"Geek Squad" and The Dalai Manifesto On Expert Witnesses

Voice of Reason writes on AM.com:

Sorry to get on a tirade but I just got handed a bill from the Geek Squad serviceman for a service call on my Gateway that I have had for 2 years now. I just had a service call last week where a piece was replaced that was worn out and my contract states that I get 1 service a year for free. Well the hard drive failed as they sometimes do, and I needed it repaired.Here comes the fun part, for a 50 gig hard drive I was charged $667.18. Yes that is correct over 600.00 for a hard drive I could get for less than 100.00. I was charged at a rate of $240.00 per hour to install it which took 3 hours and $325.00 for them to drive to my office which is less than 25 miles from there office here. I was told that all of these are the standard rates.
Well I asked the rep if I charged him 667.18 for a contrast injection would he be upset, he said of course he would, but he has no control over the pricing. As far as I'm concerned this is all horse shit, I'm sick of being charged $95.00/ hour for IT support while they sit at one of my computers and wait 30 minutes for a download to finish or for a program to scan my hard drive. Plus they charge me 1/2 the hourly rate for travel to my office.We (physicians) have been taking in the shorts for way too long and I for one am pissed off ( sorry about the language). I want to organize just like every other business in the free world. I would like to see them put all of us in jail for collusion. I have said it before but it is time to strike!!!!!!!!!!!!!Close the doors for 2-3 days don't answer the phone, all of us go see our families take them fishing or go play golf, round on your hospital patients if you have them, but otherwise stop, Only by a massive shut down will anyone, inscos and gummit, see that we aren't going to take this crap any longer.My prices just went up 50% and no more free work of any kind unless it is something I want to do, not what some patient or inscos think I have or should do!!!!!!!!!Sorry but I'm pissed!

Among other posters, Dalai responds:

Shoulda got a Dell with a 4 year service policy. Or learn to open the can of your computer and swap the drive yourself. 5 minute hardware procedure, 1 hour or so to reload the drive.
On the more serious medical front, I think in the end docs are their own worst enemies. How 'bout them expert witnesses? Without them, the lawyers are SOL. But Google the term "medical expert witness" (I've made it easy by linking it for you), and you get 40,000+ sites that will connect you with a doc that will say the sun didn't come up this morning if you pay him/her enough. My personal solution is to make it ILLEGAL to pay for such expert testimony beyond travel expenses and such. Some of these plaintiff whores make $5,000-$20,000 per case that goes to trial, so they have every motivation to drag your sorry backside into court, even if there is no case. This must stop. The tort-reform bills going through various state legislatures, and even Congress, are not dealing with this issue as strongly as they should.
For us imagers, the clinicians with their own scanners are presenting an interesting problem. They are generating more imaging business, and the more upstanding of them contract real rads to read their stuff, but their out-of-control self-referral is bringing down the house on ALL of us. This baby doesn't want to go out with the bathwater. Then you have the ERs that order everything but a corpora-cavernosagram in the middle of the night (at least I haven't had to do one yet), and want the answer yesterday, overtaxing the system at that end.
$700 for an hour of work to replace a hard-drive? Maybe I'll join the Geek Squad....

I've been wanting to post something like this for a while, but just never got around to it. I've been sued twice, both for rediculous reasons. Don't get me wrong: I make mistakes, as do all rads and even all doctors, and all human beings in general. However, the tort system in this country, especially with the contingency basis upon which many of these cases are pursued does nothing to correct mistakes, it simply pads lawyers' pockets. In my first case, I and two of my colleagues were accused of missing a lesion on a mammogram that wasn't there. The "expert" was a general radiologist that had been sued 7 times before himself. His deposition would have been funny if it wasn't directed at ME. That case was dropped. The second case, which is awaiting summary judgement, accuses me and another rad of not seeing a chest tube on a radiograph that wasn't there. I kid you not. It is one of those classic "shotgun" suits where every doc that had the bad fortune to get his or her name on the chart was sued, with no regard for level of involvement with the patient. Once I get summary judgement, I will seriously consider seeking sanctions for the litigating attorney. I think he was expecting all NINE of us docs to settle just to make him go away. He is in for a bit of a nasty surprise.

I am very serious about my solution to the "expert witness" problem. Look at it this way: if you can pay for testimony, then it can be bought. If I am called to testify, I refuse payment, and I require a subpoena. Therefore, I am there as a free-agent, not paid by anyone, and I can speak the truth. Period. Now, the standard answer an "expert" gives when asked on the stand how much he is being paid is something like, "(muffled thousand dollars) for the time I put into this case, but I am here to give my expert opinion and payment doesn't change what I'm going to say." Sorry, I don't buy it.

Many professional societies are starting to sanction their members that grossly perjure themselves on the stand. That's a start. However, the ONLY way, in my humble, simplistic opinion, to completely stop the abuse of (and by) the legal system is to decouple the testimony from payment. That is what I practice personally. I have had lawyers look at me like I have three heads when I tell them this, which maybe is indicative of how it impacts them.

I refer to this declaration of independence of testimony from reimbursement as the "Dalai Manifesto". Outrageous? Yes, but I haven't heard a better idea yet.