Collateral damage

Six and a half years ago, my malpractice insurer made a payment to settle a case against a company I once ran in a neighboring state. Nine years before that, a physician who worked for me had lasered a tattoo on a woman’s ankle. She claimed it got infected and then scarred, but refused to be examined at that time, or later.

This case wound its way slowly through the system. I drove to the nearby state to plot strategy with the insurer’s attorney for dealing with the $50,000 claim. "I can’t understand why anyone would take a case this small," said the attorney.

When we got to the courthouse that January day, we saw why. The plaintiff – whom I had never met – was accompanied by a lawyer. He and my attorney met with the judge.

"Settle this case," she ordered.

And so we did, for $22,500. The plaintiff stipulated that I "did not act negligently in any respect."

As we exited the courtroom into the hall, the plaintiff approached me. "My tattoo isn’t gone yet," she said. "Would you be able to treat it?"

My attorney’s jaw dropped. Not mine, though. I had her put her ankle up on a bench to look at it. There was no scarring, just the hypopigmentation one sees after laser treatment in that area.

"You know," I told her. "I’m all the way in the next state. "The doctor here in town who treated you – the one who was going to testify against me today? He would be perfect."

We smiled at each other, shook hands, and I went home.

Fast forward to last week. A registered letter came to my office from a local electrical union. It contained a flyer that read:

Don’t be in the DARK about your doctor. XYZ hospital continues to allow doctors with recent malpractice payments to treat patients, WHY?

DR. ALAN S. ROCKOFF MADE A MALPRACTICE PAYMENT.

What kind of DOCTOR do you want treating you and your loved ones?

The accompanying letter explained that, "We intend to distribute [the leaflet] in the near future to anyone entering or leaving your medical building, as well as residents and businesses in the surrounding community. We will also be publicizing the content on DrRockoffexposed.com and through social media including Facebook and Twitter."

They added, "We strive for accuracy in all of our leaflets and websites." I was given 1 week to let them know if I found "anything untruthful or inaccurate," to "kindly let me know."

I thought the "kindly" was a nice touch.

The leaflet included a lot of nasty innuendoes about hospital XYZ, where I have staff privileges.

Bewildered, I contacted my malpractice insurer, who helpfully told me there was nothing I could do, and suggested I contact the hospital, at whom the campaign was clearly intended. I did so. The people at the hospital expressed sympathy and outrage about the union’s letter, and told me to ignore it.

An attorney affiliated with my malpractice insurer did some digging, and he sent me a link to an article showing that his union had used similar tactics against a hospital north of town 2 years ago. Their motive, it appears, is to be sure their union secures contracts for work at the hospitals in question.

In other words, friends, this is what is known in Mafia movies as a shakedown. "Nice medical staff you’ve got there," says the leaflet, in so many words. "Be a shame if anything happened to it."

As a kid, I used to watch Elliot Ness in "The Untouchables," but I never thought I would be personally involved in anything I saw there. But if you live long enough, you never know what you’ll experience. Anyhow, any publicity is good publicity, and DrRockoffexposed.com does spell my name right, even if it’s not nearly as fun to see as what one could imagine at something like www.TweetingCongressmanExposed.com.

For better or worse, the time when doctors sat in their offices, wrote notes on 3x5 cards, and collected cash payments they stowed in their desk drawers are long gone. In the Olympian corridors of power far above our heads, powerful forces that dictate our lives hurl thunderbolts at each other as they vie for money, power, and control. The trick is to stay out of their way and avoid becoming collateral damage.

Easy to say. Less easy to do.

Dr. Rockoff practices dermatology in Brookline, Mass. He is on the clinical faculty at Tufts University School of Medicine, Boston, and has taught senior medical students and other trainees for 30 years. Dr. Rockoff has contributed to the Under My Skin column in Skin & Allergy News since January 2002.

Six and a half years ago, my malpractice insurer made a payment to settle a case against a company I once ran in a neighboring state. Nine years before that, a physician who worked for me had lasered a tattoo on a woman’s ankle. She claimed it got infected and then scarred, but refused to be examined at that time, or later.

This case wound its way slowly through the system. I drove to the nearby state to plot strategy with the insurer’s attorney for dealing with the $50,000 claim. "I can’t understand why anyone would take a case this small," said the attorney.

When we got to the courthouse that January day, we saw why. The plaintiff – whom I had never met – was accompanied by a lawyer. He and my attorney met with the judge.

"Settle this case," she ordered.

And so we did, for $22,500. The plaintiff stipulated that I "did not act negligently in any respect."

As we exited the courtroom into the hall, the plaintiff approached me. "My tattoo isn’t gone yet," she said. "Would you be able to treat it?"

My attorney’s jaw dropped. Not mine, though. I had her put her ankle up on a bench to look at it. There was no scarring, just the hypopigmentation one sees after laser treatment in that area.

"You know," I told her. "I’m all the way in the next state. "The doctor here in town who treated you – the one who was going to testify against me today? He would be perfect."

We smiled at each other, shook hands, and I went home.

Fast forward to last week. A registered letter came to my office from a local electrical union. It contained a flyer that read:

Don’t be in the DARK about your doctor. XYZ hospital continues to allow doctors with recent malpractice payments to treat patients, WHY?

DR. ALAN S. ROCKOFF MADE A MALPRACTICE PAYMENT.

What kind of DOCTOR do you want treating you and your loved ones?

The accompanying letter explained that, "We intend to distribute [the leaflet] in the near future to anyone entering or leaving your medical building, as well as residents and businesses in the surrounding community. We will also be publicizing the content on DrRockoffexposed.com and through social media including Facebook and Twitter."

They added, "We strive for accuracy in all of our leaflets and websites." I was given 1 week to let them know if I found "anything untruthful or inaccurate," to "kindly let me know."

I thought the "kindly" was a nice touch.

The leaflet included a lot of nasty innuendoes about hospital XYZ, where I have staff privileges.

Bewildered, I contacted my malpractice insurer, who helpfully told me there was nothing I could do, and suggested I contact the hospital, at whom the campaign was clearly intended. I did so. The people at the hospital expressed sympathy and outrage about the union’s letter, and told me to ignore it.

An attorney affiliated with my malpractice insurer did some digging, and he sent me a link to an article showing that his union had used similar tactics against a hospital north of town 2 years ago. Their motive, it appears, is to be sure their union secures contracts for work at the hospitals in question.

In other words, friends, this is what is known in Mafia movies as a shakedown. "Nice medical staff you’ve got there," says the leaflet, in so many words. "Be a shame if anything happened to it."

As a kid, I used to watch Elliot Ness in "The Untouchables," but I never thought I would be personally involved in anything I saw there. But if you live long enough, you never know what you’ll experience. Anyhow, any publicity is good publicity, and DrRockoffexposed.com does spell my name right, even if it’s not nearly as fun to see as what one could imagine at something like www.TweetingCongressmanExposed.com.

For better or worse, the time when doctors sat in their offices, wrote notes on 3x5 cards, and collected cash payments they stowed in their desk drawers are long gone. In the Olympian corridors of power far above our heads, powerful forces that dictate our lives hurl thunderbolts at each other as they vie for money, power, and control. The trick is to stay out of their way and avoid becoming collateral damage.

Easy to say. Less easy to do.

Dr. Rockoff practices dermatology in Brookline, Mass. He is on the clinical faculty at Tufts University School of Medicine, Boston, and has taught senior medical students and other trainees for 30 years. Dr. Rockoff has contributed to the Under My Skin column in Skin & Allergy News since January 2002.

Six and a half years ago, my malpractice insurer made a payment to settle a case against a company I once ran in a neighboring state. Nine years before that, a physician who worked for me had lasered a tattoo on a woman’s ankle. She claimed it got infected and then scarred, but refused to be examined at that time, or later.

This case wound its way slowly through the system. I drove to the nearby state to plot strategy with the insurer’s attorney for dealing with the $50,000 claim. "I can’t understand why anyone would take a case this small," said the attorney.

When we got to the courthouse that January day, we saw why. The plaintiff – whom I had never met – was accompanied by a lawyer. He and my attorney met with the judge.

"Settle this case," she ordered.

And so we did, for $22,500. The plaintiff stipulated that I "did not act negligently in any respect."

As we exited the courtroom into the hall, the plaintiff approached me. "My tattoo isn’t gone yet," she said. "Would you be able to treat it?"

My attorney’s jaw dropped. Not mine, though. I had her put her ankle up on a bench to look at it. There was no scarring, just the hypopigmentation one sees after laser treatment in that area.

"You know," I told her. "I’m all the way in the next state. "The doctor here in town who treated you – the one who was going to testify against me today? He would be perfect."

We smiled at each other, shook hands, and I went home.

Fast forward to last week. A registered letter came to my office from a local electrical union. It contained a flyer that read:

Don’t be in the DARK about your doctor. XYZ hospital continues to allow doctors with recent malpractice payments to treat patients, WHY?

DR. ALAN S. ROCKOFF MADE A MALPRACTICE PAYMENT.

What kind of DOCTOR do you want treating you and your loved ones?

The accompanying letter explained that, "We intend to distribute [the leaflet] in the near future to anyone entering or leaving your medical building, as well as residents and businesses in the surrounding community. We will also be publicizing the content on DrRockoffexposed.com and through social media including Facebook and Twitter."

They added, "We strive for accuracy in all of our leaflets and websites." I was given 1 week to let them know if I found "anything untruthful or inaccurate," to "kindly let me know."

I thought the "kindly" was a nice touch.

The leaflet included a lot of nasty innuendoes about hospital XYZ, where I have staff privileges.

Bewildered, I contacted my malpractice insurer, who helpfully told me there was nothing I could do, and suggested I contact the hospital, at whom the campaign was clearly intended. I did so. The people at the hospital expressed sympathy and outrage about the union’s letter, and told me to ignore it.

An attorney affiliated with my malpractice insurer did some digging, and he sent me a link to an article showing that his union had used similar tactics against a hospital north of town 2 years ago. Their motive, it appears, is to be sure their union secures contracts for work at the hospitals in question.

In other words, friends, this is what is known in Mafia movies as a shakedown. "Nice medical staff you’ve got there," says the leaflet, in so many words. "Be a shame if anything happened to it."

As a kid, I used to watch Elliot Ness in "The Untouchables," but I never thought I would be personally involved in anything I saw there. But if you live long enough, you never know what you’ll experience. Anyhow, any publicity is good publicity, and DrRockoffexposed.com does spell my name right, even if it’s not nearly as fun to see as what one could imagine at something like www.TweetingCongressmanExposed.com.

For better or worse, the time when doctors sat in their offices, wrote notes on 3x5 cards, and collected cash payments they stowed in their desk drawers are long gone. In the Olympian corridors of power far above our heads, powerful forces that dictate our lives hurl thunderbolts at each other as they vie for money, power, and control. The trick is to stay out of their way and avoid becoming collateral damage.

Easy to say. Less easy to do.

Dr. Rockoff practices dermatology in Brookline, Mass. He is on the clinical faculty at Tufts University School of Medicine, Boston, and has taught senior medical students and other trainees for 30 years. Dr. Rockoff has contributed to the Under My Skin column in Skin & Allergy News since January 2002.