Plastic surgeon sues former patients for comments made in on-line reviews

Jay Pensler, a plastic surgeon in Chicago, was unhappy with some on-line reviews of his work and is now suing three former patients for defamation. The patients, who are named in various reports of this story, apparently made scathing remarks about his care, his attitude and even his wife who apparently serves as his nurse. According to one report, the comments, recently removed from the websites Citysearch and Yelp, described the doctor as “…’dangerous,’ ‘ruthless,’ a ‘liar’ and ‘horrible.’" And the surgeon was called a “'rude jack***’ and ‘his wife … is a very rude unprofessional b****.’” Another report states that photographs of the alleged botched breast surgery were posted as well and quotes the woman as saying she now had “Frankenstein” breasts. The doctor says the photos have been altered.

One of the more interesting features of the story is that the names of what was thought to be anonymous reviewers were obtained from the two websites by subpoena.

Diligent research by the Skeptical Scalpel reveals the existence of a similar story from earlier this year in Marin County, California. A plastic surgeon named Kimberly Henry is suing former patients for posting critical reviews on the website DoctorsScorecard.com. This report mentions that a 2009 suit by a San Francisco dentist in another such case was dismissed by a California court, which cited that states anti-SLAPP [Strategic Lawsuits Against Public Participation] law, and awarded the patient $43,000.00 to be paid by the dentist for her legal fees. A law professor from UCSF said that the California law protected this type of review as long as the reviewer did not post “false facts [sic].”

A number of talking points arise:

Should a doctor ever sue his patients?
Will these suits simply invite more scrutiny of his work?
Are anonymous on-line reviews really anonymous?
Can people say anything they want on-line [except “false facts”]?
What did the monster's breasts look like or was the reference to Dr. Frankenstein's breasts? Either way, I don't recall seeing them in any of the movies.

Community Outreach: Fake Surgeon Makes (Road)House Calls

I know it’s late on a Friday afternoon and maybe few will read this but as a budding journalist, I feel compelled to write this story as it is a tale that cannot wait to be told.

Today, MSNBC reports that a woman pretended to be a plastic surgeon and talked two or more other women into allowing her to examine their breasts in bars in the Boise, Idaho area. She told them her name was Berlyn Aussieahshowna, which believe it or not, “was bogus” or so the account reads. She gave them the phone number of a real plastic surgeon whose office staff became increasingly concerned after receiving “a number” of calls looking to make appointments for liposuction and breast augmentation with Berlyn Aussieahshowna, whose real name is Kristina Ross.

Then the story gets a little weird as it turns out the Ms. Ross is a “transgendered” individual formerly known as Kristoffer Jon Ross.

The perpetrator has been charged with two felony counts of impersonating a physician.

Not mentioned in the article but follow up questions come to mind. For example, what were the victims thinking when they allowed themselves to undergo breast examinations in bars (not that such a thing has never happened before)? However, it probably has not occurred too often under the guise of a medical procedure. And what sort of woman undergoes the exam (OK, she had a few drinks. She figured she’d get a free exam.) but then apparently when sober, calls for an appointment to schedule surgery with the good doctor? In retrospect, does this still seem like a good idea?

And who says health care is not accessible to the masses?

Update: In April of 2011, Ms. Ross, who had pleaded guilty to two counts of misdemeanor battery, was sentenced to 360 days in jail.

Don't Scan Me, Bro'

The huge uproar about full body scans and harassment of air travelers misses an important point. Yes, there is concern about invasion of privacy, perceived near sexual assault and radiation exposure. Even mild-mannered Captain Sullenberger commented on the absurd practice of x-raying and searching pilots. For God’s sake, if a pilot wanted to make mischief, she wouldn’t need to put C4 in her bra. She could fly the damn thing into a building herself.

My problem with all of this is that the government seems to have an endless reservoir of bad ideas, starting with the thankfully now obsolete question, “Did anyone else pack your bags?” Did they really expect someone to say, “Well, a man named Ahmed knocked on my door this morning and offered to help me pack, so I let him.” And we always seem to be reactive rather than proactive. A guy hides explosives in his shoe in 2001 and to this day, we all have to take off our shoes at the airport. Unless this shoe removal is taking place everywhere else in the world, it seems to me that asking grandma to put her flip-flops on the scanner is unlikely to stop a terrorist. Last year another guy hides explosives in his underwear, and now we need to scan everyone’s underwear and frisk 3-year-olds. Are these procedures really thought to be effective or are they simply window dressing to reassure the public that stern measures are being taken?

Memo to the TSA: they’re going to try something other than a bomb in a shoe or Jockey shorts next time. Good intelligence such as the discovery of the plot to send explosives via cargo planes last month will do far more than all of the airport screening measures.

The public is fighting back. Just Google “TSA boycott” and see that a number of people are calling for a boycott of air travel altogether. Over 5000 people “Like” a Facebook page suggesting that all passengers opt out of the full body scan on 11/24 (the day before Thanksgiving), although I am not sure just how that will hurt the TSA. And there are courageous individuals like John Tyner ("If you touch my junk, I'm gonna have you arrested.") refusing to play the game at all. But of course, he did not get to take his trip either.

For me, the terrorists have already won. If their goal was to disrupt air travel and cause the American people to lose confidence in their government, they have succeeded.

[TSA logo by Ogel Volk via The Consumerist]

Liver Transplant Denied Medicaid Patient

Medical Quack, a blogger/tweeter on various topics, posted a story about a man who was denied a liver transplant in Phoenix. Due to budget cuts, Arizona Medicaid recently decided not to pay for such transplants for patients who had liver failure due to hepatitis C. The hospital would have had to absorb the cost of the procedure, estimated at some $200,000 to $500,000, and a hospital spokesman pointed out that there are 22 other patients with Medicaid on their liver transplant waiting list. The local news reports deplored the situation as did Medical Quack.

This is a sad story but what is the solution to the problem? Who is going to pay for this man's (and the other 22 patients') liver transplant? Both the news reporters and Medical Quack did not offer any suggestions. I have always been amazed that people seem to believe that the money will appear like magic. The fact is that health care for people without money has to be funded by people with money. It can come from taxes, surcharges on insurance or whatever. The reality is that some degree of health care rationing is inevitable, especially in a down economy.

Other ethical questions to ponder:

What if the patient had been an illegal alien lacking even Medicaid coverage? Should the taxpayers foot the bill? The cost of care of illegal aliens has been paid for by the taxpayers or absorbed by hospitals for years but how much longer can it continue?.

Did the Phoenix patient acquire hepatitis C while abusing drugs? If so, should it matter? Should the taxpayers have to fund all of his medical care including a liver transplant?

Should the taxpayers have to pay to support people who abuse themselves by using drugs,alcohol or tobacco? What about obesity? Somewhat of a precedent exists regarding alcohol. Over 2/3 of states still have the Uniform Accident and Sickness Policy Provision Law on their books. This law permits insurers to deny coverage for any policyholder who is injured while under the influence of alcohol or narcotics. I recently participated in the care of a patient who was readmitted to the hospital for the umpteenth time with acute respiratory failure secondary to chronic obstructive lung disease. She is on oxygen at home and continues to smoke. Yes, it can be done. She removes the oxygen tubing and lights up.

Research Study of the Day: Postoperative Outcomes Worse in COPD Patients

Internal Medicine News reports that a paper recently presented at the American College of Chest Physicians annual meeting found that patients with chronic obstructive pulmonary disease [COPD] fared much worse after all types of surgery than patients who did not have COPD. The authors reviewed outcomes of over 468,000 patients in a clinical database, 5% of whom had COPD. Not surprisingly, the COPD patients had significantly longer hospital lengths of stay and higher rates of complications and mortality.

The database contained no information about how the COPD patients were managed in preparation for their operations. Thus, the authors could not recommend any specific advice on how to limit the adverse outcomes.

Meaning no disrespect to the authors of this study and knowing how hard it sometimes can be to think of ideas for research, I wonder what they expected to find. Is there anyone who would not surmise that patients who have a major medical illness such as COPD would do worse than those who are not?

Research Study of the Day: Seeing Meat Makes People Less Aggressive

Who thinks up these experiments? According to a study from McGill University in Montreal, people who look at pictures of meat are significantly less aggressive than those who don’t. The report on Science Daily states that subjects were asked to punish a script reader for mistakes he made while sorting photos, some of which depicted meat and some which did not. The subjects were told that the punishment consisted of varying degrees of noise to the point of actual pain. It seems that photos of meat made the subjects less prone to inflicting the severest punishment. The study’s leader was surprised by the finding having felt that the sight of meat would have the opposite effect because of its association with hunting and other aggressive behaviors.

The report also contains the following amusing sentence. “The idea that meat would illicit aggressive behaviour [sic] makes sense, as it would have helped our primate ancestors with hunting, co-opting and protecting their meat resources.” This is another example of the mischief that can result from too much faith in spell-checker.

Just how crazy are people?

[“Contrail” is short for “condensation trail,” which is a visible plume of water vapor or ice crystals formed by condensation created when the hot exhaust of a jet or rocket meets cold air at high altitudes.]

While researching the story of Mick West, the computer programmer who runs the website ContrailScience.com and who identified and explained in detail the November 8 “mystery missile” seen over Los Angeles (where else?) as an airliner contrail even providing the flight number, I discovered a rather incredible mass delusion.

It seems that numerous people think that the government is spraying chemicals into the air for nefarious purposes. The deluded ones see long-lasting contrails as what they call “chemtrails.” There is a website called ChemtrailCentral.com which is filled with all manner of paranoid ramblings about this. For example, this gem from the FAQ section of the site describes the possible reasons for the government’s alleged activity:

Weather Modification
NASA is currently conducting several programs that are studying the effects of contrails on weather and the effects do not appear to be beneficial. [Truncated by me.]

Population Control
The use of chemical and biological agents by a government against it's own people is, unfortunately, a historical fact. Even unintentional accidents can occur. But, some people suggest that Chemtrails could actually be part of a program to reduce the population and many feel Chemtrails have caused them to become ill and perhaps they are right. If the Chemtrails contain biological agents then people already weakened by other factors may have even died as a result of the additional strain on their systems, but could such a diabolical purpose be the ultimate goal? History has taught that even the most unconscionable schemes can be made into reality by men filled with fear and hate, and with such weapons in the hands of government we must remain vigilant until answers are forthcoming.

Inoculation Program
Chemical and biological weapons have been used for centuries but have recently entered the world stage as a primary threat. Biological agents have the ability to spread and multiply in casualties. These bioweapons are easy to produce and difficult, but possible, to defend against. The recent actions of the military to require anthrax vaccines for all service personnel show that this matter is of high importance. Some propose that the government may be quietly releasing bioagents to vaccinate citizens via the air. This could account for reported illnesses since a vaccine sometimes makes a person sick. Municipal water supplies might not be universal enough and could be easily sampled and tested, but everyone breathes the air. And the federal government rules the air.

By my rough count, there are over 1500 registered users of the ChemtrailCentral website. Apparently these folks are allowed outside unsupervised and can vote. They also have access to Twitter. Just search "#chemtrail" on Twitter to read the current speculation that the government is spraying aluminum and barium or my favorite, that North Korea is spraying Ebola virus. Or you can Google "chemtrail" to find out more.

Sometimes the Internet makes me nervous.