This is the story of Doctor X, who cannot be identified any more particularly than that. This is also the story of the medical practice that Doctor X very nearly ruined, and may still ruin. And this is, most important, the story of the patients Doctor X treats, and of the mistakes that Doctor X makes in treating those patients -- careless, stupid, criminal mistakes that cripple those patients. And of how Doctor X is still practicing, still making mistakes, and of how nobody seems to be able to do anything about.
Doctors form specialty practice groups. You can find them by category in the Yellow Pages, ranging from Allergy, Asthma, and Immunology through Otolaryngology through Nephrology to Vascular Surgery. A group of three, four, five, or more doctors with the same skill join together, form a partnership, open an office, and capitalize on their expertise and on their combined connections to hospitals in their area. The arrangement serves patients well, and should make the practice of medicine better, as the partners consult with one another and perfect their practice.
In the case of Doctor X, it didn't work.
Doctor X came along and joined five other similar specialists with a thriving practice. Doctor X brought some apparently valuable attributes to the business -- some characteristics that suggested more patients would be attracted to the practice. And at first everything looked fine, absolutely normal. Of course some patients had complications; some patients always have complications.
But this group of doctors, who were surgeons, and who performed operations in a number of local hospitals, began to get disturbing information back from the hospital operating theaters. At first, it just looked like patient complications were becoming more frequent. Then it became more obvious that the increased complications could be traced to surgeries performed by the new partner, Doctor X.
The most common post-op problems were misplaced stitches, resulting in torn tissues, and requiring repeat surgeries. The misplaced stitches caused infections, too, and often permanently damaged tissues that surgery was supposed to repair. As the partners investigated, they found the same patient names showing up for post-op complications again and again -- Doctor X's patients. They questioned their office staff. The patients complained of similar problems. They checked the charts. Doctor X had falsified the patients' charts, indicating in the written record that there were no problems. And Doctor X was covering up mistakes by removing the offending stitches in the offices, without recording it.
The picture got worse. Because the partnership practiced in several hospitals, Doctor X was able to take the worst of the patient problems to different hospitals from those where the original surgery had been botched. That way, the patchwork operations wouldn't be compared, in hospital records, to the documentation for the original surgery.
As competent and accomplished as doctors are, there are some things they don't do well at all. Management or employee confrontation rank right up there among the things that doctors really hate, and do very badly. These partners consulted a lawyer. They eventually asked Doctor X to stop doing surgeries. They eventually asked Doctor X to leave the practice.
But here's where the story gets maddening. You'd think it would be pro forma for the partners to register a formal complaint with the state medical authorities, who would obtain some kind of injunction to suspend Doctor X from the practice of medicine pending a full inquiry.
But no. The prospect of expensive lawsuits freezes the doctors in place. The partners fear Doctor X may sue them for defamation of character if they bring complaints. Further, they fear suits by patients against the practice itself. They cannot buy more malpractice insurance to cover the time when Doctor X practiced with them; they're stuck. The hospitals involved have made a few careful reports to state authorities, but Doctor X could sue the hospitals, too. The state medical authorities have been informed, but have taken no action yet. A few hospitals have suspended Doctor X's operating room privileges. But that's as far as it has gone, and this situation has gone on for years.
Doctor X left the partnership, true, but promptly set up a new practice. Doctor X is still making mistakes, still hurting patients. And the partners are prohibited by law from informing any new or existing patients of Doctor X's incompetence. If someone calls up asking for Doctor X, the partners must simply refer that person to Doctor X's new office and new phone number.
Ironically, that's how the partners themselves got stuck with Doctor X in the first place. Doctor X has been hurting patients for years. Other doctors knew about it. But, when the partners phoned for Doctor X's references, former associates didn't say anything. In effect, they were forced to cover up for Doctor X, to lie by omission.
Over this entire situation, and over a growing population of chronically injured patients, looms the threat of lawsuit, and the structure of tort law in the United States. The trial lawyers may say they stick up for patients' rights when they resist any limits on punitive damages. But clearly, it is patients who end up getting punished by the system, not doctors.