Doctor’s proposal target attorneys
UNDER DEBATE: AMA considers whether to give its OK for physicians to refuse to treat trial lawyers and spouses, except in emergencies.
BY CAROL M. OSTROM; Seattle Times staff reporter: June 14, 2004

  When a patient who happened to be a trial lawyer told Dr. Steve Klein, "If you screw up, I'm going to sue you," Klein sent him packing.
  Being threatened makes it hard for him to think clearly, said Klein, a brain and spine surgeon and chief of surgery for Northwest Hospital & Medical Center. "I can't render the best care."
  That's why Klein supports a proposal to allow doctors to refuse to treat trial lawyers and their spouses, as long as it's not an emergency.
  The resolution is being considered by American Medical Association (AMA) delegates meeting in Chicago to set policy for the doctors' organization.
  The proposal, by a South Carolina surgeon who wants to bring attention to the "professional-liability crisis," is expected to be extremely controversial, said Tom Curry, executive director of the Washington State Medical Association. Yesterday, it met with an angry response at the meeting.
  Curry said the eight delegates from Washington state take the position that "it's not unethical for a physician to refuse to treat, or transfer care of a patient, if he or she feels there's a communication or trust issue."
  At the same time, the proposition that doctors could reject all trial lawyers and their spouses is "highly problematic," he said. "Most physician's would be concerned that would be a little too much."
  Still, he said, all the doctor-delegates understand the strong feelings that led to the resolution. "It's a sign of the times, and a good indication of the depth of the frustration out there," he said.
  The South Carolina surgeon, Dr. J. Chris Hawk III of Charleston, has said he wants to spotlight the need for reform of the civil-justice system.
  "If trial attorneys were given the opportunity to experience the access problems caused by the professional--liability crisis, then perhaps they would be willing to help change the system," he wrote in his resolution.
  He has asked the AMA to tell doctors they may ethically refuse to treat plaintiffs' attorneys or their spouses, except in emergencies or when they are otherwise required by law or regulation. Yesterday, Hawk attempted to withdraw the resolution; it wasn't immediately clear whether it would be brought forward to delegates, who begin voting on policies today.
  According to the AMA’s current ethics code, doctors can refuse care to individual patients, except in emergencies. But the prospect of doctors barring a whole class of patients drew trial lawyers' reactions ranging from gentle disappointment to edgy incredulity.
  "It's silly," said Reed Schifferman, a Seattle plaintiff’s lawyer. "It's disappointing. I would like to think the vast majority of doctors I know aren't going to treat you based on your job."
  Carlton Carl, spokesman for the Association of Trial Lawyers of America, said it would demean the medical profession to pass such a resolution.
  "It would be a shame and very disappointing if doctors turned the Hippocratic Oath into a hypocritical position, denying access to medical care to a profession or specific group of people," he said.
  Frank Shoichet of Seattle, like many plaintiffs' attorneys, says doctors should realize that problems with malpractice insurance are caused by the insurance industry, not lawsuits.
  "Maybe doctors ought to think about not treating insurance company executives instead - it might get to the root of the problem," he said.
  Klein, the neurosurgeon, said he has a responsibility to his other patients and to his family to turn away litigious patients, because a lawsuit is so destructive and distracting for a doctor.
  Most doctors he knows feel that way, he said: "Why would you purposefully treat someone you believe is going to sue you?"
  He recalls his first threat, 20 years ago, from the mother of a girl who had been shot in the head. Klein was in a trauma center, where he had to try to help the girl. He told the mother the wound was life -threatening and that doctors would do their best.
  "She said, 'She better be the way she was or you're going to pay,'” Klein recalls.
  The girl died; the mother sued.
  Now, when patients or families say things like that, Klein says, he helps them find another doctor, telling them they appear to have a "gross misunderstanding of the nature of surgery," because they're not accepting the fact that there are risks.
  He's done some types of brain surgery 500 times without problems, he says. But, he adds: "Statistics catch up with you. These risks are real. It's the limits of medicine. If somebody can't accept that, I don't want them as a patient, whether it's a trial lawyer, an accountant, a reporter, another doctor."
  Klein said he wouldn't refuse treatment to someone simply because he or she was a trial lawyer or opposed doctors' demands for limits on lawsuits.
  "I'd even treat (U.S. Sen.) Patty Murray," he joked.
  Murray, who has opposed limits on noneconomic damages in medical--malpractice suits on the grounds that it would disproportionately hurt women and the elderly, has been targeted politically by doctors and their allies.

Carol M. Ostrorn: 206-464-2249 or
Information from The Associated Press is included in this report.