June 2002 Bulletin


Write to The Editor, AAOS Bulletin, 6300 North River Road, Rosemont, Ill. 60018-4262


The medical malpractice crisis occurring in Pennsylvania has disrupted the delivery of medical care and has caused many physicians, including my wife and I, to leave the state. Why is it that the American Academy of Orthopaedic Surgeons has not protected the orthopaedic surgeons of Pennsylvania? What strategies have the Academy developed to combat the ever increasing, systematic and disabling harassment of orthopaedic surgeons by the legal community?

Photographs of our "PAC" members with congressmen do not impress me or my Pennsylvania colleagues. I would appreciate that the Academy take a more aggressive role in protecting its members—that would do more to promote public healthcare deliver than all of the Academy’s self-promotional public health campaigns.

John A. Prodoehl, MD
Harve De Grace, Maryland

Editor’s Note: If you would like to read more about Dr. Prodoehl’s experience, read his article entitled "Rising cost of practicing medicine is driving physicians away," in the October 2001 issue of Orthopaedics Today.

William W. Tipton, Jr., MD, Executive Vice President of AAOS, responded to Dr. Prodoehl’s concerns: "I sympathize with Dr. Prodoehl. He, like many of our Fellows, has faced a tremendous challenge from skyrocketing costs of professional liability insurance. We all worry about access to care if doctors are forced to stop seeing patients as a result. I assured him that the Academy is not ignoring this problem and although he didn’t particularly see the value of visiting members of Congress, I explained that this is, indeed, one important way in which we were responding to the situation. These visits build valuable working relationships with elected officials and help educate them about the issues orthopaedic surgeons face on a daily basis. In turn, they are more apt to support our positions when legislation is drafted.

"Although the Capitol Hill meetings may be the most visible of our efforts in fighting the rise in professional liability premiums, I want to assure members that the AAOS is also working in other ways to fight this problem. The Board of Councilors recently surveyed orthopaedic surgeons about their experiences with the rising cost of professional liability insurance; this data will help us develop new strategies for dealing with this problem. Further, since so much of the activity surrounding professional liability is occurring at the state level we are helping state orthopaedic societies advocate for tort reforms in their communities. To read more about these efforts, please see the article in this issue of the Bulletin beginning on page 15. As always, if you have any concerns on this or any other, please feel free to contact me at (847) 823-7186 or tipton@aaos.org."

IRS Intimidation

You recently published a warning from the Internal Revenue Service (IRS) Communications and Education Division (Feb. 2002 issue) warning physicians about offshore trusts and illegal tax schemes. Unfortunately, you failed to obtain the "real-life example" side of the story, or for that matter ANY information other than what was provided you by the IRS. In so doing, you have done the physician mentioned, an orthopaedic surgeon from northern California, as well as your readers, a grave disservice.

There is a large body of evidence that suggests the IRS has selectively targeted physicians to serve as trophies to put on display for the Senate Finance Committee and other governmental watchdog groups responsible for IRS funding. Targeting physicians also serves a purpose of intimidation. Of greatest concern is the extreme harshness of the punishment with which the penalty was administered. A SWAT assault team with automatic weapons was sent to the home of the (surgeon). With (him) still in surgery, they found only his terrified young teenage daughter at home.

The doctors continued to pay taxes throughout this period (at least until they were stripped of their practices). Using the off-shore trust plan saved one doctor about $20,000 in taxes for three years, NOT nearly the "millions" claimed by IRS agents Hernandez and Gaugham in the article. However, the Federal government will lose over $1,000,000 in tax revenue alone by stripping these three doctors of their practices just during the period of their incarceration.

Lonnie Crockett, the former tax attorney and advisor identified in the IRS warning letter to physicians has yet to serve one day of a prison sentence. Of Mr. Crockett’s approximately 200 clients who had established off shore trusts, only the orthopaedic surgeon and two colleagues—an ENT surgeon and orthodontist—are serving prison terms.

The tax law is nearly 1.4 million words, 650 forms and 13,000 pages of explanation, leading Treasury Secretary Paul O’Neill to be in quoted in February as calling it "an abomination," and "an unbelievable mess."

In the future, please don’t just "copy and paste" the IRS e-mails. Please give the physicians who read your journal more credit than the IRS is willing to grant.

Stephen D. Mulder, MD
Templeton, Calif.
San Luis Obispo County
Medical Society

Would you like to comment on something you read in the Bulletin? Let's hear from you. Send your letter to the Editor, Bulletin, AAOS, 6300 N. River Rd., Rosemont, Ill. 60018. Fax (847) 823-8026.

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