Wednesday, August 22, 2012

"Assuming your innocence..."

     Thank you, to the anonymous person who made the comment starting with these words.
     You assume my innocence based on my "numerous and heartfelt" blogposts--then, to be fair, since you don't know me, you suggest that I may not be innocent...
     What are "guilt" and "innocence" in a case such as mine?  Who has laid down the parameters against which doctors, especially (because we have assets?) are measured once the feds get their hands on their lives?  The government will find me guilty of something, won't it?
     The fact is that the government's methodology for determining guilt or innocence is different these days from yours, and mine, and from our founding fathers', and from that of everyone we know, and from what people--in their naivete and inexperience with the forces of government--must think is standard procedure when someone is suspected of a crime.
     I doubt if the government's agents even suspect me of a crime.  They've nabbed me and expect a ransom.  They've nabbed me because they believe a ransom is easily obtained.  They've already taken the ransom, but haven't released me, because they want more.
    The government's methodology is not not intuitive or rational.  It's rapacious, and it denies the rights of people like me to run a business, by taking away funds and supplies necessary to run that business.    HIPAA introduced into law many statutes that had been rejected by Congress when they were presented as part of the Clinton Health Act.  It seems to me they make it possible to indict just about anyone operating a private medical practice--certainly anyone who accepts Medicare or Medicaid, since these are government insurances.  Doctors are frightened about this state of affairs.  Paranoid doctors are not good doctors--they're always looking over their shoulders, expecting attack.  It is unfortunate that my blog confirms that attacks are random little blitzkriegs in the medical profession, because the last thing I want is for doctors to be more fearful than they already are.  Their hypervigilance keeps them from providing good care.  Very often patients are "turfed" from one doctor to another, because they seem risky and litigious, or because they need so much expensive care to get well.  Providing too much care makes the government suspicious.  I talk about this in my "Outliers" post.
     Am I guilty?  Yes, probably--though I don't know of what.  Probably, because I see how the government's set-up allows them to find someone like me guilty of something--especially if it's related to coding or billing.  They may persist in a so-called case against me, if only to save face when they don't find something truly criminal, or to rake in funds for the government's giant maws--which take in and digest more money than any of us can imagine.
     Am I innocent?  Yes, certainly.  I have not committed a crime in any sense of the word as it is and has been defined by all of us common folk for centuries.  I know my business, and there is nothing in it that would constitute fraud or a deliberate attempt to deceive anyone.
     The whole point of this blog is to insinuate that the government's destruction of my career--and my motivation to practice medicine--is not an isolated event.  It seems to me that doctors are besieged by overwhelming threats of many kinds, especially those of governmental and corporate powers.   There are also threats from malpractice suits, censorship by innumerable regulatory agencies, contradictory advice from healthcare groups, and--oh, I almost forgot--the expectations of patients.  In addition, doctors fear that they will make medical errors as a result of too many bureaucratic distractions.  Such errors make us feel terrible (whether or not lawsuits develop) because we are human, and care about the effects of our actions.
     Too much fear and distraction, and too much guardedness, destroy what is most special about doctors.  No wonder we are tired and so many of us want to retire after ten years.  No wonder there is so much criticism of the medical profession.  The rampant criticism of medicine--which is a byproduct of its political and financial importance in this country--feels personal to doctors, and makes practicing medicine harder.   In this atmosphere, everyone suffers.

   

6 comments:

  1. I didn't "suggest" you weren't innocent, but allowed - since I only know what you post about it - for that possibility. As I thought I made clear, I "suggested" exactly the opposite. If you read me as unsympathetic (to put it in dry terms similar to "assume you are innocent" and "or not") I have miscommunicated or you have misread. I wouldn't have read as many of your posts and come to the conclusions (technically guarded as they are) I have if I didn't believe what you write about your practice and your crisis.

    However, if the government's sole motivation was running a scam, not only would this be happening to most doctors, but we would have to assume that the individuals involved were particularly callous and evil people who were either under orders from on high or dedicated on their own to reducing the national debt by ripping off honest care givers. It is much more likely that they - the individuals involved - thought they were going to find something, and not having found it are now subject to the all too human - if dishonorable - unwillingness to admit a mistake. Unfortunately - and this, as I tried to highlight, should be the part of special interest to those of us who don't know you but who care about your rights and those of all Americans - the rules on seizure of property and requirements to bring charges, together with the weight of legal fees which often become a deciding factor in any problem which ends up in court, aid them in avoiding the honorable solution of saying "Sorry, wrong guy!". At least it is the part whose correction offers any hope at all of finding a solution to ending the abuses to which you have been subjected. Nicer guys in the FBI and local Federal Prosecutors office probably won't cut it, and I also doubt that someone on high has decided that docs are a cash cow for totally unjustified shake downs. But even if that were the case -and even more so if that is their primary motivation - the antidote is a changing of the laws which now allow them to hold almost indefinitely the property they seize.

    As I asked in that previous comment - given the apparent fact that there is much Medicare fraud (and almost certainly the word from on high to the FBI and prosecutors is "find it") and also given the apparent fact that worldwide developed countries keep medical costs down by on average to about 60% of what we pay as a nation by having more - not less - government involvement, what practical solution do you see for bending that cost curve while not over-burdening caring docs like yourself? I appreciate as much as an outsider can your desire to focus on taking care of patients without the bureaucracy headaches, let alone the full scale assault you have experienced, but I am left without a clear idea of how we as a nation can solve our health care costs problem without the bureaucracy part, though clearly the assault part is beyond defense.


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  2. I did understand that you were saying you thought I seemed innocent--and was grateful that in telling my story that was the impression of a complete outsider. Thanks for your comments.
    One point about which I disagree is your (logical) supposition that the government can't be trying to generate substantial income by attacking and forfeiting doctors--using statutes that were entered into legislation for other purposes (the war on drugs, the war on terrorism) which, with slight interpretive liberties, now allow them to invade clinics and force doctors into settlements before anyone has a chance to determine guilt of innocence. In fact, the government boasts fairrly regularly about the billions of dollars it "seizes" from doctors--including money taken from doctors like me, most of whom are too chagrined to publicize their plight, or are so confused by the obfuscation of billing and coding procedures that they assume they did do something wrong, and have no idea how to defend themselves.
    I mentioned in an early post that a prominent law firm in Tallahassee (with many offices throughout Florida) quoted $1 million as an estimate of legal costs to "begin" my defense against the government. What is a doctor supposed to do when confronted by federal prosecutors, a raid, drained bank accounts, and total silence? It's like a terrible parent, who makes a kid feel guilty by saying, "I know what you've done," but not outlining the transgressions. No one functions well in such an environment, and doctors are like everyone else--they just want it to go away. Afterwards, the doctors go away too, having been made to seem disreputable.
    Is there really a lot of fraud going on in the medical field? Are you sure you haven't been bamboozled, too, by the press releases the FBI issues--the ones that tell Americans how much fraud there is in the medical profession? Are you sure you haven't been a pawn of the media, which loves a story about demoralization?
    Doctors are not committing fraud, is my guess. Fraud is being "detected" when doctors make enough money for the feds to pay attention. But fraud could be detected in anyone, as Dr. Dawson points out in other comments on this blog. It's not accident that I had money in the bank and they took it. If I had no assets, I wouldn't have been an interesting target.
    Fraud IS being committed in the medical field, but not by doctors. I won't belabor this point, unless you ask me to, because I bring it up in several posts. Suffice it to say that the mega-fraud being committed by real charlatans--not doctors--is a major bugaboo to unravel. Maybe it's too hard for the feds. As one lawyer told me, "You're low-hanging fruit--" and he used to be a prosecutor,so he should know.

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  3. Thanks for your comments and I'm glad I wasn't misunderstood.

    Without specific knowledge, but based on my usual suspicions about conspiracy theories involving hundreds - if not thousands - of members, I still find it difficult to believe that busting known innocents is DOJ policy. Boasting about seizures I would think implies success at busting criminals, not good citizens. I don't have any data on Medicare fraud and have only heard in passing of it's prevalence, and usually from those on the right who use that as a count against the program. In any case, the feds intent is less important to me as an outside observer than their ability to hide the evidence. As I said previously, a change in property seizure laws regarding timeliness of charges solves both the problems of their hiding mistakes or evil intent, whichever it is. Easier said then done of course, especially on an issue with low public awareness like this. Your persistent presentation of your case - not the usual act of someone who is guilty and hiding something - is very helpful and hopefully gains greater publicity about the problem. I for one knew nothing of this "legal" abuse prior and appreciate your bringing it to my attention. I hope you gain a wider audience for your compelling story.

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  4. I have to say it is really just beyond my ability to understand why the government has decided to seize doctors' assets. However,

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  5. I am not an advocate of any conspiracy theory. I do think busting doctors is a lucrative business for an ailing government treasury. Like you, keeping a citizen like me in the dark about the reasons for a raid and substantial forfeiture seems unconstitutional. Where are my rights, I keep asking? Thanks for your affirmation. I do have some ideas about how the delivery of medical care could be simplified and economized in this country, and will address that--if I can do it concisely (anything less than the 2,600 pages of the Affordable Care Act should be an improvement!) in an upcoming post.

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