Letters to the Editors

Plaudits for a doctor who fought back

Thank you for detailing neurosurgeon John Guarnaschelli's ordeal ["Message to plaintiffs' lawyers: Sue me at your own risk!" Dec. 4].

I've long hoped a national physicians' organization (AMA, are you listening?) would create an elite legal organization to assist physicians in pursuing appropriate countersuits. If the organization routinely identified and aggressively fought errant malpractice lawyers, few of them would view the medical profession as an easy target.

How much easier would Guarnaschelli's case have been for him if an organization was already in place to assist in his case? The expertise acquired as a result of his experience should not have to be reinvented every time a physician is wrongfully charged, and we physicians could have a major impact on the number of medical malpractice cases filed.

Guarnaschelli's "pilot study" has demonstrated the benefits of a more aggressive strategy. "Several suits filed against me over the last 15 years have all been dropped or dismissed," he noted. The response of the offending attorney in his article is exhibit A for such a coordinated effort: "He told the (Louisville) Courier-Journal that as a result of this trial and verdict, he'll never take another medical malpractice case 'unless they leave the scalpel in the chest and it's showing through the skin.' "

We physicians have the ability to make unnecessary medical malpractice cases far more costly to those who pursue them. Will we do so?

David L. Anders, MDPeachtree City, GAtheanders@mindspring.com

I review medical malpractice cases for several plaintiffs' attorney firms. Without exception, the best plaintiffs' lawyers would never file a suit without a thorough review of all records by at least one outside medical expert.

The attorneys I deal with are well-informed and review all pertinent literature relating to a case. I'm sure that there are lawyers like the one in the article who don't feel it's necessary to have expert medical review, but they are in the minority. My job as an expert medical witness is not to build a case for an attorney. Rather, it's to see if the case meets standards of care, and, if so, to tell the lawyer early on, so that he can inform the plaintiffs that they are wasting time bringing a malpractice action.

The description of the case in Medical Economics suggests legal malpractice. I think the jury award of $60,000 in punitive damages is ridiculously low.

Charles P. Riley, MDPensacola, FL

E-resistance—or common sense?

I find it alienating to read an article and headline such as "Most doctors are e-resistant" [Practice Beat, Dec. 18]. While it's conventional wisdom that docs are dumb technophobes, as the headline suggests, there may be an alternative explanation for that 90 percent who don't communicate with patients by e-mail. In fact, it's even there in your article: Legitimate security concerns, and a lack of interest in working (and incurring liability) for free.

Doctor morale isn't high nowadays. If you want to knock me, please do it for an appropriate reason.

William MacDonald, MDEverett, WAwmacdonald@everettclinic.com

Edited by Gail Weiss,
Senior Editor

Address correspondence to Letters Editor, Medical Economics magazine, 5 Paragon Drive, Montvale, NJ 07645-1742. Or e-mail your comments to meletters@medec.com, or fax them to 201-722-2688. Include your address and daytime phone number. Letters may be edited for length and style. Unless you specify otherwise, we'll assume your letter is for publication. Also, let us know if you don't want your e-mail address printed with your letter.

Gail Weiss. Letters to the Editors. Medical Economics 2001;4:11.