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Should We With-Hold Payment to Doctors, Financial Advisors and Others Who Make Mistakes?

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A Modified Reprint … and Different Perspective on “Never-Events”

By Dr. David Edward Marcinko FACFAS, MBA, CMP™

Dr. MarcinkoOK; I admit it. I played HS baseball as a youth. Today, I am a doctor and financial advisor. I owned and operated a surgical center and did musculoskeletal surgery for two decades.

Later, as a health economist and financial planner, I acted as an SEC registered investment advisor to medical colleagues for almost 15 years.  I’ve been a reporter, writer and journalist for three decades and Editor-in-Chief of this ME-P for eight years. Along my career path several physician-partners were dual degreed lawyers.

I still am deeply involved in all these activities as a hobbyist, consultant, part-time practitioner, editor and educator. Occasionally, I do make mistakes. There … I admit it. I am not perfect!

For example; I remember the time when I ordered the wrong patient medication dose [noted and corrected by an astute RN] – Dropped an infield fly ball and lost the game – Used the wrong corporate EBIDTA, for an estimated financial calculation, which cost me and the client a few bucks – Referenced the wrong citation and made an author angry – Forgot to check a reference source which made my publisher mad at me – AND – Confused two different medical malpractice cases I was reviewing to the chagrin of my defendant doctor and his attorney; etc, etc.  You get the picture.

Mea culpa – mea maxima culpa!

The Encore Post

And so, it is with delight that the ME-P re-posts the following essay – on mistakes – by colleague Dr. Michael Kirsch who is a gastroenterologist that blogs at MD Whistleblower.

Medical Errors Earn Hospitals Money – Who Knew?

In brief, it goes something like this.


The argument to withhold payment for medical care that resulted from medical error is potent.  This is known as a never-event because it is not supposed to happen – ever! Giving a patient the wrong blood type during a transfusion is a good example of a never-event.

Unfortunately – Keep in mind that defining a medical error is not as easy as it sounds.  One can easily imagine how easy it would be too confuse a medical complication, which is a blameless event, from an error or a negligent act.

Consider This

If the patient develops a complication, should I, the hospital and those I consult not be paid for the additional care required?

Now, by extension, let us consider some other professions in the same way; especially those for which I am associated.

IOW: Would every profession consent to returning fees for mistaken advice or service?  So, do you agree with the following?

  • Financial advisors should return fees if investment performance is below a designated threshold or differs from their peers.
  • Attorneys that offered ineffective legal arguments at trial should surrender fees after appeal.
  • A professional baseball player who drops a fly ball should lose a day’s pay.
  • A newspaper publisher should offer a rebate to all readers if a news story is found to be inaccurate owing to a lack of proper editorial oversight; etc.

I think you get the picture! And, see how I personalized these examples.


We realize that mistakes of all types cost money, as do some of the hypothetical examples above.  We also accept that financial incentives can change behavior and can be an effective tool.



But, every human endeavor has a finite error rate and we should be cautious before using an economic drone attack against only the medical profession; or even the others mentioned above … and more.

Let’s use a scalpel here and not a sledge hammer.  And, those of you outside of medicine; please feel free to explain why your occupation should be spared from this health reform strategy?

The Reprint: Would every profession consent to returning fees for mistakes?


Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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3 Responses

  1. Great Post,

    Dr. Marcinko – I don’t know the answer, but the concept is interesting and provocative. Just what I expect from you and the ME-P.

    Many thanks.



  2. Does P4P lead to over-diagnosis and excessive treatment?




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