12 December 2008


You would think that receiving financial compensation for some sort of injury or illness would be a good thing. Dr Grumble is not sure it always is. Sometimes all the wrangling that goes on is distressing. The only certain winners are the lawyers. Sometimes even doctors win. Some of Grumble's colleagues made a lot of money from the miners' compensation. There were those that appeared in court and there were the jobbing doctors that assessed the claims. All got good money. They were paid lawyers' rates. Had Dr Grumble had the right expertise (he is unwilling to say whether or not he did) he would not have helped. He had the strong impression that too much money was being spent on the process and not enough on the victims. It seems he was right. A vast industry had grown up around the compensation scheme. That could never have been right.

Two-thirds of the claims cost more to administer than the cash paid out and some claimants are still waiting for the money a decade after they put in the claim. Others died before they got the cash.

As Dr Grumble has been implying compensation is not always a good deal for the victim. Sometimes despite every effort they end up with nothing or a derisory sum. On the other hand one of the best things you can do for a patient is give them money. It's rare for a doctor to have much influence over this but it does happen. Here's a letter Dr Grumble received from a grateful patient some years ago. Identifying details have been removed but otherwise it has been reproduced warts and all.

Dear Doc,

I hope you are well and and happy in your new career [The patient went to great lengths to track Grumble down].

I am now 65 years old and want you to know the best help and advice in my life came from you, "Well beyond the Call of Duty."

I know the DSS pestered you for reports on my condition and you did a fine job on my behalf. [Dr G was precise and honest.] To give you some idea what this means to ratbag and myself, if we have visitors we can buy extra milk and a few cakes without being short the following week ; and the best of all not to dread Christmas when we could only buy a few cheap crap presents. Now I feel good. We can buy everyone a crap present but affordable.

It took 5 years but you will be pleased to know the following. On turning down my claim for "industrial injuries" they said I had only been exposed to a minimum amount of ................. and by chances of probability it was not the cause of any problem. [Dr G thought this was nonsense and with something of a heavy heart because of the long haul and uncertainty of the outcome he advised an appeal.]

I appealed on both these points and won. In February of this year I was awarded £27-50 a week FOR LIFE and £8089-40 back pay. WOW! Ratbag and I felt we had won the pools. There was however a few pound short from my award and when I went to the XX Board on another matter I told them of this and "Will my luck never end", another £36-62 PW and £1132 back pay.

As you can see, I've had £9221-40 lump sum and am now on £64-12 per week. With my pension on top of this, I shall soon be paying income tax (can't wait).

When ratbag goes to the Post Office every week she asks if I want her to pick up Doc's money - this is how we both think of it because, without you, this would never have happened and both of us are so grateful to you.

I know you will be pleased your work on our behalf turned out so well for us so there is no need to reply to this letter (can't read your writing anyway). I will put my address on the rear of the envelope and then I will be sure if they don't return it that you have it.

Many thanks and best wishes to you and yours.

Of course Dr Grumble replied saying how happy the letter had made him. It really did. The letter had a profound effect on Dr G. It contributed to his returning to clinical work. Another terribly sad incident had contributed to his leaving. But that's another story.


Jobbing Doctor said...

Sometimes you just slave away and feel that nobody appreciates you. Then something like this happens and it makes it worthwhile.

I have not bought myself a bottle of whisky for more than 25 years. My patients are very generous.

Please consider sharing the reasons for your leaving clinical medicine and then rejoining it. I think that would be valuable for your many admiring readers.


Nutty said...

I am renewing my DLA claim. My GP has been kindness itself, reassuring me that I shouldn't worry, saying "I know you", as indeed he has for twenty years.

By contrast, my consultant wouldn't discuss it. He didn't seem hostile, just not interested. I wanted to shout at him "It may not be much to you, but it's an absolute fortune to me." I didn't shout, though, I just made polite noises and shook his hand on the way out.

So whether I can afford my heating bills next year will turn on whether the DWP contacts the doctor who cares or the one who isn't interested.

It had never occurred to me to send a letter of thanks, but following what I have just read on here, if I get my DLA, I shall ask the DWP who supplied the medical report and write to thank them.

Dr Grumble said...

My GP has been kindness itself, reassuring me that I shouldn't worry, saying "I know you", as indeed he has for twenty years.
The annoying thing is that Dr Grumble is often asked by the authorities about patients he really does not know. Sometimes he has only seen them once when they were acutely ill. He is required to fill in the forms in his own time and without seeing the patient again. Questions can include details such as whether or not the patient can peel potatoes. Even if a patient has severe rheumatoid arthritis there are only two ways of finding out. One is to ask the patient. The other is to give the patient a potato and peeler and ask them to do it. In general Dr G has not asked the patient if they can peel potatoes which is often not the main issue if a patient is acutely unwell.

One problem with all of this is that the powers-that-be seem to think that doctors are able to say whether or not a patient can do certain tasks by looking at a set of notes. The way we find out is to ask the patient. We are not magicians.

Dr Grumble once wrote a report for a government agency describing how severely affected a patient of his was. Everything Dr G had written was absolutely accurate. It included describing the extreme severity of the patient's disease. The authority concerned wrote Dr G a stern letter saying that they had followed the patient and that she had been able to go shopping etc. Dr G wrote back pointing out that she had very severe disease just as he had stated and that he had never said that she couldn't go shopping and that if they were able to observe what she was able to do themselves why were they bothering to ask Grumble.

Lionel said...

I quite like the NZ no blame compensation approach.

The pie remains the same size without the lawyers eating a slice.