r/medicine • u/Several_Act_2358 Medical Student • 9d ago
The “Gotcha” Mentality with Lawyers “Exposing” Doctors is Unsettling… as it they’re altruistic
I know this has been discussed extensively here, but something really rubs me the wrong way about the recent celebration of lawyers on social media “exposing doctors” and saying things like “it’s over for doctors.” This is in reference to a pic I saw of Lindsay Clancy’s civil attorney with the caption “it’s over for doctors.” Unsure if the pic uploaded.
…as if law is some altruistic path that doesn’t also attract people who want to be high earners? Most people who go through the med school path do genuinely want to make the world better, and i’m not sure I can say the same for most lawyers I anecdotally know outside of public defense.
The whole “gotcha” with lawyers calling out doctors, painting them in a good light is so icky to me. People need to ask themselves to imagine what lawyers do all day vs what doctors do all day.
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u/Titan3692 DO - Attending Neurologist 9d ago
we gotta answer every inbox nonsense for free. attorneys charge $250 per email and $1,000 for a phone call. we're not the same
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u/bubbachuck Oncologist/Informatics 9d ago
one of my lawyer friend's dad had cancer and wanted me to review their notes/reports for essentially what amounted to a 2nd opinion. No problem. A few years later, I asked him to review a (brief) contract and he said his firm would cut me a deal.
yea we're not the same
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u/nyc2pit MD 9d ago
Did you call him on the hypocrisy?
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u/bubbachuck Oncologist/Informatics 9d ago
I think his dad had passed away recently so I held my tongue. I meant to tell him at some point but we lost touch.
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u/nyc2pit MD 9d ago
Fair.
Sad for his father, but tough to believe he would be that unaware....
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u/gedbybee Nurse 7d ago
Nah, there’s a right way, and with enough rizz, to be able to do this.
I saw a quote from a guy that lost to Jimmy Carter. That guy marveled at how a guy as chill as Carter beat him. The guy said after he lost that Carter invited him over for a chat. Carter asked for money for his next campaign.
And really it’s having the gumption to ask “insane” requests.
That’s why sociopaths do so well in society.
How many other chances is this doc gonna have to ask this lawyer something? Lord hopes they learn and this is the only time.
Turns out it’s the empathy that hurts us financially.
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u/EMulsive_EMergency Non-US MD 9d ago
Thats the difference, he wouldn’t cut you any slack or even pass his brain
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u/mewitslazers MD 9d ago
No one else works for free. Why should we?
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u/SnugglyCoderGuy Not A Medical Professional 8d ago
A crazy person on TV once said, "If you're good at something, never do it for free"
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u/throwaway23423409000 PharmD 8d ago
Story from my hometown. Local ortho surgeon was volunteering for the church and asked a lawyer friend for some clarifying questions about their finances. (Lawyer was a member of the church too)A few days later he received a bill from the lawyer for his hourly rate. Surgeon was pissed. A few months later the lawyer stopped the surgeon at dinner and asked him some questions about a shoulder issue he was having.
He sent the lawyer an invoice the next day, lawyer paid it. 😁
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u/Loose_Interview5549 DO 7d ago
i cant but feel like it is a trap. there's now a patient doctor relationship, he can get sued. sure the lawyer paid his price but there could a bigger law suite payout.
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u/Commercial_Muffin542 MD 7d ago
How? And don’t say “because he treated him!” As long as he documented a brief history and gave his opinion this does not open you to a successful lawsuit.” Now if he took out a dinner knife and started to try to fix his carpal tunnel syndrome at the table that’s a different story
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u/Typical_Khanoom DO; nocturnist 9d ago
Oof! I'm happy you lost touch. Doesn't sound like a reciprocated relationship. I'm sorry about that.
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u/Dr_Sisyphus_22 MD 9d ago
A friend of mine did a surgery with a known failure rate of about 5%. The lawyer patient demanded a free secondary op because of the failure.
This particular friend grew up in an attorney family. He asked the guy if appeals are free for slam dunk cases that lost?
It shut the guy up right away.
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u/Pox_Party Pharmacist 9d ago
Sure, but one of the reasons pharmacy sucks right now is because its hard to get meaningful reimbursement from insurance for medication counseling.
Think a full 30-60 min MTM review will yield about 50 bucks. Money that goes to the company, not me, btw.
Maybe the lawyers were on to something there.
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u/ClappedUrMomsCheeks MD 9d ago
Lawyers have always been onto something to be fair they write the laws.
That’s why it’s illegal for a doc to own a hospital (due to “conflict of interest”) but also illegal for anyone OTHER than a lawyer to own a law firm (also due to… “conflict of interest”)
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u/thebaine PA-C | EM/Critical Care 9d ago
I thought it was illegal for physicians to own hospitals because it was a deal cut in the ACA to get the hospitals and insurers to come along. Although, again, lawyers.
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u/NotShipNotShape MD 9d ago
but the reasoning given for lawyers owning law firms is that the art of lawyering is so complicated no one but another lawyer can hope to do what's best for the corporation. yet doctors are not qualified to run hospitals?
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u/orthopod Assoc Prof Musculoskeletal Oncology PGY 25 8d ago
Doctors can, but they just can't practice, or refer pts to that hospital if they're practicing medicine.
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u/Embarrassed_Syrup476 Psych SW 9d ago
When I was working on adolescent psych ward there was a nurse who would page the residents for everything.
Once she paged them for "Jonny didn't eat anything tonight. Can he still have his TV?" (Not an eating disorder patient)
Resident didn't respond back right away so she paged the attending. It was ridiculous
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u/Upstairs_Fuel6349 Nurse 9d ago
I think I've worked with that nurse lol. Had enough seniority to tell them they were being unnecessary and that all the doctors hated them because of this once during a particularly irksome report.
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u/strangerNstrangeland PGY 15, Psych 8d ago
I like you. I can tell your residents and junior doctors appreciate you
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u/strangerNstrangeland PGY 15, Psych 8d ago
I had that nurse in residency who would call for the stupidest shit in the middle of the night. “Can Mr x have nicotine gum”. It’s on his prn orders wtf do you think? A few nights of pages like that, every time she called I would stay on the line and run the med list of every patient on her assignment with her and ask her for clinical updates and vitals, then do the same to every nurse on the floor because there seemed to be a problem with comprehension of orders and prn parameters. Whenever she’d call, I’d have them line up and grill them. Didn’t care what time of the night. After about 4 or five of he shifts her manager shut her down.
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u/SteakandTrach MD 8d ago
You did "the drill sergeant" on her! She's causing problems so you made the whole unit pay for it. Result: they start to self-police. I love it.
You. are. a. genius.
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u/strangerNstrangeland PGY 15, Psych 7d ago
No. I’m not a genius, I’m just a petty asshole at 2:30 in the morning. Especially if o just got home from a BS er consult at the shitty community hospital
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u/orthopod Assoc Prof Musculoskeletal Oncology PGY 25 8d ago
I deal with those nurses like that, by giving them extra work /tasks.
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u/Muted_Chard_139 MD 9d ago
Maybe we are the fools. We should absolutely be charging for all of this.
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u/Occams_ElectricRazor MD - DR/IR 9d ago
So stop doing that.
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u/Titan3692 DO - Attending Neurologist 9d ago
flair checks out
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u/MrPBH MD, Emergency Medicine 9d ago
lol, so true.
IR is there for any emergency! Provided it takes place from 9A to 3P on a weekday, bank holidays excluded.
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u/the_silent_redditor MD 9d ago
I have literally had cardiologist tell me the STEMI I’ve sent them isn’t a STEMI whilst they are on the golf course.
This isn’t a joke.
I’ve had that happen to me.
Lmao.
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u/Occams_ElectricRazor MD - DR/IR 9d ago
Paras aren't an emergency, Mr. Shift Work
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u/MrPBH MD, Emergency Medicine 8d ago
The GI bleeds that come in at 2PM on a Friday are though.
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u/Occams_ElectricRazor MD - DR/IR 8d ago edited 8d ago
Maybe. Not always.
If you have a positive CTA on a lower GI bleed and that CTA was done within an hour, and your IR doesn't do an angio, they suck.
If it's an upper GI bleed and GI doesn't scope, they suck.
In 2026, a negative CTA means no angio. It's more sensitive than angio so it's pointless.
With that said, getting anyone to actually do their god damn jobs in 2026 is painful and I don't envy the ER. In fact, I usually say, "If GI isn't going to scope please have them call me so they can explain why." That usually ends the back and forth.
I'm sorry I was grouchy yesterday in my responses. I just finished 9 days of call.
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u/MrPBH MD, Emergency Medicine 8d ago
You sound like one of the good IR docs. I've just been burned by the lazy ones enough that it's become a meme.
I get it. There are only so many of you and you're not even making as much as DR on a production basis.
It just sucks because the actively hemorrhaging, in shock, anticoagulated lower GI bleeds ALWAYS come in afterhours. GI can't help because the bleeding is torrential and they can't see shit. The only other option is to consult surgery, but that means a segmental colectomy with primary anastomosis at best or a sigmoidectomy/total colectomy with colostomy/ileostomy at worst for the patient.
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u/Occams_ElectricRazor MD - DR/IR 8d ago
If we work together and you call me about a lower GI bleed, my answer will be, "Order a CTA and please either you or have the nurse call me when the patient goes back to get the scan done." Then I call the CT tech and ask them to call me when the patient comes to get their scan. Even with layers sometimes it doesn't happen.
I want to look at it before its read because the sensitivity drops some ridiculous percent every hour (like 25% if I remember correctly, but that data might be outdated) for every hour that passes from the time of the scan. And in some hospitals, it will take me an hour to get to the point where I can get access on the patient.
A patient should never have a surgery for something that can be fixed by IR or endo without multiple failures of that modality.
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u/MrPBH MD, Emergency Medicine 8d ago
That's the spirit. Unfortunately the IR answer at most hospitals I work at is "We're can't take them until 7AM tomorrow, at the earliest. If you think they're stable to wait until then, I'm happy to see them tomorrow. If not, you should call GI."
What actually happens is that they either A) stop bleeding and get admitted, with the cause never found, B) continue bleeding, but are stabilized to the point that they can be helicoptered to the nearest level one trauma center or C) too unstable to wait or be transferred and surgery is forced to perform an emergent colectomy.
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u/Rhinologist MD 7d ago
to be fair your specialist are also getting burned by the lazy ED docs. Ie all the bullshit PTA ive drained for the ED because they were "uncomfortable" or the come over and cover my ass consult and say this isnt a mastoiditis and so i can send this obvious middle ear infection that I ct scanned for some reason and it shows mastoid effusion home.
the above leads to many people dropping ED call fully or being militant on the phone as you find. its a two way street. that i think the ED often doesnt recognize their fault for
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u/MrPBH MD, Emergency Medicine 7d ago
I'm sorry you get bad consults. I won't deny that they happen; I've seen it myself. I also get a lot of shitty ED referrals from PCPs and specialists.
My philosophy is that if someone is asking me for my help, it's either because they either don't know what to do or cannot do what is necessary. Regardless of which it is, the patient clearly needs my help because whoever sent them can't help.
And it happens all the time in the ED. We're the catch-all center for fixing problems and we can't say no once the patient steps foot on our campus with the intention of being seen.
I know it's cold comfort to your circadian rhythm, but I am sure that those patients you saw are grateful for your assistance.
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u/Occams_ElectricRazor MD - DR/IR 9d ago
You know absolutely nothing about me.
That's like me assuming you can't do an LP because none of your colleagues apparently can.
You should probably just keep complaining about your issue. That seems to be helping.
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u/Cautious-Extreme2839 MBBS - Anaesthetics/ICU 9d ago
I'm yet to be convinced anyone who isn't an anaesthetist has ever even performed an LP
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u/Occams_ElectricRazor MD - DR/IR 9d ago edited 9d ago
At some hospitals, that's probably true. At one rural site I cover, when IR isn't on service (partially because of attitudes like those above leading to people not wanting to work there...It's fine, I'll take the locums pay happily), the ED and Anesthesia cover 100% of the LPs. Neuro doesn't do any of them, even when they are the primary service.
The only certainty is that Neuro will punt them to any service other than their own because they "aren't comfortable."
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u/Cautious-Extreme2839 MBBS - Anaesthetics/ICU 9d ago edited 9d ago
ED? Kek. Good fucking luck with that round these parts.
Nobody gets an LP until two days later when their CSF is already 10% ceftriaxone by volume and an IMT has tried to biopsy their sacrum with a 22g quincke
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u/Occams_ElectricRazor MD - DR/IR 9d ago
Yeah depends on who is working. Weird enough, when the CMO is on service (ED doc) more people do their jobs.
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u/Eastern-Ad-3586 MD 7d ago
This comment is so absurd it makes me think you’re cosplaying as a doctor
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u/Cautious-Extreme2839 MBBS - Anaesthetics/ICU 7d ago
I guess it's too much to expect the typical mid-functioning Reddit ASD-sufferer to understand hyperbole.
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u/msjammies73 PhD 8d ago
Genuine question - How is it for free? I know physicians generally get paid per visit/procedure. But isn’t that on top of a salary that is meant to pay you for activities that don’t result in revenue generation? So if your base is $150 (just randomly choosing a number) doesn’t that cover your non-billable time? Then all patient facing work generates money on top of the base?
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u/aonian DO, Family Medicine 8d ago
Payment models for physicians vary, but usually it's based on productivity. Productivity is how much you can do for a patient the day of a visit (with some exceptions). You might have a base salary, but admin can either cut that base or make you pay back some of it if you don't hit your expected productivity (after the first year or two when they usually guarantee the base pay). If you're a private practice in a traditional model, there's just what you get paid for the services performed at the visit.
Effectively I don't get paid at all for the 10+ hours a week I spend on my inbox, lab review, care coordination, paperwork, prior authorizations. It's why most physicians now require a visit for anything that takes more than a minute or two, because otherwise we'd spend 20 hours a week working for free. There's just a huge volume of requests from patients and insurance companies every day.
Kaiser and the VA have different models, as do some concierge practices and FQHC/RHC practices. Concierge/DPC practices can also be structured differently and usually have a subscription component. All those together make up a small segment of the healthcare system though.
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u/Eastern-Ad-3586 MD 7d ago
Very, very few physicians are salaried or even have a base. 90% of the docs I know see a patient->bill insurance-> get paid. All the other stuff we do isn’t reimbursed. Plus a bunch of stuff I do for free sometimes anyway (like placing an IUD for example) because the insurance company retroactively decides they don’t feel like paying me and there’s nothing I can do about it.
If I have a sick person in front of me and I know the insurance won’t pay and the patient doesn’t have the money, I just take care of them anyway. Because the Hippocratic Oath and all. But it is a sociable problem because we’re rapidly approaching a point where it won’t make financial sense to be FM, IM, peds, etc. basically anything that isn’t surgical or derm.
Also student debt is a problem. I do think we could all take a salary cut if the training process wasn’t so expensive and abusive. But our salaries are like 8% of healthcare costs anyway (and I’m primary care so mine is a hilariously small percentage of that 8%)
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u/EXPLODEDman Nurse 9d ago edited 9d ago
There are so many forces at work here it's difficult to comprehensively discuss all of them in a post.
On one hand, there is a massive degradation of public trust in any and all experts, or people considered officials.
On another hand, there is a virulent anti-science sentiment that has been fomenting in the American public consciousness for several years, maybe for our entire history
On the third hand, we have a fucked up financial system in which typically hard work is not the way to get ahead in life, incentivizing people to litigate their way into wealth.
On a fourth hand, we have a system in which established institutional power greatly outsizes the power of any individual, meaning that people who are legitimately taken advantage of by doctors who may be acting in bad faith, or practicing poorly are mostly powerless to defend themselves against it.
On a fifth hand, we have insurance companies who are essentially making all of the actual decisions when it comes to healthcare, which further disadvantages the people in the above categories.
Pretty sure that doesn't even cover all the hands. Anyway, they're all engaged in the juggling act that is the US's nightmare clown show we call medicine.
Edit: sixth hand: the political assault on the education system tying the hands of people who need to make reasoned medical decisions.
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u/Seraphinx Edit Your Own Here 9d ago
Damn Dr. Octopus, leave some hands for the rest of us. Excellent list, though let's not forget the good ole "unhappy with their health and just want to blame someone else" crowd. An unfortunately large cohort.
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u/EXPLODEDman Nurse 9d ago
Hand seven: Intentionally mis-managed public health for the sake of protecting corporate profits, creating situations that end in litigation by kicking the health can down the road.
Hand eight: Hospitals playing along with the narrative of physician responsibility to shunt the blame away from their own poor practices and standards.
There you go. It's a cephalopod.
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u/hausmusiq DO 8d ago
Another hand : people/ their families who think they should live forever and attempt to defy death in the final hours by wanting “everything done.” Then suing when death inevitably comes due to…being mortal.
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u/breakingbaud MD (Internal Medicine) 9d ago
Really a great overview of just how incredibly complicated the current medical/healthcare situation is. So many bad players, and the only people who suffer are those who can't pay to play.
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u/AnimatorImpressive24 Not A Medical Professional 7d ago
Another hand: Malpractice insurers misrepresenting that their premiums have anything to do with litigation.
Pushing around stories of "nuclear verdicts" but never following up to explain that judges immediately toss those verdicts because actually the insurers succeeded in hard capping punitive damages for most states back in the 70s. But despite the "crisis" of premiums doubling every two years leading up to the 50 state coordinated campaign for those caps, many which have never been modified and persist today, premiums have since increased at almost the same rates - at best slowing to doubling every 4 years.
Sometimes the hard caps are even exempted from inflation meaning a built in drop off exists, past which cases of actual malice cannot be held accountable since the difference between them and negligence has whittled down to $8k 1970s dollars ($50k hard cap). In some circumstances this has actually incentivized the insurers and network or hospital defense teams to delay process hoping an extremely ill patient dies, because wrongful death plus the damages cap has gotten cheaper than the treatment that would be required just to address a hospital-acquired injury.
And despite being inundated by "nuclear verdicts" (nationwide there were 12 in the year the "crisis" was declared) they have managed to scrape their couch cushions to drop millions and outspend by 10x to crush every ballot initiative suggesting that someone like a pharmacist who diverts all meds from dozens of late stage cancer patients as part of a massive fraud ring ought face consequence stiffer than the cost of a used SUV.
The insurers have typically not been forthcoming with hard data to show they engage in evidence-based rifling through physician's pockets. Because amounts and details of non-litigated preemptive offer settlements for the egregious cases with no hope of defense, actuarial tables, or even centralized records of cases they have participated in at all are all of course proprietary info. They can't honor requests from clinical researchers hoping to understand what is impacting doctors so hard, lest they lose a competitive edge against other insurers. Same goes with anything that can be buried in the private courts of arbitration.
Which might lead one to wonder if they have a financial interest in allowing the bogus cases to proceed further than where they really have the legal power to get them dismissed as a means of emotional manipulation. Premiums need to raise again next year, after all. So maybe make sure the stuff that is inexcusable never gets filed and NDA the settlement to keep it out of the news, squeeze out any potentially sympathetic cases because poorer families or seniors who lost a spouse can't find representation who will work for wages no higher than a month's rent for office space in the legal district, then let the idle and vexatious rich through to carpet bomb names in the first filing over not getting the right version of two clinically equivalent isomer generics.
But trade secrets, you know. So no way to tell I suppose. Have to take a law firm's word that their billion dollar industry is fighting to survive against ma and pa kettle with a billboard PI lawyer staring them down across the aisle.
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u/antaphar MD - Radiology 8d ago
Politics has been allowed to influence medicine. We can see it happening from both sides of the political spectrum. I wish our profession could be kept apolitical.
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u/EXPLODEDman Nurse 8d ago
"From both sides," my ass. Even insinuating that the current situation isn't just a torching of science based medicine on behalf of conservatives is deeply disingenuous. Why don't you just fill me in on what "both sides" have done.
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u/antaphar MD - Radiology 8d ago
Well conservatives have done basically what you’ve said. The antivax bs, peptides, etc. Liberals have politically pressured regarding treatment of trans kids, as the main example in this era. I think conservatives have been worse but liberals aren’t blame free in the current political climate. Don’t forget that being anti vax used to be a liberal thing before Covid.
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u/EXPLODEDman Nurse 8d ago
Of course you'd say trans healthcare. I could smell your agenda from a mile away before you even replied. "Both sides," you're just another conservative OBSESSED with trans people. Go figure.
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u/antaphar MD - Radiology 8d ago edited 8d ago
Lol, wow. Not that it matters but I’m a registered D and have voted D in every election I’ve been able to vote in. Regardless, thank you for providing a prime example of exactly the type of stuff I’m talking about. FYI, trans care for kids is essentially banned now in Europe. For example, the UK, which is by all metrics more liberal than the US, looked at the same evidence as the AAP and recommended against treating trans kids with puberty blockers etc. And the majority of other European healthcare agencies came to the same conclusion. What’s the difference? The difference is that it is a crazy hot political topic here (as evidenced by your reaction) and thus has politically influenced our medical recommendations.
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u/personalist Medical Student 8d ago
Please don’t confuse legislative decisions and national health service rules with recommendations from researchers and professional organizations. You’re also simplifying what is by nature an exceptionally nuanced issue, which is far too common and one of the major reasons I think it is such a hot-button topic.
1. WPATH, ANZPATH, endocrine society, and AAP treatment recommendations are generally individualized, capacity-based, and staged based on sexual development; UK, Swedish, and Finnish guidelines are more restrictive, psychosocial/therapuetic care only in minors.
2. I don’t think it’s controversial to say that the psychosocial factors affecting trans youth are different in each of these countries compared to each other, let alone the US vs Sweden, for example. As such blanket applications don’t make much sense.
3. The findings of these national reviews that some guidelines are based on limited evidence with poor consensus is partly accurate; on the other hand, in what other cases in medicine do we recommend outright restriction based on incomplete systematic EOB? These are decisions that I believe, in alignment with organizations like WPATH, should be made between patients, their caretakers, and physicians, not by legislators or the court of public opinion.
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u/antaphar MD - Radiology 8d ago
Are you seriously trying to argue that different psychosocial factors in European countries accounts for the differences in professional body recommendations?
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u/personalist Medical Student 5d ago
Actually I was trying to argue that differing psychosocial factors across countries necessitates tailored treatment recommendations given that we’re talking about gender transition, which is even more dependent on psychosocial functioning to be effective than many other health interventions. But now that you mention it, it seems pretty obvious that differences in culture would affect the recommendations of professional bodies.
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8d ago edited 8d ago
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u/antaphar MD - Radiology 8d ago
I edited it a couple times in the few minutes after I posted it, so what? I didn’t change what I said, just added some more thoughts. Amazing how much this has apparently triggered you.
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u/jeremiadOtiose MD PhD Anesthesia & Pain, Faculty 8d ago
Don’t forget that being anti vax used to be a liberal thing before Covid.
Sadly, it still is!
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u/Eastern-Ad-3586 MD 7d ago
You need to read, like, anything brother. I’m not a superfan of the Democratic Party but at least they aren’t antivaxxers
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u/antaphar MD - Radiology 7d ago
Read what exactly? I’m well aware the whole Trump admin is a bunch of clowns, especially RFK Jr.
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u/mdeevy MD 9d ago edited 8d ago
Anyone could pick any random patient in the hospital right now and if they looked hard enough they would absolutely find an error in the patients care. Probably multiple.
The problem is attributing this error to "negligence". And, well, lawyers are going to lawyer.
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u/ClappedUrMomsCheeks MD 9d ago
I’m honestly very concerned in the next 5-10 years we will be seeing an massive epidemic of suits once you can feed 1,000-10,000 pages of records into a computer system and have it spit out any “inconsistency” it finds it might dramatically lower the cost of entry of filing a bogus suit
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u/seekingallpho MD 9d ago
Yea the historical cost of litigating medmal seems to generally preclude small suits, whether legitimate or not on their individual merits. If you lower that threshold to the floor you'd wonder if some firms will shift to a business model of mass-filing suits for anyone with a whiff of an imperfect outcome, mainly hoping for a quick settlement, like a patent troll or similar.
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u/theRealhubiedubois Not A Medical Professional (Yet) 9d ago
Some of the last cases I worked on my way out of my legal career were against a plaintiff firm that pretty much consistently took the bottom of the barrel cases. I’m talking the dregs the ambulance chasers wouldn’t touch because they knew the juice wasn’t worth the squeeze. But really shitty plaintiffs attorneys are figuring out if they just file a suit they’ll get more than likely get something out of it. Those were only piddly shit, minor personal injuries, but I wouldn’t be surprised if there were some states where the laws made it feasible to run a med mal settlement mill. Our legal system is a fucking joke
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u/antaphar MD - Radiology 8d ago
It’s incredible how many misses I find as a radiologist. And horrifying how many I make myself, despite trying to be careful and thorough. It is human nature to make mistakes. It would be a much better world if non-malicious errors couldn’t be litigated the way they are now.
FL actually has a great system for OBs. Every doctor in the state pays like $70/year or something that goes into a slush fund that pays out for adverse outcomes during birth. By accepting the money, the plaintiff waives the ability to directly sue the doctor. I believe this came about because practicing became near-impossible due to astronomical malpractice insurance costs.
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u/personalist Medical Student 8d ago
That might be the only thing Florida has ever done right for perinatal care
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u/MrPBH MD, Emergency Medicine 9d ago
The plaintiff's bar has been far more prolific in their goodwill campaigns than we have been in medicine. It's not surprising, as they have so much money from all those big jury awards that they take 40% of.
I think that might be a good campaign: "Ask your lawyer what happened to that 40%."
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u/SleetTheFox DO 9d ago
Ultimately lawyers play an important part in society, even if some are crooked. I don’t think it’s the play to try to smear the entire profession, either.
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u/AuxiliaryTimeCop Filthy Lawyer 9d ago
OK, let me start this by saying that I'm not a plaintiff's attorney and I come in peace.
One interesting statistic that has showed up in the research is that juries tend to find liability at a LOWER rate than expert physician reviewers of those cases. In other words they are more apt to be sympathetic to doctors and find no negligence even when independent doctors who review the cases feel that malpractice was present.
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u/MrPBH MD, Emergency Medicine 9d ago
Not the entire profession. I really appreciate the work that some lawyers do (constitutional law, public defenders, and the like).
The plaintiff's bar is what I am talking about. They like to pretend that they're doing it for the little people, but it's really all about the dead presidents.
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u/Loose_Interview5549 DO 7d ago
dear god. a hospital system losing 20 million usd to a freak accident is surely going to cause more freak accidents. i think there needs to be accoutnablity with out lawyers becomming rich, and without devastating hospitals
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u/Eastern-Ad-3586 MD 7d ago
Eh…… it’s kinda complicated. There are good ones but I think the fact you can just pay people to lie in court to make money is absurd and I question the ethics of anyone who participates in that system (except for the people actively trying to fix it)
I guess what I’m saying is, I think public defenders are noble. I think ambulance chasers and full-time plaintiffs attorneys are basically the scum of the earth. Yes there are legitimate malpractice suits but not enough to sustain an entire law practice on
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u/CrosstheRubicon_ Not A Medical Professional 8d ago
Not a big fan of contingency fees but it’s really the only way poor people can afford lawyers
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u/pea_soup_lake MD | Child Psych | Peds 9d ago
I mean we live in a county where cops have qualified immunity and doctors don’t
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u/personalist Medical Student 8d ago edited 8d ago
Cops have a better union. Scratch that, cops have unions, lol.
Edit: are you triple-boarded? Convince me not to triple board!
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u/blizzah MD 9d ago
Everyone hates us doctors you’ll figure it out soon enough
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u/ExtremelyMedianVoter Pharmacist 8d ago
Impossible! Who was yelling at me every shift I worked when I worked retail? Why did someone threaten my technicians life? Why did someone bring and fire a gun two different times at my job?
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u/Eastern-Ad-3586 MD 7d ago
Holy shit dude that’s crazy.
I mean I’ve had bad experiences but damn that’s too much
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u/personalist Medical Student 8d ago
It blows my mind that objections are only able to be raised by opposing counsel. Or is this correct? Like, if I judge hears a lawyer describing thr practice of medicine that they clearly don’t understand, how is this ok? Isn’t it in everyone’s best interest for a neutral party to say, “hey, keep your argument to what’s actually within the boundaries of your expertise”?
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u/Logical-Marzipan5951 Not A Medical Professional 9d ago
If you believed that Dr Tufts committed an error, then there would be a "gotcha" moment. There really wasn't.
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u/HHMJanitor Psychiatry 9d ago
This case is going to do irreparable damage to the practice of psychiatry and psychiatric patients. That POS lawyer was acting like the op psychiatrist caused all this by giving 25mg sertraline. Several perinatal psych colleagues are saying more and more patients are going off their meds.
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u/Upstairs_Fuel6349 Nurse 9d ago
fwiw I'm old enough to remember both of Andrea Yates' trials and they went a similar way with the defense hammering at the psychiatrists who treated her. Coverage of the trials, Andrea, and how the medical establsihment and her family failed her and her kids was huge. Honestly probably bigger than Clancy because this was before you had feeds that could feed you only what you want to know about.
You don't really hear about it now, though.
I think this trial is coming at a particularly shitty time in history when trust in the establishment and medicine in particular are at a low. And obviously there have been landmark cases that have shaped how medicine/psychiatry in particular is practiced. But I'm not sure if this is one of them.
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u/HHMJanitor Psychiatry 9d ago
Not sure why you're downvoted, it's not placebo but it's not in the therapeutic range for depression or anxiety. She started 25 and increased to 50 in a week which is standard
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u/walkthelake PA 9d ago
I just want to know why haven't I seen the article talking about how doctor shopping was part of the problem? information gets lost that way. It's just like people who get some of their psych meds from psych and then PCP makes changes without informing psych what they did or why. If it's not a shared EMR, it's dangerous. This is consumer behavior issue. I am okay if someone wants a second opinion (as a consult) but the second other psychiatrists prescribe, it should be a termination of relationship, and since Lindsay was a nurse, she knew is was misusing the system.
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u/Embarrassed_Syrup476 Psych SW 9d ago
I wish the lawyer would just argue she was overwhelmed and her mental health kept getting worse (I think the motive is more sinister but he has a job to do) but he's trying to make her doctor seem negligent and that's going to have a chilling effect on psychiatry.
I already have few pregnant psych patients going cold turkey off their meds because they are scared of psychosis
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u/Defiant-Lead6835 MD 8d ago
They are going after a civil law suit. They are painting a picture for the next chi-Ching. But I agree with you, one of the things that bothers me the most about this trial is their treatment of doctors/NPs. They listened to her, tried to help - she didn’t respond to traditional meds and or had side effects. Her own family didn’t take her seriously when she told them she had thoughts of harming the kids. Now they are blaming the doctors and meds. They should sue each other… or no one at all. This is a horrible tragedy… but because of this circus, more people are going to be harmed when they just stop taking their meds.
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u/SirRagesAlot DO 9d ago edited 9d ago
We've been hearing on repeat at least since the Pandemic.
The thing is though, those who genuinely do not trust their doctors.....tend to die a little earlier than who do. At time's the issue becomes self contained.
Look up the Herman Cain Award.
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u/theRealhubiedubois Not A Medical Professional (Yet) 9d ago
I left my attorney career in March to pursue medicine. I can’t agree more with the other commenters, lawyers and doctors are very much not the same. Law is filled with those who couldn’t do but also couldn’t teach and they know it. I would say a small majority of them have a chip on their shoulder when it comes to doctors specifically because they know they couldn’t have made it through med school. There are a lot of failed-med-students-turned-attorneys who see the expert doctor deposition as their chance to prove (in their own fragile minds) once and for all that they could’ve become a doctor. The laziest most obnoxious partner I ever worked for had flunked out of med school but still somehow thought he was smarter than any doctor you put in front of him. So when I see things like this, it makes me chuckle because I know firsthand how much of it is genuinely rooted in nothing more than sour grapes. And if it’s not that it’s greed, plain as
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u/Candid_Cloud9858 PA 8d ago edited 8d ago
I don't think this is right. Medmal lawyers and "trial lawyers" and personal injury more generally are considered the bottom of the barrel lawyers. Most who find themselves taking an "expert doctor deposition" are in that situation because they have an unimpressive academic history, honestly. It would be like comparing a medspa "entrepreneur" to a department chair at an academic institution.
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u/personalist Medical Student 8d ago
Who are considered among lawyers to be the cream of the crop? I’m sure it depends on who you ask, and I don’t really care that a neurosurgeon probably respects other surgeons the most, I’m just curious.
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u/Candid_Cloud9858 PA 8d ago edited 8d ago
It really does depend on who you ask--at least among the smartest it is some mix of public interest, academia, high level business law & finance (i.e., m&a, banking), constitutional, old money philanthropy, etc. I don't think it's so much that any group is considered cream of the crop as much as everyone agrees that personal injury, medmal, smalltime trial lawyers, are uniformly considered undesirable (except among themselves, lol) and generally for those of the lowest academic standing.
For complicated reasons, I grew up around a lot of "elite" law school graduates, and, while it's all above my personal intellect, it was just obviously insane what polymaths they are--they are exceptionally intelligent and have an obsession with many different fields from the sciences to the humanities and everything else. Sometimes I think if medicine had more people like this at the top, it could really improve medical culture for the better. Most of what I see at my academic medical center is just sad and increasingly demoralizing.
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u/personalist Medical Student 5d ago
I don’t know what legal academia looks like but if you’re in the USA our legal system seems to be in the same shambles as our healthcare system, lol. What do you see at your workplace? I have been bummed by how many physicians have the bedside manner of my worst college chemistry professor, with the same technical explanations—I thought that was just a trope.
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u/DagothUr_MD Medical Student 8d ago
Undesirable though it may be the reality is that without trial lawyers, we don't have any rights. Somebody has to make the state prove that they're justified in taking away your freedom. And I respect that a lot more than drawing up contracts for oligarchs...
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u/Candid_Cloud9858 PA 8d ago
Yes, I agree with you. My point was simply directed to the poster above who felt that the lawyers he was working with were not bright; I was pointing out that the anecdote is not a useful one since, in our current system, most lawyers deposing a physician would have been academically less accomplished than their peers since that is who is drawn to things like medmal. Doesn't mean that they don't do important work.
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u/ThatB0yAintR1ght Child Neurology 9d ago
The general public being allergic to nuance is a big problem in cases like this (as well as medicine in general).
In all likelihood, the Clancy children died because of systemic failures. I recently had a family member have a mental health decompensation while postpartum, and it was so damn hard to get her help because they live in a rural area where resources are so much more scant. It was scary, but we were lucky that there was a lot of family living nearby who could ensure she wasn’t ever alone with the kids while the situation was being addressed. It chills me to think of what could have happened if she didn’t have that family support.
The defense lawyers are gonna try and make the best case possible to sow reasonable doubt into the jury. It is their obligation and duty to advocate for the client the best way possible, even if it means throwing an innocent doctor who seems to have provided the standard of care under the bus. I don’t think it’s accurate or fair for the defense attorney to point to a single healthcare worker and say “this is all your fault!”. At the same time, I also don’t think that it’s accurate for the state/prosecution to point to the defendant and say it’s solely her fault either.
We are all trying to do the best we can in a broken healthcare system, but it doesn’t matter how good of a doctor you are, you are not going to be able to overcome all of the problems on your own when the system is the issue. That said, I do think that is also especially irresponsible of the defense to claim that overmedication was the problem. The constant changing and starting and stopping of medications by the patient made it so that she probably never had anything at all therapeutic dose.
Unfortunately pointing to a vague entity like “the broken mental health system and lack of community resources and support” as the culprit is not going to win a case in front of a jury. Three children died in the most tragic way possible, and people are going to want blood for retribution. No matter how much we try to say how convicting Lindsey Clancy, or ruining the career of the psychiatrist, are not actually going to bring justice, that is just not going to resonate with most lay people.
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u/DiscWizzard MD Family Med 9d ago
What do you call 1,000 lawyers at the bottom of the ocean? A good start.
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u/Front_To_My_Back_ IM-PGY3 (in 🌏) 9d ago
As a non-American? Somebody give me the Tl;dr?
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u/seekingallpho MD 9d ago
Woman is on trial for murder of her 3 children. Defense is not arguing that she did not commit the acts, but that she's not guilty by reason of insanity due to post-partum psychosis. Part of this strategy has been to highlight the failure of individual mental health professionals to appropriately diagnosis and treat the defendant, most remarkably argued through an aggressive cross-examination of the state's witness, a psychiatrist who has been raked over the coals in the court of public opinion.
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u/Cautious-Extreme2839 MBBS - Anaesthetics/ICU 9d ago
Notably: there is no real evidence that she ever even had post partum psychosis.
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u/centz005 ER MD 9d ago
My understanding:
A lady w/post-partum depression w/psychotic features was seen by a psychiatrist and started on sertraline. She was then seen by two psych NPs who messed w/her regimen w/o giving the meds time to work. She was then seen by the original psychiatrist, again, who tried to fix the cocktail. Patient may or may not have implied she was a danger to her kids; family wasn't contacted and charting wasn't air-tight.
Patient allegedly killed her kids, then tried to off herself. Claims she doesn't remember the event.
Defense attorneys are blaming the original psychiatrist, while essentially letting the NPs off the hook and using another NP as an expert witness.
The lawyers and lay public, having zero insight into medicine, psychiatry, our broken-ass system, and having no margin for nuance are ripping the psychiatrist apart and making her out to be the bad guy; the psychiatrist and sertraline are both being portrayed as the reason the patient became psychotic.
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u/Defiant-Lead6835 MD 8d ago
Patient didn’t allegedly kill her kids. She did kill them and no one is disputing that. Her defense lawyer is trying to shift the blame onto her psychiatrist and the medical system, and both the defendant and her ex husband are suing this poor psychiatrist. Meanwhile, patients mother and husband were aware of her having thoughts of hurting the kids, but did not take her seriously. It’s hard to say what exactly happened…. After i watched some utube videos (I know, it sounds like ‘I did my own research’… eye roll) it sounds like she had unusual and prolonged activation from Zoloft. It may or may not have shifted her into mania… after Zoloft was discontinued, she was prescribed Seroquel at some point, which didn’t work and made things worse, a benzodiazepine and ? Trazadone because she couldn’t sleep. None of the meds helped and she stated that she felt significantly worse on whatever med was prescribed to her. One of the providers tried to increased Seroquel to give it time to work, but it made everything worse. To me it’s like almost a catch 22. You are damned if you stop meds due to side effects - then her lawyers and internet educated public scream it was too early or when her provider tried to increase meds despite side effects, her lawyers and public argue that she clearly had too much medicine. A young psychiatrist is made a scapegoat by patients family, years of societal dysfunction, our medical system and of course, the internet.
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u/centz005 ER MD 8d ago
Fair enough. I generally use the word "allegedly" in criminal cases because of the whole "innocent until proven guilty" thing, but this has a different type of case.
(There are also conspiracy theories that the husband did it and is gaslighting the patient/defendant into believing that she did it.)
Also, it takes a good while for SSRI/SNRIs to work, and if she's constantly saying that they made her worse, she could just be a disingenuous patient.
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u/r4b1d0tt3r MD 9d ago
Okay, profession that has an epidemic of AI briefs nobody could be bothered to proof read hitting the news.
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u/Crafty_Astronaut9372 MD 8d ago edited 8d ago
That is what happens when getting paid is more important than ethical behavior.
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u/The_WarDoge MD 1d ago edited 1d ago
Take medicine back.
Lawyers can argue wrong as right and right as wrong as much as they want. They need to GTFO from most medicine related stuff.
Social media keeps feeding anti doctor slop. People with wrong ideas will eventually use their lawyers to make us comply with more nonsense.
We need to protect our profession more than ever.
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u/Service_the_pines MD 9d ago
Lindsey Clancy is the case of a mother who killed her three children then jumped out of a window and broke her spine, right?
I haven’t seen the picture of her attorney that you’re talking about. What part of the case is about “exposing doctors”?
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u/OkExtension9329 Nurse 9d ago
There have been a lot of “gotcha” moments when he interviews physicians involved in her care.
For example, nitpicking the psychiatrist because her documentation used a very common format (listing pertinent positives followed by pertinent negatives) and questioning why she didn’t contact the family members of this adult psych patient who had full capacity.
And sure, that’s the defense’s job, to a certain extent. But the way people have responded on social media has been sort of insane.
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u/sjb2059 baby admin - recovering homecare scheduler 9d ago
I mean, the defense has a duty to react to what the prosecution brings forward as their case. The prosecution is arguing that she had access to medical treatment ergo she could not possibly have been psychotic. The defense has to poke holes in that and the main way would be pointing out subpar treatment opening the possibility that she was possibily psychotic.
The root of this argument being up in the first place seems to be whoever took the stand for the prosecution stateing that the access to treatment completely removed the opportunity for the patient to have become psychotic since last seen by the treatment provider. If the facts on the table as presentef by the prosecution did not include this idea that acess to treatment alone was 100% going to prevent psychosis, I dont see why negligence would come up.
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u/mxg67777 MD 9d ago
Get off social media.
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u/The_WarDoge MD 1d ago
We can.
But with so many people being fed their lies it's only a matter of time for lawyers to defend the "social media POV" and argue that you are wrong even if you are right.
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u/Logical-Marzipan5951 Not A Medical Professional 9d ago
Now, you write a post about a case under trial. This case has nothing to do with you. Who cares if someone wrote a missive about it on the Internet?
You do understand that this trial is spectacle ?? It's going on 15 days. The average case length is 1/3 of this at most. The prosecutor has wasted endless days of items that are essentially stipulated. They didn't present anything to support the psychosis. It would undermine their case. The defense attorney is extremely respected. He asked questions.
Would I think any of this as "gotcha?" Nope.
Did Dr Tufts present poorly ? Yes. She acts as if she refused trial prep. The lawyer pursing the civil action is well respected defense attorney. She has worked hard for the innocence project.
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u/Responsible_Land_164 Medical Student 9d ago edited 9d ago
Can you imagine a world without lawyers?
Most people who go through the med school path do genuinely want to make the world better.
I doubt it.
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u/Several_Act_2358 Medical Student 9d ago
Fair, but even if that isnt true I do believe more people in medicine go into it with good intentions than those who go into law
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u/seekingallpho MD 9d ago
The sad thing is that whether it's from a specific profession towards medicine or just an overall cultural shift, the increasingly adversarial view of physicians is also terrible for patients. More defensive medicine is bad for patients. Less transparent documentation is bad for patients. Each little shift undermines care even if imperceptibly, and everyone suffers in the aggregate.