The terrible plight of Dr. Conrad Murray

Dr. Conrad Murray can't win. The Michael Jackson family, through their surrogate Reverend Jesse Jackson, hints that the doctor may have done something terribly wrong in the death of Jackson. Jackson fans were brutal. On the website vitals.com that rates physicians there were more than 100 comments (as of Saturday). The writers mostly railed against Murray as "Michael's Killer." What Murray did or didn't do in the tragic hours before the fateful 911 call that brought the paramedics rushing to Jackson's home is nothing but wild conjecture and speculation and grist for the tabloid mill.

Yet, that Murray finds himself on the medical and legal hot seat is no surprise. When things go wrong with their celebrity client-patients, doctors always feel the heat. Because invariably the things that go wrong deal with drug use, questionable medications and treatments that they allegedly give their ailing or troubled celebrity clients. The suspicion is always there that the doctors did something either negligent or unethical in catering to and indulging their clients real or imagined medical needs. The hunt to scapegoat the celebrity attendant doctor is then on with a vengeance. Their background, training, and experience are quickly called into question.

That's the case with Murray. His training at Meharry Medical College School of Medicine, one of the oldest and most renowned black medical training facilities in Nashville, Tennessee, his internships, his years of experience and work as a cardiologist are under an intense microscope. The tons of money that Murray racked up in unpaid bills, and the liens and pending suits to get the money back have been dredged up to paint Murray as a doctor with a checkered and shady history.

HealthGrades which rates America's physicians based on their training, experience, patient responses, and quality of care, did not give Global Cardiovascular Associates a glowing four star rating. In the crucial area of patient care, there were six patient responses. They rated Global Cardiovascular on ease of scheduling appointments, office environment, cleanliness and comfort, office staff friendliness, and most importantly the wait time before seeing a physician. Murray's three person staff rated only fair in the responses. Vitals. Inc. gave Global Cardiovascular a marginal rating on the critical areas of patient response time; follow up, and most importantly, accuracy of diagnosis. The clinic ranked below the national service average in a couple of these rated categories.

This is not damning proof that the clinic doses out substandard care, or is any way deficient in its medical practice. However, patients, medical rating boards and health care providers do place major emphasis on these as measures of patient care in decisions about the effectiveness and competence of physicians and their hospitals and clinics.

Even if Murray's clinic had received a world class four star rating from the rating physician services, Murray or any other doctor who attended Jackson would still raise eyebrows even if they did everything by the book. It comes with the turf.

Heart-related deaths account for more medical malpractice and wrongful death lawsuits than for any other medical problem. One survey found that they account for 30 percent of all dollars shelled out by doctors and insurers to settle malpractice suits. Malpractice awards for heart attack typically allege misdiagnosis or mismanaged diagnostic methods or medical tests. Because the outcome of a misdiagnosed heart attack is obviously poorer than a rapidly treated heart attack, the patient may suffer severe consequences. This is the prime reason that the dollar award for heart attack malpractice cases is almost always much higher than the average payout for other alleged medical screw-up cases.

It may be that Murray did not do anything wrong in how he handled Jackson. But that won't end things for Murray. He'll likely be slapped with a lawsuit, or even multiple lawsuits. That's been the lot of legions of other cardiologists. And possible lawsuits may be the least of his problems.

He will carry an even greater burden; and that's the burden of being the doctor who was there when Jackson died. And everyone expects that doctors are supposed to save lives and not raise suspicions that they did something to end a life. It's a terrible dilemma for any doctor. Dr. Murray is hardly the first to face it, but it's one he'll have to live with.