Jerry Brown (D) signed a bill (AB 1838) that will allow students enrolled in accredited medical school programs in California to become physicians in less than four years, the Sacramento Business Journal reports (Robertson, Sacramento Business Journal, 7/18)…In a release, Bonilla said the bill “is an innovative step towards addressing [the physician shortage] and meeting the needs of our communities without diminishing the quality of patient care” (Sacramento Business Journal, 7/18). ”
You keep citing the 440,000 and yet you have not educated yourself on JCAHO. If JCAHO thought random drug testing and post-adverse event drug testing was part of the solution, JCAHO would have mandated it as part of the hospital certification process. And yet, they have not.
If you want to get random drug testing of physicians in hospitals done nationwide, get JCAHO to make it a mandate. If you want to increase attorney fees for medical lawsuits, pass Prop 46.
Cute.
I’m responding, I’m not engaging. I will not go back and forth with you on issues that you want to distort for the attention.
After watching the first 30 seconds of your video, I realize that not wasting my time on you is a good decision.
I don’t think I’ve ever been in a hospital myself, and certainly not with my sister who I cared for for 10 years, where more than one doctor worked on us at a time. If during a surgery, I can assume that more doctors than 1 would be tested. Having said that, I’d certainly be willing to take a drug test as one of those doctors and be eliminated from blame when my test comes out negative!
So what harm is Prop 46 going to bring that outweighs all the good it will do?
The doctor shortage excuse is baloney. This is the same argument they used in 1975 when they passed MICRA to begin with. The NY Times did an article 10 years later that found 5/10 of 1% actually left the state. But the proponents of MICRA were swearing up and down that doctors were leaving the state in droves!
We have 22 states with no medical tort reform and 13 have found it to be unconstitutional. There are no doctor shortages in those states because they don’t have tort reform and their healthcare costs are not high because of it. This chart shows that many states without tort reform have LOWER healthcare costs than states that do. AND New York which does not have tort reform has more doctors per capita than most states. http://goo.gl/69vWGa
Your scenario of 300 people not receiving any care is not based in any kind of reality.
People need to consider how willing they are to go to a doctor or hospital and becoming part of the 440,000 that die from errors and decide whether we need to worry about doctors having hissy fits over being drug tested when our entire military is randomly drug tested, while they protect us all from harm.
Cute. You who were not gonna engage me anymore.
Here’s one of my ACTUAL YouTube videos:
https://www.youtube.com/watch?v=gR-w9LLpieM