February 21, 2011

Yes, there will be an investigation of the excuse-writing doctors, but no, they will not be found to have violated medical ethics.

Instapundit links to Gateway Pundit who links to this press release from UW Health:
These charges are very serious and in response, University of Wisconsin School of Medicine and Public Health and University of Wisconsin Medical Foundation, the UW Health entities that employ the physicians, have immediately launched an investigation of the reported behavior.
It's good politics and good public relations to take this seriously, of course, but I think the outcome is predictable.
The investigation will identify which UW Health physicians were involved and whether their behavior constituted violations of medical ethics or University of Wisconsin and UW Health policies and work rules....
I don't know the details of the rules or medical ethics, nor do I have any inside information about the way my university handles such things. But I know how the doctors defended themselves when I confronted them, and I think their explanation will be accepted.

They said they were really "seeing" the individuals who asked for notes, and they individually listened to their "patients" reports about what their symptoms were. I had a longer conversation with a second doctor and, like the one I interview on camera, he had his approach to ethics down pat: Doctors providing notes for employees accept their patients' statements about what their symptoms are all the time, and the people they spoke to on the street really did mention symptoms, such as headache, diarrhea, insomnia, and — notably — stress (including stress from the budget plan and the protests). This puts this within the range of something doctors routinely do.

I'm not saying that's the right resolution, but I predict that will be the result of the investigation, perhaps with a public-appeasing, forward-looking statement that doctors ought to avoid the appearance of impropriety by refraining from this activity in the future.

Am I right?
Yes, and it will be outrageous.
Yes, and it is the right resolution of the kerfuffle.
No, these doctors are going to get in more trouble, and it's a good thing too.
No, they'll get in more trouble, and I think it's a shame.

  
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57 comments:

Ut said...

You mean to tell me that the University of Wisconsin ... which has a 99.4% liberal faculty, is going to investigate these Democrat doctors and that this investigation is going to result in total vindication of the embezzling co-conspirators?

Gee, someone alert the media.

MayBee said...

Everyone knows which doctors to go to if they want to file an injury claim against Halliburton.

Ut said...

You know what ... fuck 'em all.

I want the union to win. I want the doctors to go ahead and give these scumbag teachers notes and let them embezzle it all.

I've come to the conclusion that there is only one way any of this is ever going to end.

And the quicker we get to it the better.

RBB said...

I have no doubt that they will be absolved, if only because several were high ranking faculty in the Department of Family Medicine. They will investigate to give the appearance of concern and then it will disappear. As a physician myself, I had to laugh at the guy in the MacIver video that cited patient confidentiality and the private medical conversations he was having with the patients. ON A STREETCORNER! That in itself might be a HIPPA violation, because he interviewed and presumably examined patients in the open with no concern regarding their privacy. They really didn't think it through very well.

BJM said...

Weren't the docs involved in a conspiracy to commit payroll fraud?

Doesn't WI have laws against criminal conspiracy?

JAL said...

I want to know what the malpractice insurers for these malfeascant MDs have to say.

Would you want to insure someone who so cavalierly abused their license in such a way?

Not me.

Fortunately, for some people the bottom line is where the rubber hits the road and the buck stops.

SteveR said...

No consequences whatsoever. Done deal, fox guarding the henhouse, etc

Mr. D said...

UW won't do anything, but they don't just answer to UW. There are going to be a lot of angry school boards. And are we sure that J. B. Van Hollen would sit this one out?

Fen said...

Wordgames aside, the doctors knew they were handing out sick leave notes so that workers could take the day off to protest.

Its like ditching exams to go to the beach, then finding a doctor at the beach to excuse you from class that day because you got a sunburn from skipping class that day.

Bushman of the Kohlrabi said...

It's OK. Only the taxpayers are getting screwed. They don't matter.

Elliott A said...

There is no instance where a physician can ethically give a patient a note unless the individual is a patient of theirs and they are aware of an illness or injury, or they treated or consulted on the illness or injury in an appropriate setting. This is no different than writing a prescription for a controlled substance when you know the intention of the individual receiving the prescription is not to use it for its intended purpose. It is fraud and is against all rules and codes of conduct. The docs Ann spoke with gave the 'cover your ass" answer, but upon examination, it is really pathetic.
I am sure that the patients waiting in the clinic would be happy to know that while they are waiting for medical care, the doctors are abusing their licenses for a political cause.

JAL said...

Not to mention the HIPPA issues.

I have an ER doc in the family. The extremes they have to go to in the ED to supposedly protec the patients' privacy is just plain silly.

And then doctors examine people on video, known and unknown, with the crowds milling around on a street corner. . .

Did they get signed waivers from every "patient" that it was okay?

There are days I wish I were a lawyer .. .

Heh. Did these guys not see the frog walked Medicare doc fraudsters the other day on the news?

Their medical board may not be the only interested party.

Fen said...

No consequences whatsoever. Done deal, fox guarding the henhouse, etc

Much like the collective bargaining scam.

Methadras said...

A pointless masturbatory effort.

Henry said...

"How were you feeling this morning?"

"Awful. Insomnia, headache, diarrhea, stress. Thank God I was able to get out to this protest and breath some fresh air."

"Here's your note."

Jason said...

Its Madison. Its the UW. They support the "cause". Of course nothing is gonna happen.

Of course, if this had been a tea party rally and right-wing doctors had been doing this, then all hell would break loose.

David said...

They helped other to lie, so lying for themselves will not be an obstacle.

This is an interesting side issue but not the main event.

The main event is the immediate legislation on the table, and the bigger question of who is in charge.

Fen said...

Its like ditching exams to go to the beach, then finding a doctor at the beach to excuse you from class that day because you got a sunburn from skipping class that day.

If they permit this, then all students at the University should be allowed to use this method.

You'd think the University would hold its teachers to a higher standard. Role-modeling or somesuch.

Regardless, I'm betting that based on this weeks shenanigans, students across Wisconsin will have alot less respect for their teachers. Some may even stage a walkout when they don't get their way :)

vnjagvet said...

I think Althouse is right that the UW "investigation" will result in exoneration or at most a cosmetic and meaningless slap on the wrist. I suspect at least 90% of the faculty and an overwhelming majority of UW's administration are proud of their colleagues' blow for "social justice".

But I am not as sure that every school board that was a victim of the fraud perpetrated by the Street Corner Docs will let them off the hook. I think it is more likely than not that the school administrations will not pay the teachers submitting the SCD's excuses in blank.

PETER V. BELLA said...

Union teachers and gummint doctors are allowed to lie, cheat, commit fraud, violate ethics, shut down the school system without just cause, and not be punished. It is part of the policy.

Read the fine print.

Big Mike said...

I predicted this at 5:46 on the "No Tea Drinkers" thread. It's a very old story.

Susan said...

I'm really surprised that these doctors don't see the logical result of their behavior, which is to speed up the blending of separate sick day and vacation day pots into one paid-time-off pool.

Employers who know that paid sick time is being abused tend to implement policies like "need a doctor's note if you miss more than three consecutive days". But if they start to realize that doctors might be writing notes for "social justice" reasons -- i.e. "I think it's criminal that your employer only gives two weeks vacation. Why, in Europe... -- then the remaining holdout companies will just adopt one big pot. Which lefties oppose.

Fen said...

I think thats where Ann pulled it from. She does that sometimes.

Fen said...

Susan: I'm really surprised that these doctors don't see the logical result of their behavior

And isn't it the same pattern? Unions abuse the rules, then throw tantrums when the rules are changed to limit abuse.

Revenant said...

I assume, given that we're talking about a university, that any and all left-wing excesses will be excused. Nothing ever happened to the Duke faculty, who committed far worse offenses than this.

But as others have noted, this doesn't begin or end with the university. Doctors are required to keep records of their consultations with patients, and these doctors did not. Add in the fact that they're being quite open about their real motives, and I don't see it holding up in court.

virgil xenophon said...

This is all part of the left's "we're on the right side of history"/" we hold the moral high-ground so-we-can-do-anything-we-want" sense of entitlement bit. Why,by these lights, should they be ashamed? Nothing to be ashamed about; no tactic too brazen or thuggish in the furtherance of a righteous cause,--nothing to be alarmed about--nobody here but us chickens!

M.Z. said...

Y'all seem to think there is a prima facie case that these notes are illegitimate. It ain't gonna work that way, nor should it.

bagoh20 said...

These doctors could make a fortune out here in California prescribing medical marijuana. The same "understanding" operates, but out here the patients only want permission to waste their own money.

ricpic said...

A Member Of The Club

He was young and oh so promising
And a member of the club:
So what if he'd made a few mistakes?

What he'd done was indefensible
But all that promise wasted:
Them that have shall win...whatever it takes.

John Althouse Cohen said...

Why is diarrhea mentioned as a typical symptom you'd expect from people who are out protesting? On the contrary, if they have diarrhea, I'd assume they are not up for a protest and would be staying at home till they get better.

S said...

It's HIPAA, not HIPPA.

I think there's an outside chance that they will be punished, most likely if someone not on the unions' side steps forward to say that they got a note with no inspection and no claim of symptoms.

bagoh20 said...

The chance of punishment for this obviously unethical behavior is zero, and it should be used immediately by some smart-ass student to explain his absence from class.

I would love to hear a teacher explain why the student should be punished for sacrificing their own education after this week-long rip off they have been handed.

Almost Ali said...

I suspect many of you poll takers have been living in a van down by the river.

What do you mean: Yes, and it will be outrageous[!]

No, it won't be "outrageous"! Not even mildly disconcerting, or something that would turn a single, informed head. Because real life ain't a soap opera.

Allison said...

I didn't vote, as none of the choices lined up.

I would just like it if the investigation somehow woke up a doctor or two to realize their worldview isn't the only one in the world that their patients have.

I was a grad student at UC Berkeley during the 2000 election, the attacks by Al Qaeda, and some of the war in Iraq. At one point, I had to go to the campus medical center for something, and knew I'd be there for a long time, so I brough along Woodward's book Bush at War. I had it with me in the room during the exam, and the back cover, which had pics of Condi, Cheney, Rumsfeld, and Powell and someone else--GWB, I think?-- on the back.

DURING THE physical exam, while I'm naked except for those dumb cloths, the doctor said "aren't those the 5 ugliest people in America?"

I was so shocked at this outrageous question in such a context that I didn't do my standard ignoring of liberalism at Cal. I answered her: "No, actually, they are very attractive people. (pause while stammering) And what you said is completely inappropriate."

She was utterly shocked that I said something, and immediately said "oh, right. sorry, you're right." I said nothing during the rest of the exam. When she was finished, she tried to apologize again for her statement being inappropriate, but I was too upset to say anything else to defend my view.

It was so typical of my experience during those tumultuous years that not only was nearly everyone on campus egregiously left, but they were UNAWARE people actually could disagree with them. It had never occurred to her that someone could be not of her politics, so it had never occurred to her that it was inappropriate to speak politically in an examination.

JAL said...

@ JAC re diarrhea

Funny -- I was thinking the same thing.

What an awful place to be if one has diarrhea.

Ich. Ooops.

bagoh20 said...

Diarrhea = uncontrolled spewing of crap. Therefore the diagnosis is probably correct.

edutcher said...

Anybody wanna bet these would be the kind of doctors sitting on your death panel?

Prosecute them and the teachers for whom they wrote the excuses for conspiracy to commit fraud.

Mary Beth said...

So, what happens if someone with one of these notes develops a serious illness or dies from something that should have been found in any basic physical exam? Will they or their family think it is unethical to sue the doctor that wrote the note? Or will they assume that the doctor, university, and insurance company has deep pockets and it's only fair that they get their share?

Revenant said...

These doctors could make a fortune out here in California prescribing medical marijuana. The same "understanding" operates, but out here the patients only want permission to waste their own money.

Another key difference is that the left-wing state government enthusiastically cracks down on medical marijuana users and dispensaries, despite them having been legalized by referendum over a decade ago.

Ann Althouse said...

"I think thats where Ann pulled it from. She does that sometimes."

What does that even refer to? This post is based on the things that are linked in this post and my own original thinking.

William said...

It's vexing that none of these physicians had sufficient imagination to comprehend how such actions would be understood by those not in sympathy with their politics. Since they're doctors, I would presume the problem is not density but arrogance....Well, nothing very bad will happen to them and they will live out their lives convinced of their own rectitude.

William said...

People are not as cynical about physicians and teachers as they are about lawyers. But give it time.

G Joubert said...

I don't know the details of the rules or medical ethics, nor do I have any inside information about the way my university handles such things. But I know how the doctors defended themselves when I confronted them, and I think their explanation will be accepted.

Acceptable to whom? Other public employees? Ann Althouse, you aren't too far behind. You feed from the public trough, no? Has that thought occurred to you?

Fen said...

Ann: What does that even refer to?

That sometimes a commenter will link to an interesting piece and you will headline it later that day.

I've seen many examples of this here over the last several years. I assumed you did that, and its not meant as an attack on your ability to think independently.

Charlie Martin said...

I think you're making an essential error, which is that failures in ethics are the only thing for which they can get in more trouble. I suspect that, first, the doctor who is Director of Residency may well lose that job, although they may allow her to quietly resign in a week or two. One of the few things for which you can get in real trouble as a tenured professor in a medical school is embarrassing the Dean in a way that could impact funding.

Second, the actual state medical board needn't, and likely won't, defer to the University.

And third, they decided to put themselves out in front of what is turning into a major, nationwide battle; as symbols, if nothing else, the consequences will be very visible.

Ann Althouse said...

"I've seen many examples of this here over the last several years. I assumed you did that, and its not meant as an attack on your ability to think independently."

This is a strange post to say that about since I show a path of 2 bloggers before I get to the news article. If I take something from the comments, I link to the comments.

Often people in the comments put up links to very prominent news stories, like stuff linked on Drudge or Memeorandum (which I don't always do a link for ... for various reasons).

I put a lot of effort into giving credit to the place where I actually get something (with the 2 exceptions above). (Drudge is an exception because it's so huge and it never does "via" links and because I do link to it some of the time. Memeorandum is an exception because it's an automatic aggregator, and I do throw it a link every few days.)

Fen said...

This is a strange post to say that about since I show a path of 2 bloggers before I get to the news article.

True. I didn't notice that at the time I posted.

But I wouldn't get wrapped around the axle over it. I was responding to Big Mike's comment that he had predicted all this and it was old news.

Fen said...

as in "buck up, maybe your comment gave her the idea to blog on it".

I'm sorry if my remark implied your were plagiarizing or somesuch. That wasn't my intent.

Allison said...

Actually, I would think more than ethics or even funding is the concern of a malpractice suit against their doctors. Clearly the med school and university would want to do everything to limit their exposure to some strange liability issue.

The Drill SGT said...

@ Charlie Martin said...


There's one more for the list. The University malpractice carrier should be going bonkers. let me count the ways:

- some of these doctors were residents and have procriptions on their practice outside the academic setting. which the UW has already said was not within scope.

- there is now internet video of docs committing either/both fraud or sloppy exams/evals and then making signed statements. can you imagine how the opposing attorney would use that video against one of these docs or UW in a malpractice case?

Rate.Increase!

Scott M said...

From The Atlantic's Ford Vox,

UW's doctors have demeaned not only the doctor-patient relationship, but in so doing, risked the stature doctors hold in our discourse on public policy. When commenting on social issues, physicians trade on the honor of our profession, benefiting from the public's assumption that the wisdom won of caring for so many at their most vulnerable imbues us with some privileged understanding of collective need.

Scott M said...

Slightly OT, I wrote above:

"From The Atlantic's Ford Vox,"

How, technically, is that supposed to be written? Since it's a writer at The Atlantic I was trying to show the possessive with the 's, but only italicized the title of the magazine.

knox said...

On the contrary, if they have diarrhea, I'd assume they are not up for a protest and would be staying at home till they get better.

LOL. That was my thought. If there's ever a time one needs to be close to "home base."

Andrew said...

Holy Cow, I can just imagine my employers response if I missed four days of work and returned with a note saying I was absent because I had the “Stress”.

PatCA said...

As Allahpundit says, wrist slaps for everyone.

Fen said...

Holy Cow, I can just imagine my employers response if I missed four days of work and returned with a note saying I was absent because I had the “Stress”.

Even worse, the cause of your "stress" is related to the venue you ditched work for.

sydney said...

Nothing will happen. Most of those doctors are listed as having their MPH - Masters of Public Health. MPH programs are notorious for their leftist political bent. During the Bush years I attended a lecture by a family physician from academia who was supposed to be an expert on immunizations. He had a position on the government board that approves our current immunization schedule. The lecture was supposed to be about. Immunizations, but he went on and on about the evil that is Bush and war and the threat our then administration was to public health. You can bet the farm the investigators will be sympathetic to the crime.