Entrepreneurs will tell you success is in the execution. Anyone can come up with an idea, but the execution of it separates the pretenders from the real empire builders.
The same goes for many healthcare laws, which have undergone radical revisions in recent weeks. The laws may have changed, but enforcing those changes will be particularly difficult.
Healthcare laws rely heavily on tips and expert witnesses – meaning healthcare self-regulates. When RaDonda Vaught was indicted because of a fatal medical error, the prosecutors brought a slew of expert witnesses to testify the medical error rose to the level of being a crime.
There is no legal argument for healthcare behavior to be considered a crime or worthy of legal liability – civil or otherwise. There is no standard legal theory or method of adjudication. It comes down to medical experts and witnesses. It comes down to self-regulation.
When a physician makes a mistake, it is reported by someone to the medical licensing board or state attorney general’s office. That office then initiates an investigation, gathering experts and witnesses to testify against that physician. Sanctions against that physician essentially depend on the interpretation of others. If other medical professionals believe that person committed a crime, then he or she did.
In this way, healthcare is only bound by the laws it chooses to adhere to. If a law is medically unjust, healthcare can effectively nullify it by standing in solidarity against it. The only problem is in healthcare, we lack such unity.
We have no shortage of healthcare providers clamoring to be expert witnesses or to showcase their charisma on media outlets. It is endemic to the field. But the same physician or nurse seeking personal glory is the one who will testify against a colleague in the court of law.
No other profession behaves like this. Law enforcement has immense union protections for its members to where officers cited for multiple misconduct violations can continue to work in that department. Federal agencies place immense stigma against those who whistle-blow or testify against former associates, even in cases of legitimate federal misconduct – and good luck getting any lawyer to testify against another one of its own kind.
Yet healthcare has no shortage of expert witnesses and purported legal experts. No shortage of professionals willing to bend medical data or interpret medical information a certain way to justify a given legal stance. As a result, we see opioid litigation essentially boiling down to testimonies from competing expert witnesses. It is professional cannibalism. No one wins when litigation outcomes distill down to different interpretations of clinical knowledge.
It is time we protect the integrity of healthcare by demonstrating a sense of solidarity.
Healthcare has always been and will always continue to be a self-regulating entity. No law can change the standard of care in medicine so long as those practicing medicine adhere to good patient care. We in healthcare define what it means.
So instead of fighting non-clinically trained politicians or law-makers for the healthcare laws they enact, healthcare should unify in a stance of noncompliance. Agree not to comply with laws intended to subjugate healthcare to the political whims of lawmakers.
It requires physicians and nurses to put the common good of healthcare over individual self-interests. We would hope this is why most entered healthcare in the first place.
But hope is not a strategy. We have yet to see individuals in healthcare sacrifice for the common good when it comes to healthcare regulations and uphold a sense of solidarity.
Let us call it for what it is. It is time to end snitch culture in healthcare.
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