Blog - Laura Novak

Doctors Don't Lie - Do They?

5/1/2011

Two minutes after my son was born. His own team works on him while my C-section continues off camera.

The high risk portion of my pregnancy lasted four months, during which my husband and I met many fetal/maternal specialists. Our son's life in the intensive care nursery lasted three months, during which we encountered every pediatric specialist known to mankind. It was our experience that medical people are precise, caring, cautious and meticulous. Our son's life was always in their hands. And we trusted them implicitly.

People who ponder the Palin pregnancy story have often asked the general question, Do Doctors Lie? I asked the two specialists who have weighed in on this blog before. Here is the first doctor's reply. You are welcome to weigh in as well.

There are a lot of subtleties to this story. Usually when the patient/parent wants you to lie for them, it’s insurance fraud, either commercial or Medicaid. They might ask you to lie to get the insurance to cover something they otherwise wouldn’t. That's not going to fly. It’s a huge legal risk and you wouldn't trust a parent that asked you to lie for them to keep quiet. Their very request makes them as untrustworthy as the doctor would be if he or she lied.

But doing something to help a patient without the patient actually know you're doing it? Probably happens, more in the heyday of managed care than now. Using words in an authorization request that you know will get something approved but aren’t necessarily “nothing but the truth” happens. But that is not the same thing as lying. It’s a way of assuring care for children.

Fudging records just doesn't work. Period. Too many people see them. Nurses, technicians, insurance companies. It’s too easy to get caught and doctors don't have the training to get away with it. Doctors aren’t trained in fraud. With electronic medical records, it's now close to impossible. Because they all have audit trails so that changes are all recorded by what was changed and by whom. And any time someone logs into a record to view it, that is recorded as well. A hospital can tell who is viewing a famous patient’s record.

And even if someone “snooped” in to a famous person’s medical records, to release that information in any way is both illegal and punishable by law. It has happened multiple times.

I think the family practitioner had an attorney to keep the newspaper honest, both legally and as a witness. Perhaps she wasn’t worried about what she had to say, but she certainly would have been concerned about being misquoted.

No doctor is going to put him or her self in jeopardy for a patient that is likely to be under the microscope like Palin. Even if this whole birth thing happened before she was nationally or world famous. There are too many witnesses in a hospital.

Ask Michael Jackson's doc how he feels about cover-ups now. The truth tends to find a way out.

And as far as the idea that someone was stuffing a pillow under their clothes for a month-long public pregnancy and that a doctor would sign a letter stating she took care of this patient while pregnant, that is just not going to happen. There is no penalty for the “patient” but the doc could lose their license.

I would still say her water broke and she went home to have the kid in relative privacy. In the end, “No harm, no foul”. Her actions may have been risky or inadvisable, if in fact the story of leaking fluid is true. But would a doctor lie about it? I don’t believe so.

By the way, anyone seen a long form on Palin?

eclecticsandra

5/1/2011 08:47:39 am

Another question is whether not commenting on the validity of a letter with her signature is "lying."

Banyan

5/1/2011 09:02:27 am

As a medical researcher, with some knowledge of the inner workings of medical studies, and as a participant (on the side of MDs) in several legal trials, I can tell you doctors and nurses DO lie, distort, misrepresent, misremember, etc., etc.

Lying extends (or used to, before the electronic data systems) to charting, though the changes tend to be minimal for reasons discussed above -- just enough to CYA.

Charlotte Bradford

5/1/2011 09:34:44 am

The problem is the specialist here is making very general comments that of course would not apply to every conceivable situation. If a sitting governor who is a doctor's patient effectively backed her into a corner, would she lie? How about if the governor had the power to negatively affect her husband's ability to earn a living? The specialist seems anxious get Palin off the hook here, but really does not have a deep knowledge of the background situation.

mistah charley, ph.d. link

5/1/2011 09:37:32 am

Do you ever watch the tv show "House, M.D."? Greg House's often-repeated dictum there is "everybody lies."

To respond specifically to a couple of Doctor 1's points:

a) Presumably Mat-Su has electronic medical records, accurately entered, with modifications tracked and accesses recorded. Nevertheless, these have not been brought forward with respect to Trig's birth or Sarah's medical care.

b) The letter about Sarah's medical status attributed to Sarah's doctor was not released from that doctor's office nor physically signed by that doctor. The peculiarities of formatting, information covered, and wording have been discussed in detail by others. The bottom line is that the doctor has NOT signed that letter on the bottom line.

c)"No doctor is going to put him or her self in jeopardy for a patient that is likely to be under the microscope like Palin". Two things about this: Palin has NOT been under the microscope. And the relationship between Palin and the doctor is more multidimensional and intense than is typical for most people and their physicians - they are both leading figures in a small community, and both belong to the same church. Under these circumstances, unusually big favors might be done.

If Baby Hoax happened, if Babygate is just a Big Lie, rather than a negligently Reckless Ride, no medical ethics have been breached. No one was provided with bad care, no one's life was put in danger, no one's protected confidential medical data has been revealed. All that happened is that Sarah (not her doctor, not Mat-Su hospital, not the hospital where Trig was born) told a lie to the public.

And, as Dr. House often says, everybody lies.

honestyingov

5/1/2011 09:43:05 am

Laura,
I see nothing about what the Dr. thought of Palins Dr. CBJ letter that she submitted and SAID CBJ signed. Did he/she see it? The wording seemed VERY strange and ambiguous with the descriptive terms and descriptions.
( Please have your Dr. read it )
The other problem with the letter ( other than at the last minute before the election so it could be VERIFIED )was that there were numerous oddities with the letter. It looked like a VERY poor job of Photo-shopping.Have your Dr analyze that letter.It is a KEY element to the equation and Palin used it as a basis to debunk any questions about her.

Laura Novak link

5/1/2011 09:56:37 am

Thank you all for commenting. You all bring up great points (of course!) I did not bring up the letter nor do I know if this doctor has seen it, though my guess is not.

I was planning to do that in another round of questions. The reason for that is because I wanted to approach this generally at first. Let's look at the bigger picture of "lies" in medical records etc. The letter is such a huge topic in and of itself, I hope both these doctors will go over it for me and comment. That's one thing that has been lacking, at least for me: a doctor's analysis of it.

I will post the second specialist's comments to this general question in two days. What I like about both of them is that they bring different perspectives to this. And that's a good thing. Pursuit of the truth requires entertaining theories that we might discard later, but need to consider in order to fully appreciate where we're going. Or so I believe!

beaglemom

5/1/2011 10:40:12 am

I have no doubt in my mind that doctors lie. It's all about protecting one another. In the Palin case, the doctor protected herself by being amazingly vague and then there's the likelihood that the infamous letter was not prepared by either the doctor or her office. Show the doctor you're interviewing all of the available photos from the less than two-month pregnancy and describe the "wild ride" and Sarah's variations "on the theme" thereof and describe how she smacked the fake belly in the video for Israeli television. Better yet - interview a female doctor who has had children. Sarah faked it. End of story.

molly malone

5/1/2011 11:16:13 am

Laura, thank you for continuing to investigate this puzzling story.

It has been--what, three years?--and my memory of events has grown seriously fuzzy, but I do not recall Palin's doctor ever confirming S.P.'s account of the wild ride.

What sticks in my head is that she said something to the effect that *things calmed down and there had been no reason why Palin couldn't fly back to Alaska. And her other statement was that Palin never asked permission to fly. So I must be remembering wrong, because those two statements are contradictory. Reason I mention this at all is because, at the time I still thought the birth hoax was nonsense, and was surprised that Palin's doctor didn't just flat out say, "Of course she was pregnant with Trig, and I delivered him at Mat-Su Hospital." No violation of doctor/patient confidence there; Palin had already given her full credit and made her a major player in the drama. It was the doctor's choice whether to concretely confirm or not. And she did not. Instead, she danced around it.

*The knowledgeable readers on this site have a better memory of the doctor's public statements than I do. I welcome any and all corrections because, for me, it was the doctor's unusual responses that first set the suspicion bells tinkling. When a person doesn't do what you'd ordinarily expect him/her to do, it is usually because they have good reason for not doing it.

KarenJ

5/1/2011 12:21:19 pm

It's amazing how many of your specialist's caveats, Laura, can be answered simply with...

There was no medical record of a 2008 birth to Sarah Palin, therefore no record changes were made.

There were no legitimate witnesses because the family entered and left by a back door, no one ever recorded via camera/video the happy but tired mother, and no one ever saw her "sleeping in another room."

Otherwise, the complicity was done willingly because of close familial or spiritual ties of those involved.

I will agree with one thing the specialist said; the complicit doc could lose her license if the secret is ever revealed.

It's no wonder there's so much more pushback with these 3-years-old sudden recollections and anonymous revelations, as the Bailey, Dunn, and McGinniss books get closer to release date.

curiouser

5/1/2011 12:51:58 pm

What I see as most pertinent in the doctor's opinion is that it's unlikely we'd see medical records that support a pregnancy and birth if Palin faked it.

The biggest point I'd like to make is that there hasn't technically/legally been a lie from Palin's doctor, up to this point, even in light of a hoax. From what I’ve read, CBJ was never quoted, and she never wrote, that she directly attended to Palin during the alleged prenatal visits, labor, or delivery. She never verified that she even wrote the letter that was presented by the campaign.

Considering a possible lie in the future or one I missed in the past,I'd want to add the religious factor. Would a doctor be more likely to lie if they had a deep religious conviction that the lie advanced God’s will and His Kingdom? What if the doctor knew s/he'd be financially compensated if they lost their license? What if the doctor believed they'd never be investigated?

curiouser

5/1/2011 12:54:13 pm

Sorry for the grammar errors above. I posted too soon.

Bobcat Logic

5/1/2011 01:00:37 pm

Anyone reading this blog right now (11 PM Eastern, 8 PM Pacific), turn on your television.

Obama is going to announce we've killed Osama.

This will change...well, not everything... but a lot. Including, perhaps,also, too, this discussion.

5/1/2011 01:15:12 pm

I have personal experience with a doctor’s lie of omission on my medical records. I found out when I filed a professional disability insurance claim that was primarily rejected because my primary doctor’s records didn’t support my claim. My doctor explained in a letter to me that she habitually omitted certain of my symptoms over a period of years because she didn’t want to give health insurance companies a basis to refuse to cover me at some future time. And, yes, she put her license at risk and I wasn’t even a personal friend.

I’d also like to add that I seriously doubt that CBJ has electronic files. I’ve seen a lot of doctors, most in larger practices than CBJ, and only two of them have electronic patient files.

DebinOH

5/1/2011 11:09:29 pm

Laura, Very interesting. Thanks!

Would a doctor get into trouble for protecting a patient by mouth but following everything correctly on paper? I think movie stars, etc. do stuff like this all the time? Maybe not?

I am not sure about the medical record released since it wasn't being submitted for insurance purposes which is what I think would matter most in the cases of fraud.

I think that since there is the possibility of adoption how does it color this scenario? Is it possible to research it from that angle as well?

mistah charley, ph.d. link

5/2/2011 03:44:53 am

Babygate - Big Lie or Reckless Ride?

My own appraisal, based on viewing the photos (which is to say, assuming they have not been tampered with) as well as reading all the accounts, is Option 1 - Big Lie.

If this is correct, then Sarah's physician, Cathy Baldwin-Johnson, MD, FAAFP, has done some lying for her. But these are, arguably, white lies - lies to the press, lies to the public, but not lies when she faced legal penalties for perjury. All of CBJ's lies and misdirections are in the direction of bolstering the "Sarah is the mother" story, something that while technically a lie if we're focusing on the issue of who is the BIRTH mother, is figuratively accurate if we assume that the baby is or will be adopted and Sarah is the ADOPTIVE mother. The adoptive mother is, from that point on, the REAL mother, and the fact that birth certificates are issued bearing the names of adoptive parents is a very strong indication that telling a "white lie" about who gave birth to a baby is something that the state itself is quite willing to do.

However, the birth certificate for an adoptive child must have the accurate date and place of birth, or it is a forgery. I believe in the Big Lie theory of Babygate, and in my opinion Sarah would be willing to issue a forged birth certificate for Trig if she could get away with it.

So, the Big Lie theory of Babygate could be confirmed if a birth certificate with a different date or place of birth was produced. If a birth certificate with Mat-Su and April 18 were produced, I would want additional information to guarantee that it was in conformity with official records. This could be done, with Sarah's permission, as we have seen with Obama's certificate. If the State of Alaska's official records disconfirm the Big Lie theory, then either the state's records have been tampered with (wouldn't this be a crime?) or else the Reckless Ride really happened.

GhostbusterTX

5/2/2011 05:48:46 am

Was Mat-Su even using full electronic medical records in 2008? I know of at least one similarly-sized community hospital that was all paper as recently as six months ago.

Also, my experience is that my medical records are riddled with mistakes of various sorts, most unintentional but not all innocuous.

Not that that makes much difference; between reasonable privacy accomodations for a sitting Governor and/or family and HIPPA it's not inconceivable that the number of persons who had any personal interaction with the "patient" were very, very limited, and that access to any medical information would be restricted even from most of the staff on duty during Palin's stay, real or not. If I were trying to pull this off, I'd be not so much worried about the nursing staff, who could be simply excluded from her care, as the billing department, who would need to have some sort of data to process. That's where plot would have to rely on HIPPA.

Laura Novak link

5/2/2011 08:13:06 am

Bobcat Logic: thank you for directing the attention of anyone who was on here last night to what was really important. Since President Obama's speech revealing the death of Bin Laden, I've had second and third thoughts about continuing this conversation.

Mrs. Palin is so very unimportant. And small, at the same time!

But since I'm here, I want to say again what great points you've all made:

And issue of omission or redirecting the attention is critical. So too (also, too) is the relationship between the Palins and the doctor - as well, wasn't the doctor's husband an insurance executive who was also on the hospital Board?

The one thing I do take issue with is the idea that someone, after the fact, says that yes, that's my signature on that letter. If they are not specifically asked, why would anyone say that?

I'm going to go back and look at the letter again. I know others have done some serious sleuthing on it, I just don't recall the details.

May we all keep on with what is right and important. Thank you!

mistah charley, ph.d. link

5/2/2011 09:20:21 am

Admittedly, Ms. Palin seems like very small potatoes right now. However, the euphoria of the moment will pass. Palin's strengths of fanatic supporters and sociopathic ambition, and the backing of right-wing billionaires, may continue. She is still dangerous. And even if her monied backers abandon her as too flawed a vessel, there will be some other manifestation of the phenomenon Scharlott has identified. Palin may - hopefully will - fade, but the puppet masters of the Military Industrial Congressional Financial Corporate Media Complex will find other figureheads to use in milking, shearing, and slaughtering the sheeple.

Bobcat Logic

5/2/2011 10:44:21 am

I wonder if the "puppet masters" worry about Sarah turning on them?

She is also clearly insane enough to implicate them by accident, which must be a worry.

I wonder how they plan to deal with her now that her stale-date has passed?

rubbernecking

5/2/2011 01:07:30 pm

Dr CBJ seems to have little to gain but much to lose by deliberately releasing false information in a signed letter in order to influence a Federal election. I tend to think the letter's statements related to Trig (http://www.latimes.com/media/acrobat/2008-11/43179602.pdf) are probably factually true but other facts are missing, e.g., birth method, birth weight, birth date. The factual omissions protect CBJ legally and/or minimize conflicts with false statements given by Palin. I believe CBJ's lawyers reviewed the letter before it was released and this may have contributed to the delays in releasing it. I assume Piper's birth year is a typo which was overlooked because everyone was so focused on the Trig details.

I've read the palindeception (PD) analysis of the letter . The PD analysis claims the doctor should have released the letter directly to the press rather than through the McCain campaign? Why? It appears that Obama's doctor's letter was also released by his campaign, not directly by the doctor. Doctors in private family practice wouldn't have national press contacts. It's seems completely appropriate that they would release the letter to the respective campaigns for dissemination.

The PD analysis complains the letter attests to facts CBJ cannot know first hand; Obama's physician also attests to facts that he cannot know first hand--such as medical history about Obama's mother and grandfather.

The PD analysis is also very worried about the misalignment of the first page of the letter. This can also happen when a printer's manual feed is used to load letterhead. I can see that there is some variation in the ink color in the signature but it seems a big leap to say this means the letter is false.

If someone modified or forged a letter, what was CBJ's role? She refused to provide the letter Palin requested but then she does absolutely nothing when the campaign publishes a false statement under her name to the national press? Wouldn't her lawyer have contacted the McCain campaign?

If CBJ knowingly released false information, she took a huge gamble. The Palins can't hide Trig's birth cert forever. Won't they need to show Trig's birth cert to enroll him in school?

mistah charley, ph.d.

5/2/2011 09:29:11 pm

@Bobcat Logic - In referring to the political insiders and wealthy contributors who engineered Palin's rise to the vice presidential nomination as "puppet masters", I realize I've used language that overstates their degree of mastery. Kurt Vonnegut wrote himself into his book Breakfast of Champions, and discovered in the process that he had less control over his characters than he initially believed. Rather than being able to manipulate them with steel rods, it was more like he was connected to them by stale rubber bands. From my perspective as a social scientist, I'd say this is a novelistic way of expressing the insight which B.F. Skinner supposedly formulated in the Harvard Law of Animal Behavior: Under carefully controlled experimental conditions, the pigeon does what it damn well pleases. So yes, I think the wealthy donors may have doubts about how compliant Sarah would be if she actually became President. If so, they have the option of cutting back on the cash. My guess is that they want to keep her as part of the right wing noise apparatus, part of the chorus of voices to confuse the people.

@rubbernecking - With regard to CBJ's participation in Babygate, I think she did not realize, when she first agreed to be part of the cover story for Trig, how big a deal it would get to be. When this became clear, it was too late to stop. "In for a penny, in for a pound".

@mistah charley, ph.d.

5/2/2011 11:18:53 pm

I agree that CBJ did not anticipate the national interest in the story. She also didn't anticipate Palin's inability to stick to one version of the story! When CBJ realized the risks to her own career, she got her lawyer involved. She refused further interviews. If CBJ deliberately released false information, she did so knowing that Palin loves attention and can't stop talking about herself.

Is it possible CBJ lied in her published letter? Yes. But it seems crazy to assume the letter must be completely false just because it doesn't support the fake pregnancy story.

Someone on McCain's staff knows more. His staff would have asked for Trig's birth cert when the Bristol rumors first broke. They would have involved in the decision to request/delay/publish Palin's medical letter. One of these staffers will eventually spill the back-story.

rubbernecking

5/2/2011 11:20:31 pm

Sorry! Comment at 6:18:53 is from rubbernecking to mistah charely. I put the @mistah charley in the Name box instead of the comment box.

Laura Novak link

5/3/2011 03:39:04 am

Rubbernecking, et al., You bring up an important point and one that clarifies something else that some people run with. The idea that the doctor didn't release the letter "on her own" doesn't hold water for me. Palin was working for a campaign. In the same way a scientist might work for a company or a university, when they release information about their experiment or discovery, they alone, by themselves, do NOT answer the zillion phone calls or fax a statement or type in email addresses to the zillions of reporters trying to get the story. They release their information/findings/what have you, via the media relations office of whomever they work for. To say that CBJ did not stand somewhere and hand out her letter to the press doesn't mean anything. It's simply not done that way. So there is no significance or suspicion for me there. Nor is there about her stating later that it was her signature. How many times have we seen someone do that?

You're right: one assumes that her lawyer saw what she wrote. Clearly SOMETHING had them all "dithering" about what to print. And clearly they didn't want questions or provide time for them at 11 pm before election day. That the letter focused on the birth of a child tells us that they were trying to prove something.

But like I said: why not have the campaign simply address it. Unless they didn't know. And THAT is always possible.

One more thing: I don't think that method of birth is important. C-section, vaginal, what difference does it make? It could also have been the OB on call at the time. That CBJ might not have witnessed the birth doesn't trouble me - she put her name on a letter stating basically that this woman carried the child and went through prenatal care for it.

I'd like to perhaps discuss the letter in more detail. Up next is a comment from Doctor #2. You'll find it interesting!

5/4/2011 09:02:14 am

I want to say that it still is important to expose this lie if we can. The reason is that we need to show that these type of people deliberately lie and mislead Americans for their own gain whenever possible. It's such a colorful lie that breaking it may get the attention of some of the most gullible and misled.

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