Thursday, May 8, 2008

Stress From Medical Malpractice Case Causes Doctor To Develop Angina; Doctor Face Elevated Stress and Suicide Rates?


A strange reminder awakened interest late Thursday afternoon during this week's jury trial. An 83 year old defendant had severe angina while walking down from the witness stand following his cross examination. This particular defendant was a doctor being tried for medical malpractice. His co-defendant, another doctor, came to his aid and instructed him to take an aspirin. ( A good tip for most experiencing angina. Aspirin is thought to prevent platelets from clumping together and causing heart damage.) Thankfully, the doctor recovered well enough to attend the last day of trial and see his name (and of the co-defendant) cleared by a favorable jury verdict. While this particular physician has a strong will to live: I could not help to be reminded how stressful the medical profession can be for those involved.

A rarely talked-about paradox exists: doctors are trained to save lives; however, that same training can make physicians efficient at ending their own lives. Approximately 300 to 400 U.S. doctors kill themselves each year. That is thought to be a higher suicide rate than the general population (except perhaps for Washington D. C. prostitutes who threaten to publish names of their famous clients.) One hypothesis is that mental illness is magnified in a profession that elevates and glorifies physicians up to hero status. In such a system, admitting psychiatric problems could be tantamount to exposing Superman to kryptonite and thus constitute a career ending flaw. Consequently, the physicians often go untreated for depression or other mental illness.

What happens when depression becomes too much? Unlike the normal population, doctors have access to prescription drugs. They also know the correct dosage to stop pulmonary and cardiological function. The American Medical Association labeled physician suicide as "an endemic catastrophe." The American Foundation for Suicide Prevention has initiated an educational program to help troubled doctors. Unfortunately the AMA does not officially publish suicide statistics. However, men in the U.S. are thought to be four times more likely to commit suicide then women. It is estimated that 23 per 100,000 men will commit suicide. However, when it comes to physicians, male and female suicide rates appear to be equal.



Is there a solution to stress reduction for physicians? From a legal perch trying to peer into the tight nit medical profession, one suggestion would be to avoid medical malpractice trials. Of course, if that happened, some lawyers would need to look for another job.

16 comments:

blond Bombshell said...

Congratulations on both victories Legal Pub. You rock and you know it!

Shell

Anonymous said...

Thanks for a great job.

Doc

Joel A. Brodsky said...

A large part of the problem is that the patient/doctor privilege, even in the context of mental health treatment (psychiatric treatment and anti-depressant medications) are not truly confidential. If there is litigation all doctors know that mental health treatment records often come out. All that is needed is a court order that judges are too often only to eager to enter. Take a look at the federal, or any states, mental health record confidentiality law and you will see that there are dozens of exceptions to confidentiality. Also, the MIB (Medical Information Bureau), the insurance industries clearing house for all medical information, has records of everyone’s insurance claims and the related medical treatment. Every time you apply for health insurance, life insurance, disability insurance, you sign a release for the company to get your medical treatment history from MIB. Also, if you are on a psychiatric drug (for treatment for depression lets say), most states do not provide that your pharmacists records are confidential from subpoena.
So every doctor knows that, if he is involved in litigation (and almost ever doctor is involved in litigation at some point), where his mental capacity or state of mind is, or even could be, even slightly relevant, there is a good chance that the record of his entire psychiatric and mental health treatment will come out. Doctors know this better than most people since they are involved in the disclosure of medical records on a daily basis.
I know the response to this is that the further disclosure of the records by the persons receiving the records is supposed to be illegal, but that is not always the case, and information often makes its way around the small and insular medical community. Further no real penalty is ever applied for violating this rule. Also, even if the records are not re-disclosed after there initial disclosure, what doctor wants lawyers, paralegals, secretaries, clerks, court reporters, insurance company employees, etc.. seeing notes and records of his or hers mental health treatment where as one court put it, “the patient discloses the innermost secrets of his soul”.
What is needed is a “true mental health professional/patient” confidentiality law that says that no mental health records are to be disclosed to anyone, period. As LP shows in the introduction, people are dying for fear of going to treatment, so this issue is a matter of life and death.

Ms Calabaza said...

Hey LP, from Shell's comment I gather you won. Congrats!!

Mr. Brodsky,

I can't believe this - but I agree with you on this one!

ralph said...

Great job Joel. I understood and agree.

Ralph

Anonymous said...

An aspirin saved me from major heart damage too!



K.P.

Anonymous said...

Got to admit, Brodsky hit the mark.

Anonymous said...

Joel, I am beginning to think you do in fact deserve the label as an
"excellent" lawyer. Great comments.


Bill

Anonymous said...

Yup, keep it up Joel and I may have to change my opinion too. That was an informative, thoughtful post!

california surfer dude said...

I over heard, Five surgeons discussing who makes the best patients to operate on. I thought they would say the one with the best insurance. But they said the followning:

The first surgeon says, “I like accountants because when you open them up, everything inside is numbered.”

The second responds, “Yeah, but with electricians, everything inside them is color coded.”

The third surgeon says, “No, librarians are the best because everything inside them is in alphabetical order.”

The fourth disagreed and said,“I like construction workers…those guys always understand when you have a few parts left over at the end, and when the job takes longer than you said it would.”

But the fifth surgeon shut them all up: “You’re all wrong. Politicians are the easiest to operate on. There’s no guts, no heart, and no spine. Furthermore, the head and butt are interchangeable!"

Surfer Dude

Anonymous said...

Whoever surfer dude is, you got some serious ups on levity. Thanks for brightening my day before I sharpen my knife.

Doc

Anonymous said...

Does know how increase the risk of suicide for doctors? I don't think it does. It does increase the chances their suicide will be successful.

Docs commit suicide because they are under too much stress. That is the risk factor, in my opinion.

Doc

Anonymous said...

Does know how increase the risk of suicide for doctors? I don't think it does. It does increase the chances their suicide will be successful.

Docs commit suicide because they are under too much stress. That is the risk factor, in my opinion.

Doc

Anonymous said...

Legal Pub, you are on a roll. I hear, that is 3 Defendant's verdicts in a row. You need to slow down or your candel will burn out long before it should.

Anonymous said...

Bottom line, no victim no crime.

Savio's death doesn't mean a thing unless the grand jury signs it on the dotted line.

If they do, then we shall see what if anything the prosecution can actually prove...

Legal Pub said...

First, let's wait for the ruling. The new law allowing hearsay statements may not be constitutional. It does not really seem fair that statements where the declarant can not be crossexamined could be used to convict a defendant. Keep in mind the laws are designed to protect the innocent. While Peterson may be unpopular, he still has rights.This case may end up affecting the rights of future defendants some of which may end up being convicted even though they are innocent.

We will update the story after the decison as it should be the judge and ultimate the Appellate Courts that should decide this very important issue.