- Del Meyer, MD - http://delmeyer.net -

Professional Gridlock: Law, Teaching, Medicine

According to insurance executives, doctors, once among the most dependable workers in America, are leaving their jobs in sharply rising numbers to collect disability benefits, sometimes earning more on disability than by working. Surgeons, known for continuing to practice though suffering from arthritic hands, formerly ranked with lawyers, accountants, and architects in occupations most favored for disability coverage. They now rank below shipping clerks and traveling salesmen. Insurers believe that declining morale is key to the growth of disability claims. Physicians have become frustrated about changes in their profession–working harder for less money under increased stress, having their medical judgement questioned and hearing critics dismiss their complaints as the whining of a spoiled elite. As morale declines, disability insurers are experiencing a drain on their earnings as doctors are incurring disability claims at about twice the rate expected from all other occupations.

In the days when physicians and hospitals were rewarded for doing an unlimited number of tests, Dr Marcia Angell, then executive editor of The New England Journal of Medicine, once said, “If you think you are healthy, you have not had enough tests done yet.”

We send our children to school to learn the traditional 3 R’s . . . which have now been modernized to Reading, Writing, and Math [RWM]. Recently, a majority of teachers in Massachusetts failed a proficiency/certifying test in these basics. How then, can our children learn?

Julie Stroike, Executive Director, Central Texans Against Lawsuit Abuse, reports that personal injury lawyers provide limited work and limited contact with clients, but still reap a windfall while clients are left with little or nothing. For instance, several computer makers were sued for falsely advertising the size of monitor screens. The suit was settled. Each class member received either a $13 rebate toward the purchase of a $250 monitor or the right to a $6 cash rebate in the year 2000. The lawyers had negotiated a $5.8 million legal fee for themselves . . . Meanwhile, the critics of the GM pickup truck lawsuit concerning side-mounted gas tanks questioned the worth of the $1000 coupons awarded to truck owners as compared to the $24 million fee for the attorneys.

The National Education Association and the American Federation of Teachers decided against merging when the reality of departing splinter groups threatened the vice-like grip that the teachers thought they could establish. The teaching profession has been using legal statutes to make what they thought were professional gains: class size, textbook selection, school day and school year length, number of teaching assistants, and credentialing, just to mention a few. With urbanization eliminating the need for a long summer recess, the number of days in class could have easily increased from the traditional 180 days. However, the days that students spend learning has decreased to 175 to allow teachers more time off. Critics claim that teachers who don’t want to join the full-time professions, working 260 days a year, are the biggest obstacles to increasing teaching time for our children.

When the California Supreme Court recently criticized Kaiser Permanente for administering its mandatory arbitration system for members to take claims to court, they asked independent providers to bid to administer its system. The American Arbitration Association [AAA] declined to bid. In fact, the AAA had already begun the initial steps to eliminate all health-care arbitration before the “explosion” of claims with pending patients’ rights legislation. The senior vice president of AAA states that employee and consumer product issues are different from health care. “With a consumer it might be a house or computer at issue. With health care, it’s someone’s life.”

Senator LeRoy Greene has said, very few laws help or protect. Most restrict. We pass a thousand laws in California every year and haven’t learn to subtract. He says we’re headed for legal gridlock.

The Charter Schools are gaining momentum as a mechanism to bypass the network of laws interfering with education. Organized teaching argued against the schools saying that they would be the haven for the white and wealthy. However, the majority of Charter students are blacks and other minorities. The teaching lobby now wants to eliminate this bright light for the poor by closing these schools because of racial imbalance–not enough Caucasians. Apparently, educating children is no longer the primary purpose of the teaching lobby . . . Are patients still the primary concern of the health care lobby? Do we have the courage to eject our leaders that want to define the practice of medicine legally rather than medically? Will we be looking for “Charter Practices” in the not too distant future to bypass the network of laws interfering with the care of patients?