The Good, the Bad, and the Dirty

On its 2016 album "Death Of A Bachelor," Panic! At the Disco has a song entitled, The Good, the Bad, and the Dirty. In the song, vocalist Brendon Urie proclaims,

"If you wanna start a fight
You better throw the first punch
Make it a good one."

The proclamation, to me (but I could be wrong as only the writer of the song knows the meaning behind the lyrics), sounds like he is challenging his doubters (other verses reference doubters and former friends) which is normal. Successful people normally do not get to where they are in life without some driving force, and that driving force can be proving people wrong. But when this proclamation is applied to healthcare providers, it takes a different tone.

An intentionally "defiant" healthcare provider is not something you see. Healthcare is extremely regulated, even if there is room for improvement. However, a provider screams Urie's proclamation when they do not follow those regulations. By failing to do simple things required in the regulations, a provider is screaming for a fight, and the Government normally lands a good punch. For example, Raleigh Orthopedic Clinic was recently hit with a $750,000 fine for failing to execute a business associate agreement. Details can be found here. Other "punches" that the government can land include False Claims Act allegations, ZPIC overpayments, etc.

Being defiant is a good thing in most cases. Civil rights would not have advanced to the point they have without defiance. We would never have gone into outer space without defiance. Artist, athletes, professionals, workers. Most would not be where they are without defying doubters. But, in healthcare, defiance is costly and the "punches" are good.