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Physicians, Beclown Thyselves

I've been having a few more thoughts about the bogus doctor's notes handed out in Wisconsin recently.

My first thought is that it would have been awesome if one of the counter-protesters had gotten a bogus excuse note in the name of "Juan Epstein."

On a more serious note, the University of Wisconsin Health System -- whose residents were caught handing out the notes -- says it's investigating the matter and will act appropriately.

I'm still an amateur, but I'm thinking the residents might just be in the clear -- at least largely. The limitations on their practicing say that they can only operate under the direct supervision of UW Health -- and they were there with Dr. Kathy Oriel, UW Health's Director of Residency. So they were being directly supervised by their school's chosen representative.

No, the real blame falls on Dr. Oriel, who now has to explain how her actions -- and those under her direct supervision -- were perfectly moral and ethical and proper. And on her employer, UW Health, in whose name she is fully authorized to act. If she doesn't go, then the entire program has been thoroughly discredited.

But the residents? Wrist slap. They should have known better, but they aren't expected to really know better at this point -- which is why they are not held fully responsible for their actions. No, their supervisors and institutions are.

Hope you enjoyed your career, Dr. Oriel. If there's any justice, you just brought it to a glorious end.

Finally, any school district presented with a doctor's note from an absent faculty member certainly should not accept that at face value. It's thoroughly documented that a ton of such notes were absolutely fraudulent. The faculty member should be told that they can withdraw the note, or submit corroborating documentation -- a second note describing the date, time, and location of the exam, a receipt from their co-pay for the visit -- no, nothing that would violate doctor-patient confidentiality, but verifies that they were genuinely ill and treated by a doctor. Further, if the note is not from their regular doctor, that should raise even more red flags.

Others have noted that this was an act of "civil disobedience." One of the defining elements of such acts is to accept the consequences of such acts. Dr. Martin Luther King, Jr. didn't have high-powered lawyers at hand to bail him out after he was arrested -- note that his famous missive is not datelined "Press Conference" or even "My Attorney's Conference Room," but "Birmingham Jail."

These doctors chose to make a political stand -- and, in the process, violated the professional and ethical standards of their profession. Far be it for me to deny them the full benefits -- and consequences -- of those actions.


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Comments (25)

Unfortunately (for all the ... (Below threshold)

Unfortunately (for all the rest of us) it's pretty typical of the baby boomers to want to "Make a statement" or "Do their own thing" without consequences. And they've taught their children well. Sorry about that guys and gals but their are rules and they apply whether we like it or not.

I am not as incline to let ... (Below threshold)

I am not as incline to let the residents off so easily. They should have been taught higher standards than a typical person and even a typical person knows better than to commit fraud. Doing something you know is wrong and saying "my supervisor told me to" doesn’t hold up in any field especially a highly ethical professional field like medicine.

Residents are not med stude... (Below threshold)
jim m:

Residents are not med students. These people already have MD after their name. While they are still learning they are far from being ignorant students. They take direct care of patients and are capable of making their own medical decisions.

Perhaps their punishment should be less, but they should by no means be let off the hook for their malpractice. And yes you can sue a resident for malpractice.

Maybe someone directly invo... (Below threshold)
Upset Old Guy:

Maybe someone directly involved (is epador here?) could speak to HIPPA as it relates to what happened at the protests. It would be a major belly-laugh if a government agency ended up coming down on those folks.

ANY and EVERY "Teacher" who... (Below threshold)

ANY and EVERY "Teacher" who attempts to use one of these Cracker-Jack "excuses" should be themselves reprimanded and punished for fraud.

And the Doctors should have formal complaints lodged in their public records. People who might go to these Doctors in the future should be able to easily discover how unethical and dim-witted they are!!

Jay, Those residents... (Below threshold)

Those residents are a minimum 26yrs.old (4yrs college 4yrs med.school)to say they are not responsible is BS. By the time I was 23 I was a Naval officer. They should not be held to a lesser standard. I am also a CRNA. I work with residents (thankfully not these dunderheads). The vast majority of residents I have worked with I would be proud to call family and that is no BS. My guess is Dr. Oriel ask for help and most residents said "no thanks" but then there is the dunderhead brigade. These guys should be ridiculed and Oriel should get a verbial a**kicking. ALL of them shuld have better judgement...thats where you hit them. Words all MD's hate " I question your judgement Doctor' Alas, I can feel the tension in the air.

Anyone who got one of these... (Below threshold)
Les Nessman:

Anyone who got one of these bogus 'exams' who then comes down with something should sue the 'doctor' who gave them an 'exam'. Make them explain how thorough the exam was and what medical procedures they followed in order to give a quality exam.

I hope the kids that were d... (Below threshold)

I hope the kids that were dragged to these things took advantage and got themselves a pile of 'get out of school free' notes to use, too...preferably after the weather warms up ;)

If the "Residents" couldn't... (Below threshold)

If the "Residents" couldn't figure it out on their own - and their ethics are so flexible; then they should also bear the consequences.

After all, they are 'adults', aren't they?

I think I didn't spell out ... (Below threshold)

I think I didn't spell out my idea here clearly enough, so I'll try again:

The residents in question here are small fry.

I want the big fish. If that means throwing back the minnows, I can live with that.


I got it JT. I am in total ... (Below threshold)

I got it JT. I am in total agreement. In regards to the residents, they should lose their residency for showing poor judgement and putting the university in a negative light. Let all these "doctor's" find a small rural hospital that will accept their application for residency. That will humble them. ww

The residents, Dr. Oriel an... (Below threshold)

The residents, Dr. Oriel and the UW Health System have now opened themselves up to future and perhaps current medical malpractce suits with that stunt. If the doctors were so willing to fraudulently issue notes without a complete examination as required by their profession, then a malpractice lawyer could use this as both examples of their willingness to cut corners and their reckless disregard of patients' true medical condition.

Will UW ignore this potential threat or will they be good little university types and let the school and their own careers face the possibility of multimillion dollar malpractice lawsuits?

I wonder if those Resident ... (Below threshold)

I wonder if those Resident Physicians counted the time they spent at the protest as part of their 80 hours? (80 hour rule is a time limit any Resident is allowed to "work")

@Gladius: I was a Resident when I turned 23 years old & age does NOT reflect maturity.

I don't see why we have to ... (Below threshold)
jim m:

I don't see why we have to be in the position of saying that in order to get the big fish we have to throw back the small ones. That just shows them that they can game the system and that maybe next time they will do better than the ones that got caught.

This should be an object lesson for doctors everywhere that medicine is not the servant of any political ideology and that it is concerned with making people well and not with BS issues of social justice.

If these residents need to lose their careers over their mistake so others learn not to debase themselves and their profession then they need to lose them.

This is the difference between medicine being a calling or a profession and it being a trade. If a doctor is nothing more than a tradesman then we need to start paying them a whole lot less. Clearly the message being sent is that we cannot trust the ethics of any physician because they can be bought and sold by political interests.

Jim,The politicians ... (Below threshold)

The politicians have done exactly what you are saying: debased medicine and made physicians tradesmen. The draconian cuts in physician reimbursement prove that to be true.

I agree with Justrand. ... (Below threshold)

I agree with Justrand.

They should be given the opportunity to withdraw the note. If they choose not to they should be required to provide additional evidence to support their claim (copay receipts, etc).

If this evidence isn't produced the teacher is terminated for cause, "falsification of school district records".

We should fry the big fish ... (Below threshold)

We should fry the big fish and the minnows. Letting the small ones off is like saying we should only go after the mastermind of the bank robbery and not worry about all the others involved.

Lying is wrong. This is gra... (Below threshold)
Rich Fader:

Lying is wrong. This is grade-school, kindergarten, hell, nursery-school-level ethics. These guys are grown men and women. What medical career, boys and girls? You're done. Good luck paying off your loans working at McDonald's.

ok 1. I was a reside... (Below threshold)

1. I was a resident @ 22
2. Whether I was mature or not then, I was held to full adult responsibilities and my residency director had to speak to all my infractions. like the time I. called the hospital CEO at home and cussed him out (somehow I managed to escape castration for that one)
3. Residents are not small fry if you consider the economic impact they have in finding and work for the U. firing them without replacement could have a big effect on the bottom line and could hurt the u more than clearing out some tenured faculty

finding was supposed to be ... (Below threshold)

finding was supposed to be funding

@epador: are you a graduat... (Below threshold)

@epador: are you a graduate of UMKC?

The Juan Epstein reference ... (Below threshold)

The Juan Epstein reference took a sec - funny show.

I agree with the comment about "civil disobedience" - too many nowadays want to challenge authority and not be subject to any repercussions. Bunk!

The point of the exercise is to disobey, be brave enough to be harassed, beaten, and arrested. Then to use the same system that oppresses you to fight for your rights and point of view. If you lose then, you are willing to accept punishment and incarceration to further your protest against the system.

These two year-old's only want to have a tantrum and then go out for ice-cream afterwords.

Naw, I was a Nittany Lion.<... (Below threshold)

Naw, I was a Nittany Lion.

They certainly have plenty ... (Below threshold)

They certainly have plenty of viable defenses at their fingertips. The Insanity Defense springs to mind. (il)Liberalism, after all, is a psychosis.

And then there is the psychotic's secondary defense of being caught up in the heat of the moment and having moral relativity carry them away. Add to those the Any-Means-To-An-End and/or Self Defense.

The sole raison d'etre, after all, of an(il)liberal's existance being to own and to operate and to control the dispensing of unearned and undeserved largesse from the public trough, less demurrage -- and Wisconsin's liars, looters, thieves -- and other "Democrats" -- feel their livelihoods are under threat.

Did Dr Oriel call in sick? ... (Below threshold)

Did Dr Oriel call in sick? Fired!

Did Dr Oriel participate, and cause her residents to falsify medical records? Fired!

Did Dr Oriel participate, and cause her residents to falsify University and/or state government documents? Fired!

As for the teachers availing themselves of the false "sick slips", ordinarily I would suggest an official reprimand be placed in their teachers file for 2 years, HOWEVER: Since the USA ranks last in education of 21 industrialized nations, I would fire them - maybe those teachers have identified the cause of sub-standard education (one of them), an over-riding interest in politics and paychecks over the education of our youth. If they leave their jobs to protest, what are they teaching our students, and what do you think they will say to them when classes resume?






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