Advice we can't afford to follow; Professional name-calling; Electronic outsourcing should streamline office procedures; How to safeguard your credit; Replace high-tech with high-touch; Why practice defensively if jurors ignore the facts?
I appreciate that attorney Evelyn Bradford is "advising" us to settle small claims without the hassles of prolonged litigation ["How to squash a small malpractice claim," July 10]. No doubt the fact that she and her ilk would receive a nice chunk of money for simply writing a letter or making a phone call has nothing to do with her helpful recommendations.
In the present legal climate, we need to treat every patient as a potential adversary, and be aware that we can't afford to be less than 100 percent perfect. Just about every procedure carries a risk of complications. Bradford knows this, but she just doesn't care. It's all about money.
Roland Garza, MD
I was sure Bradford's article was a joke, or perhaps a test to see whether we physicians were reading your magazine. But I'm afraid you've discredited yourself by printing such a one-sided view of human error.
I agree that there's something wrong with our medical system, but there's something more wrong with the legal system and Bradford's attitude. At least two of the scenarios she presents look like honest human error, in which the physicians tried to do their best andwhen things went awryreacted responsibly by trying to remedy the problem. However, in Bradford's perfect world, people who make mistakes should immediately pay money.
McDonald's should not serve this woman hot coffee.
Thomas A. Bragg, DOMoberly, MO
As a DO, I was surprised that osteopathic physician Carl Pesta took you to task for referring to a doctor as an "osteopath" [Letters to the Editors, June 19]. I had no idea that title was considered outdated and inappropriate. Since MDs are sometimes called allopaths, I thought DOs could be called osteopaths. For future reference, what are the politically correct terms for DOs?
Steven Gitler, DO
Cherry Hill, NJ
Editor's Note: We generally try to use "osteopathic physician," or we simply indicate the doctor's specialty.
Your cover story, "Will the Internet finally put an end to paperwork?" [July 10], misleads readers to believe that the companies mentioned in the article will handle all of their practice management needs. It's evident that the author doesn't fully understand the term "practice management."
Sending claims electronically to a payer is only a small part of practice management. Comprehensive practice management includes data entry, filing invoices, balance billing, resubmission of rejected claims, following up on slow invoices, generation of aged accounts for follow-up, and generation of practice reports. None of the companies listed in the table that accompanies your article provide practice management.
Richard A. Krumholz, MD
Thank you for your news item regarding credit theft ["Could some thief be using your name?" Financial Beat, June 19]. Here's a tip on how to prevent this from happening.
Each of the three major credit bureaus allows consumers to add a statement to their credit report. You can save yourself a lot of grief by writing the following: "Do not issue any credit cards or approve credit lines without personally contacting applicant at work." You can even indicate a code word that the credit bureau has to get from you. This simple step protected me when someone tried to secure a credit card under my name.
The national credit bureaus are:
Montgomery, AL Diane@masalink.org
Editor's Note: Residents of Colorado, Georgia, Maryland, Massachusetts, New Jersey, and Vermont can obtain free credit reports. So can those with credit or employment problems. Otherwise, you'll pay $2 to $8.66 per report, depending on which state you live in.
In my opinion, FP Gil Solomon's patient education advice ["Turn your computer into a patient education library," Computer Consult, June 5] is sorely lacking in wisdom. He reports how he saved a panicky 75-year-old patient an office visit by e-mailing her a pamphlet on benign positional vertigo. That sounds good until one considers her complaint: sudden onset of vertigo. Solomon ought to remember that other, not-so-benign conditions, such as blood pressure disturbances, electrolyte abnormalities, andoccasionallymyocardial infarction can present the same way.
Solomon's action exemplifies the danger of being more conscious of speed and economy and, as he writes, "less focused on treating acute illnesses." Practicing in the "managed care era" is no excuse for providing "the average 15-minute office visit" that doesn't give patients the attention they need. We must not allow the convenience of modern technology and the pressures of time and money to make us careless.
R. Wayne Porter, MD
I'm amused at your frequent articles on ways to avoid malpractice judgments, particularly your cover story about cases in which doctors failed to provide adequate information about their experience with a particular procedure or financial incentives to withhold treatment ["The new rules on informed consent," June 19].
When are we going to realize that under the current tort system, very little depends on the facts? Many cases are decided by courtroom theatrics. There's a rich doctor and a rich insurance company on one side, and a relatively poor injured party on the other. To compensate him for his injury, we should take some money from the doctor and give it to the patientregardless of the facts.
Do you really think that if doctors disclosed financial incentives and other information, plaintiffs' lawyers wouldn't find other angles to pursue, such as medical history?
Contrary to the oft-repeated cliche "the system works," our justice system is hopelessly broken and needs to be replaced. Expert jurorsnot lay people who don't understand the nuancesshould decide cases in highly technical and scientific fields.
Michael Pinn, MD
Suzanne Duke. Letters to the Editors. Medical Economics 2000;17:14.