BOYCOTT THE LAWYERS

Doctors are irate over malpractice. But they have not yet gone as far as Shakespeare, who suggested killing all lawyers. Still, at a meeting of the American Medical Association last summer, a surgeon from South Carolina proposed that doctors not treat lawyers who sue doctors. And while calmer voices dismissed the proposal, it highlighted the friction between lawyers and doctors that sometimes strains the patient-doctor relationship when lawyers seek medical care....

The proposal by the surgeon from South Carolina that doctors should simply refuse to treat lawyers runs counter to the popular image of altruistic doctors who are supposed to treat all patients, without regard to their occupations or beliefs. But the reality is that in nonemergency situations, doctors are free to choose their patients, just as patients are free to select their doctors. No oath, including the two most famous, those of Hippocrates and Maimonides, compels a doctor to treat a patient, said Dr. David J. Rothman, an expert on medical oaths who teaches medical students at Columbia....

The American Medical Association says there is a malpractice crisis in 20 states. In those states, the group says, some doctors no longer provide certain high-risk services like emergency and trauma care and delivering babies, or they have stopped practicing altogether. The A.M.A. also cites data from the National Association of Insurance Commissioners showing a 750 percent increase nationally in malpractice insurance premiums since 1975. For some specialists, the annual insurance premium exceeds $200,000.

In addition to those who say there's no way they can hide their profession, lawyers in a spot check seemed to favor one of two strategies in seeking care. Those in one group try to avoid identifying themselves as lawyers on doctors' intake forms. Physicians, they believe, often become anxious in treating lawyers. As patients, they say, they may be subjected to overtesting because of their profession, and thus risk having unnecessary procedures. But other lawyers are emphatic in letting the doctor know their occupation: They believe the extra tests they may get will lead to better care.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

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