A prospective juror in an insurance case was asked if he had ever done business with the insurance company in question, and what he thought of insurance agents. He replied that he placed them “just a notch above lawyers.” We may think of this as just another way ploy to avoid serving on a lengthy jury trial, but the association is sobering–even if you don’t drink. Remember when “public confidence” polls placed doctors near the top along with priests, ministers, rabbis, and supreme court justices? At the other end of the spectrum were congressmen, legislators, lawyers, and used car salesmen. As we leave the high moral ground and become increasingly preoccupied with the bottom dwellers, might we not also fall to “just a notch above lawyers?”

Online discussion between two attorneys as excerpted by the Wall Street Journal:

Stuart Taylor, Jr (Author): The implicit point of all this seems to be that feminists are right to support Anita Hill and not Paula Jones–regardless of which of the two women has a stronger claim to being a victim of sexual harassment–because supporting Anita Hill helps the feminist political agenda, and supporting Paula Jones would hurt that agenda. In other words, it seems to me that you have implicitly conceded that the positions of feminists in these two cases are fundamentally unprincipled–that they are driven by political expediency and not by a commitment to evaluation of individual claims of sexual harassment on the basis of a neutral analysis of the evidence. Please correct me if I’m misinterpreting you…

Susan Estrich, (USC law professor): You believe in principle. I believe in politics. Here is what I learned in law school. I learned that if you push any legal questions hard enough and far enough, principle turns into politics. No avoiding it. We live on the slippery slope. You and I were the best in our class at arguing both sides of every issue–but you could type faster, and so you got the Fay Diploma, and I worked harder, so I got to be president of the Law Review. But we both got the game. “The Legal Process” …took the place of those much-feared value choices…

Yes, medicine has always represented those much-feared (and respected) value choices. As we deal more with the professions on the slippery slope, we can only slide down hill. When we’re in the mire with everyone else, we will all look, smell, and act the same. There is “no avoiding it.”

Congratulations to the UCD School of Law for making the list of top 50 law schools according to the USNews “Best Graduate Schools.” UCD Vet School was number one, the Medical School was 13th in Primary-Care, and the MBA program was No 44.

Hostess pointing out guests to new arrivals at a cocktail party: “The Von Soostens under the chandelier represent old money; the Hendersons by the champagne punch represent new money; the Gibbons admiring the bookcase represent lottery money; the Krogers sitting on the velvet divan ladened with gold and diamonds around their wrists, waist, and necks represent managed care money; and Dr Livingstone, my HMO doctor, bending over the diving board with his wife tugging on his coat represents no money.”

A patient brought in a hospital bill stating “here’s one for your column.” He had gone through a pulmonary rehabilitation program at one of the hospitals. The bill to medicare was $4576 for 18 three hour sessions. He said with a class of 12, it was $54,912 for the hospital or $3000 per session. He said he was unable to find any medical benefit. He call some of the twelve and they couldn’t either… Who needs beds anyway?

The current Fortune magazine reports that Lovelace Health Systems, a subsidiary of CIGNA, is combing through hundreds of medical charts in search of those “customers” who might benefit from mood-elevating drugs which Fortune termed “sinister but laudable.” The Zung Questionnaire is mailed to “heavy user” patients defined as those who have visited the ER or been admitted to a hospital three times in a year, or are taking seven or more medications, or have medical bills of $25,000 per year. If they are considered depressed, they are referred to their doctors for a prescription of Prozac, Zoloft, or Paxil. The impact has been dramatic. The medical expense of one group of 2,079 patients who took part in the program decreased by $2.1 million. Fortune’s response: Prozac and its siblings could be an important remedy for rising health care costs… An alternate response: If they could find ten more groups like that, they’d save enough to pay their CFO like a CEO for figuring this out.