• Welcome to OGBoards 10.0, keep in mind that we will be making LOTS of changes to smooth out the experience here and make it as close as possible functionally to the old software, but feel free to drop suggestions or requests in the Tech Support subforum!

Law School is a sham

My boss is 56. Both kids grown. He stays in the office until 8-9 every night, not because of deadlines. Im convinced that its either bc he doesnt want to go home to his wife, or really has nothing else to do.

Eh, I work in academia and see plenty of folks with tenure staying late because they don't want to go home to their wives. I've gone one who has season tickets to the Suns, the college team, and then was debating getting season tickets to the women's college team just to take up time. DAMN.
 
My boss is 56. Both kids grown. He stays in the office until 8-9 every night, not because of deadlines. Im convinced that its either bc he doesnt want to go home to his wife, or really has nothing else to do.

Quite possible. Maybe even likely.
 
Correct. That's why unpaid law firms say collections. We've sued clients for non-payment before.

Yes, Accounts Receivable are worthless if you don't actually collect them, it is just another term for pro bono. Cash actually in the door is the only thing that matters.
 
Yes. Getting your clients to pay is a big part of running a business so that you can make money. And usually, the more money a client has, the longer it takes them to pay you.

And usually the more work the client needed done immediately, the longer it takes them to pay you and the more likely it is that they bitch about the bill.
 
And usually the more work the client needed done immediately, the longer it takes them to pay you and the more likely it is that they bitch about the bill.

Very true. Incidentally, some of the biggest assholes we deal with in terms of collections are fucking lawyers who needed something quickly and want to spend a whole bunch of time asking asinine questions so they can pad their billable hours.
 
My boss is 56. Both kids grown. He stays in the office until 8-9 every night, not because of deadlines. Im convinced that its either bc he doesnt want to go home to his wife, or really has nothing else to do.

That's the kinda lawyer you want. One w/ nothing else better to do than think of ways for your side to win.
 
That's the kinda lawyer you want. One w/ nothing else better to do than think of ways for your side to win.

Eh, you assume that he's in the office working. That's not always (or usually) the case. Sometimes he's just an asshole that is universally hated so he sits in his office and surfs porn.
 
Eh, you assume that he's in the office working. That's not always (or usually) the case. Sometimes he's just an asshole that is universally hated so he sits in his office and surfs porn.

Change that to "surfs the boards" and that's about half of the posters here.
 
we listened to some presentation this week about how lawyers are 4x more likely to develop mental health disorders than those professionals outside the field of law

L O L

I would suggest the word should be aggravate instead of develop. Very few other professions attract as high percentage of people with personality disorders of the cluster b variety.
 
A lot of the people at SSA were former lawyers that got burnt out and decided to collect an annual salary of $100k with no real expectations or demands and good vacation and sick time policies.
 
Nice - looks like we have another ambulance chaser here... THIS COUNTRY NEEDS MORE LAWYERS!

Do you believe that negligent medical providers should not be responsible for the damage caused by the negligence?
 
I can understand your mindset, when I was in private law practice I did a ton of CYA stuff too (like memos to the file, CYA letters to clients telling them not to do what they were about to do, etc.).

The difference is that in many cases neither I nor the law firm got paid for that activity. Sophisticated clients don't want to pay for me to cover my ass. At least in a firm like ours a lot of research time to "double check" that we were giving the right answer, or time spent writing memos to the file, gets written off and never billed. Therefore in the law the temptation to CYA everything is tempered by the knowledge that you're spending time that you won't get paid for, time=money, and there's an opportunity cost. Even more important, clients will fire lawyers who constantly CYA and choose ones who are more confident and efficient - in fact, I just fired a lawyer for this reason. Good lawyers learn to balance the urge to CYA against the opportunity cost. Lawyers who spin their wheels CYAing on every matter are not successful.

In medicine, as far as I can tell there is NO opportunity cost to CYA testing, and in fact, the CYAing is a huge profit center for the entities running the tests. Thus the medical culture strongly encourages the CYAing. I bet your mentors trained you to run all these tests, the hospital is happy to run the tests and collect the money, the patients have been taught over the years to expect a lot of tests - in short, unlike the law, everything is set up to maximize the testing, because the downside (huge costs to insurance companies/Medicare and ever-rising premiums) are completely removed from the people making the decisions to over-test.

While a doctor's subjective fear of a lawsuit (reasonable or unreasonable) plays a role, the fact is that all the financial incentives support over-testing and that absolutely plays a role. Pretending otherwise is just putting your head in the sand.

You'd lose that bet. I was trained and I work in a healthcare system where there is no profit motive. No one in my hospital sees an extra dime for seeing an extra patient, performing an additional procedure, or ordering another test. I also work in a healthcare system where I am well protected from malpractice torts. Yet, and you'll just have to trust me here, excessive and low-yield tests get ordered and are performed at probably a greater rate than when a profit motive and stronger malpractice concern exist - probably because there are no insurance companies to act as a check on the system (I moonlight locally, so I have some perspective on what it's like on the "outside", as we call it).

I see your point about CYA in the legal world, but consider this: clients, i.e. patients, in medicine do want to pay for me to cover my ass. And I disagree with the idea that the healthcare system is chiefly responsible for that expectation. I think it has more to do with A)the crazy evolution of our health insurance and how patients are divorced from the actual cost and B)a better informed populace who can read on WebMD about how their headache might be from a bleeding aneurysm and how they might need a head CT. Regardless of how we got their, whether it's demanding for unnecessary antibiotics for their child's viral ear infection or opting to biopsy something when it could have been surveilled for less cost, patients largely prefer more and more elaborate things to be done.

Believe me, I know that there are some shady, underhanded things that some physicians do to improve their bottom line. I find it particularly loathsome considering my chosen profession and career path. I also think that it's a negligible part of the extraneous healthcare costs in this country, as evidenced by, IMO, rampant superfluous tests I see even in the absence of a profit motive. These extra costs are incurred chiefly, I think, because the physician feels compelled to incur them - whether due to pressure directly from the patient or from the threat (real or imagined) of legal action.
 
Last edited:
You'd lose that bet. I was trained and I work in a healthcare system where there is no profit motive. No one in my hospital sees an extra dime for seeing an extra patient, performing an additional procedure, or ordering another test. I also work in a healthcare system where I am well protected from malpractice torts. Yet, and you'll just have to trust me here, excessive and low-yield tests get ordered and are performed at probably a greater rate than when a profit motive and stronger malpractice concern exist - probably because there are no insurance companies to act as a check on the system (I moonlight locally, so I have some perspective on what it's like on the "outside", as we call it).

I see your point about CYA in the legal world, but consider this: clients, i.e. patients, in medicine do want to pay for me to cover my ass. And I disagree with the idea that the healthcare system is chiefly responsible for that expectation. I think it has more to do with A)the crazy evolution of our health insurance and how patients are divorced from the actual cost and B)a better informed populace who can read on WebMD about how their headache might be from a bleeding aneurysm and how they might need a head CT. Regardless of how we got their, whether it's demanding for unnecessary antibiotics for their child's viral ear infection or opting to biopsy something when it could have been surveilled for less cost, patients largely prefer more and more elaborate things to be done.

Believe me, I know that there are some shady, underhanded things that some physicians do to improve their bottom line. I find it particularly loathsome considering my chosen profession and career path. I also think that it's a negligible part of the extraneous healthcare costs in this country, as evidenced by, IMO, rampant superfluous tests I see even in the absence of a profit motive. These extra costs are incurred chiefly, I think, because the physician feels compelled to incur them - whether due to pressure directly from the patient or from the threat (real or imagined) of legal action.

I don't know you or where you work so I am not qualified to contradict your personal experience. Further I agree with a lot of what you say, it's the just the flip side or another aspect of what I am saying, which is that the whole system (including the WebMD patients and the absence of cost from patient decisionmaking) is set up to encourage overtesting.

I am curious though how it is that "No one in my hospital sees an extra dime for seeing an extra patient, performing an additional procedure, or ordering another test." Are they doing the work for free? Money is being paid by someone for these tests. Even "non-profit" hospitals make money. Physicians who are salaried (i.e., Mayo clinic) don't have a profit motive to run the tests, but on up the chain the CEO, CFO, and other management gets evaluated by whether the hospital is operating at a loss or at a profit. The overtesting creates profit. A hospital with lots of operating profit tends to have a very highly paid executive team. So, upper management has no incentive to try and stop the overtesting or change the culture, because they make money from it. I suspect that in many systems, they overtly or covertly encourage it.

Further, in your case you say your mentors did not train you to overtest because it would make you more money. But they did train you to overtest, correct? You didn't come up with this idea on your own. Your mentors and managers are part of a culture that has no brakes or checks on overtesting, and they trained you the same way. In some practices, that training is profit-based, in others it may not obviously be so but that's just because the incentive is a few steps away.

The incentives may not be obvious but they are there.
 
The idea to overtest is simply because the tests exists through the advancement of technology. I wouldn't be surprised that in the future whole genome sequencing is prescribed and paid for by who knows so that we can tell you the exact probability odds of every single possible thing that could ever happen to you (a hypochondriac's worse nightmare). The more technology advances the more predictability is needed to cover the idea that you may miss something.
 
Further, in your case you say your mentors did not train you to overtest because it would make you more money. But they did train you to overtest, correct? You didn't come up with this idea on your own. Your mentors and managers are part of a culture that has no brakes or checks on overtesting, and they trained you the same way. In some practices, that training is profit-based, in others it may not obviously be so but that's just because the incentive is a few steps away.

The incentives may not be obvious but they are there.

I am in the military, which will hopefully explain a lot. No one, from the commanding general to the custodial staff, sees another penny for doing more. If anything, the system ought to contain costs, but it doesn't. As I mentioned before, in some ways costs are higher because a provider is free to order a test as frequently as deemed "necessary". So, at least within the confines of this system, I can't help but believe that the lion's share of this over testing is occurring because of something other than greed.

Regarding my training, I was trained in a military hospital as well, as were the overwhelming majority of my instructors, so I don't think your point about how they trained me stands since they weren't concerned about profit either. For example, no one ever said to me, "do it this way because you can bill more for it." But I routinely heard, "do it this way, because I once got named in a suit when I did it another way."

I don't want to downplay your point. At worst physicians abuse the system and at best it's a conflict of interest. I just think that my set of circumstances demonstrates that the problem of over testing principally stems from sources other than a desire to maximize profits.
 
Back
Top