Michael Arnold Glueck, M.D., and Robert J. Cihak, M.D.
Tuesday, Jan. 14, 2003

The nation is becoming more medically and legally paralyzed daily. Lets examine a few items telling us more about what we're becoming as a country than perhaps we might care to admit.

East Coast

As 2003 approached, physicians in several states pondered whether or not to go on strike. In West Virginia, one work stoppage actually occurred; as of this writing it's still under way.

The issue there and elsewhere: ruinous increases in malpractice insurance premiums, driven by predatory lawsuits, that have forced physicians to stop performing certain procedures, move their practices, or retire early. The American Medical Association lists 12 states where lack of certain specialists – most often surgeons and obstetricians – has become a significant problem.

Also as 2003 approached, the government abolished a program that permitted U.S.-trained, foreign-born doctors to gain permanent residency status if they work in "underserved" areas, mostly rural, for five years. The program, which sponsored over 3,000 foreign doctors, was canceled for security reasons, most notably difficulties in monitoring the travels and non-medical activities of these aliens.

Some are – of course – suing, and Sen. Sam Brownback, Kansas Republican, wants remedial legislation. "Immigration," he told the Wall Street Journal, "plays a critical role in the health-care infrastructure of rural America. ... In many communities in my state, were it not for foreign-born doctors, there would be no doctors."

So, what do we have here? To put it bluntly, American doctors refusing to practice, and to live, under constant threat of legal action, financial ruin, hundreds of thousands of changing pages of regulations, and jail, while America scrounges up medical personnel desperately needed in their own homelands because we can no longer get enough young Americans to go into medicine, or stay there.

But what does it mean?

It means – again to put it bluntly – that our health care and legal systems may be approaching the first stages of collapse. Unthinkable? Think again.

The present crisis was decades in the making. Once (Messrs. Shakespeare and Dickens notwithstanding) a lawsuit was an ex extremis remedy, not an everyday tool of greed, extortion, political activism and governmental oppression. A confluence of circumstances – especially the increased use of punitive damages, lawyers' contingency fees (a large percentage of any settlement), class action lawsuits, "runaway juries" and endless new incomprehensible laws and regulations – turned malpractice law into a racket and a lottery.

Insurance companies responded accordingly, raising premiums to cover their losses and then some. Even worse, a diabolical alliance of social engineers and bureaucrats dating back to the Progressive Era undertook to socialize medicine by making it impossible for private physicians to function, let alone succeed. "Disaster by Design," we call it, the deliberate manufacture of crisis and scandal and criminality.

It's working. Now add to this the malice of managed care, the financial shakiness of so many HMOs and hospital chains, and the post-9/11 emergency public health powers that governments at all levels have awarded themselves, and it is far from inconceivable that American medicine as an institution could, in its own way, collapse.

West Coast

In Southern California – particularly Los Angeles and Orange counties – the trial lawyers are up to their newest creative entrepreneurial shakedowns directly against the people.

A small cadre of Beverly Hills trial lawyers has been using lawsuits to extort millions of dollars from business owners and, in effect, from their customers. They are targeting thousands of small and minority-owned businesses such as nail salons, automotive repairs shops and small restaurants with defendant names gathered right from the yellow pages.

Maryann Maloney, Executive Director of Orange County Citizens Against Law Suit Abuse (OC-CALA), notes:

"Shamelessly, they send extortion letters to these employers, who face language barriers in some cases, and limited resources in all cases, threatening to sue for minor violations which may have already been resolved. These lawyers pressure employers to essentially pay up or go to court. But with no actual plaintiffs, victims or damages, the only parties benefiting are the lawyers."

And All Around the Town

Since the state bars rarely discourage anything that puts more money in their legal briefcases, it's time for the attorneys general and legislatures in California and throughout the nation to act against these abuses.

It's time they represent and defend the people who elect them rather than advocate for the trial lawyers who donate millions to their legal shills to keep them "in power" – money that comes from attorneys' billion-dollar "war chests" painfully extracted from defendants.

At this point we know you probably have little or no concern for your physicians – but it's not just the doctors who are getting sued systematically any more – it's all of you, from pre-cradle to post-grave. Scream out loudly and boldly while you still can!

Michael Arnold Glueck, M.D., is a multiple-award-winning writer who comments on medical-legal issues. Robert J. Cihak, M.D., is a former president of the Association of American Physicians and Surgeons.

Contact Drs. Glueck and Cihak by e-mail.

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