More people are using walk-in clinics for primary care
“‘People are much more consumerist today,’ Dr. Lo said. ‘No one wants to wait two weeks to see a doctor. In fact, no one wants to wait an hour in my waiting room. People are much more concerned about getting things done on demand, and they have difficulty finding a primary care doctor who will see them promptly.’”
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>>But at least your precious assets will be protected, eh? I mean, it would just be too much trouble to go incorporate. That’s just wasteful. Never mind the tax benefits that come with incorporation for the small businessman. You must not work for yourself.
Incorporation is a speed bump if there’s a devastating lawsuit, it’s simple to “pierce the corporate veil”. Not much practical advantage to incorporation for a small practice. I did it anyway, for the small advantages that it offers, knowing that malpractice defense is not one of them. So what’s you’re point?
It’s simple to pierce the corporate veil? Tell me, how many times have you done it?
It’s only easier (it’s never simple) if you violate the corporate form and don’t treat the corporation as a separate entity – paying your home mortgage out of corporate funds, buying family Christmas presents out of the corporate account, etc. Other than that, it’s very difficult.
If you have that much of a misconception about corporations, what makes you think your assessment of the insurance and legal industry are correct anywhere else?
“The urban legend relating malpractice premiums to economic conditions refuses to die, but doesn’t stand up to examination. How does that explain the discrepancy between neighboring states, such as Illinois and Indiana, or California and Nevada, for the same specialties for the same year? Are their economies that much different, or is it the different legal climates that exist in these states?”
Surely you’re not arguing that these “crises” haven’t occurred everytime there has been a significant economic downturn in the last 30 years? Or that they are occuring in states that have caps? Be serious.
California can be easily explained – insurance reform. Different premiums in different states can be caused by a lot of factors. These can include anything from the number of payouts to the competency of the executives running the company and where they invest. Why did two Pennsylvania insurers go under and others didn’t? Those two made poor financial decisions and in one case they simply looted the company. To suggest it’s a matter of caps v. non-caps is simplistic at best.
By the way, jb, I like your full disclosure of your coverage. Would you also give full disclosure of adverse results in your practice? References of satisfied customers?
I’ve seen the proposal of waivers of liability bandied about the blogosphere, to go to more of a contract basis for malpractice. Would you also advocate more information about you and how you rate as a physician being made available to the public so they can make a more informed decision?
Considering that you would reject a patient who dared ask about malpractice coverage, I suspect that you would not. Interesting how physicians expect patients to fully understand that “you’re not God” and “bad things happen” but if a patient dare ask a question about your ability to compensate for your own negligence you fire them.
Perhaps the only contractual arrangement physicians want to enter into is one where they hold all the cards and can’t be held accountable for anything. Nice work if you can get it.
Yes, I do give information about “adverse results” in my practice. Every time I discuss surgery with a patient, I inform her about the more likely and significant potential complications, and whenever I can, the percentage of cases that they are likely to occur. I compare my complication rates to these published rates, and so far have fortunately not had to tell anyone that my complication rate differs from published standards. If my rate were higher for a particular procedure, I would probably stop doing it. Even before HIPAA made it a federal crime to discuss one patient’s care with another, I did not provide “references of satisfied customers.” I rely on word of mouth for much of my new business, but it does not come from me or my office.
I would have no problem having my “report card” available for public view. The people who object to that should be patients who would find doctors unwilling to care for them if they are sicker or harder to work on than usual (obese, multiple previous procedures, hard to control diabetes, heavy smokers), for fear that their report cards would reflect these unfavorable outcomes.
I do not fire patients who want to discuss complications; in fact, as I wrote above, I initiate the discussion and occasionally make it clear to some who are wavering that it is entirely their choice to take the risk of the operation or live with whatever medical condition that brings them to my office. Firing a hypothetical patient who wants to discuss malpractice compensation would be a risk management tool. I am not perfect, nor are my outcomes, but it is a well established fact that a poor outcome in a patient who is predisposed to sue is the most likely scenario for a lawsuit. I can’t eliminate poor outcomes, but minimizing my exposure to lawsuit-disposed patients is a way for me to minimize my risk of being sued.
I hope that none of the young docs who read this blog believe the nonsense being proposed that incorporating your practice will protect your personal assets from a malpractice claim. It just ain’t so. Ask a competent lawyer. Just think: incorporating costs a few thousand in most states, and a few hundred bucks per year to maintain. Why not just do that and blow off the malpractice premium? Answer: they will take your house, your car, your savings, and your furniture, depending on state law. In my state, the house is protected because I’m married, but that’s not true everywhere. As I said, talk to a competent lawyer who is versed in asset protection.
Amen jb.
Find a COMPETENT lawyer, tell him/her you want to incorporate your practice to protect your assets in a malpractice suit, judge the answer for yourself.
I’m sure it varies from state to state. What they tell me in my state is it protects from some smaller “slip and fall” kinds of claims, but is of no use whatsoever in a malpractice suit. I did incorporate, but with the knowledge that the advantage for me was small.
Actually, as any COMPETENT lawyer will tell you, your house and car are almost certainly protected in bankruptcy, even with the new bankruptcy law. The house has limits, which you might surpass, but don’t worry – it won’t be any worse than trying to live on $250,000 for a lifetime despite the fact you have to breathe through a tube.
Incorporation can easily protect your non-medical assets if you do it. It’s not difficult. If you own rental homes, for example, place them in a corporation or LLC. Again, as any COMPETENT lawyer would tell you.
It is interesting to see that physicians wouldn’t want to work on more difficult patients. Although I guess I shouldn’t be surprised.
I think my state’s homestead laws protect the family Bible, 40 acres and a mule, too.
Gee, it’s so easy to protect assets. Why bother with insurance? I think I got one of your mass mailings last week. Is there a seminar coming soon?
Then move to a different state or advocate for a change in the bankruptcy laws.
What are you going to do when the rates don’t fall? Where will you turn next for “relief”? Or will $250K all the sudden not be enough, just as $500K wasn’t for Missouri?
I hope your memories of this “crisis” last longer than your memories of the last one. It’s a lot easier learning the fallacy of tort reform that way than having to learn it by being a victim. Of course, what with your indestructability, that’s probably not an issue for you.
The cap in Missouri wasn’t enough, not because of the dollar value, but because the cap could be lifted in so many exceptions that it was useless.
This time round, they got a hard cap, which was what they wanted in the first place.
http://msma.org/cgi-bin/cgiwrap/msmaorg/htmlos.cgi/003169.5.2288874789915668050
And when this cap isn’t enough? Where will you turn then?
Or will you even remember 10 years from now during the next economic downturn? Or do you just figure that you’ll be retired, so screw the injured patients?
Try retiring on that $250,000 for a lifetime your jury award got knocked down to for having the wrong kidney removed. Or being disfigured for the rest of your life as a result of a burn.
I’d sue my lawyer for not getting my economic damages addressed.
Sorry, but if you don’t have any lost wages (ie, you’re not employed), you don’t have any extra money to retire on.
You’ve got money to pay your caregivers and medical bills. That’s it. You’re not even going to make it to the beach in Mississippi on $250,000 for a LIFETIME.
glory be, I finally got you to admit your lie that noneconomic damages are all the injured party gets.
We’re getting somewhere.
Actually, it is all they “get”. The rest goes into the pockets of caretakers. If your mama gives you $20 to go to the store and get $15 worth of goods and you can keep the change, you didn’t get $20. You got $5.
If a child gets a $25 million award in a state with caps, then all but $250K of that will end up in the hands of caregivers. That’s it.
Although your statement does serve to further illustrate the fallacy that caps will have any effect on insurance premiums (it will have plenty of effect on victims). It’s a tiny percentage of cases that will even be affected by caps.
That’s why these insurers and Medical Association reps made the following statements:
“While MICRA was the legislature’s attempt at remedying the medical malpractice crisis in California in 1975, it did not substantially reduce the relative risk of medical malpractice insurance in California.”
~James Robertson, Assistant Vice President and Associate Actuary, SCIPIE Indemnity Company (California’s second largest medical malpractice insurer), in written testimony responding to a question from an administrative law jugdge who is overseeing a case in which SCIPIE has requested a 15.6 % rate hike. April 30, 2003.
“Non-economic damages are a small percentage of total losses paid. Capping non-economic damages will show loss savings of 1.0%.”
~GE Medical Protective regulatory filing with Department of Insurance (TDI), October 30, 2003. The revelation was contained in a document submitted by GE Medical Protective to explain why the insurer planned to raise physicians’ premiums 19% a mere six months after Texas enacted caps on medical malpractice awards.
You can’t eat money. My “mama” gave me twenty bucks, I got food.
The person didn’t “get” the money in that it went to the caretakers.
The person “got” care. To say the person got nothing is just another lie.
The person with “no income” either magically found a way to live on nothing, or had some source of income to pay the rent and put food on the table before the accident. He continues to have that. If the income had come from savings and was exhausted, that’s economic damage.
You’re good at twisting words, the fact remains that economic damages should be paid. To the extent that they’re not paid, it’s a failure of the plaintiff lawyer.
Now throw out your bag of quotes. It’s time to change the subject again.
A child has no income, his sole source of income is his parents.
I used direct quotes from your allies. Sorry you didn’t like them, but they certainly weren’t twisted. You can verify them for yourself – I told you where they were published. It must really suck to find out they are contradicting everything they’ve told you when they are under oath and trying to raise rates.
Is this conversation still going on, being April, 11, 2007 or is this old and has stopped?
TY,
PD
Healthcare is a joke. I lost my job and therefore my health insurance and then found out I was pregnant. I had to go on medicare because I don’t have $10,000 to pay for having my baby. Let me tell you, being on medicaid is not fun. I hate going to my doctor visits because the staff treat me like I’m a piece of crap that’s just a waste of their time, all for being on medicaid. No one greets me with a “hello” no one asks “how are you?” nothing. I get, “get on the scale!” and “Go give me a urine sample!” and that’s it. Basically I’m less than human and ignored, I don’t count, I don’t exsist, and they act like they’re doing me a favor by seeing me. I hate doctors/ nurses and the whole healthcare system. I’m just so sorry you doctors aren’t making all that much off of me.
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