Sunday, January 27, 2008


I have introduced this word to the English language. As I define it: it is subtle findings in a patient as symptoms. signs or abnormal labs that at the time of its occurrence does not suggest serious condition but if a serious condition happens after that the patient, his family, his lawyer and expert witness will use it against you as a physician or health care provider.I am not against patients' rights. I am actually for good medicine that is delivered to all people regardless of their country, income, race and colour. When I made Taman Health Plan my main goal was to deliver this advancement of medicine to all the people in America and my plan was actually good to other countries. Part of the delivery system is patients compensations for health care providers mistakes. In reality my plan have a lot of mechanisms to guard against medical mistakes to begin with.Returning back to subtloma a simple example is a patient have cough for few weeks you take care of that he looses few pounds and come to you few months later with lung cancer. He sues you for a Million dollars for few dollars you get. Many times you get less than one hundred dollars for 3 or 4 visits after the insurance companies squeeze you or the Medicare and Medicaid that are squeezed by politicians give you few dollars. Then you fight in the court for this law suit and you loose a lot of sleep and time for the subtloma. The risk benefit ratio is just huge for 30 dollars you get from seeing a patient you may end by a law suit for a million dollars. I cut my hair for 30 dollars and I will never sue my barber. Lawyers and patients are playing the lottery game and all the health care system is suffering.You may end by winning the case as a doctor but in real life you had lost a lot. Lawyers of course gamble with these cases since it is hard to counter-sue them. In Moses law if you sued me for X dollars and you lost you pay me this X dollars. The sicker the patient is and the more you have cases against you the more money the lawyer will get. So simply if the patient is destroyed and your career is destroyed the lawyer is likely to be better off. The good lord and my great lawyer are protecting me from subtloma. Though I can not prevent my paranoid fear from getting another subtloma.There is no doubt there are a lot of good people who would never use subtloma against their doctors. Similarly a lot of honest lawyers would never do that. However, the current medico legal system in America encourages that. It is a random and unjust system that works for a lot of times to bad people while good people get nothing. So if we want to really compensate the patients we have to do it right and just to every one. It has to be a predictable and uniform system. The lottery legal system that we have and built on dishonesty has to be replaced by a just legal system.In my medico-legal law of Taman Health Plan doctors have to be honest all time and medical records have to be open to patients. No fault on doctor if he honestly explain what he thinks went wrong he does not pay anything but the plan pays. What needed compensation as malpractice will be compensated. Insurance to all patients for things happen to patients that is not considered malpractice can be done in conjunction. Doctors who are not honest will suffer more in this plan. In the current legal system if you are honest patient will sue you next day. You will pay a lot in malpractice fees sometimes enough to stop practicing medicine.Until we get a just medico-legal system a lot of doctors will be sleepless at night for fear of subtloma. Similarly a lot of money will be lost for unnecessary investigations to guard against subtloma.