Are California doctors violating their Hippocratic oaths in California Prop 45 fight?

Why Are CA Doctors Breaking Their Hippocratic Oath on Prop 45? 

Paul Y. Song, MD  Physician, Executive Chairman of the Courage Campaign, Healthcare Activist
Huffington Post 

10/08/2014 

 

An Open Letter to my fellow medical professionals about California's Proposition 45 and the primary obligation we have to protect the well being of our patients.

Like generations of doctors before us, when each of us graduated from medical school, we were asked to raise our hand and recite the Hippocratic Oath. This was a defining moment in many of our lives. Reciting the words carried great weight and purpose: "I will apply all measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice."

It is through the prism of these words that I watch you appearing in advertisements against Proposition 45 and react in horror. Dr. Amy Nguyen Howell, Dr. Marshall Morgan, and Dr. John Maa, I believe you are betraying your Hippocratic Oaths, and Registered Nurse Candace Campbell, I believe you are betraying the Nightingale Pledge. In fact, in your roles advocating against Prop 45, you are spreading lies designed to mislead and scare the public -- our patients -- in order to protect the insurance industry. It is unconscionable.
The facts are that since 2002, health insurance premiums have increased 185%, while wages for the bottom 70% of our state have remained stagnant. During this same time, California health insurers have issued over 45.7 million denials of treatment, while making record profits which have translated into record cash reserves in the billions.

So let's take a real look at your arguments:

In advertisements paid for by the health insurance industry, you claim that we should keep the new "independent commission" and that special interests are sponsoring Proposition 45 to give "one politician" new power over our health care -- including what treatment options our health insurance covers.
First off, there is absolutely no conflict between this new "independent commission" -- Covered California -- and Prop 45. The Affordable Care Act (Obamacare) was written to accommodate just this sort of rate regulation, and 35 other states already have some version of it.

Covered California is actually run by purely political appointees, some of who have a long cozy history with the private insurance industry. Unlike the State Insurance Commissioner, who is publicly elected to serve as the ultimate consumer protector, the citizens of California have no say in who is appointed to this "independent commission" whereas the Insurance Commissioner is publicly accountable and can be voted out of office.

As for giving the Insurance Commissioner new power over treatment options, this is false on so many levels. First and foremost, it is the private health insurance industry and their administrators, many of who have never cared for a patient, who are denying care, while telling doctors what treatment and drugs they can provide. Our Insurance Commissioner does not do this now and Prop 45 will not give him the authority to do so in the future.

In fact, Prop 45 would simply apply the same regulatory framework to health insurance which has proven so successful regulating auto, home, and medical malpractice insurance in California. Auto insurance rates have actually decreased in the 26 years since Prop 103, saving Californians billions of dollars in premiums. In 2012, our state Insurance Commissioner actually saved doctors like yourselves over $44 million in excessive malpractice premiums using the very same system proposed in Prop 45.

With regard to special interests funding Prop 45, it is actually Big Insurance -- Kaiser Permanente, Well Point, and Blue Shield -- that is spending $37 million of our patients' premium dollars to try and kill Prop 45.
For every dollar that is spent on this campaign trying to protect patients against excessive, unreasonable health insurance rate increases, Big Insurance is spending almost 40 times as much to protect their lucrative status quo.

So, I urge you to stop spreading these lies. I challenge each of you to publicly debate the facts in person. Our patients are suffering mentally and physically from outrageous rate increases, and as the Hippocratic Oath makes clear, we must "keep them from harm and injustice." I call on you to renounce your opposition to Prop 45 and remember the promise you once made to all of your future patients.

Follow Paul Y. Song, MD on Twitter: www.twitter.com/paulysong

Doctor fires employee when she tells him she has cancer

Even before I read this, I had figured out that empathy and a desire to help others don't seem to be traits that medical schools look for when accepting students. And how did this doctor not know that it is against the law to fire someone for getting sick?

A Woman Told Her Boss About A Devastating Cancer Diagnosis. He Responded By Firing Her.
The Huffington Post
By Mollie Reilly
09/11/2014

A Pennsylvania community is rallying around a woman who was fired from her job at an oral surgeon's office following her diagnosis with cancer.

Carol Jumper, who lives in Hopewell Township, Pennsylvania, was diagnosed with cancer impacting her pancreas, liver and ovaries in August. According to her fiance, Dennis Smerigan, Jumper received a letter from her boss, Dr. George Visnich, in which the oral surgeon said he was laying her off without compensation. Raging Chicken Press published the letter on Sunday.

"The symptoms of the disease, the pain medications you will need and the side effects of the chemotherapy will be significant and distracting,” reads the handwritten note, which bears Visnich's letterhead. "You will not be able to function in my office at the level required while battling for your life. Because of this, I am laying you off without pay as of August 11, 2014."...

Smerigan told the Beaver Countian that his fiancee worked for Visnich for more than 12 years...

Current and recovering cancer patients are protected against job discrimination under the Americans with Disabilities Act so long as the individual is able to perform the job's essential functions.

Unconscious patient's cell phone captures doctors mocking him during colonoscopy

See all posts on colonoscopies.

Unconscious patient's cell phone captures doctors mocking him during colonoscopy.
Sarah Fruchtnicht
Opposingviews.com
22 Apr 2014

A Virginia man is suing after his cell phone captured audio of doctors allegedly mocking him while he was under anesthesia for a colonoscopy.

The plaintiff, D.B., says doctors joked about firing a gun up his rectum and accused him of having STDs during his medical procedure.

"On April 18, 2013, during a colonoscopy, plaintiff was verbally brutalized and defamed by the very doctors to whom he entrusted his life while under anesthesia," the complaint says.

D.B. sued Safe Sedation LLC and Safe Sedation Management in Fairfax County Court for defamation, infliction of emotional distress and illegally disclosing his health records.

The patient said he left his phone on and recorded everything on accident. When he later drove home with his wife, they discovered the recording.

The doctors, Tiffany Ingham and Soloman Shah, are not named as defendants but are accused of mocking D.B. as soon as the anesthetic knocked him out.

"Tiffany Ingham, M.D. started to mock, and then continued to mock, the amount of medicine required to anesthetize plaintiffs," the complaint states. "Referring to plaintiff, Soloman Shah, M.D. commented that a teaching physician known to both him and Tiffany Ingham, M.D. 'would eat him for lunch.'

"Tiffany Ingham, M.D. agreed that plaintiff would be 'eaten alive' and also jokingly discussed a hypothetical of firing a gun up a rectum," it says.

"And really, after five minutes of talking to you in pre-op I wanted to punch you in the face and man you up a little bit," Ingham allegedly said to the patient while he was under.

Doctors allegedly discussed D.B.'s prescription medication and an irritation he had on his penis. v "A medical assistant at GMA touched plaintiff's penis during the colonoscopy," the complaint states. "Although plaintiff's penis is not involved in a colonoscopy, the medical assistant noted there was not 'much of a penile rash.' Tiffany Ingham, M.D. responded, 'No, you'll accidentally rub up against it. Some syphilis on your arm or something.' Solomon Shah, M.D. responded, 'That would be bad. That would be real bad.'"

"Tiffany Ingham, M.D. then stated to all present in the operating suite that, 'It's probably tuberculosis in the penis, so you'll be all right.'"

The lawsuit notes that the plaintiff has neither disease.

In a final remark on tape, Ingham allegedly said she would make a note in D.B.'s file that he had hemorrhoids even though he didn't.

He's seeking $1 million in compensatory damages and $350,000 in punitive damages. COMMENTS

No need to anesthetize everyone
By: Publicgood

I did just fine during my colonoscopy with no anesthesia at all. I think doctors who anesthetize all patients are doing it for the same reason that they refuse to allow patients to have a DVD of the procedure: they don't want to listen to patient's questions either during the procedure or later on.

Colonoscopy souvenir DVDs
By: Publicgood

I am shocked that doctors across the US have stopped providing DVDs of colonoscopies in response to medical records requests. It's okay that they don't automatically give souvenir DVDs, but it's not okay to violate the law regarding patient's rights to access to their medical records. Doctors even claim that it's a cost-cutting measure; this is obviously false since digital memory is getting cheaper by the month and has always been cheaper and more compact than the VHS tapes on which colonoscopies used to be saved.

How UCLA's Millionaire Doctor/public employee David Feinberg got $1.3 million amid tuition hikes, budget cuts and a recession

Dr. David Feinberg

[Maura Larkins comment: Both Dr. Feinberg and Chancellor Gene Block are psychiatry professors. A lawsuit has been filed against yet another professor of psychiatry at UCLA. Dr. Alexander Bystritsky is accused of causing the wrongful death of a woman by giving her dangerous medications in order to make her feel happy and to believe she was cured of her illness, causing her to give a large donation to UCLA.

What kind of ethics does Dr. David Feinberg have? What's he going to do with all this money? I'm guessing it's not all going to scholarships for students who can't pay tuition at UCLA.]


UCLA's Millionaire Doctor David Feinberg
How Feinberg got $1.3 million amid tuition hikes, budget cuts and a recession
By Beth Barrett
LA Weekly
Mar 31 2011

Last year, when Stanford Hospital & Clinics was considering poaching Dr. David Feinberg from UCLA, where he is the associate vice chancellor and CEO of its public hospital system, the university brass and the powerful UC Board of Regents decided to do whatever was required to keep their golden administrator.

Things were bad at UCLA when the feverish bid to retain Feinberg broke out. It had just been slammed with $60 million in academic program cuts by the deficit-riddled state of California, and faces another $96 million bite on July 1. In a series of recent hikes, the university raised average student tuition 40 percent from about $7,000 to more than $11,000.

More tuition hikes were coming, and the university owed its employees $21.5 billion in future pension payments that it had no clear-cut way to pay.

But the vast Ronald Reagan UCLA Medical Center, a public nonprofit, had experienced a financially robust previous year under Feinberg, and the facility in 2009 enjoyed high patient-satisfaction rankings as usual. Despite California's stubborn recession, UCLA Chancellor Gene Block — like Feinberg, a psychiatry professor at the School of Medicine — decided to make his colleague a staggering offer: He would nearly double Feinberg's $739,695 base salary to $1.33 million.

That included a 22 percent pay raise of $160,300 and an annual "retention bonus" of $250,000 paid every year that Feinberg does not leave for another job. Block also decided to continue Feinberg's "incentive bonus," which had hit $210,739 in the previous fiscal year.

There was nothing else quite like Block's offer elsewhere in California's university medical schools. The next highest paid is UC San Francisco's CEO Mark Laret. San Francisco, like UCLA, is a top facility, ranked seventh in the nation by U.S. News & World Report, close behind No. 5 UCLA.

In 2010, Laret's $739,700 pay was reduced as a result of the systemwide pay cuts. But with an "incentive" bonus of $176,912 and a car allowance of $8,916, he earned $876,215. Now, suddenly Feinberg was in line to earn nearly half a million dollars more than Laret.

On June 30, Feinberg will begin getting his annual quarter-million-dollar bonus simply for not leaving for another job.

Feinberg's juicy pay package led to uncomfortable headlines for UCLA on Sept. 17, the day after the Board of Regents approved it.

Then, in late December, Feinberg earned UCLA another round of unwanted media attention. The San Francisco Chronicle obtained a private Dec. 9 letter in which Feinberg and 35 other executives in the UC system lashed out at the Board of Regents. The highly compensated group weren't demanding help for academic programs and students. They were threatening to sue the struggling California universities if the regents didn't boost the executives' long-standing $245,000 salary caps used to calculate their pensions.

The change would create a sizable pension boost, costing the universities $5.1 million per year — for just 36 government employees. In addition, the 36 executives insisted the new pension deal be retroactive to 2007, taking from the universities an additional bite of $51 million.

In the letter, Feinberg and the others wrote that it was "the University's legal, moral and ethical obligation" to hand over the pension boosts. They also threatened, "Failure to do so will likely result in a costly and unsuccessful legal confrontation," and emphasized that they were writing "URGENTLY."

The letter, which proved to be deeply embarrassing to UC officials and the regents, was widely assumed to have been leaked by a UC university system insider disgusted by the demands.

The demands from the 36 were a direct political challenge to UC President Mark Yudof, who had publicly opposed bigger pensions for university executives. The University of California system owes $21.6 billion in future pension payments to all its retirees — but it hasn't got the money, and doesn't know where it's going to get it. Yudof is pursuing fiscal reforms to raise the missing billions, including upping the retirement age for future employees from age 60 to 65 for maximum pension benefits — and, once again, raising student tuition and fees.

The leaked letter enraged students, critics of cushy government pensions and salaries and incoming Gov. Jerry Brown, who is a nonvoting member of the Board of Regents.

Brown opined in the Chronicle in December: "These executives seem very out of touch at a time when the state is contemplating billions of dollars in reductions that will affect people who are far less advantaged."

In early January, under a media spotlight, Block opposed the pension boosts, and the demand was not approved by the regents.

But three weeks later, without a formal vote, the regents — who include such notables as investment banker Richard C. Blum, husband of Sen. Dianne Feinstein, and Sherry L. Lansing, former chair/CEO of Paramount Pictures — found a way to give Feinberg and other UC system medical center executives statewide a different costly reward: "incentive" bonuses totaling $2.6 million that had been deferred from 2009.

Feinberg topped the bonus recipient list, raking in $218,728.

The popular doctor now has critics aplenty. Students, facing further tuition hikes as Gov. Brown struggles with a massive deficit, are flabbergasted at the Wall Street–like disparity between how the UC system treats its highfliers versus its students.

Student Matt Margolis, president of the Bruin Democrats, says thousands of UC, California State University and community college students "have to take quarters off, drop classes, get kicked out of their housing." For UC leaders "to respond to the need to scale back by cutting the budget and raising tuition — I don't see how that sits well with the CEO of the medical center having his salary doubled...

Dr. David McKee sues patient's son for Internet defamation and hires a private detective to find out which nurse called McKee a "tool"

UPDATE: Defendant Dennis Laurion wins Internet defamation case in Minnesota Supreme Court.

David McKee v. Dennis Laurion

"When a doctor hires a private detective to find out which one of the 4,400 nurses in St. Louis County, MN may have called him a “tool” you know the man is serious about defending his reputation. That is just what Dr. David McKee of Northland Neurology and Myology is doing in preparation for the next leg of his defamation lawsuit against the son of a former patient, Dennis Laurion.

"When neurologist Dr. David McKee treated World War II veteran Kenneth Laurion his reportedly insensitive remarks and dreadful bedside manner had the vet’s son, Dennis Laurion, up in arms. The younger Laurion took his wrath to the web and posted unfavorable reviews about Dr. McKee on several rate-your-physician websites. Dennis Laurion contended that Dr. McKee failed to treat the elder Laurion with concern and respect.

According to Laurion, Dr. McKee “seemed upset” that Kenneth McKee was moved to a ward after a stint in the intensive care unit and said to his patient, “When you weren’t in ICU, I had to spend time finding out if you transferred or died.”

Laurion also reported that the doctor dismissed the stroke patient’s need for therapy before pulling Kenneth Laurion up to his feet and forcing him to walk without any regard for whether the patient’s hospital gown was tied at the back. Dennis Laurion even went so far as to write that when he “mentioned Dr. McKee’s name to a friend who is a nurse, she said, ‘Dr. McKee is a real tool!’”

"Angered by Laurion’s Internet critique, Dr. McKee filed a defamation suit against Dennis Laurion for $50,000. In his case Dr. McKee alleged that after treating Kenneth Laurion for his stroke, Dennis Laurion made “false and malicious statements” about the doctor to “nineteen different professional and medical organizations, regulatory agencies, and websites.”

"Upon hearing the case, Sixth Judicial District Judge Eric Hylden dismissed Dr. McKee’s lawsuit because he found Dennis Laurion’s comments to be a matter of opinion and thereby protected by the First Amendment. But in January of 2012 the Minnesota Court of Appeals reversed Judge Hylden’s decision and ruled that a jury should evaluate that certain statements made by Dennis Laurion for their truthfulness and defamatory potential and returned the case to the lower court for further consideration.

"McKee v. Laurion is now scheduled to go to trail in January of 2013. But the Laurions are not backing down. They are already busy filing petitions with the Minnesota Supreme Court. The Laurions contend that the Minnesota Court of Appeals made an error in their determination that Dennis Laurion made false statements about his father’s allegedly “not-so-nice” neurologist. It appears that the only evidence the appeals court had to support their decision was Dr. McKee’s assertion that Dennis Laurion lied. And when you consider that a stroke sufferer will be dragged into court to give testimony on this issue just after his 88th birthday, it seems that Dr. McKee’s private investigator might have an easy time finding that nurse." ---DefamationLaw.net



Doctor's suit tests limits of online criticism
McClatchy Tribune News Service
March 30, 2012

MINNEAPOLIS — Two years ago, Dennis Laurion logged on to a rate-your-doctor website to vent about a Duluth neurologist, Dr. David McKee.

McKee had examined Laurion's father, Kenneth, when he was hospitalized after a stroke. The family, Laurion wrote, wasn't happy with his bedside manner. "When I mentioned Dr. McKee's name to a friend who is a nurse, she said, 'Dr. McKee is a real tool!' " he wrote.

McKee wasn't amused. He sued Laurion for defamation, and now the case is pending before the Minnesota Supreme Court.

McKee, 50, is one of a small number of doctors who have gone to court to fight online critics, in cases that are testing the limits of free speech on the Internet. "Doctors are not used to public criticism," said Eric Goldman, an associate professor at the Santa Clara University School of Law in California, who tracks such lawsuits. "So it's a new phenomenon for them."

While such cases are rare, Goldman said, they've been popping up around the country as patient review sites such as vitals.com and rateyourdoctor.com have flourished. Defamation suits are "kind of the nuclear option," Goldman said. "It's the thing that you go to when everything else has failed."

McKee's lawyer, Marshall Tanick, said the doctor felt he had no choice but to sue to protect his reputation and his medical practice.

"It's like removing graffiti from a wall," Tanick said. He said Laurion distorted the facts — not only on the Internet, but in more than a dozen complaint letters to various medical groups. "He put words in the doctor's mouth," making McKee "sound uncaring, unsympathetic or just stupid."

[Maura Larkins comment: Wait a minute. Dr. McKee is complaining that someone filed a complaint about a doctor??? Patients are just supposed to silently accept whatever a doctor dishes out?]

McKee calls Laurion "a liar and a bully," and says he has spent more than $7,000 to "scrub" the Internet of more than 100 vitriolic comments, many traced to a single computer (IP address) in Duluth.

"Somebody who holds a grudge against you can very maliciously go on the Internet, post anything they want, and ... basically redefine who you are," he said.

Laurion, 65, a retired Coast Guard chief petty officer, says he deleted the Internet comments shortly after the lawsuit was filed and "never rewrote them."

At the same time, his lawyer, John D. Kelly, defends the postings. He says it was Laurion's perception that "the doctor's speech and conduct were tactless and inconsiderate." And that, he argued, is "constitutionally protected."

So far, Minnesota courts have had mixed reactions. A district court in Duluth dismissed McKee's lawsuit last year, but the state Appeals Court reinstated it in January. Laurion has appealed to the Minnesota Supreme Court.

The dispute isn't about McKee's medical decisions, but about something less tangible: his body language and comments when he walked into Kenneth Laurion's room at St. Luke's Hospital in Duluth on April 20, 2010.

In his online postings, Dennis Laurion wrote that McKee "seemed upset" because he thought his father, then 84, was still in intensive care.

"Never having met my father or his family, Dr. McKee said, 'When you weren't in the ICU, I had to spend time finding out if you transferred or died,' " according to Laurion's account. "When we gaped at him, he said, 'Well, 44 percent of hemorrhagic strokes die within 30 days. I guess this is the better option.' "

Laurion, who was visiting with his wife and mother, wrote that McKee was brusque and dismissive during the exam, especially when his father raised concerns that his hospital gown was hanging open at the back. "Dr. McKee said, 'That doesn't matter,' " according to Laurion's account. "My wife said, 'It matters to us,' " and they left the room.

McKee discovered the online comments when a patient brought them to his attention. He filed suit, seeking more than $50,000 in damages. "The way he quoted me was completely inaccurate," McKee said in an interview. At the time, he said, nobody in the room "appeared to me to be the slightest bit upset."

[Maura Larkins comment: Figure it out, Dr. McKee. Their husband and father was in your care. They couldn't afford to make you angry. You were in a position of power.]

According to court documents, McKee admitted making a "jocular comment" about only two ways to leave the intensive care unit, but said he only meant that he was relieved to find Laurion in his hospital bed. He denied citing any statistic about stroke deaths and said the entire story was distorted beyond recognition.

"Every physician gets an occasional complaint from a patient, or even a patient's family member, but this was so ridiculous," he said. "This just seemed so extremely over the top, and really meant to be harmful."

In the first legal battle, district Judge Eric Hylden in Duluth sided with Laurion. "The statements in this case appear to be nothing more or less than one man's description of shock at the way he and in particular his father were treated by a physician," he wrote in dismissing the suit in April 2011.

The appeals court disagreed, ruling in January that some of the statements were fair game for a defamation suit and sending the dispute back for trial.

Tanick, McKee's lawyer, said the case isn't just about someone voicing an opinion. He said Laurion defamed the doctor by accusing him of things "that never happened."

Laurion's lawyer, however, says it's a matter of perception. "Something happened in that room that disturbed the four members of the family significantly," he said.

More than a dozen defamation suits have been filed since 2004 by doctors or dentists over online reviews; most have been dismissed or settled, according to Goldman.

Some medical practices have even tried to silence critics by requiring patients to sign a form forbidding them from posting comments on the Internet.

But Dr. Jeffrey Segal, a North Carolina neurosurgeon who promoted the controversial forms, says he's since had a change of heart; he "retired" them last year in the face of widespread criticism...



Here's a similar case from California.

Almost Half of Doctors Burned Out by Rising Workload

Almost Half of Doctors Burned Out by Rising Workload
By Shannon Pettypiece
Bloomberg Businessweek
August 20, 2012

About 1 in 2 doctors are burned out, showing signs of emotional exhaustion and little interest in work as patient loads increase, U.S. researchers found.

Doctors working in emergency, family and internal medicine were the most likely to feel drained, according to the study released today in the Archives of Internal Medicine. Researchers said burnout also was tied to long hours, with 37 percent of physicians working more than 60 hours a week.

The number of doctors reporting feeling burned out is surprising and troubling, said Tait Shanafelt, a professor of medicine at the Mayo Clinic and lead study author. He said the trend may cause physicians to quit or reduce their workload just as demand for doctors is increasing with the aging population. The issue may get worse as 32 million Americans are expected to get health insurance by 2014 under a new U.S. law, increasing the number of people seeking medical care, he said.

“Right at a time when we are trying to provide care to people who are uninsured and projecting workforce shortages we are seeing this burnout rate creep in, which may cause physicians to reduce workloads and consider early retirement,” Shanafelt said.

He added that burnout has also been linked to medical errors and worse patient care in previous studies.

The study found that 46 percent of doctors show at least one sign of being worn out. Shanafelt said the burnout was about 10 percent higher than in the population as a whole. Unlike with other professions, more education isn’t linked to a lower risk of feeling drained among doctors, the study found.

Across Specialties

Researchers collected responses from 7,288 doctors across all practice areas to measure levels of emotional exhaustion, depersonalization and sense of professional accomplishment. The data was compared with surveys of the general population.

There was no increased rate of depression or suicide among doctors compared with the general population, a sign that the burnout is specific to the work environment, Shanafelt said. He said more research is needed to determine proper treatment.

Doctors have been increasing the number of patients they see to make up for reduced reimbursement from health insurers and the government, Shanafelt said. Physicians in private practice are also dealing with more bureaucracy, such as a push by the government to implement electronic medical records.

“If this were only 5 percent, we could say that these are just people who don’t manage their stress well or need additional training,” Shanafelt said. “But with almost one out of every two physicians, we have to say there must be something about their environment contributing to this.”

California patient wins anti-SLAPP motion against doctor she criticized

Also see interesting case in Minnesota, Dr. David McKee v. Dennis Laurion.

Filler v. Walker
Citizen Media Law Project

Dr. Aaron Filler filed a complaint against former patient Susan Walker in Los Angeles Superior Court on May 31, 2011. In his complaint, Filler alleged defamation and interference with prospective economic advantage in response to Walker's review of Dr. Filler on a physician rating site.

On August 24, 2011, Walker filed a motion to strike based on California Code of Civil Procedure §§ 425.16 and 45, California's anti-SLAPP statute. Walker's motion argues that Walker is shielded from liability as the "dissemination of consumer information about medical care is a vital ‘public issue' and the internet is a ‘public forum,' and that Dr. Filler is a public figure subject to the burden of proving actual malice. Filler filed an opposition to this motion on September 16, 2011, also requesting leave to amend the complaint to plead more specific factual allegations to establish actual malice. Walker replied to Filler's opposition on September 22, 2011.

After a hearing on April 19, 2011, Walker's motion to strike was granted. In the order filed on May 8, 2012, Judge Elizabeth White held that Filler's claims arose from Walker's act of free speech in connection with a public issue under CCP § 425.16 and that Filler did not establish a probability of prevailing on these claims. In accordance with this order, Judge White later ordered Filler to pay $50,259.65 to Walker for attorneys' fees and costs.

Party Issuing Legal Threat: Dr. Aaron Filler; Aaron Filler, MD, PHD, APC; Imagebased Sugicenter Corporation; Neurograph Institute Medical Associates

Party Receiving Legal Threat: Susan Walker; Does 1-25

Doctors are not very happy

Physician Frustration Grows, Income Falls -- But a Ray of Hope
Medscape
Mark Crane
04/24/2012

Physician income overall has declined since 2010, yet there are tiny glimmers of hope in some specialties. Frustration is mounting, however, and doctors in every specialty are bracing for what they expect to be further income declines as healthcare elements are implemented, such as ACOs and required treatment and quality guidelines.

Those are some of the insights from Medscape's Physician Compensation Survey Report: 2012 Results. The report is based on a survey that garnered responses from more than 24,000 US physicians representing 25 specialties.

"Physicians' sense of worry may be greater than the reality, but it's understandable," said Judy Aburmishan, CPA, a partner in FGMK, LLC in Chicago, a firm that represents physicians and other healthcare providers. "Hospitals are buying up private practices both in primary care and the specialties. The heavy-handed message they send out is that if you don't join us, you won't survive. There is great uncertainty and fear about what healthcare reform will mean for physicians once it's fully implemented."

Some of the major findings from Medscape's 2012 report:

1. Dissatisfaction with medicine is intensifying, although a majority of physicians would again choose the same career path. In 2012, just over half of all physicians (54%) would choose medicine again as a career, far less than in the previous year's report, where 69% of physicians would choose medicine again.

2. The top-earning specialties in 2012 were the same as in the previous year, even though their incomes declined in general. In 2012, radiologists and orthopedic surgeons again topped the list at a mean income of $315,000, followed by cardiologists ($314,000) and anesthesiologists ($309,000). The same 4 specialties were in the leading positions in last year's survey. The bottom-earning specialties also remained similar: pediatrics ($156,000), family medicine ($158,000), and internal medicine ($165,000).

3. Who's up, who's down since 2010? "Decreased reimbursement" is the overall buzz-phrase, yet a minority of specialties saw modest gains. The biggest income increases were in ophthalmology (+9%), pediatrics (+5%), nephrology (+4%), oncology (+4%), and rheumatology (+4%). The largest declines were in general surgery (-12%), orthopedic surgery (-10%), radiology (-10%), and neurology (-8%).

4. Do men or women earn more? Overall, male physicians earn 40% more than female physicians, although that difference is only 23% in primary care. Experts say that the difference is related to choice of specialties and lifestyle preferences that women choose.

5. Don't write off private practice! Although physicians are rushing toward employment, partners in private practice far outearn physicians in other work environments. Overall, partners in private practice earn significantly more than solo practice owners and employed physicians, who earn less than either group.

6. The "rich doctor" myth may be just that, although "rich" is relative. Overall, only 11% of physicians say they consider themselves rich, while about 45% say their incomes are no better than that of many nonphysicians, and another about 45% say, "My income probably qualifies me as rich, but I have so many debts and expenses that I don't feel rich." The specialties with the highest percentage of physicians who felt rich were pathology (15%), radiology, oncology, and gastroenterology (14% each).

7. Doctors in all specialties are swamped with paperwork. A third of physicians (33%) spend more than 10 hours per week on paperwork and administration.

8. One healthcare reform goal of reducing "unnecessary care" garners negative response. The vast majority (67%) of physicians said they won't reduce the amount of tests, procedures, and treatments they perform (in order to comply with insurer treatment guidelines) either because the guidelines aren't in their patients' best interests or because doctors still need to practice defensive medicine.



Doctors bemoan paychecks that most plebes would kill for MSN April 28, 2012 Nearly half of all doctors say they regret choosing a career in medicine, according to an annual survey conducted by Medscape. Only 54 percent of doctors said they'd make the same career choice again, down from 69 percent last year. Lower incomes from "decreased reimbursement" apparently play a role in this dissatisfaction, though certain specialties enjoyed modest income gains. But even though physicians made mean incomes that ranged from $156,000 (pediatricians) to $315,000 (radiologists, orthopedic surgeons) per year, only 11 percent of doctors considered themselves rich (cough, cough), and 45 percent agreed with the statement "My income probably qualifies me as rich, but I have so many debts and expenses that I don't feel rich." Physician, cheer thyself.