Med Mal in the Caymans and Illinois

As many people know, we have a great deal of problems with medical malpractice in Illinois, particularly in Cook County. There are only two counties who score higher than us, nationwide (in Los Angeles and Washington DC). One of the biggest problems is apparent agency.

For example, Dr. Dumas, wearing a St. Fozzie's lab coat, makes a critical error and causes harm to a patient. The patient sues for negligence or Med Mal. St. Fozzie's legal team steps in and says, "Hey, wait, the doctor isn't a St. Fozzie's employee; this doc has limited staff privileges." The patient turns around and says, "Well, since Dr. Dumas was wearing a St. Fozzie's lab coat, I assumed he was a St. Fozzie's employee." St. Fozzie's is hung for apparent agency because it's *apparent* that a possessive relationship exists between the doc and the hospital. Then the patient sues Dr. Dumas for everything he's supposedly worth, hoping to dip into the "deep" pockets of the hospital.

Little do they (or anyone else) know, hospitals have shallow pockets. Medical malpractice suits have no caps in Illinois and a judge could totally award a patient $20-30 million dollars if it's a landmark case. Cases that involve babies also tend to score big windfalls. Juries love babies.

Everyone loves babies.

So after accounting for any judgments against the docs and shelling out tens of millions in Med Mal insurance, we celebrate the fact that we've *only* lost $1M this month in the operating margin. The pockets aren't so deep. If you're looking for deep pockets, try the offshore accounts in the Cayman Islands. Or maybe Bono's bank accounts. OH wait, Bono's accounts were moved offshore to the Caymans. Hypocrite! How in the world did I get on that topic?

ANYWAY, the Physician Partnership Team had this wonderful brainstorming session on Friday about how to publicize some of our new docs and make them feel special. Doctors LOVE having their picture taken; it's a freakishly easy way to pacify them. However, it dawned on me that if we take their pictures, print out new St. Fozzie's banners promoting said physicians, people *just* might think they're St. Fozzie's employees. Duh, right? I emailed the Risk Management guru who confirmed my suspicions. Any physician banners would brazenly contradict the anti-apparent agency movement around here. So back to square one. I have to find another way to promote the new docs without inviting monstrous Med Mal violations!

Reflections on the ER Finale

I will hedge this reflection by saying I’m not a pessimist, only a realist!

I wasted away the day yesterday, writing my last big Econ paper. Around 8pm, I called it a day and flipped on the tube. I landed on the series finale of ER and upon recognizing Dr. Carter’s return, figured I could give ER two hours of my life. ER started in, what, 1994? Maybe 1995? Whatever the case, it was during that time in my life when I thought I would become an M.D. I watched ER religiously, trying to follow characters’ movements and diagnoses as if the plot involved real stories from the ER. I fell away from my ER devotion when I went to college in 1997 and haven’t seen it since.

So while I watched the finale, I cultivated a few observations:

First, when did John Stamos join the cast? He’s so pretty.

Second, the Gilmore Girls doctor (long brown hair) kept tucking the little fly-away pieces of hair behind her ears…while scrubbed in for the pregnant mom’s delivery. You can’t wear sterile latex gloves and keep touching your hair. Her hair should have been tied up in a tight bun! And that one nurse with the French manicure? Yeah, that wouldn’t fly either. Dr. Carter stepped in to assist on that same delivery and that’s completely against the law. Physicians must have staff privileges in the hospitals; to assist in any kind of medical fashion would probably land him in a lawsuit and lead to a revoking of his Illinois medical license. If any kind of malpractice or negligence occurred, he’d be broke. Illinois out-of-pocket malpractice compensation amounts are not capped. In other words, any lawsuit award would surely strip our beloved Dr. Carter of the $50-60 mil he had to construct the Carter Center.

Which brings me to my second point: the Carter Center. I love that Dr. Carter would think so highly of the underprivileged in Cook County, Chicago, to provide them with top-rate medical services, diagnostic services, dental coverage, counseling and psychiatric services. First, the Carter Center must have received appropriations, in which the state of Illinois grants the Carter Center a certificate of need. This process often takes six months, as the Board researches the area and whether the community really needs those additional hospital beds and medical services.

Third, in light of the current economic situation, the underprivileged are the last people to receive adequate medical care, especially in Chicago. Hospitals are closing their doors at an alarming rate and even University of Chicago’s hospital closed their ER. Urban hospitals are going bankrupt because of the indigent care concerns. The underprivileged population cannot pay for their medical care, while the baseline costs of medical care increase exponentially. These factors create a vortex that is threatening even the financially-savvy hospitals. Thus, it is completely unreasonable to spend $50-60 mil in capital into an urban hospital center. Dr. Carter’s philanthropy requires a billion-dollar trust fund because it the charitable care the Center provides would never result in a positive bottom line!

I’ll step off my soap box now! Does anyone have the ER seasons on DVD, so I can catch up on the last 11 years?

Joke Journal

The Board of SSFHS, feeling it was time for a shakeup, hired Jill Holiday to be the new CEO.

This new boss is determined to rid the institution of all slackers and bring real fiscal discipline. On a tour of the facilities, Jill notices a guy leaning on a wall near the staff lounge. The room is full of doctors, nurses and aides and she wants to let them know she means business!

The CEO walks up to the guy and asks, "And how much money do you make a week?" A little surprised, the young fellow looks at him and replies, "I make $300.00 a week. Why?" Jill, towering over the guy, then hands him $1,200 in cash and screams, "Here's four weeks pay, now GET OUT and don't come back!"

Feeling pretty good about her first firing, a slightly taller Jill looks around the room and asks, "Does anyone want to tell me what that goof-off did here?"

With a sheepish grin, one of the radiologists, mouth full of pepperoni, mutters, "He is the pizza delivery guy from Dominos..."