between the lines
pointed perspectives and penetrating punditry

What the AMA Could Learn from the MLB

by Jack Cashill

As an experiment, I decided to give myself five minutes to discover who were the best and worst professional baseball players in Kansas City.

Not knowing where to begin on the Internet, I randomly started by plugging in baseball.com and hit a solid line single to right. Here is what I learned in those quick five minutes.

Royals’ first baseman Mike Sweeney is arguably the best player in Kansas City. The day I looked—and these stats are updated daily—the 6-foot-2-inch, 215-pound 28-year-old was batting .311 with 27 homers and 90 runs batted in. He accomplished this, I learned, despite his 10-day suspension for brawling with Detroit.

Donnie Sadler, however, was off his game. The 5-foot-6-inch, 26-year-old infielder was batting only .133 with zero homers and two RBIs. In his 98 at bats, the woebegone Sadler could muster only three doubles and 13 singles. In 15 more minutes, I could have examined just about every at-bat in either player’s career. Bottom line: if I had to choose between the two for my team, I would choose Sweeney even if he charged 10 times as much

Now to Find a Doctor
If I had to choose a cardiac surgeon, however, I would probably just start by, well, by asking around. There is really no better way to proceed.

Karen Russo, Director of The Wrongful Death Institute in Kansas City, has learned this the hard way.
In examining suspicious deaths, she has come face to face with the informational black hole known as the medical establishment.

Among her recent clients is a prisoner in the Missouri system who has been the unfortunate recipient of care from the CMS, the Correctional Medical Services. If most of the CMS physicians do good and decent work under difficult circumstances, some—as you might imagine—do conspicuously neither. The problem, as Russo has learned, is that it is almost impossible to tell one from the other until the patient is carted away.

Russo began her investigation with the Missouri Board of Registration for the Healing Arts. She hoped for an easily accessible Web site that posted the doctor’s photo, bio, and relevant stats—a DOCTOR.COM. No such luck. Here is all that the board coughs up:

n Whether a doctor is an “MD” or “DO”;
n The doctor’s license number;
n When the doctor received that license in the state of Missouri;
n Whether the license is current;
n Whether or not there has been any disciplinary action;
n The doctor’s address.

If, in fact, there has been disciplinary action, the board reports it carefully and discreetly, assigning it to any of seven or eight disciplinary categories.

When Russo asked the Board of Healing Arts for additional info., she was referred to the American Board of Medical Specialties. This second board could only add the doctor’s specialty and the type of his or her certification. Worse, there were discrepancies in information between the Missouri Board of Healing Arts and the American Board of Medical Specialties for specific doctors.

If this were all the data available in baseball, we would know only of Mike Sweeney that he played first base for the Royals, had been suspended for doing something unpleasant this
summer, and lives at 29 East Bejesus Lane in Leawood.

The Swango Factor
What neither board will tell you are some of the less savory but arguably relevant facts about a given physician. One such trifling detail, as Bill Allen recounted in the St. Louis Post Dispatch, is whether the physician has, oh, say, a homicide conviction. Allen identified at least one such recovering murderer who was still practicing medicine in Missouri.

It gets worse. Consider the truly mind-boggling case of Dr. Michael Swango. As detailed in James Stewart’s excellent book, Blind Eye, Dr. Swango helped pioneer an innovative new medical specialty, namely poisoning people. Says Special Agent Tom Valery with the Department of Veterans Affairs, “Our feeling is that he is a serial killer, based on his trail of mayhem and death.” Still, no matter how high the body count, the wily doctor has not yet been nabbed for a single murder.

For all that, his career path has been painfully respectable. It started at Southern Illinois University where Dr. Mike developed the charming habit of scrawling “DIED” in large block letters on the charts of dead patients. His oddball behavior and general incompetence at SIU led several fellow students to lobby for his expulsion,
but it did not prevent Swango from graduating or getting an internship in general surgery at Ohio State University.

Swango began to hit his stride at OSU as at least five patients made suspicious final exits. The administration investigated but didn’t bother calling the cops—hey, a lot of people die in hospitals—and Swango was exonerated. He even got his license to practice medicine in Ohio. But in the meantime he had taken an EMT gig in Quincy, Ill., where he proceeded to spike his co-workers’ iced tea with arsenic. This time, they caught him and sent him to the slammer.

This detour to the big house scarcely slowed down his career. In 1992, Swango secured a resident slot at the University of South Dakota’s internal medicine program until—oops!—a rebroadcast of a prison-side ABC 20/20 interview got him in a pickle with his bosses. In gentlemanly style, he was asked to resign.

In between jobs, he seems to have poisoned his fiancée until she killed herself in despair. Then he promptly resumed his fast-track medical career at the Veterans Affairs Medical Center in Northport, N.Y. There, he continued to refine his increasingly lethal skills until administrators got a tip from South Dakota that Michael Swango wasn’t exactly Marcus Welby. Said the dean of SUNY’s medical school in something of an understatement, “Standard procedures for checking applicants were not followed.” Guess not.

One step ahead of the bloodhounds, Swango jetted off to greener pastures in Zimbabwe. Hoping to find another Dr. Schweitzer, the locals ended up with another Dr. Jack, but one who didn’t bother asking permission. After a rash of unexplained deaths and some seriously deranged behavior, the Africans booted him. He was finally nabbed at O’Hare Airport and convicted on fraud charges for his bogus application at Northport.

And if hospitals are this deeply mired in the dark, imagine the plight of the poor consumer.

The Health-Care Card
Can a doctor’s capabilities be documented as clearly as a ballplayer’s? For a marketing project, I once
interviewed a top cardiovascular surgeon at a major Dallas medical center. In a candid moment, he acknowledged that his veteran team loses two percent of its patients on the table. Then he admitted that the skilled young teams at his hospital lose up to eight percent of theirs.

As a patient, I just might want to know that and any other verifiable stats on outcome. I might want to know, too, where the doctor went to school, what his class rank was, where he interned, what fellowships he pursued, what other
patients and doctors think of him, how many times he’s been sued and to what result.

If we’re talking about a real patients’ bill of rights, this would be a good place to start. After all, even on his worst day, Donnie Sadler never killed a customer.

The views expressed in this column are the writer’s own and do not necessarily reflect those of Ingram’s Magazine.