Random Drug Testing for Lawyers

In this article a veteran doctor expressed frustration on a California's ballot initiative Prop 46 (Troy and Alan Pack Safety Act) to mandate Random Drug Testing for Doctors. The Ballot initiative is sponsored by Trial attorneys. 
Author, Dr. Robert Weinmann has served as President of Union of American Physicians and Dentists for several years.   

When Should Lawyers be Drug Tested?
The correct answer is when they are awake and can give consent.
 
The next question is why aren't they already tested when they go to court especially when they represent known felons, drug traffickers, or persons indicted for murder? The correct answer is because lawyers write laws to suit themselves.

A medical tech who was reportedly addicted to drugs and who stole fentanyl that was expected to be used for patients awaiting cardiac surgery caused the death of two patients and got a few dozen others infected with hepatitis C when he altered the contents of their syringes, stole the fentanyl and replaced it with saline that turned out to be infected. That bloke is now doing 39 years in prison. As this man drifted from job to job, protected from having to reveal his erratic job history, he was protected by law.
  
Wrongful administration of fentanyl was also associated with Michael Jackson's death. This time the culprit was a physician. Now comes an effort to correct this situation, an effort, we believe that is steeped in hypocrisy and swimming in money. 

In California we expect the Troy and Alana Pack Patient Safety Act to qualify for the initiative process.
The goal is to alter MICRA's (Medical Injury Compensation Reform Act) $250,000 ceiling cap on non-economic damages so that malpractice lawsuits become more lucrative for trial lawyers. So far CAPP (Californians Allied for Patient Protection) have thwarted the trial lawyer's goal. Proponents point out that there is currently no law that requires doctors to take random drug tests. They don't mention that there is also no law that requires lawyers to take random drug tests. Proponents argue that surgeons don't have to be tested randomly before operations but imply that that should be done. The same proponents don't mention that lawyers who are trying to put someone to death or save someone from the hangman's noose are also not tested. Why not? 

Both the surgeon and the trial lawyer are involved in death-struggles although, truth be told, it's the lawyers who as prosecutors are allowed to strive to put someone to death and may win kudos for so doing. But now the lawyers, especially those whose specialty is malpractice, want to impose random testing on doctors while continuing to exempt themselves. The idea, they say, is to stop the abusive overprescribing that in the case of 10 year old Troy and his 7 year old sister, Alana, was linked to their being killed by a drugged driver who had overdosed on prescription medication. 

Trouble is that this noble concept has been hijacked by the trial attorneys who for years have been trying to increase malpractice liability in the hopes of higher payouts and better paydays for themselves. A recent study by the Berkeley Research Group reported declining malpractice claims and lower awards. This trend would be turned around were the Troy and Alana Pack Safety Act enacted into law  -- one estimate is that attorneys would win about $127,500 more on average than they do now were the initiative to succeed. That explains why the ballot summary for this initiative conceals the initiative's true purpose, not patient protection, but lawyer enrichment.

So why not amend the Troy and Alana Pack Safety Act so that it also includes lawyers, e.g., random drug testing for any lawyer within a few hours of a scheduled court appearance, or anytime a lawyer is arguing a death penalty case? Lawyers, from time to time, steal from client's trust funds, sometimes to support drug habits, so why not also test lawyers randomly?

Sometimes lawyers miss statutes of limitations. Test all of them who do that. Sometimes lawyers create false documents or prosecutors fail to turn over exculpatory data to defendants. Test all of them, too. In cases where a wrongful prosecution has led to wrongful imprisonment, why not skip the drug testing and have the prosecutor finish up the sentence that was wrongfully imposed on the hapless defendant? Some lawyers, some doctors, and even some judges benefit from loopholes in the system.

If we plug these loopholes by amending the Troy and Alana Pack Safety Act, then, just maybe, with a level playing field, the proponents would improve their credibility with the public. At the moment, the initiative is tilted more to trial lawyers' enrichment than to anybody's safety. 

Robert Weinmann, MD
http://www.politicsofhealthcare.com/

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The Ninth Circuit Court criticizes Attorneys for Stonewalling Discovery on Dubious Legal Grounds

In this Calloway v. Veal, No. 13-15605 unpublished decision, the Ninth Circuit reversed the Eastern District of California's summary judgment against defendant Jamisi Jermaine Calloway for failing to provide him an adequate opportunity for discovery on his Eighth Amendment medical indifference claim. While the Court took to task the magistrate judge and district court over its handling of Calloway's discovery requests, it saved its harshest criticism for the attorneys representing the California Medical Facility prison in Vacaville:

The Court noted, “[Defendants] stonewalled Calloway’s public records request for the policy and refused to produce it to him on dubious legal grounds—yet promptly produced it without objection once Plaintiff obtained representation.”

No Disciplinary Action was taken against the attorneys for stonewalling discovery on Bogus legal arguments. Attorneys working for California State Agencies would continue to abuse their 'legal opinion' especially against plaintiff for lack of any accountability.  
edca.typepad.com/eastern_district_of_calif/2014/05/ninth-circuit-reverses-edca-court-over-pro-se-prisoner-discovery-issues.html 

This is not uncommon for Pro Se Plaintiff's to hear Bogus Legal excuses from attorneys working for California State Agencies.

In the matter of Medical Board of California against Dr. Sheikh, a Judge signed a discovery order. San Joaquin County Attorney and California Attorney Generals have refused to comply with the Judge's orders on Bogus grounds. They claim that Judges order was not properly served to them. Dr. Sheikh explained the situation before California Senate.
http://goo.gl/I6EdHM

Dr. Sheikh filed a Motion to Compel in the Federal Court (Eastern District of California). The Same Federal Court did not even hear Dr. Sheikh's Motion to Compel. The Ninth Circuit has also denied hearing so far.
Doctors should also have Access to Justice.

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Senator Feinstein, California's Grils, Nigeria's Girls

 United States Senator Feinstein from California has proposed actions for the Safety of Nigerian Girls.
The Senator noted; 

I support whatever actions are necessary to locate, capture & eliminate the Nigerian kidnappers. #BringBackOurGirls http://t.co/xOsCmHrGd0
— Sen Dianne Feinstein (@SenFeinstein) May 7, 2014

We should also consider safety and well being of our Doctor Girls living in California. Some are even committing suicide. Recently California Medical Board noted suicide of three doctor girls in one small community because of the stress. We should support whatever actions are necessary to save our California Girls.

Goofy for Healthcare stated,

"Even though California's Doctor Girls belong to Human species, we should still care for their well being." 

@AssemblyDems California Girls #Doctors from Human species are committing suicide. Where is their California Dream? https://t.co/p0NHsNvVsg
— Goofy Barks For MD's (@GoofyBarksFor) May 12, 2014

California's Doctor Girls deserve to pursue their California Dream.

Rehan Sheikh

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California Medical Board Judges Rubber Stamp Accusations against Physicians

Yes, California Medical Board Judges merely rubber stamp accusations against Physicians. 

In the name of the Medical Board of California,  Attorney General publishes accusations against physicians. The accusations are presented before the Medical Board Judges, who independently rubber stamp Attorney General's accusations.

An innocent and qualified physician cannot defend himself or herself even when physician has correctly diagnosed and correctly treated a patient. The doctor is deprived of her / his Right to Work by revocation of license. The patients are deprived of one more doctor.  



Goofy For HealthCare

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How Physicians Eat their Young

"Dear Colleague," 
begins the 5 February 2014 issue of the American College of Physicians newsletter just before it tells the recipient that 

"Our records indicate that you earned your ABIM certification prior to 1990 and therefore hold a time-unlimited Certificate." 

The newsletter then reminds internists in this category that they're sometimes  referred to as "grandfathered" because they don't have to recertify every ten years. Next comes the financially self-serving bombshell with the newsletter's announcements of the "ABIM Maintenance of Certification Changes" and the disclosure that "as of March 31, 2014, ABIM will begin reporting whether or not board-certified internists (including those with time-unlimited certification) are meeting 'Meeting MOC Requirements.' "

In other words, starting on 3/31/14 some internists will be more equal than others (see George Orwell's 1984).

The hammer falls on the next page where the newsletter tells its readers that;

"If you do not complete the ABIM MOC program requirements, you  will be reported as 'Certified, not Meeting MOC Requirements.' You will NOT be reported as "Not Certified" for failing to meet MOC requirements." 

Internists who don't measure up can count their lucky stars for ACP's largesse and also for the advice of its lawyers about what ACP needed to do to avoid individual and class action lawsuits.

This article from ACP does not disclose costs to prospective participants but it does mention that passing the MOC exam by 12/31/23 "is in addition to continuing to meeting the point requirements of the MOC program (including the two- and five-year milestones."

The first comment we've received by one of the board-certified internists with a time-unlimited certificate is this wry remark : 

"So ... they are going to allow those of us that do not have to recertify to continue to be listed as certified but will list us in a way that sounds LESS CERTIFIED than those that pay them (underlining added)."

We looked up some of the information that we think all physicians should be interested in, boarded or not, recertified or not. We relied on IRS Form 990, a public document few physicians ever see.

As of 2011, total assets of the American Board of Internal Medicine were $57,586,843. Internists should ask themselves why ABIM needs total assets of nearly $60 million. ABIM's Chairman of the Board's pay package was about $800,000 -- not bad, eh?  Recertification costs for an allergist were $2,700 while MOC costs for allergists were $2,850. Why shouldn't ACP want to get in on the action if there's a ready contingent eager to pay?

In fact, the door is open, not so much for complainants, but for competitors who can identify a possible need and a probable payer (the latter is the crucial element!). It's part of physicians' flight or fight response from the practice of medicine, unfortunately, with the focus on flight.

Author; Dr. Robert Weinmann
The article published at the following link. 
The Weinmann Report - politicsofhealthcare.com: How Physicians Eat their Young 

About Author; 
Dr. Robert Weinmann, from San Jose, California is a seasoned  Physician who writes on Politics of Healthcare. 

http://politicsofhealthcare.blogspot.com/

References
Journal  of American Physicians and Dentists, V. 16, #2, Summer, 2011, "Board Certification -- a Malignant Growth," Dubravic, Martin, MD

www.politicsofhealthcare.com, Saturday, 7/21/12, "Money and Medicine," Weinmann, Robert, MD

Journal of American Physicians and Dentists, V. 18, # 3, Fall, 2013, "Maintenance of  Certification (MOC): the Elite Agenda for  Medicine," Christman, Kenneth, MD ("the elite
medical establishment correctly foresaw that there was a huge treasure
 in the medical certification business")

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The Weinmann Report - politicsofhealthcare.com: DISILLUSIONMENT INVADES MEDICAL PRACTICE

The Weinmann Report - politicsofhealthcare.com: DISILLUSIONMENT INVADES MEDICAL PRACTICE 

Author; Dr. Robert Weinmann

Saturday, February 22, 2014

DISILLUSIONMENT INVADES MEDICAL PRACTICE

"The best decision I ever made was coming to the USA for advanced training. The worst mistake I ever made was deciding to stay."

So sayeth a respected physician, a department chairman in his specialty, whose name is being withheld since he didn't give us permission to use it. The point is that this doctor's doctor expected to spend his life caring for people, healing the sick, the force behind the profession for so many neophytes in medicine. They did not expect to become nursemaids to insurance companies or to the Affordable Care Act.  But that has become their fate because taking care of patients, actually comforting them, has taken second place to the requirements of paperwork without which neither doctor nor hospital can be paid. Today after  interviewing  a bevy of doctors who spent about an hour each on computerized hospital discharge orders (it used to take 10 minutes if you wrote legibly) it became clear how disillusioned they were.

In our previous column we described how the internists found a way to mega-wealth by opting out of clinical practice and opting into the rarified world of industrialized and corporate billing ($800,000 for the board chair according to that year's IRS 990 form). But here's the other side of that coin: according to Kathy Kristof's report in MONEYWATCH,  internists see one patient every 30 minutes, put in 54 hours per week, but waste 23 percent of their time doing paperwork for insurance companies. Take home pay is around $185,000 (about a half-million less than the board chair's 800 grand). The lesson is learned: income has shifted away from clinical medicine and patient care and towards control of capital just as in business.

The new motto is "profits before patients." Keep that in mind as your doctor rushes out the door from your clinical visit. You are important, yes, but the paper trail is crucial. That's where the money is. By the way, Kristof's article is entitled "$ 1 million mistake: Becoming a doctor."

Dr. Robert Weinmann, San Jose, California writes on Politics of Healthcare; http://politicsofhealthcare.blogspot.com/
References


$1 million mistake: Becoming a doctor, MONEYWATCH, by Kathy Kristof, 9/10/13 (my editorial comment-- insurance companies are increasingly forcing hospitals and their doctors to process patients as though they were produce, get 'em in,et 'em out, and bill 'em quickly)


Obamacare enrollees hit snags at doctor's offices, LOS ANGELES TIMES, by Chad Terhune, 2/04/14 ("people are having trouble finding doctors")


LifeForSale.com,  documentary movie, Evelyn Li, MD, Medical Consultant ("Life For Sale explores dangerous nooks and crannies of healthcare that until now have remained hidden from public view" -- RLW, Editor, www.politicsofhealthcare.com)

Late addition to post, 2/24/2014: "Doctors, insurers face off over pay," SAN JOSE MERCURY NEWS, by Tracy Seipel, 2/14/14,  ("... insurers are often caving in to the doctors ... medical costs are the largest component of a health insurance premium ..."  What this otherwise well researched story doesn't tell is that physicians' share of the health care policy premium is from 17 to 18% and that the insurers get the last word in the 'face off' when they use Utilization Review to deny specialty services, e.g., consultations, or refusing to cover physical therapy or to approve expensive diagnostic studies)

Posted by Robert Weinmann at 2:29 AM