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Sat Mar 3 16:14:19 GMT 2007

Ron,

I followed your excellent example. Your deep antipathy toward Tom aside, I
don't know what you found so objectionable in the four small pages we are
able to read from the Amazon website. The place where I trained had a
similar ethnic ebbing and flowing. It sounds like a fictional story of a
principled scientific doctor fighting with some other wicked greedy docs who
actually run the hospital and don't care about the patients as much. You're
right that sounds too far fetched.

Why can't we know who this Professor Z is?

I believe Tom and Dr. Mattox are making the same point. The reason laws like
Never 27 are passed is because we have done such an abominable job "policing
ourselves". I'm not sure it is logical to believe that powerful groups will
be able to provide their own oversight. Certainly doctors, lawyers and cops
would not be poster children for this concept. I worked at place where
economics and internal politics were RELATIVELY less forcefully influential
than most. I worked with brilliant and dedicated physicians. But we were and
are forced to work with some absolute stone killers and murderers. I don't
think once in over a quarter century did a doc lose their privileges let
alone get fired. Well there was one but that was more an example of how the
Never 27 laws will be used and abused than anything useful or fair.

Rob Smith

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Thomas Anthony Horan
Sent: Saturday, March 03, 2007 9:22 AM
To: Trauma &amp; Critical Care mailing list
Subject: RE: Never 27 Law Watch

Gosh Ron,

 To read any book you will have to be able to maintain attention for more
than three paragraphs. Maybe you attention deficit was a reaction to the
source of the recommendation? The surgeon author has over 300 peer reviewed
articles and is an associate editor of a well know journal. The book comes
from his experience in NY. Many on the list have  had a lot of interaction
with the author.

Any way I found it an accurate reflection of what the real problems are and
how the medical profession protects its incompetent members. If law 27 had
been in force during the events related, the book would not have been
needed.

Tom

> ----------
> From:
trauma-list-bounces at trauma.org[SMTP:trauma-list-bounces at trauma.org] on
behalf of Ronald Gross[SMTP:Rgross at harthosp.org]
> Reply To: 	Trauma &amp; Critical Care mailing list
> Sent: 	sábado, 3 de março de 2007 00:04
> To: 	Trauma &amp; Critical Care mailing list
> Subject: 	RE: Never 27 Law Watch
> 
> Hey Tom,
> 
> I Googled this mysterious Professor Z that you seem to admire so much
> and couldn't find a damn thing about him.  So I looked at his book on
> the only place I could find it on line - Amazon.com.  I read page 1 and
> I have to ask the question....Is the rest of the book the same
> fictitious garbage as page one is?  
> Wait!  I get it - we have now moved into the realm of evidence based
> fiction.  Great.  Just great.
> 
> Ron
> 
> 
> >>> "Thomas Anthony Horan" <thoran at sarah.br> 3/2/2007 12:45 PM >>>
> Dear Ryan,
> 
> you are absolutely correct and Ron provides no evidence to support his
> contrary minded view.
> Recently a well known Surgeon  from new York has published an account
> of how poorly the current accountability situation plays out in a
> hospital. "Behind the Green Door" professor Z worth the read.
> 
> Tom
> 
> > ----------
> > From:
> 	trauma-list-bounces at trauma.org[SMTP:trauma-list-bounces at trauma.org]
> on behalf of Ronald Gross[SMTP:Rgross at harthosp.org] 
> > Reply To: 	Trauma &amp; Critical Care mailing list
> > Sent: 	sexta-feira, 2 de março de 2007 10:07
> > To: 	Trauma &amp; Critical Care mailing list
> > Subject: 	Re: Never 27 Law Watch
> > 
> > Ryan,
> > 
> > It is quite clear that you have never been involved with an
> investigation of a reportable "adverse event".  And I am sorry to say
> that it is just as clear that you fail to give the average "consumer"
> (formerly known as a patient) the credit that he/she is due when you
> assume that these folks are accepting their PMD's golf partner as their
> physician.
> > 
> > I hope you return to this list with your revised comments 2 or 3
> years after you have entered the real world as a practicing physician. 
> Even better, as a solo practitioner who hangs out a shingle in a town
> where there are 16 other surgeons, you don't have time to play golf, and
> your practice grows solely on your ability to practice medicine or
> surgery and care for your patients the way they want to be cared for -
> as if each and every one of them were the most important person in your
> world getting the best results possible.
> > 
> > Good luck,
> > Ron
> > 
> > >>> Ryan Shanahan <rs339 at georgetown.edu> 3/1/2007 6:10 PM >>>
> > With considerable respect to Drs. Mattox and Gross I would question
> whether anyone on this list or the hospitals they work for create enough
> report-able events to make this law an administrative hassle.  If it is
> the case than the reporting requirements should be the least worry. 
> (granted the last report-able event "any adverse event ... that causes
> death or serious disability" is uncomfortably vague)
> > 
> > For all the problems that the consumerization of medicine has and
> will continue to create it should allow people to compare and choose a
> doctor based on some objective criteria.  At least something more
> objective than a list in a phone book or their primary care providers
> golf partner.  Yet there has been considerable reluctance to provide> 
> practice quality data like this to the public.  Usually adverse events
> like the ones mentioned in this law are buried in an internal QC review
> with admonitions to do better in the future and very little tangible
> change.  Every so often when an error occurs a patient sues but that is
> the exception rather than the rule. (Keepnews D, Mitchell P. (2003,
> September 30). Health systems' accountability for patient safety. Online
> Journal of Issues in Nursing 8(3):2).  More often patients sue when no
> error has been committed.
> > 
> > Legislation like this is the least efficient way to make the required
> changes in openness and accountability for mistakes but if the
> profession is unwilling to make the changes internally then external
> prodding is the only way left.
> > 
> > Ryan Shanahan M'09
> > 
> > 
> > 
> > ----- Original Message -----
> > From: KMATTOX at aol.com 
> > Date: Thursday, March 1, 2007 11:35 am
> > Subject: Re: Never 27 Law Watch
> > 
> > > Ron:   I think that the majority of the persons on this list  
> > > (including 
> > > international members) are in total agreement wi
> th  you.   There 
> > > are a few on this 
> > > list that are supportive of the  Regulatory Industrial Complex and
> 
> > > the clip 
> > > board carrying job assurance  programs. 
> > > 
> > > k
> > > <BR><BR><BR>**************************************<BR> AOL now 
> > > offers free 
> > > email to everyone.  Find out more about what's free from AOL at 
> > > http://www.aol.com.
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