[Note: I wrote the quoted post months ago, so will only respond briefly to what I assume is inadvertent thread necromancy. I will also note, to link this to the actual thread topic, that the problem with self-regulation is also demonstrated by such entities in other contexts, such as the abjectly useless California Bar Association, which has not yet disbarred Orly Taitz.]
Old Grunt wrote:
A Legal Lohengrin wrote:
Medical Boards generally are. Look at Dr. Harold Shipman. It took him murdering 218 people just that we know for sure he murdered. He may have murdered hundreds more. Nobody even looked into him, even after hundreds of people dying in exactly the same way. A simple tox screen would have turned up the heroin he used to murder his patients. These boards exist to protect doctors at all costs, and to maintain our illusion that there really are professional standards to which doctors are held.
Doctors often complain about the costs of malpractice insurance, but still, it is a tiny fraction of the real quacks out there who commit the vast majority of malpractice, while not even getting a slap on the wrist. I will note that by comparison, legal malpractice insurance is inexpensive. However, to some extent, the same situation prevails in at least some if not most bars.
Hold on a second. I have to take some umbrage with this. First, Harold Shipman was a British Doctor. Different country, different regulatory practices.
Note, I said "generally." I'd really want some specifics as to how our practices differ, such that a Harold Shipman or anyone like that is impossible here. I don't see anything substantively different, except reforms that occurred here as well as in the UK in response to various death doctors.
While I don't think Dr. Harold Shipman changes everything, if it makes you better, I'll offer Dr. Michael Swango instead, an American serial killer doctor who murdered a relatively modest 60 known people.
Wikipedia on Swango wrote:
Despite a very poor evaluation in his dean's letter from SIU, Swango got a surgical internship at Ohio State University Medical Center in 1983, to be followed by a residency in neurosurgery. While he worked at the Rhodes Hall wing, nurses began noticing that apparently healthy patients began dying mysteriously with alarming frequency. Each time, Swango had been the floor intern. One nurse caught him injecting some "medicine" into a patient who later became strangely ill. The nurses reported their concerns to administrators, but were met with accusations of paranoia. Swango was cleared by a cursory investigation in 1984. His time as a resident included a month rotation at Columbus Children's Hospital. There were suspicions at this point and he was required to have someone else with him at all times while at Children's. Nurses were instructed not to call him even if he was listed as the doctor on call. He was not hired as a resident physician after his internship ended in June.
Needless to say, it goes on and on. At least some of this activity was outside the country.
Old Grunt wrote:
To make the profession draconian with uber-strict regulations would end up harming patients.
I'm not sure what is "draconian" about actually doing an investigation when multiple nurses report a mentally disturbed doctor who is beginning his career as a serial killer, and instead brushing it under the carpet, when an even minimally competent investigation would have had him drummed out of the profession. Both Shipman and Swango exhibited bizarre behavior, but Swango was considered disturbed for most of his career by his colleagues.
I pick these examples because they are particularly egregious, not because they are common. My point is that Shipman and Swango are both examples of the level of absolutely egregious behavior, that stuck out like a sore thumb, that slips right past medical boards. While I could come up with example after example of actual serial killer doctors who went under the radar, the more common example is the flat-out incompetent doctor allowed to make mistake after mistake for years or decades. The nurses at any hospital seem always to have a "that guy" in mind if you discuss the staff at their hospital. I've rarely seen anything happen to those "that guys" other than losing privileges.
Old Grunt wrote:
However, state medical boards don't exist to protect doctors.
That may not be their express purpose, but just like any self-regulating profession, whether it's the practice of law or medicine or anything else requiring a license, the regulators are generally going to be people within that profession. They tend to protect their own, just as police officers or clergy or any other group with some kind of specialty that stick together.
This isn't a criticism of doctors as such, but of regulatory bodies.
Old Grunt wrote:
I just don't think people have a good understanding of why it is tough to second guess the decisions made by physicians.
That's why you need a professional witness, such as a doctor or a lawyer, preferably in the same field of specialty, to give competent evidence on whether a professional's behavior fell below an objective professional standard, in order to prove malpractice.
Old Grunt wrote:
I also don't exactly buy the notion that, simply because a physician has had a lot of mal-practice cases against them, they should have their license yanked. If that were the case, then we are allowing tort lawyers to influence the scope of practice. Do you know what the number one factor is behind Doctors not getting sued is? It has nothing to do with competence. It's amount of time spent at the bedside (the reference for this can be found in Malcolm McDowell's "Blink"). Some of the biggest dick head doctors are brilliant and will give you the best care possible. Some of the most incompetent doctors are gregarious and the patients love them. It doesn't translate to professional competence.
I'm not talking about allowing (especially unfounded) malpractice claims to decide, by themselves, whether licenses should be yanked. I am well aware that there are kinds of doctors and specialties where malpractice claims are more likely, and good reasons why some doctors, despite being exemplary physicians, would have an unusual number of deaths among their patients, such as specializing in particularly difficult cases or particularly high-risk procedures.
I am also not saying that self-regulation is, itself, a bad thing. The problem is that the very people most competent to judge whether or not a physician is, judging from an objective standard, too incompetent to hold a license are also, by the very nature of them also being in that profession, going to be inclined to be biased in favor of members of that profession. I'm certainly not saying doctors, as a whole, are less competent than any other profession and, in fact, doctors are probably on the whole the most competent professionals.
I am saying, though, that I have seen too many regulatory bodies like medical boards that are basically toothless and do nothing even in the case of the most egregious kinds of incompetence, up to and including outright serial killing. YMMV and probably does.
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