Wednesday, February 23, 2005

It's a wonderful life?

I recently came across this story about a small town family doctor who had his license revoked, and now the town is coming to his aid.

Obviously, one can never judge the merits of these things based on a news story, but I was struck by the level of support he is getting from the townspeople.

Critics say Hsu resists change. He says he trusts traditional medical techniques over technology that is not necessarily for the benefit of the patient.

"I'm not giving the people all the bells and whistles, and people on the board think that's bad medicine," he said.

He gives the example of a man who suffered a heat stroke and was brain dead. It was one of the cases in which the board accused him of inappropriate care.

"I told his mom that he was going to die and if we transferred him to a Bismarck hospital, he was going to die there, too," Hsu said. "Allowing his mother to be with him was all that I could do. And to me, that's an honorable thing."

Hsu said the bigger hospital would have made thousands of dollars for a transfer he believes would not have saved the man's life.

John Olson, the medical board's attorney, urged the board to revoke Hsu's license last year. He told the panel that the revocation "is absolutely essential in this case ... he needs to be out of the practice of medicine."

While I don't know the doctor or any of the specifics, I'm troubled by the harshness of his penalty, the revocation of his medical license, relative to the amount of community support he seems to be getting from his patients. He claims to have never been sued for malpractice, making me wonder who filed the complaint with the medical board. His wife claims a competing hospital is behind the effort to revoke his license. It seems to me there should be other alternatives besides revoking his license completely. Is he such a danger to his community that he shouldn't treat people at all?

I'm sure there are many older physicians out there who may not have kept up with the latest treatments and protocols. They may not be as aggressive or lawsuit-defense-minded as a lot of physicians are nowadays. How many of us physicians now have the freedom and luxury to decide on the "right" thing to do, independent of malpractice fears or concerns over reimbursement costs or costs to the patient? How many physicians would be sanctioned if the medical boards only knew the micro-details about our practices? A lot, I bet. But that's not the same as malpractice or incompetence. It's about being held up to an arbitrary standard, depending on the values of whomever is on the medical board. In a way, it's like being sued for malpractice, except by doctors.

According to the article, Dr. Hsu sounds like a self-sacrifing small town doctor who has devoted a lot of time for very little return, at least monetary-wise. I wonder if it's a matter of differences in what constitutes "standard of care"? I wonder a little if there is any racial prejudice behind it. Or maybe Dr. Hsu is a menace to society and should never touch a patient again. I don't think we'll ever really know. All we do know is that Elgin, North Dakota no longer has the services of Dr. George Hsu. And that Dr. Hsu is finally getting paid back some of what he invested in his town. I hope this story will end up being a wonderful life.