It’s A Slippery Slope Being a Doctor

This piece written by trial lawyers, of all things, in the WSJ was eye-opening for me. We all know that in EVERY profession there are bad apples. Look at the opioid crisis, for example, and the “pill mill” docs. I want every one of these idiots prosecuted. The problem is, however, that it’s not that simple. Look at this case in the article:

Dr. Paulus was indicted by federal prosecutors, accused of putting stents into the coronary arteries of people the government said didn’t need them.

Concerned about the quantity of coronary-stent procedures performed at King’s Daughters, federal prosecutors hired a pair of doctors to review Dr. Paulus’s old cases. In some patients, Dr. Paulus had reported arterial blockages of 60% while the government’s doctors said that the patients’ angiograms—essentially chest X-rays—showed blockage of 30% or less. The government took this as proof that Dr. Paulus had misdiagnosed patients as part of a scheme to defraud Medicare, Medicaid or private insurance companies.

Here is the deal. Richard Paulus MD is a very highly regarded doctor. During the trial, experts could NOT even agree on how much different arteries were blocked on angiograms. It says a lot about our ability to pick up and treat CAD, huh? Anyway, the jury convicts Paulus but the judge overruled the verdict and granted an acquittal. The story didn’t end there:

Citing the Sixth Circuit’s ruling in a recent case that variability in cardiology is limited to 10%, the panel overruled Judge Bunning and reinstated Dr. Paulus’s conviction. 

This is scary stuff. Dr. Paulus is 71 and will be sentenced in March. A Ohio-based cardiologist Harold Persaud, who was convicted in 2015 of similar charges, is serving a 20-year prison term!

So, to be fair, this article was written by his attorneys and it is biased. I really do want doctors, who exploit patients for financial gain, to be punished. But it can be a really slippery slope. Dr. Paulus is going to jail. Is he a bad guy? I don’t know but King’s Daughters Medical Center in Ashland, Ky even put his name on the front of its heart center.

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Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected]

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4 Responses

  1. Pat says:

    I’m watching a really good miniseries on Amazon Prime right now called “Life and Fate,” a long, often dreary story of the lives of various wartime Soviet citizens during the Stalingrad campaign, 1942-43. It’s in Russian, but worth your time if you can stand the subtitles. Soldiers, brilliant physicists, even a decorated, true-believer commissar are variously targeted, squeezed, interrogated, and worse. Anyone at any time could be deemed subversive, or unpopular.

    If medicine was developed over the centuries by individuals for individuals – with some notable hiccups – it has been almost totally consumed as somehow the property of the mob. The vanguard of this is the awful, immoral system of Medicare/Medicaid which can point the finger at anyone of us as the next target of convenience to appease the proles. Even the DPC docs have to fear their state medical boards.

    Maybe Dr. Paulus cheated, maybe not. But doctors are targets and will remain so. Every bad-apple doc out there only encourages our own commissars to more tightly regulate and scrutinize in the name of The People. It is not fun going through life knowing this, and it is definitely not worth it. Thoughtful students should avoid this industry for happier, more honest pursuits. Just say nyet.

    • Steve O' says:

      Very right you are! The change in medicine is as deliberate and cruel as the crushing of the peasants by Lenin during the Russian Civil War. Doctors must be eliminated; replaced with a cadre of terrified incompetents who will lie and cheat to save their hides. Intellectualism is the arrogance to make up your own mind, and that is subversive. The new Masters of the “healthcare industry” won’t stand for it.

      • PW says:

        As they say caught between a rock (being sued for “doing too little”) and a hard place (being prosecuted for “doing too much”). I don’t recommend being a physician to anyone these days. Better off as a NP or PA.

        • Kurt says:

          Or a specialty Doc that requires as little call and in hospital care as possible.
          Now I know why some many med students strived for anesthesia and optho.

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