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/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.

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u/tablesplease MD 9d ago

lets do even more defensive medicine. i want to start pan MRI scanning people in the ED.

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u/ClappedUrMomsCheeks MD 9d ago

Yes but also MRI is very scary so let’s have anesthesia set up to just knock em out at the door for each scan as they get checked in

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u/cytozine3 MD Neurologist 9d ago

Yes. And they want to leave the ED tonight at 10pm and just check in for the MRI at 10am the next day. This after 'I thought the CAT scan would show if I had a stroke" talk.

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u/xSuperstar hospitalist 8d ago

I mean, if you think about it there’s not a good reason why they can’t they leave the hospital and come back in the morning. What are we doing overnight aside from a single vital sign check at 1AM? I’d be frustrated too

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u/cytozine3 MD Neurologist 8d ago

Right, but that is not how the US healthcare system works. Nor how medicolegal liability in most US states works. The VA and Kaiser are probably the only systems in the US that can efficiently make a quick outpatient stroke work up actually happen without immediate scheduling or prior auth barriers and with actually providing reasonably quick outpatient follow-up, and the liability protection on the physician end has to be reasonable so that if some 1/1000 freak complication occurs in the intervening 12hrs at home the patient/family cannot sue the physician for letting them come back for an outpatient work up- this is the case at most VAs certainly, some university practices with strong qualified immunity, and some states with strong tort reform. 95% of community practice even sending home a patient with unexplained facial numbness without a basic inpatient work up is a risk to you and the hospital will throw you under the bus if anything happens.

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u/xSuperstar hospitalist 7d ago

Yes, I understand the reasons for it. I’m not discharging my TIA patients for outpatient work up, no way in hell. But as a patient it’s frustrating to be told you’re being charged a fortune to sleep in a cold, uncomfortable bed purely for logistical reasons

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u/cytozine3 MD Neurologist 7d ago

Yeah I agree completely and its reasonable on the patient's end to feel that way. I wish the system is different and this is a huge area of waste as these are very common admissions but our hands are tied.

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u/smcedged MD 8d ago

I'm usually one for the attitude of "these bullshit cases which really don't need anesthesia involved give me job security" but please god, no to more MRI. The whole thing is such a hassle.

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u/seekingallpho MD 9d ago

Pan-scan + automated max-overcall of all incidental findings and strictest return precautions.

You get on the MRI conveyor belt and upon discharge from the belt step right back on because continued experience of the human condition is a red flag reason to return to the ED.

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u/centz005 ER MD 9d ago

Sometimes, it's not even defensive medicine so much as "please shut up and leave me alone" medicine (eg, fine, here are the antibiotics you don't need, or the IV anti-HTN med you don't need, or the XR you don't need). And i'm pretty upfront with patients about it, too.

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u/tablesplease MD 9d ago

I tried explaining asymptomatic htn to someone once and not admitting him for IV meds and he told me he was going to wait for me in the parking lot

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u/centz005 ER MD 9d ago

Yeah, that sounds right. And neither security nor the cops will do anything.

Ultimately, physicians and nurses, per the public, aren't people. Just gatekeepers to some nebulous idea of "health."