Grading Sandwiches and Surgeons

If Dr. Donda West had been looking for a good turkey sandwich instead of a good plastic surgeon, she could have counted on the government to warn her away from the likes of the doctor whose actions seem to have cost her life. Downstairs from the Brentwood Surgery Center is a Quiznos sandwich shop, which bears a rating on its door attesting to its most recent grade from local health authorities. They inspect regularly, grade strictly and force businesses to warn the public when problems have been found inside.

But that's for turkey sandwiches or cups of coffee. Not for people who are cutting you open.

In retrospect, it's clear the doctor Donda West chose was a disaster waiting to happen, or more accurately, a man who had already caused enough harm that anyone who knew the facts about him would not entrust their life to him.

The records from the criminal justice system make clear he was a repeat offender, a doctor with a serious drinking problem who had thus far avoided killing anyone on the road, but not for want of opportunity. The fact that the State Medical Board was finally coming after him for his license is not the point; the point is that it took them this long, and that, for better or worse, he was in trouble for his driving, not his operating.

It's the records from the civil justice system that are the most horrifying. Yes, everyone makes mistakes. Bad things happen to good doctors. Things can go wrong in the best medical centers, with the best doctors. The fact that a doctor has been sued doesn't mean he did something wrong; sometimes insurance companies settle even in questionable cases. But Dr. Jan Adams was a cosmetic surgeon who had held himself out to be board certified when he wasn't, who had already paid out two major malpractice awards for stupid mistakes, not to mention unethical conduct, and was facing a third at the time he operated on Donda West. If she had known that, would she have put her faith in him? Of course not.

So why didn't she know?

Dr. West wasn't just the mother of a celebrity. She was a well-educated, successful professional woman, a faculty member for 24 years and former chair of the Department of English, Communications, Media Arts and Theater at Chicago State University.

But records from the criminal justice system aren't easy to find, and records of settled and sealed civil cases are even more difficult to come by. Googling Dr. Adams wouldn't have told her what she needed to know. He wasn't about to tell her what she needed to know. And there was no sign on the door, like there is on the door of the sandwich place downstairs.

Her celebrity connections, far from protecting her, made Donda West a more likely victim. A friend of mine, a distinguished doctor here in Los Angeles, firmly believes based on experience that celebrities get the worst medical care. There are two reasons for that. The first is that they tend to go to celebrity physicians, the ones you've heard of and seen on television. Famous doctors are rarely the best doctors. The best doctors are the ones you find in major universities and medical centers, not those with television shows of their own. There are exceptions, to be sure, but in general, a doctor who claims their affiliation with a television or radio network before or instead of a university is a doctor to watch on TV, not one to entrust with your health.

The second reason that celebrities get bad medical care, though, is not that they pick the wrong doctors, but that whatever doctor they pick is too eager to impress them, to show off to them, to keep them as a patient. They may get appointments faster, but they also are more likely to be told "yes" when they should be told "no." Doctors are known by the patients they treat. Having celebrity patients becomes a calling card few doctors can resist, even when they should, and it can impair the judgment of even the best of them. Not to mention the worst.

We would never think of allowing restaurants to serve us food without some system of regular inspections to ensure we don't get sick from eating there. The same should be true for doctors. We need more information, more readily accessible, about who is safe and who is dangerous. It's not enough for the health inspector to grade the sandwiches downstairs when the doctor upstairs is the one who needs watching.

To find out more about Susan Estrich and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at .

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