Dead Certain

pay.”
    “And that somebody was Carl Laffer.”
    “But what you’re saying is that if he hadn’t gone out of his way to protect Gavin McDermott, who’d behaved completely irresponsibly by getting drunk when he was on call, it would have been McDermott sitting there in that courtroom getting his lunch handed to him. No wonder Laffer was so quick to come to Claudia’s defense during the morbidity and mortality conference.”
    “Yeah,” agreed Elliott. “He knows what it feels like to have your professional reputation publicly torn to shreds by a bunch of lawyers.”
    “True,” I mused. “But what I was actually about to say is that he knows what it’s like to end up being screwed on behalf of Gavin McDermott.”
     

CHAPTER 20
     
    After dinner I asked Elliott back to my apartment. Even though I did my best to make the invitation sound offhand, I knew I wasn’t fooling anybody. It had taken three years for me to make up my mind. There was nothing casual about it.
    If Elliott was nervous, he didn’t show it. Instead, he spent the ride back to my place telling me about the fraud case that had occupied him for so many weeks in Springfield.
    “It would actually make a pretty good soap opera,” he began, “at least the civil portion of the case. From the transcripts, the criminal trial actually seemed pretty cut and dried.”
    “It was insurance fraud, wasn’t it?”
    “Medical insurance. Two obstetricians with an incorporated practice were convicted of defrauding the government of millions by billing Medicaid for tests and procedures that were never performed.”
    “But didn’t your client say all along that he didn’t know?”
    “He did. But under the criminal statute it doesn’t matter. He was a principal of the corporation and that made him responsible in any criminal proceeding.”
    “But not in a civil action?”
    “Dr. Butler, our client, was seeking to recover for loss of income and damage to his reputation caused by his partner’s criminal behavior under tort law.”
    “Do you honestly believe he didn’t know what was going on in his own practice?”
    “If there’s one thing that this case has taught me, it’s that doctors can be incredibly naive when it comes to business,” replied Elliott. “Their whole training teaches them that medicine is far loftier and nobler than the crass pursuit of the dollar.”
    “Maybe that’s why they hate managed care so much,” I ventured. “Companies like HCC rub their noses in the dollars and cents of medicine.”
    “Oh, I don’t know,” he countered. “It’s not like most physicians have exactly taken an oath of poverty. My client didn’t have any problems taking the money—or spending it as long as it was coming in. He says it never occurred to him to question how, with insurers constantly lowering the ceiling on what they’re willing to pay for certain procedures and their patient population remaining pretty steady, their practice was making more instead of less money.”
    “And it really was all his partner’s doing? „
    “Apparently the partner was having an affair with the woman who was in charge of the practice’s billing. After the trial she confessed that it was like being given a license to print money. The other doctor actually argued during the civil case that he hadn’t considered what they were doing as wrong. He went on and on about how the government was unfairly forcing doctors to work harder and harder for less and less money. He was just leveling the playing field.”
    “I get it,” I remarked, pulling off Lake Shore Drive onto Fifty-third Street. “It’s a variation on the Robin Hood defense. Only instead of robbing from the rich to give to the poor, you rob from the government to keep the rich rich. I take it the jury didn’t buy it.”
    “Are you kidding? We had a panel of blue-collar workers and retirees from downstate Illinois. They didn’t have a lot of patience for doctors complaining about how hard they work and how poorly they’re rewarded.”
    “And yet, you know, I’ve watched what Claudia’s had to go through for her training, and I’m not sure I’d be willing to go through it if I didn’t know that at the end of the road I’d be making a shitload of money. She and I were talking about it the other night—not the money, but just what she’s had to give up. She’s spent whole years of her life in the hospital, turned her back on anything resembling a normal life, all in order to