At the beginning of 2001, one of our doctors went to jail. It may have had nothing to do with the practice of medicine, but rather with law. Although there may be information that wasn’t available in the papers or in the facts as he discussed them, it is important for us to understand them. Many doctors could go to jail while practicing good medicine.
This doctor had a large convalescent hospital practice. He would see these patients once a month. Many of his patients were unable to communicate with him, and the examinations were unchanged for months and sometimes year. The important thing for him to do every month was to review the medical record to see what was going on and to discuss the patient with the nurse for any problems that weren’t recorded. Then as he walked around the hospital ward, his examination was focused on the primary area of disease or new items the nurse brought to his attention. These patients did not need a detailed examination on a monthly basis.
A nurse noted the lack of significant examination and reported him. Many physicians with similar practices have told me they practice the same way. In fact, most family physicians stated that this is how they practice office medicine. Only the required examination, based on the patient’s complaint, is all that there is time to do. Hence, he was within the community standard of care.
In the old days from which this physician came, a doctor would charge a fee commensurate with the degree of detail of the examination. However, at this time, there are thousands of numbered codes, each representing a certain type of detail. Unfortunately, there was no number that correctly identified the type of evaluation that he did. He, therefore, used a numbered code that he felt was close to what he did. He unfortunately chose a number that reflected a degree of examination that he didn’t perform, unbeknownst to him. Therefore, he was indicted and sentence for not following the letter of the law. Physicians don’t make good lawyers. They don’t think in legalistic terms. It has been estimated that perhaps half of all physicians breaks rules of which they are totally unaware.
As lawyers in practice and lawyers in congress control more and more of what physicians do, and put doctors in legal straight jackets, we will find physicians fending for themselves to the detriment of their patients. When doctors become lawyers and business people, then who will we have as our doctors? Then we as patients soon won’t have any body on our side. We must act before it’s too late.