They Shoot Horses Don't They

They Shoot Horses, Don't They? is a 1969 American drama film directed by Sydney Pollack. In his youth, the main character saw a horse break its leg, after which it was shot and put out of its misery.

She was not a horse but 87-year-old Lorraine Bayless collapsed last Tuesday in the dining room of the Glenwood Gardens independent senior living apartments and the staff refused to initiate CPR because it was against policy, so the woman died awaiting EMS. I wonder if we will reach a point when shooting people like Lorraine Bayless to put them out of their misery will be acceptable practice. Apparently the family did not protest and the woman had a DNR order…so all the ingredients were there except the gun.

The major concern of the staffer in question was liability of course. Lawyers out there, this could have been your mother, unless of course you react like her family.

The Good Samaritan approach is not only rarely practiced anymore but it is strongly discouraged, especially if you are a nurse or a doctor, because you can be sure you are facing a malpractice suit if there is death or complication. It is the ZEROES (at the right of 1) that make everybody tick NOT the HEROES. The latter are good for a short news segment then bye bye.

Sadly this is cheapening the value of human life In America, at a time where respect for animal life is at an all time high…so is the actual cost of living (no relation but thought I put it there).

As I mentioned in previous blogs, many things have been contributing to cheapening human life: violent video games where lots of people are blown off like nothing, same in Hollywood movies, drone attacks that make war seem very remote and Starwars-like, mass murders by single nobodies (Fort Hood, Aurora, New Town, etc.) or rudimentary methods (manure, turning our own planes against our own WTC).

Of course there were also natural disasters that contributed to the cheapening and sense of frailty of human life: Thailand tsunami, Japan Tsunami, numerous earthquakes, Katrina, Sandy and others.

Nothing however is as cheapening, disheartening and disconcerting as the latest discovery about drones. In the last of INNOCENT UNTIL PROVEN OTHERWISE, drones can actually target American citizens and execute them just based on the belief that they may be terrorists. Collateral damage is something we blame others for. We are back to the Far West where we shoot first and worry about it later, where we hang horse thieves on the spot. At least then the duals tried to preserve a modicum of fairness and the opponent had skin in the game.

I can picture members of the administration sitting in the  situation room watching it all on a TV monitor, like for the Bin Laden kill…except popcorn and refreshments will be served this time around. It would be Reality TV at its finest and most sinister. Wouldn’t that drone video feed closely mimic those very violent videos that we are all starting to blame for gun violence?

What do 00BAMA, H00LDER  and 007 have in common?

A License to Kill…from the Sky!

More Jeopardy than Alex Trebek

Doctors, educated as they may be, are about the only group in America who is always guilty until proven otherwise (in contrast with the dogma: innocent until proven otherwise on which the US legal system is based). Allegations about you are made public and your license can be suspended PRIOR to any adjudication or due process. All this brouhaha even though not final and just alleged puts a big target on your back from day one: Happy patients will distance themselves, less happy or ruthless patients will seek a lawyer to sue you and take advantage, lawyers would advertise in newspapers soliciting cases against you. colleagues will avoid you, malpractice insurance will drop you, health insurance will stop paying, Medicare and Medicaid will drop you, certifying boards will do the same and the downward spiral will go on and on. So even if you win at the end and restore your license, what have you got left to come back to?

I always said building is a lot more challenging than destroying. Building may take years, destroying takes minutes. Look at the World Trade Center. It takes years to educate a doctor, using a lot of time, money and dedication, years to have him/her gain their experience, and minutes or puny hours to destroy him/her. Everything is on the internet because anybody can say Oh!

Some may think you can go practice in another State. Fat chance. Other states you are licensed in will automatically follow suit. Let me tell you a story that will blow another American legal dogma right out of the water:  Double jeopardy.

A NJ-licensed doc lived in neighboring PA. He did not have an active license in the latter nor did he practice there. The NJ Board fined him $10,000 as related to something he allegedly did or did not do. A couple of months later, the PA Medical Board sent him  a letter also asking for $10,000, even though he was not practicing at all in PA and his license there was inactive! I assume that if he also had a CT or DE or another license he would have to pay this fine OVER AND OVER AGAIN. So much for double jeopardy! If this doctor had shot a person in NJ, he would be tried there and serve a sentence and that would be it. If he then moved to PA or CT he would not be tried and serving his sentence there again and again!

Everybody wants to be a doctor but they do not know what waits. In the mid-80s two people bought their MD degrees from some south of the border University and "practiced" as anesthesiologists at Beth-Israel in Manhattan. No foul occurred that I remember but they got caught and the country was in horror! That of course triggered a whole bunch of regulations nationwide, especially the need for hospitals and  credentialing institutions to double check every item in your resume de novo going back to hospital. If you are a doctor pushing 50, you can imagine that task will be daunting and take an enormous amount of time and cost.

Unlike other professionals that command similar incomes or better, doctors have to be regularly relicensed and recertified. They have to attend at least 50 hours of continuing medical education per year. They have to put up with more and more intrusion and more and more regulation, while they are paid less and less. Lawyers, accountants and others, as they gained seniority and experience they charge more. Not true for doctors. Other professionals get hefty bonuses at the end of the year, not doctors. Other professionals get fees, royalties and commissions commensurate with good outcomes, not doctors.

The general public does not realize the plight of doctors and there maybe is a perception that they are all greedy and rich. Wait till Obamacare kicks in full gear. They are already predicting doctor shortages: early retirements or change of craft? Maybe moving abroad to one of those clinics mushrooming south of the border. There is talk about having nurses do more. I wonder if they will have the same jeopardy structure or would they get a hail pass…because they are not doctors!?

American Doctor 2013 Hippocratic Oath:  SCREWtiny,  Jeopardy, No Money!