The Malpractice Cast Net
Having been the intended victim of a few upset family members who have wrongly accused me of malpractice, I have a small bit of insight into the types of cases that are occasionally brought against physicians. In order to ease the pain of the natural but unexpected death of a loved one, and often to ease their own feelings of guilt, claims of malpractice are tossed out like a cast net by angry grieving relatives in the hope that a nice trout might be snared from amongst the bait. Of course before the net is pulled in, the circling sharks invariably take a huge chunk of the catch. There's usually enough left over to feed the family though. Admittedly, most of these attempts come up empty, never making it to trial or inducing a settlement offer, but they are still annoying. Even painful.
It all starts with a patient's unexpected death. Young healthy people aren't supposed to die, so obviously it must have been someone's fault. Did the patient seek the advice of a physician recently? Or maybe not so recently? The eager attorney will devour the bait without requiring the accusers to pay anything up front. It's her pleasure. The blood is in the water, and she is anticipating a big meal. Even if she doesn't get the big catch, she'll settle for some scraps to keep her fed. People die every day, and they usually seek medical attention at some point, so there is always plenty of bait. Heck, people sometimes go to the doctor just for a checkup. If a serious condition develops later, maybe it should have been picked up on the initial visit, right?
Is there any symptom or sign mentioned in the medical record that could be remotely connected to the cause of death? Never mind that certain symptoms are so vague and common that they aren't initially diagnostic of anything in particular, or that the initial signs of disease may be subtle. If the patient saw a physician even once, and the particular complaint (perhaps among many) wasn't fully addressed, then the fact that the patient died sometime thereafter is a red flag that negligence might have occurred. Chum for the sharks, you might say.
Perhaps more tests should have been done. Obviously the patient died, so the workup and treatment plan must have been inadequate, right? Negligent, even. Malpractice. Did the patient follow up again prior to his death? No? It must have been the physician's fault for not encouraging more aggressive followup. Maybe a certified letter should have been sent. Maybe the physician should have called the patient at home every day to inquire on the status of the condition, since the patient shouldn't be expected to take any responsibility for his own health.
The reaction to Flea's settlement among many in the blogosphere is disturbing. While none of us know the specific facts of the case nor the physician himself, I will say one thing: based on what I DO know, I would eagerly accept Dr. Flea as my own children's Pediatrician. Physicians like him are a rare breed these days. He takes his own call. He is available to his patients 24 hours a day. He makes house calls, for chrissakes. He obviously cares about his patients a great deal, and he seems to have superior medical knowledge and medical judgment. If anyone can't recognize these things, than they deserve the HMO assembly line care that is becoming all too common these days and that eventually all of us will likely have to settle for. The old-school docs are becoming extinct.
Why do I give him the benefit of the doubt? Because I too have been personally accused of negligence, and I have settled cases in which I gave appropriate care in order to eliminate the possibility of a megaverdict. Because I was a fan of his blog, and in his posts he shared his practice style with all of us. I am confident that he is not the sort of physician that would ignore his patient for five weeks if they needed him. Any of us can miss a diagnosis in the early stages of disease, and obviously many medical conditions become more apparent over time. So despite his mistakes regarding the trial blogging, I doubt he is responsible for the death of that patient.
I hope he will share the details of the case with us someday, but until I am convinced otherwise, I will stand behind him. If he decides to move to Texas, I've got a couple of patients already lined up for him, and I will gladly refer many more.