Archives for September 2003

Going Bare – my take

Medpundit has a post about a doc (FP) who is going without medmal insurance. The implied rationale is that since his net worth is negative (debt), and since suing him looks unattractive (no insurance), this is his plan to not get sued.

A Chance to Cut is a Chance to Cure had previously written about Florida docs who were ‘going bare’, making their hospital the big target, which has some attraction: hospitals are Institutions and not easily attacked, and they generally have squads of attorneys on staff or retainer, making them hard to sue effectively (though it happens often enough).

This is stupid for several reasons, and I’m not a shark plaintiffs’ attorney, I’m sure they’d be glad to explain more reasons. First, from a purely practical aspect, most hospitals won’t let you be on staff unless you’re insured for at least a minimum amount. They aren’t interested in being the deepest pocket, and as we’re (mostly) not their employees they don’t want the multi-mil$ liability.

Second, as was explained to me when I was but a pup, “yeah, you have nothing now, but you will someday, so I’d get a judgement and then renew it every 7 years”. Because your net worth is negative today doesn’t mean it’ll stay that way. Just remember that bankruptcy doesn’t wipe out many jury verdicts.

Third, the nail that sticks up is the one that gets hammered down. This doc is deliberately making himself a target, and might get sued just to scare others into not going bare.

Lastly, say he gets sued. All his legal expenses are out of pocket (mine are covered in my policy), billed at huge numbers per hour (more than an FP collects by far), and there’s no settling for more than you have in savings, because you don’t have it.

I gripe every time I write a (substantial) check for medmal insurance, and I thank my lucky stars I have it.

Gadgets I want

Add a power washer to that list. I rented one today to get our porch ready to re-paint (and an awful lot of the old paint came off), and it was terrific. The porch is ready to paint! (Write me for directions, and I’ll supply the rollers).

I also used it to clean the pebble-finished front porch, and to remove some (concrete drool? the stuff that inevitably winds up on the old surfaces from the new concrete project). It worked well for that, too.

I couldn’t start it for about 10 minutes, then I found the ‘on’ switch. Doh! Then it started on the first pull. Heh. A good time was had, and it’s a lot of fun.

Dr. Bradley gets it

kill as few patients as possible

Hehehe. Perfect memo for the circumstances.

Sidebar Links

I thought I’d try some visual links to my blogrolled sites. To that end, I spent a few enjoyable hours with my stripped-down Photoshop, and made some. What you see (over on the side) is the result.

I thought they’d be unusual, and visually appealing. I think, now that I see it, that they look like nothing so much as horrible highway billboards, competing for attention, and not complimenting either each other or their surroundings (they’re ugly). Individually, nice. Presented like this: eyesore.

However, as someone who isn’t allowed to choose his own clothing due to well-documented style deficiencies, I’ll leave them up for comment. In this case, the majority will rule (unless it disagrees with my wife; I’m not stupid).

PS: I’m going to add some more links, but am holding off to see the outcome of this.

On a more serious note,

Below I linked to somewhat humorous research about ovarian cancer prevention. When it was linked by InstaPundit, I got an email from the Senior Counsel to the Tennessee Attorney General notifying me about a somewhat related issue.

Taxol is a chemotherapeutic agent used in the treatment of several cancers, but its predominant use is the treatment of ovarian cancer. The makers of Taxol have entered into an agreement with all 50 states to refund some money to patients who got taxol between 1999 and 2003; it is a somewhat complicated story, and if you’re interested, you can read all about it at:
TAXOL/Paclitaxel Consumer Settlement Website.

So how much are we talking about here?
From a .pdf release from the Tenn AG’s office:

…an estimated $55 million agreement with the Bristol Myers-Squibb Company regarding antitrust allegations involving the cancer-fighting drug, Taxol. Tennessee joined 49 other states and U.S. territories in the agreement with the drug manufacturer and will recover part of the $55 million in claims for damages, penalties and individual consumer redress.
…The Attorneys General have set aside approximately $12 million for a nationwide consumer distribution to compensate consumers who may have paid higher prices for Taxol. Under the settlement, each participating state will receive damages incurred by certain governmental facilities that purchased the Taxol or its generic equivalent. While the ultimate allocation among the litigating states has not yet been determined, more than $37 million will be set aside to be divided for this purpose. An estimated $6 million will be used for costs of notifying the public and other administrative costs.

12.5 Mil for patients out of a 55 Mil settlement. Hmmm. If you qualify, sign up now, or the lawyers will keep it all. I guarantee they won’t give any of that money back.

Texas loses another MedMal Insurer

Although there will be smug “I told you so’s” from those who opposed Prop 12, this has very little to do with the Texas malpractice climate.
MySanAntonio : Business
Though at first it sounds quite ominous:

JEFFERSON CITY, Mo. Farmers Insurance Group said Wednesday it will stop selling medical malpractice insurance, narrowing an already tight market for physicians in some of the 18 states – including Texas – that it serves.
Farmers Insurance has “suffered significant underwriting losses” recently and plans to refocus on its core lines of home, business, auto and life insurance, said Michelle Levy, a spokeswoman for the Los Angeles-based insurance group.

Farmers Insurance stopped writing new medical malpractice policies Friday and plans to halt renewals Jan. 1, subject to the approval of insurance regulators in each state. The insurance group has active malpractice policies valued at $94.5 million – down sharply from the $231 million in premiums it had last year, Levy said.

In 2002, Farmers Insurance lost more than $100 million on its malpractice policies; losses this year were following a similar trend, she said.

You have to read to the last paragraph to find the real impact on Texas docs:

Farmers, through Truck Insurance Exchange, has 87 medical liability policies in Texas for a premium of about $3.5 million, a company spokeswoman said. That represents about 2.3 percent of the Texas market.

So, 87 Texas docs have to get a new insurance carrier (the avg. premium for all 87 docs is $40, 230). This is very inconvienient for them , but isn’t the end of the world. And then they’ll be able to say they aren’t insured through the Truck Insurance Exchange.

Thanks to George for the link!

A prescription I’m not ready to write yet

Sperm Prevents Ovarian Cancer , from our South Korean research colleagues.

And good luck getting that prescription filled.

via Incestuous Amplification

Microsoft Doesn’t email you Patches

Another in a series of Public Service Announcements.

Not only is Bill Gates NOT going to send you a huge check for jamming up email systems, Microsoft Never Emails Their Patches.

Say it with me: Microsoft doesn’t email their patches.


The W32.Swen virus which purports to be an email from microsoft, has taken off like a rocket just in the last 48 hours. It seems that huge publicity over previous email worms has not yet taught windows users to NEVER run an attachment (unless you requested one, from a completely trusted source), and not to use an email client that defaults to showing pretty HTML, instead of plain text messages. Security forum topic and some of the many news articles.

Interestingly, the virus also hits one of those web ‘unique visitor’ type counters, (see this post) and as of early morning the counter was at 615k hits.

It looks like the easiest REMOVAL tool is here bitdefender Swen page. (download and run removal tool from the link at the bottom of the page after the long description of what the virus does).

So, to recap: just delete attachments you don’t know. I use and frequently update an antivirus program, and I also run a program that ‘quarantines’ dangerous email attachment types, to prevent their accidental clicking. I’ve only gotten one of these so far, but I was late getting SoBig, so I’m not the bellweather for virus propagation.

Why I won’t be taking any more ACEP surveys

My professional organizational body, the American Society for Emergency Medicine (ACEP), periodically wants member opinion on a variety of topics. Today I got an email (as did all other members with email addresses) asking us to take a survey for presentation at our upcoming national meeting.

So, I went to take the survey, which was 3 or 4 pages of ‘select the answer’, and an occasional ‘explain other’ section. Then time to submit the survey:
Wrong Answer
I pushed the continue button, back to the last page of the survey. Submit. Cannot Change Answers, Continue. Continue. Last page: Submit. After doing that like an idiot for about 5 round trips, I gave up.

Now, were I more paranoid, I’d suspect that my answers did’t quite line up with their desired answers, so it’s rejected. I didn’t change my answers, by the way.

And, they won’t be counted, either. If only I lived within the 9th Circuits’ area, I could get the whole thing stopped. Hehe.

Cal doc shot – Doctor shot, hospital evacuated Sep. 20, 2003

BALDWIN PARK, California (AP) — A gunman wounded a doctor at a hospital, prompting a partial evacuation of patients and medical staff and sending sheriff’s deputies on a room-to-room search of the sprawling facility.

The victim, whose name was not released, was hit twice in the body and once in the arm, and underwent surgery at Kaiser Permanente Baldwin Park Medical Center, authorities said. He was listed in stable condition.

The doctor was being treated in the hospital’s intensive care ward, said Los Angeles County fire Capt. Tony Duran.

The shooting apparently took place in the urology department, said hospital spokeswoman Socorro Serrano.

This is on every ER doc’s list of worries, and interestingly, it didn’t happen in the ED. For myriad reasons the vast majority of ED’s in the US are now at least somewhat secure, and waltzing in with a gun would be hard, but not impossible.

An active shooter in a hospital is a nightmare, probably at least as bad as a shooter in a school; schools actually consider security in their design, and kids, even today’s kids, can run. Oldsters in a hospital bed can’t walk, let alone run, and every hospital I’ve ever been in is a rabbit warren of halls, rooms that open into other rooms, exits and entrances that are unguarded, etc.

The havoc this would wreak on a hospital is astounding, and I feel very sorry for every single employee and doc there. And that goes double for the injured physician.

And I pray it never happens in my hospital.

Navy Docs are Movie Heroes

Yeah, right, you say. Well, I just saw a movie making Navy doctors heroes, and then I thought, how many others are there?

Tonight’s fare, Dive Bomber, also covered here and here, is a barely pre-Pearl Harbor story of flight surgeons discovering pressure suits for naval aviators. (That the pressure suits look like those worn with diving helmets is amusing, and possibly accurate).

Mister Roberts is special to me, and their Ships’ Surgeon (William Powell) is quotable in my house (“have an aspirin; here, I’ll have one with you”). Although the movie is inexplicably about a Lt.jg, the best acting is definitely the scene stealing Navy doc.

Purple Hearts is the last I can think of, and it’s one of those movies that everyone ought to know, but doesn’t (Cherly Ladd and Ken Wahl never made the A list, but it’s the best work they did). It’s also the first movie I recall R. Lee Ermey in(and he was great), but that’s another post.

OK, what other movies are there that glorify the Navy Doctor? Corpsman movies are gladly accepted, also (I’m dense, none come immediately to mind).

Angle-Grinder Man

via CNN
Angle-Grinder Man To The Rescue
My kind of idiot. If ever in London, and you get The Boot, call this chap and he’ll provide his ‘wheel clamp removal service’.

Might be worth calling just for the experience.

FDA Approves Prescription Placebo

The Onion | FDA Approves Sale Of Prescription Placebo

“For years, scientists have been aware of the effectiveness of placebo in treating a surprisingly wide range of conditions,” said Dr. Jonathan Bergen of the FDA’s Center for Drug Evaluation and Research. “It was time to provide doctors with this often highly effective option.”

“For years, I battled with strange headaches that surfaced during times of stress,” Kohler said. “Doctors repeatedly turned me away empty-handed, or suggested that I try an over-the-counter pain reliever?as if that would be strong enough. Finally, I heard about Sucrosa. They said, ‘This will work,’ and it worked. The headaches are gone.”

As industry analysts predict the drug’s sales will top $25 billion in the first year, the approval of placebo is expected to unleash one of the pharmaceutical industry’s biggest marketing battles to date.

Finally, a drug I’d be glad to prescribe.

via Cut to Cure

Our Marine from Russia

Russian joins USMC
So, this kid grows up in Russia, and wants to join the USMC. He gets to move to the US, graduates from High School and joins up!


Stand By for a Big Announcement

Stand by for….

…a resurrection.

(No blasphmey intended).