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Surgeon Calls for Powerful Patient Union with Actionable Liability Levers

Op-Med is a collection of original articles contributed by Doximity members.

For the past 4 years I’ve been living in a crucible from hell — as a husband-turned-activist, father, surgeon and citizen.

But my family is not alone — there are literally hundreds of thousands of American families every year, avoidably affected or harmed by our healthcare establishment’s ethically defunct corporate directives.

Don’t take me wrong, I know that our healthcare establishment is capable of enormous good — and that it is a crowning jewel of our civilization and society. I also know that the vast majority of physicians, at least, start out having beneficent intent towards the ill and suffering.

But, in the year 2017 the overt business influence and a rich revenue stream from our insurance investments has corrupted American medicine at its highest levels of establishment — this, I know as a matter of fact based on my very personal interactions and engagement with many well-decorated and leading physicians and medical corporate leaders.

As a surgeon, turned patient-activist, I’ve often thought that individual American patients need a professional watchdog force to defend them, in a personalized way, as they navigate the finely polished corporate healthcare maze.

There is powerful precedent for such a concept.

American Laborers and workers, susceptible to corporate abuse, have their unions.

Americans susceptible to civil rights violations have the ACLU and NAACP.

But who defends individual patients whose rights are ignored? Who defends those patients who are harmed or are in harm’s way? Very certainly not the healthcare corporations and their minions! And not the “advocacy groups” focused on creating “safe space” for patients to commiserate or kumbaya for empathy/sympathy — and not those organizations designed to address broad and impersonal policy, public health or research issues.

Don’t take me wrong. Patients need empathic shoulders, policy diplomats, and research advocates — but what is sorely missing is an army capable of providing liability blows, when things are bad or go wrong.

I am not talking about creating another “advocacy group”. Instead, what I know is missing in the healthcare marketplace is a patient-powered strike force. An army capable of delivering well-crafted and precision-made liability signals to the corporate risk managers guarding every level of our healthcare establishment — providers, hospitals, insurers, pharmaceutical and device makers, even federal and state level political leaders guided by industry lobby.

To be clear, I am not proposing anarchy. I am proposing a union of, by and for patients — capable of providing adequately powered liability signals to the corporate healthcare establishment so that it can improve and evolve.

Any one of us, healthy today, can be on the receiving end of harm at the hand of a healthcare provider tomorrow — and when this happens, there is no real force defending us!

Yes, there are medical malpractice lawyers. But most of those, take on only the cases where there is a reasonable assurance of a win — and, anyway, the vast majority of plaintiff’s cases against doctors and hospitals lose in court.

In the year 2017, American patients are where American laborers and the African-American people were in the early part of the 20th century. That is, literally defenseless in the face of an increasingly corporatized medical marketplace designed to serve the healthy and the wealthy “majority”, and polished to achieve “cost and liability containment” for the corporation.

In the 20th century, American laborers and the African-American people created and supported powerful unions, such as the AFL-CIO, the ACLU and the NAACP. And the American patient has a lot to learn from those examples.

These unions defend the rights of individual citizens against powerful corporate and status quo forces using the force of liability and litigation.

IMAGINE American history without the AFL-CIO, the ACLU or the NAACP. What would America look like today?

Irrespective of the political criticism some direct at unions, the state of labor and civil rights in America would be unimaginable had these forces not emerged onto the scene with the teeth they possess.

Unions give Americans voice — they empower citizens in the face of utilitarian corporate forces.

Unions are necessary for the evolution of a well-balanced market and a just democratic republic. Because unions empower and balance the marketplace equation.

There is no question that the individual American patient, today, needs a powerful counterbalance to the well-polished and powerful corporate healthcare establishment — with its robust complement of well-polished marketing and legal defenses.

Isn’t it time for the American patient to have a union of his or her own, with the power to impose real liability on the healthcare establishment when needed by the susceptible patient — and every patient who walks into a hospital or provider’s office is susceptible, make no mistake.

The lucrative nature of healthcare reimbursements has, in many cases, turned the patient into nothing more than a package on the conveyor belt of corporate medicine. Inside hospitals, administrators and leading doctors, use the term “service line” to describe their money machine.

In such an environment countless patients, already vulnerable because of their illness, are also susceptible to the corporate system’s impersonal orientation, to predatory practices, and when avoidably harmed, to irreversible loss and liability.

It is a virtual certainty that our federal government will not be able to autonomously defend the patient position well. Not because it is intentionally corrupted or malicious, but because our federal system is designed to accommodate and serve diverse stakeholders based on their lobby power — not just patients. And in the healthcare marketplace, today, patients are the weakest of all the stakeholders in the market equation — even though they are the basic source of value to the establishment.

THIS, is not right.

BUT — — IMAGINE, a union designed to achieve balance and justice for every American patient with a legitimate grievance. And, in my experience, almost all patients who complain about something have a legitimate grievance or need more accurate information.

IMAGINE, a union focused on the defense of individual patients’ rights in navigating a complex and, at times, impersonal healthcare system led by corporate directives.

IMAGINE, a union designed to provide its individual members access to an unprecedented watchdog organization designed to promote and defend the rights of its every member.

IMAGINE, a union designed to focus on the adverse experiences of individual patients — in order to generate granular, personalized, professionally crafted and adequately powered liability signals to the corporate healthcare establishment’s guardians. And I assure you, when corporations receive real liability signals, they respond quite efficiently!

IMAGINE, a union that operates as a Co-Op organization sustained and owned strictly by its members: that is, every individual American who is a patient or a potential patient — irrespective of race, ethnicity, religion, gender, sexual orientation, socioeconomics or immigration status.

IMAGINE, a union formed of the patient, by the patient and for the patient — for every patient.

IMAGINE, an unprecedented member-powered watchdog co-op committed to delivering adequately powered and expertly crafted liability signals to the healthcare establishment using the adverse experiences of individual patients — for the sole purpose of defending patients’ rights and improving safety and quality in a muscular way.


The Anatomy of “The American Patient Defense Union”.

Support patients_—all patients—_by signing the petition, here.

The only question is: Are individual American patients, by the millions, willing to invest in creating such a union with enough teeth to correct the system’s inequities by generating transparent liability signals and through muscular litigation when needed?

More importantly, are YOU, the American physician and patient, willing to speak up?

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