Last things to do today-then back to Japan. There will be no rest for the wicked there as I will have a lot to do-plus have to keep the full court press on the job hunt. If you know of and or are seeking a hard working professional to do your bidding in Asia-please email me.
There is a story on the CBS News as I type this-being broadcast on AFN. Its a tragic story of Carmelo Rodriguez who died of melanoma-which it looks on the surface-was misdiagnosed by a Navy doctor. In a nut shell the report shows a condition that was documented when he enlisted in 1997, got worse over time and in the end killed him. The purpose of the piece is to highlight the Ferres Doctrine. The Ferres Doctrine is a court ruling that specified that military members have no right to sue the government for malpractice made by doctors in its employ.
It is a sad and tragic story. However to me there is an unanswered question-if he had suspicion that the doctor was not giving him the right story-why not go see a civilian doctor? Just for a second opinion? It is your life at stake.
Because its against the rules for military personnel to do so. However people do it, and if nothing else it might have provided a means to get someone to sit up and take notice. There is a little voice inside of me that thinks it might not have been enough.
Plus in this particular case he was deployed when he brought it to the doctors attention.
I have had my own experience with self righteous Navy doctors so this is an issue near and dear to me. In my particular case this particular WPOS* thought his D.O. degree also gave him a carte blanche to interfere in my personal life. The privilege did not, and still does not, exist.
I would have loved to be able to sue him.
And beat the shit out of him. Sadly I exercised neither option. I have learned a lot since then and my real regret over the whole thing was not confront him directly and challenging him at the time. However under the circumstances-he had the ear of the mighty.
Which brings me back to this news story.
There are a host of issues that the story did not touch on, but should have if they had the time.
For one thing it should point out that military members do not enjoy the same confidentiality protections that civilians do. National security concerns -that old chestnut-are trotted out as a reason. So if it had been another condition, such as a sexually transmitted disease perhaps, the doctor will tell the member’s commanding officer.
Who may then punish him based on the doctors info-which prevents military members from seeking treatment from such ailments inside the military system. Its a Catch-22 created by the Morality Police that exist in the military today.
Second-no other employer does the dangerous things-like getting shot at by mortars and RPG’s- that the military does. Doctors are under enormous pressure in such situations. Should they have to also worry about getting sued by a Soldier’s family? Probably not.
Third-the military does not have enough doctors. Every hospital is understaffed, primarily because every hospital has to provide people to Iraq and Afghanistan under our twisted Individual Augmentation system. And it has more patients seeking to use the system than it can really handle.
Which begs the question: Why cannot, in the continental US, active duty people see regular civilian doctors and get reimbursed under their health insurance. Seems to me that is an out sourcing decision that would make sense.
Also is the Ferres Doctrine still valid? My own fear is that the US military will oppose any change to the law by Congress -and like my retirement robbery, Congress will not lift a finger to change it. I’m not saying doctors should be held personally liable-but as the employer the government does have a certain liability.
Let the conversation begin.
*WPOS-Worthless Piece Of S**t
Might be worth responding to if you had an inkling at all, of how health care works, or doesn’t work. Got millions of experts who have never spent more than five minutes listening to some BS ad for useless untested crap believe they know best. I am human and I know I make mistakes, but I try REAL HARD every day. If just 5% would listen, my job would be so much easier. Just keep whining. It will make you feel better!
I’d be curious if you would amplify a little bit. I’m not sure what you are driving at here. The issue at hand is that this family in the report has no redress for what appears to be a misdiagnosis by all-including the patient.
The troubling fact to me is the way military health care works-where the screeners e.g. the GP’s are the new folks so that they can then move on to their residency.
Also are you saying that patients don’t have a right to complain?
good luck on the job hunt skipps!
Skippy, you forgot number four. The biggest unspoken point of this story is it’s indictment of socialized medicine. Can you imagine the entire country on a system like this? While I have no serious issues with military care (40 + years as dependant, reservist and active duty) I know of many horror stories. This is where we are headed as a nation if you listen to all the pundits on the news.
Skippy,
I got to admit I caught a couple of seconds of the story last night on CBS and then moved on/fell asleep. The agenda at that network has been pretty clear for decades. I join Bill and Karl, Army brat for 17 years of Army health care then joined the navy for its version for the last 24 years. Talked to our Group Doc today, an excellent and very honest man who also caught the CBS show. He told me that the good SGT had been fingered with a melanoma at MEPS and that there were no circumstances he could imagine where the military would accept a recruit with a melanoma.
It looks like there was some kind of breakdown in the system and aren’t we all familiar enough with the system to realize that they happen? CBS is 99% full of shit when it comes to the military so I’m not willing to extend any cred to them on this story.
My assumption would be that the military does not want to outsource to private healthcare because Tricare probably doesn’t want to absorb those costs. Private doctors are paid much more than a military doctor working at the troop medical clinic. If Tricare was forced to outsource than the Tricare premium would probably have to be greatly increased.
I think the biggest problem with military health care at least from my Army experience are the number of malingerers who clog up the system to get out of PT or work. I have always felt that if the Army charged a soldier $20 to go on sick call the Army’s productivity would greatly increase and people with real health problems would be able to get an appointment more quickly.
I see and treat active duty military members daily in the civilian ER here in VB. They come here because 1) They wait is too long at NMCP, 2) The base clinic is closed after 1700, 3) The clinic sends them to the ER because they can’t handle their condition, 4) The member doesn’t want a military provider treatiing them. TRICARE pays all the bills without question.
I had a friend who repeatedly went to the Docs at Mare Island over several months complaining of groin pain. They told him to lay off the surfing, skiing, sex or whatever it was he had been doing that week and he’d be fine.
Testicular cancer, easily curable, in it’s early stages, even then.
They clipped his nuts, gutted him like a fish and sent him home to die, with a medical discharge. He was a great guy.
I was there when this happened. Skippy if you want to know the whole sordid story email me. I saw the Sergeant just before I went on terminal leave in May, and I was shocked to no end at his appearance on the report.
First off I am speaking from the perspective of an Army Officer who has worked in military healthcare/training for 10 years and is now seaking a PA degree. I have been to Iraq twice and I have a few issues to add to this discussion.
People seem to think that being a doctor is like being a mechanic. It kinda is… only a car with a certain problem, as it is a machine, acts the same way EVERY time. 10 people with the same disease can present 10 different ways. The same drug given to 10 people can have 20 different side effects. Add to all those variables the fact that people, even doctors, make mistakes. I’m sorry, but military providers are placed in impossible situations where they sometimes must make choices most (especially a jury of civilians who’s only view of the military is what they see on CNN) would never understand. That includes cutting corners at best (as many “standard of care” diagnostic equipment is not available on a deployment) or at worst letting people die to save others. Do you really want to add the burden of worrying that someone will sue them later?
I do not know any of the cases you talk about… but those aside, your problem seem to be more that you don’t like the attitude of the doctors more than anything else. Your answer: SUE THEM!!! which jives with the fact that statistically people who like their doctors are less likely to sue them… even if they make a mistake. On the flip side, people who dislike the provider, will sue them for anything… including common complications that are no fault of the doctor. People seem to have unreasonable expectations, then want to get paid when they are not met.
Last point: Lawsuits and overregulation are the major reason why healthcare is so expensive in this country. People will sue over anything… and many times it costs less to settle even if the doctor didn’t do anything wrong. That cost is passed on to the hospitals and doctors in the form of increased insurance premiums. It is then passed on to the individual consumer directly … or to their health insurance… which then charges everyone more. Who wins when noone wants to be an OB/GYN or the cost of care quadruples because in FL it costs six figures for malpractice insurance? Not the avg joe on the street. With suing the US Gov’t directly… Guess who’ll pay that cost? You, me, and the rest of the taxpayers. Great plan.
Brad, the plain fact is that the doctor he saw in Iraq was only concerned with himself. he looked at a bleeding sore, that had been there for awhile, and said, “If it doesn’t go away see me at Cherry Point when we get back in seven months.” He wasn’t sent to the hospital for a biopsy, and when he did get back he had to go to the hospital and throw a fit to be seen. Finally, to quiet him down, another doctor saw him, ordered a biopsy, and the next day he was told he had stage four cancer. I also bet that a little digging will find another Marine who died under the same circumstances a year or two ago.
Brad,
I submit that the relationships between the doctor and the patient needs to be a cooperative one and the patient needs to take responsibility for being informed, asking the right questions, and working together with the doctor.
My objection about military medicine is that it is NOT ABOUT DOING WHAT IS RIGHT FOR THE PATIENT. It is about doing what is right for the military. Those are two entirely different propositions-and particularly for conditions diagnosed under the DSM-IV, they run afoul of the law and the patient’s rights under the constitution and the Bill of Rights.
The doctors responsibility should be to the patient always. The CO is the one who has to look out for the military. And like a lawyer he has an overriding obligation to protect the privacy of the patient. At all costs.
All the CO needs to know is if the guy is fit for duty or not. Too many military doctors take it way beyond that-into the realm of making value judgments on the patients lives. Been there done that, got the T-shirt.