Let’s Get Real     


     Organized Medicine wants the public to believe the old-time image of the doctor as the caregiver who puts saving lives as the highest goal (not profit).  One of the messages of the healthcare industry is that nothing should come between the doctor and his patient.  This is a way of saying, "no regulation of healthcare."  Dr. Berwick has been one of the most vociferous in advancing this line.  He has suggested, for example, that doctors must be free to break rules.   This is equivalent to claiming that doctors must be free to make their own rules. We know of one case to illustrate the point that surely there are medical rules that must not be broken. In this case an 11-year-old-child, already febrile and septic with both streptococcus and staphylococcus bacteria, was rushed to the operating room, without a pre-op x-ray or blood work, to have his infected ankle incised and drained.  A chest x-ray taken in the operating room after the first of several cardiac arrests disclosed that he had bilateral pneumonia. Hours later, after several more arrests, he died.   A chest x-ray prior to the surgery would have quickly alerted the physicians to transfer him to the intensive care unit where he could have received intravenous antibiotics before any surgery was even contemplated. The need to have an x-ray and blood work prior to surgery is an example of what should be known as a "medical law", the transgression of which would be not just an "error" but a "medical crime."  Organized medicine certainly does not want to hear this.  One  of the criminal law’s chief purposes is to provide a warning to others not to engage in behaviors that can cause injury and death.

      The doctors in the above case were reckless in not obtaining blood work and a chest x-ray prior to surgery. These doctors should have been charged with the crime of reckless endangerment.  While such physician behavior in Germany would lead to a criminal

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