Saturday, February 19, 2011

Physicians Betraying Their Oath and Their Professionalism!

Well Stacy McCain has his own memeorandum thread, so I felt I should comment further. Needless to say the Daily Kos has interjected their nonsense to the mix, so there seems to be some room for clarification.

What a week it has been in Madison Wisconsin, of all places. First we have teachers roaming the capital petitioning the government for redress of grievances. Not so bad, until they call in sick, en masse, and bring their students with them as political pawns. Then we have the duly elected State Senators abdicating their sworn obligation to represent the people of Wisconsin in the state senate and literally running away to the Tilted Kilt. Now we have "Doctors" giving out sick notes like they hand out flyers in New York's Times Square.

Being sick of the Wisconsin Governor is not billable code as far as Medicare is concerned and daring an interviewer to get in the middle of a private consultation between a patient and caregiver in the middle of thousands of people is not what is meant by bedside manner. What a joke. All this professionalism is making me sick!

Don't get me wrong, I have written my fair share of sick notes, but these were for people who were, you know, sick. As a Hospitalist (if you want to know, ask Happy), I only treat patients that have been admitted to the hospital, so I shouldn't question the integrity of the Family Practice Docs who are supremely capable of making such judgements on the fly. You see, I actually see my patients, objectively evaluate their medical situation and make a decision. Of course, I take my job very seriously and wouldn't presume that "stress" is a reasonable diagnosis. Unless, of course it was manifested by pseudoseizure or conversion disorder in which case it is serious business.

This brings me to Dr. Lou Sanner. He is a family practitioner whose ego, no doubt, precedes his intellect. I have seen his type before as I meandered through medical school and residency. He is the doc who looks down his nose at you as you struggle for the esoteric answer to some zebra diagnosis, all the while pretending to know the answer himself. Well, I am not a resident anymore and what this fellow has done is professionally obscene. He has abrogated his professional responsibility for political expediency.

Don't believe me? Take his own words into account. From the AP and USA Today, respectively:

"Doctors from numerous hospitals set up a station near the Capitol to provide notes covering public employees' absences. Family physician Lou Sanner, 59, of Madison, said he had given out hundreds of notes. Many of the people he spoke with seemed to be suffering from stress, he said."

"What employers have a right to know is if the patient was assessed by a duly licensed physician about time off of work," Sanner said. "Employers don't have a right to know the nature of that conversation or the nature of that illness. So it's as valid as every other work note that I've written for the last 30 years."


Here is the good doctor in action...



Now I don't know the legality of his actions, although I am sure that the Wisconsin Medical Society may have some thoughts on the matter.

Is it really his position that he is conducting medical examinations in the midst of thousands of people while attaining a right to privacy? One of the most important things in a genuine patient/physician interaction is honesty and this dude is dishonest!

He and his colleagues, Hannah Keevil, and James Shropshire should know better. Undoubtedly they do know better, but let political emotion trump professional integrity.

Update: I think I found another "physicina" and from the video it would seem that there were nearly a dozen of there. In this case it seems to be Dr. Patrick McKenna who is freely giving out notes for activitis. Fortunately, for him he is a 3rd year resident!



Update 2: Let the mocking commence, Breitbart edition...



Update 3: More video leaking out and it isn't getting better. Doctors hiding behind privacy privilege? From top to bottom, this is an abuse of the system. Unfortunately, I can't identify this character, but I have some thoughts...




Thanks to Ann Althouse for her on the ground reporting.

Instalanche, thanks Professor! While you are here, look around. You might find we have a lot to say!

PJ Tattler offers their link, thanks...

Linked by A Moral Outrage, come back for more...

Please bookmark!

41 comments:

  1. Of the note that I saw, the license number didn't match any possible entry in the Wisconsin medical board register at http://online.drl.wi.gov/LicenseLookup/IndividualCredentialSearch.aspx

    So, fraud is being committed.

    And as a physician, handing these out without examining the patient is malpractice.

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  2. As a physician, I agree. A stain on the profession that has been plenty sullied over the past year!

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  3. Wow....amazing. These people are dumb, they don't even try to hide it.

    I thought they were losers before, now I really think they are...

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  4. If you go to this link:

    http://maciverinstitute.com/2011/02/fake-doctors-notes-being-handed-out-at-wisconsin-gov-union-rally/

    you will see a "doctor's note" signed by one James H. Shropshire MD, Wisconsin license number 33770-20. I verified the license number here: http://online.drl.wi.gov/LicenseLookup/CredSummaryDetails.aspx?chid=119067

    Of course, it is possible someone is impersonating Dr. Shropshire, but the appropriate licensing and disciplinary authorities in Wisconsin can sort that out.

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  5. http://www.dailykos.com/story/2011/02/18/946847/-Featherbed-of-Lies-take-8-Unions-Cost-us-Jobs

    Here's the deal: an individual cannot stand up against a corporation or large company alone. It is one person against a huge and impersonal thing. For all the Supreme Court's declarations, corporations are not people. They don't know the people who they employ. It isn't Joe negotiating with Bob, his boss. The corporation doesn't see Joe as a person. It sees Joe as a piece of machinery. [...] That is the problem. The corporation sees people as replaceable cogs. Unions at least give a voice to these "cogs" by telling management that these are people who are not to be used up blindly and thrown away. Left to themselves, management uses the cheapest people possible in the cheapest environment possible and wants no responsibility for them on or off the job. If they are sick, management wants to ignore their sickness and if they can't come to the job they don't get paid. If the equipment is not safe, management wants them to go home and not get paid if they get hurt.

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  6. It would be nice introduction to the real world for these cushycrats if they were fired for calling out sick, with or without a doctor's note. You know, the real world, where employment is at will and your boss doesn't need due process if he doesn't believe you? I can just imagine if I told my boss - or even better, my college professors after exceeding the maximum allowable absences - that it was OK, because I was "sick" and had a "doctor's note."

    @anonymous: We're all familiar with how unions work. The sophomoric machine metaphors are irrelevant; you can invert the diagram just as easily by observing that Joe and his fellow workers see Bob not as a person whose career depends on their production, but as "the big machine." Neither diagram forces Joe to work for less or Bob to endure Joe.

    In any case, Joe does not have problems with management if he's a government employee, because Joe is protected by the Civil Service Act. That's why the old labor pros never saw a rhyme or reason to signing up government employees, until the new blood came in and saw the money and political power they could scare up.

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  7. I know my family and their medical histories better than their PCPs, but the Texas State Medical Board takes a rather dim view of treating anyone without documentation, and a rather punitive approach when medical record deficiencies are found. I don't write prescriptions or make referrals for anyone, other than to say "You need to see your doctor", outside of professional interactions that are documented. I would have to assume that the state medical board in Wisconsin might find these physicians' records to be lacking in terms of history, physical exam findings, current medications, etc.

    I may only be a radiologist, but even I can tell you that a chief complaint does not make a medical history. Maybe they can argue that since no changes in the course of anyone's medical care was made, they have a form of no-harm-no-foul defense, but an aggressive medical board could certainly have their glutes in a sling on professionalism issues.

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  8. Dear Anonymous,

    Welcome to the world of internet trolling! I must congratulate you, you're off to an awesome start, you've managed to locate a blog that is shining some light on the unethical actions of the political left. That's step one and you nailed it. I notice that you've prepared for your troll with a link, an actual honest to god link to back up your planned troll. That's excellent, really top notch there, so many of the fools and liars trolling for the left these days don't even bother. I would make one suggestion, though, just to "elevate your game" a little bit: learn how to post hyperlinks in HTML. See, most people aren't going to bother to cut and paste an entire link, and those that might be inclined to do so (particularly on a blog frequented by honest folk who generally have a dab of common sense) probably won't bother when they see the link is to Daily Kos. Moulitsas' site might be a great place to get your marching orders, and probably it's an online social blast if you're one of the mindless drones that call it home, but most folks are going to give blatant propaganda a pass. A hyperlink hides all of this behind a nice, non-threatening bit of text, and will surely drive more people to the hive for brainwashing.

    Unfortunately, after that promising start, your fine effort at trolling went off the rails. The talking point that you posted WAS about unions, I'm sure you matched the letters up quite carefully with your assigned talking point to make sure you made no mistakes, but...swing-and-a-miss-you-were-oh-so-close...THIS blog post concerns PUBLIC SECTOR unions (unions comprised of people who work for the government, you know, that big friendly mommy organization that is just super swell enough to send you a check every month (and you don't even have to DO anything for it! What a deal, right?)) and the screed that you posted refers to PRIVATE SECTOR (that scary place where people have to actually, no fooling, WORK for a living and, like, you know, actually produce stuff that's, strangely enough, useful. How sick is that?)unions. Close. So close, and a hell of a first try, but not the same thing at all. (I know, I know, you matched the spelling letter by letter before pasting in your assigned comment, U-N-I-O-N, but trust me, not the same thing. It's confusing when the same thing is used for two different things, isn't it? English is hard.)

    Finally, (and I really don't think this is your fault at all, because the blogger DID feature the word "union" several times in his post. How were you supposed to know that it wasn't really about unions? You were duped, my good man.) the post really isn't about union misconduct at all, it's about doctors (men and women in white gowns with pokey things) not following their professional ethics. I know. Weird, huh? It said Union and everything. You'll find the proper talking points to use if you go back to your masters and ask them for their files on Obamacare (they'll probably use it's Orwellian name, The Patient Protection and Affordable Care Act, but don't be fooled), and somewhere between "Mandatory end-of-life counseling isn't about saving money by pushing seniors towards euthanasia, no way, no sir, nu-uh nu-uh nu-uh. It's not. NOTNOTNOTNOTNOT *stamp foot* " and "You know what? I make a lot more money if I take this kid's tonsils out." you'll probably find a prepared response appropriate to this blog entry.

    Look kid, I hope you don't think I've been to hard on you here. You've got a world of stuff, and I just know you'll make it in the bigs some day, but this effort was a little off. Chalk it up as a learning experience and move on, in no time you'll be spinnin' and shuckin' and jivin' and lyin' with the best of them. Good luck, and remember, hope and change, hope and change, hope and change, Good God almighty, HOPE'N'CHANGE!

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  9. Hey Dave, that was a pretty rock solid take down. Thanks1

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  10. LOL @ me. Yea, so darn rock solid that I didn't notice that you didn't actually use the word union in the OP. Looks like I'm the one heading back to the minors. Sarcasm r hard.

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  11. These are all doctors who work for the state university, meaning taxpayers are paying their salaries. They are public employees who are conspiring and colluding with other public employees to defraud the taxpayers of Wisconsin. Sounds like firing offenses to me!

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  12. Get the office numbers of these doctors. Bombard them with requests for free doctor's notes like they gave the teachers. every one of them.

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  13. Great post. Linked to you. The way the first doctor - Sanner? - makes a mockery of the doctor-patient relationship by using it, and a bit of intimidation, to defend his fraud is appalling.
    Jill at P&P

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  14. Doesn't this also contribute to the high costs of medical care? That is, doctors who are in fact, frauds.

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  15. anon 2:24. Actually, as residents, they are being paid for by federal tax dollars through the Medicare program. I don't know. Might even be a felony, except we all know that federal employees get lots of vacation. Maybe they are on vacation? If I'm a resident again, I can think of better ways to spend my vacation.

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  16. Handing one to Breitbart is just epic

    lololol

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  17. @ Happy, of course if they aren't on vacation, they would still be under ACGME work hour requirements. I mean, by their own account they are conducting some sort of history and physical....

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  18. @Happy Hospitalist: So, this is an example of the Medicare fraud the reduction of which is the argument in favor of Obamacare? Let the Kidz chew on that.

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  19. If Wisconsin Medical Board refuses to take action, parents should force school districts to investigate. Any teacher that is so "stressed" by this situation is too emotionally impaired to be with children. IMHO all medical "excuses" must be vetted and any teacher who presents one that can not be verified as legitimate should be removed. Let the firing begin...

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  20. If I did this in Arizona I would lose my license. One must keep adequate records of medical visits. I do see friends (but not family) and take a complete history and physical and keep it in a personal safe. Separate from my other medical records as I don't bill for the services. I'm not sure this falls under malpractice as they have not done any actual exam. And if these people are suffering from stress have these "docs" provided appropriate referral to psychological services?

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  21. Azygos, I am no lawyer, but I think this could easily fall under malpractice under the right circumstances. There seems to be no indication that if one were actually sick they might want to be seen by there primary physician. They have opened themselves up to significant liability if the right "patient" and "lawyer" wished to pursue it.

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  22. As a physician who knows some of these docs personally (as former colleagues but who no longer practices in WI), I am shocked by their lapse in judgement. I think it's important to recognize that there are hundreds of physicians working for UW, and only a few were involved in this activity.

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  23. If you'd like to file a complaint about any of the "doctors" in these videos, please call 608-821-4819 to leave a message or call and talk to a person on Monday (as they are closed today). I spent a long time on hold (about 30 minutes) with the clinic that Sanner works at before a receptionist could give me the number of Patient Relations.

    I don't know if it will do any good, but it's worth a try. I think people should be disgusted with this sort of behavior, no matter what political views you hold.

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  24. So what won't they lie about?

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  25. I think he is going to be looked into by the Obama regime for sitting on a death panel. He'll fit in perfect.

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  26. As hard as it is to believe that real docs would do this these are apparently medical school faculty. I'm waiting to see if the University of Wisconsin takes action.

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  27. Is there any way to go after UW-Madison? Could their accreditation as a medical school be in jeopardy if one of their profs is engaging in unethical and fraudulent behavior?

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  28. I now have the illegal actions of these pathetic Dr's to this:

    Fraud, Malpractice, Collusion, and HIPPA violations.

    I say HIPPA, since how can a Dr. say that his exam is between he and his patients private exam (which didn't occur) when they are surrounded by 30K people!? And part of hippa is medical records maintenance, which I'm sure a clipboard of mass documents blowing in the wind for everyone to see doesn't fulfill the requirements or privacy laws.

    FIRE THEM ALL. I live in Madison, I will be keeping a close eye on this

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  29. As soon as these notes are turned by the employee in for an absence excuse they have committed financial fraud and these physicians have conspired in this act. They should be charged by the Attorney General, not the Medical Board.

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  30. You know that waste, fraud & abuse Dems are always yappin' about....I agree! Lets start w/the doctors who hand out phony excuses & the teachers who refuse to do their job, both resulting in a huge taxPAYER rip off.

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  31. I'm not sure if anyone noted that Dr. Kvach is a first year resident- that means she CANNOT be a licensed physician and that ALL medical care that she provides MUST be attested and signed by the supervising LICENSED faculty. As a licensed physician and medical educator with postgraduate training (residency) experience I am deeply troubled at the fraudulent and unethical behavior demonstrated by these leaders in medical education in modeling and supporting this behavior of their charges. It is supremely disappointing that my colleagues would compromise their professional ethics to make apolitical statement.

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  32. Any resident acting so irresponsibly and unethically must be disciplined. Especially a third-year resident who will complete their training in June of this year, and then become eligible for board certification. The most effective method of complaint is directly contacting both the residency program director, and the chair of the family medicine department. The family medicine residency program director is: Dr. Kathy Oriel, MD, MS, telephone: (608) 265-3653, email: kathy.oriel@fammed.wisc.edu. The chair of the entire family medicine department is Dr. Valerie Gilchrist, MD. Her telephone number is: (608) 265-0856, email: valerie.gilchrist@fammed.wisc.edu . It is unlikely that Dr. McKenna was the only resident participating in this fraudulent activity.

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  33. "Patient, Doctor and Society (PDS) welcomes James Shropshire, MD, as PDS 2 course director. PDS 2 is the second in a series of four semesters that are devoted to teaching history, physical exam skills, *ethics*, evidence-based medicine and health care in society to first- and second-year medical students.

    "Shropshire has both lectured and taught in PDS since 2002, always receiving excellent evaluations from students. He is clinical associate professor of family medicine and practices at UW Health Monona Clinic. Dr. Shropshire earned his medical degree from the University of Wisconsin and completed his residency at the University of Minnesota Department of Family and Community Medicine."

    http://www.fammed.wisc.edu/node/16156

    Emphasis mine on ethics.

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  34. I think all school districts should tell these teachers when they return with these notes. That they need a return to work follow up with the exact same doctor that wrote the note to begin with or they can not return. No pay until they have a return to work follow up with same doctor.

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  35. This comment has been removed by the author.

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  36. "Stress" as a medical diagnosis? Ohfercryinoutloud.

    Every human being with functioning synapses encounters "stress" on a regular basis. Stress is not a disease, but an inescapable part of the human condition.

    Responsible people learn to deal with stress in a proper manner and don't use it as an excuse for dereliction of duty or any other wrongdoing.

    Anybody who cannot deal with "stress" has absolutely no business being a teacher.

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  37. Dr. Anne Eglash did not attend the rally nor did she take part in the doctors' booth at the Capitol. Please retract this information immediately and post a correction.

    Lisa Brunette
    University of Wisconsin

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  38. Wow. That guy Lou Sanner is the most arrogant, corrupt, unethical jerk I have ever seen with a lab coat on.

    He reminded me of Bill Clinton sitting in front of a grand jury saying "it depends on what the meaning of is is". What a clown ... he's actually pretending to be "consulting with" people about their health.

    The State of Wisconsin should remove him from access to patients today ... he's obviously unstable.

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  39. Don't fret, solicitors have been betraying their profession for years - Barry Costello Monelle Delmonte, Struck-off Solicitor - was heard telling Colonel Gaddafi over a plate of fish and chips on the lawn of his mums house.

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  40. University of Wisconsin has now seen fit to put old Lou's face back on it's website so they are proud to associate with him.
    That tells you quite a lot about what they think is acceptable behavior.

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  41. Hospitalists...We in the Intensivist biz have a name for them...f*&king useless.

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