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Dr. Charles urges you to support medical liability reform:

In general the malpractice system in this country needs comprehensive reform. I think special healthcare courts will be a good change someday, allowing doctors to be fairly held to objective standards of care and injured patients to receive prompt and fair compensation. The unjust lottery award system we have now benefits only trial lawyers. Trust me. I’m learning this first hand, and I am furious at the injustices.

Comments

Samson Isberg
These Health Courts that’s suppose to be a cure-all – have anybody really considered the details of that concept?
Will there be attorneys at all in these courts, representing what’s usually referred to as “the plaintiff”? And if yes, what is to keep them from doing their usual stuff – lawyering – behaving in a manner that has made them universally despised?
Who will be the judges? Do we envisage a jury made out of doctors? Or only one doctor? If the latter will be the case, what’s to keep him from following his own bloated ego and pass out verdicts on the usual basis of “what makes others small will make be bigger”. And if this court is to be lead by a regular judge, what will keep him from doing his regular routine, losing the trail of justice in the jungle of jurisprudence and ending up with a verdict that will end up on lawyerstink or some other website?
I don mean to spit in the soup here, but as one who has practiced for 25 years under a system that was supposed to alleviate the adversarial juridical system for doctors, but who also has seen this no-fault compensation scheme being raped by lawyers and corrupt doctors selling themselves like prostitutes in the streets, I sincerely think you ought to think twice before asking for Health Courts.
Anonymous
Charles sure makes a lot of claims, but he has so few facts that can support them. For example:
“These are some of the most wildly arbitrary awards, are subject to emotional whim”
Does he have proof that similar injuries to similarly situated people result in “wildly arbitrary” awards? Of course not.
“This jacks your healthcare costs up higher and higher and drives doctors out of your state, out of business, or into low risk-fields.”
Again, a dearth of facts. Patients healthcare costs are no more or less higher in states with or without “reform”, and there is no reason whatsoever to believe that health courts would save the patient a single dollar. Nor is there any reason to believe that health courts will keep any physicians in any particular state, or that physicians are leaving in mass numbers for these mythical states where everything is wonderful. And it appears, based on other physicians’ weblogs, that OB-Gyn spots are filled at one of the highest rates of specialties.
“after similar legislation in Texas that has helped lower medical malpractice insurance premiums for providers in that state.”
Again, a complete lack of facts. Rates, after increasing 400% or more in most states with and without caps, have now declined anywhere from 5-40%, in states with or without caps.
” The intent behind these bills is to improve access to health care by implementing reasonable, comprehensive, and effective health care liability reforms.”
Perhaps the biggest untruth of all. Putting aside the subjectiveness of the term “reasonable”, these are neither comprehensive nor have they proven to be effective at anything other than regulating insurer’s losses.
With all the evidence out there leading to, at the very best, inconclusive results, you have to ask – is Charles deliberately being dishonest, or is he simply willing to believe anything and everything he is told, so long as he thinks it will save him a few dollars on premiums?
Anonymous
Facts and critical thinking about a proposal are not required for lobbying.
And Samson, they aren’t proposing no fault. They just think health courts will somehow increase the 75% win rate they already have in regular courts. Where the cost savings are supposed to come from I have no idea.
CJD
Anonymous
” is Charles deliberately being dishonest, or is he simply willing to believe anything and everything he is told, so long as he thinks it will save him a few dollars on premiums?”
No, from reading his Blog, his ass is red from being sued by one of you sodomites, and if you read surveys of physicians, this puts him at much higher risk of Suicide and severe depression, not that you sodmites care, since as you often say at trial, “it’s nothing personal”.
Anonymous
That’s all well and good, but what does it have to do with any of his claims?
Oh yeah, nothing.
But I would agree that you’re suffering from serious depression.
Anirban
Where the cost savings are supposed to come from I have no idea.
Look in the mirror
Anonymous
Anirban,
Do you think that if you have health courts there won’t be lawyers? That plaintiffs will be able to present their own cases?
You do realize that the bulk of most awards go back into the medical industry, don’t you? They reimburse health insurers, they go to providers for past and future care.
Have you thought about this stuff at all? It appears you have not. You’ve got lots of what I think you believe are simple answers, but they don’t reflect an understanding of the situation.
Samson Isberg
Mr/Ms. Anonymous, tha nk you, you’ve made my point. The lawyers will not be held at bay if these Health Courts are introduced. We believed we would get them out of the whole med-mal concept back in the ’70s when we introduced our no-fault compensation concept, but they have crawled back and are now ruining the whole system.
On the other hand, like I have said before, there actually are some doctors out there that shouldn’t be practicing. And as long as bunglers, psychopaths and demented morons can use the “MD” title just as freely as I can, our profession is at risk. If we as doctors had managed to police our own, there would have been less need for others to do so.
Anonymous
It’s not simply police your own, Samson – you have to find a way to compensate not just for bad physicians, but for good physicians whose actions at times fall below the standard of care and harm results. At least, if you’re not going to have universal health care.
CJD
Samson Isberg
CJD; Your words make sense, at least as they were written they reflect the ideals that made us over here set up the no-fault compensation institution so many years ago; all hospitals chip in with a (huge) premium, a neutral institution pays out, whether it is a bad doctor screwing up or a good doctor having an unforseeable bad outcome. If it is a rotten doctor the Board of Health takes his licence, if it is a good doctor being unfortunate the government pays the tab.
But over here at least, this system has been corrupted and no longer functions the way it is supposed to do. I was in court two weeks ago as an “expert witness” in an OB case, and believe me, what I witnessed was pervertion of justice indeed. None of the lawyers knew what they should ask me, and I was not allowed to volunteer any information. The sordid mess ended up with the baby in question getting nothing. My opinion was that she should have been compensated to the tunes of several millions, but I was prohibited from saying so by the rules of the courtroom. All the lawyers wanted me to say was that her OB was an asshole, which I couldn’t say, because he wasn’t, he was just unlucky.
Anonymous
You make the argument for the adversarial system, wherein each side puts on its best case.
And I would quibble with you on one point: “a good doctor having an unforseeable bad outcome.” This does not equate to negligence in our system.
CJD
Anonymous
The problem with the malpractice system is that its not decided based on science like it should be.
Instead, lawyers poison the juries mind by bringing in a little boy in a wheelchair and playing up sympathy votes adn other extraneous BS that has NOTHING to do with determining whether malpractice occurred.
Juries are incapable of deciding complex medical malpractice cases. They dont understand medicine, they dont undertsand science, which means they are incapable and incompetent judges of whether malpractice occurred.
Thats why we need a special expert system, composed of people who KNOW SCIENCE AND MEDICINE. Thats what should be deciding these cases, not whether little johnny looks so sad in his little wheelchair.
You dont even need a special health court to address this. A prescreening panel composed of doctors and scientists would be good enough. They decide whether the science/medicine bakcs up the plaintiff’s claim, and if so, then it proceeds to a regular jury. The panel’s compensation is the same REGARDLESS of who they find for, they are not allowed to have ties to any lawyers groups on either the defense or plaintiffs side.
Expert fees are ridiculous and should be banned. “Experts” get paid to lie in court, many times more than what they would make in clinical medicine.
Anonymous
Anonymous,
You appear to be another one who has no facts to back up his claims. Considering juries find against little Johnny 75% of the time, clearly your opinions on their intelligence levels are not well researched. In fact, it is you who appears to have reached the emotional conclusion.
CJD
Samson Isberg
And that is the point, right? The operative word here is unforseeable.
I have been in an auto accident three times in my life. Each time I have been able to tell myself “If I hadn’t…” “If only I had”… or “I can’t believe I did that…”
And to be honest with you, as you have no way of identifying me, the same sentences go through my head concerning the babies I have delivered that could have grown up to be happy children if I had chosen a different solution then and there. But what seems forseeable in retrospect, even after several cognacs, obviously didn’t seem forseeable to me then and there while I was in the situation.
In those cases, it is a comfort to me that they will get compensated economically – although I know every one of them would rather be well than rich.
It is also a comfort to me that the government is paying, so that I will be able to go on working, learning from my mistakes and hopefully be a better professional from it.
Thats the way our (Scandinavian) system is supposed to work, and sometimes it does. But there are too many instances where it doesn’t, and regrettable, mor often than not, there is a psychopath at the core of it, be it a doctor or a lawyer.
Anonymous
Your complaints also strike me as typical of massive bureacracies designed to do anything, particularly govt. ones.
CJD
Samson Isberg
That’s just about the size of it, CJD
Anonymous
Silly me I thought Doctors should have a jury of their Peers not the local idiot too stupid to get out of jury duty.
Anonymous
You’re not angry, you’re psychotic.
Anonymous
No, I think this person is overwhelmed and frustrated and burned out. I would be too. It isn’t just the ligitation environment; it’s *everything.*
For his sake, though, I hope he takes a few days off soon, or finds a constructive way to channel his anger. When people are angry and overwhelmed, the risk goes up that they will make unintentional errors. They’re also more likely to alienate patients, which could come back to haunt them if something does go wrong.
Anonymous
Anon 4:25 I feel your pain. I used to work in an inner city hospital ER. I was too tired and too busy to look at other ERs. One day I was able to find time and it’s a lot better at this ER where people have jobs and insurance and the plastic surgeon is willing to come in anytime.
Anonymous
I am a visitor to this forum and I want to point out that medical malpractice lawyers only pay a fee for a Google click through if you click on the sponsored link to the right. They bid on a certain search keyword and pay a per click fee depending on the phrase. A popular phrase such as “malpractice lawyer” can go anywhere from $30 to $90 per click.
Click away!!
Anonymous
No, I think this person is overwhelmed and frustrated and burned out. I would be too. It isn’t just the ligitation environment; it’s *everything.*”
Yes, publicly expressing a desire to cut people up is clearly just a sign of burnout. That’s what they diagnosed Dahmer with, wasn’t it? Burnout?
Anonymous
“”a good doctor having an unforseeable bad outcome.” This does not equate to negligence in our system.”
Unfortunately, CJD, that’s exactly what happens all too often in our system of so-called justice.
Anonymous
“Unfortunately, CJD, that’s exactly what happens all too often in our system of so-called justice.”
Really, how often? What percentage of time does that happen?
Anonymous
Why do you MDs think that you are so special? The rest of us “professionals” learned a long time ago that the lawyers are in control and that will never change. Stop your whining. If you don’t like being unappreciated and disrespected cogs in the machine whose actions and opinions can and will be second-guessed and ridiculed by those who know little or nothing of medicine, then get out of the business. You can and will be replaced by “outsourced” third-worlders.
Anonymous
“Really, how often? What percentage of time does that happen?”
For me 2/2 = 100%. But no, I won’t spill the gutty details to you.
“You can and will be replaced by “outsourced” third-worlders.”
You are welcome to go to another country for your healthcare. Who will you sue if you don’t like your outcome? Or you can see some dude here that you can’t understand. You deserve it. Won’t break my heart.
Anonymous
The ordinary (non-MD) citizens of this country would be a lot better off with more “outsourced third-worlders”. We would have access to safe and effective natural herbal remedies and would have less exposure to unsafe and ineffective scams like “vaccination/imunization”.
Perhaps you think that people are happy with vaccine-induced autism, necrotic jawbones, and drug-induced heart attacks. I, for one, hope that the med-mal attorneys clean up the practice of medicine in this country so that we can move beyond the thoroughly discredited allopathic model.
Anonymous
“I, for one, hope that the med-mal attorneys clean up the practice of medicine in this country so that we can move beyond the thoroughly discredited allopathic model.”
Yes, God Bless the Lawyers. No Wonder the Third World is still the 3rd World. And While we’re at it, Way to Go Nambla. Little Boys deserve sex partners. And every night before I go to sleep I thank the Lord for HIV and AIDS. Way to get rid of those underlings, and if the disease doesn’t get ‘em, the naturopaths will.
NoAcuteDistress
Found a thyroid mass on exam a few days ago in patient in for an unrelated complaint. Sent him for ultrasound which delineated the problem better. Referred him to Endocrinologist for further eval and treatment. He turns to me and says, “If this turns out to be a cancer, I’m coming after you.” Yes, he is a trial attorney.
Anonymous
“Found a thyroid mass on exam a few days ago in patient in for an unrelated complaint.”
You may have committed malpractice. You should have sent him to the ER, “in case” the mass was an infective process. In the neck it could lead to an impending airway disaster, ie Ludwigs Angina. As a trial attorney, I would have admitted him, gotten a CT of the neck with IV contrast, and put him on 1:1 observation in an ICU with a Tracheostomy tray at his bedside. I would also have him started him on Broad Spectrum IV Antibiotics, “just in case”.
Anonymous
“Yes, he is a trial attorney.”
What made you to treat him anyway.Once his shady profession is revealed, gently show him the door,but don’t accept him as patient beforehand.Or you can tell him you are not a vet and face a defamation lawsuit.
Dr. Charles
I didn’t even read this thread of comments, since I’ve read them all before and know by heart the cyclical arguments. Anytime there’s a malpractice opinion on one of our medblogs a cloud of several trial lawyer-types encircles it like a swarm of bees. I can’t read them anymore, so all i have to say is this – the tort system is a cruel joke, an inflammatory display of hyperbole
and distortion. Time after time it displays it’s own injustices.
Anonymous
Dr. Charles heads to the classic retort of someone who forms an opinion without any facts and is then confronted with facts. Attack the messenger. Good stuff.
Don’t let the truth get in the way of your hyperbole doc, but if you decide to engage in an honest debate, or give your readers an honest and informed opinion, try just a few facts.
Start small – try backing up your claim that health courts will save patients money. Or, give us a good reason why we should value a lifetime of pain and suffering at what you make in less than two years.
Or should we just believe everything you say about “the tort system” because you’re a doctor?
Anonymous
Actually, you really can’t blame Charles. He’s a good kid. He’s just suffering from an affliction that is prevalent in American political discourse these days: If you repeat something over and over, regardless of truth, eventually it becomes true! And all your followers repeat it as gospel.
It’s all the rage in DC these days. Apparently even physicians are susceptible.
Anonymous
I’m the commander — see, I don’t need to explain — I do not need to explain why I say things. – George Bush
Anonymous
What a vicious group you are. Dr. Charles posted something on his site that he believes in. If you believe something different then “good for you”…But, to attack someone for their beliefs is childlike. Besides he has one of the most popular BLOGs online. Are you jealous?
Anonymous
No one is attacking Dr. Charles for his beliefs. We’re asking for some factual basis for his beliefs. After all, he is asking us to act on those beliefs to the extent they become law. Rather than give some factual basis, he attacks those who dare to question him.
Considering the effect his uninformed beliefs, were they to become law, would have on those most seriously injured by medical malpractice, perhaps he should be attacked though.
Anonymous
If anyone is attacking, it appears to be Saint Charles, when he says this: “the tort system is a cruel joke, an inflammatory display of hyperbole and distortion.”
That’s quite a statement indicting hundreds of thousands of plaintiffs and their attorneys across the country who are litigating everything from fraud in the formation of contracts to legal malpractice and who receive justice daily in our courts. From a guy whose contact with the system consists of what, maybe a couple of trials? And reading some physician blogs and talking to other docs about cases he knows little about?
Yes, clearly the good doctor deserves protection for his delicate beliefs.
Anonymous
And have the attackers given any factual support for their belief’s nooooooo.
Anonymous
Which beliefs? Be glad to provide whatever you need.
Anonymous
“Considering the effect his uninformed beliefs, were they to become law, would have on those most seriously injured by medical malpractice”
Where’s your proof that “those most seriously injured by medical malpractice” are at all helped by the current lottery system, or would be in any way hurt by health courts. You accuse others are fact-less comments, but you provide no evidence for your comebacks.
Where do you get off saying that physicians have no expertise in medical malpractice litigation. You lawyers have no expertise in medicine, yet you have no problem litigating it and trying to sound like experts about medicine in front of Juries every day. If we’re not legal experts, there’s no way in Hell you are medical experts. And don’t even think of bringing up the $500/hr. “hired gun” retired pathologist you bring in as an “expert witness” in a Neurosurgery case.
Anonymous
“Where’s your proof that “those most seriously injured by medical malpractice” are at all helped by the current lottery system, or would be in any way hurt by health courts.”
Non-economic damages, ie. pain and suffering damages, in excess of $250,000 will almost certainly be long term debilitating injuries. Juries don’t award noneconomic damages (which are different from punitives, by the way) on cases where you’re healed and fine 6 weeks later. Google any large med mal award with high noneconomics and you’ll find a very painful injury 99% of the time.
On this issue though, here’s a question for you. Considering that any case where the proposed cap would kick in likely involves millions in past and future medical bills, as well as lost wages, and probably long term care, how will capping noneconomics save you, the consumer, a dollar? If it doesn’t, what have you gained?
“You lawyers have no expertise in medicine, yet you have no problem litigating it and trying to sound like experts about medicine in front of Juries every day.”
Utterly false. In fact, the law acknowledges we don’t know anything about medicine, and requires expert testimony. Lawyers may make arguments based upon that testimony, but they cannot present facts on the issues.
And many lawyers do have a problem litigating it. The number of med mal plaintiff’s lawyers and defense lawyers is rather limited due to the complexity of those cases.
“And don’t even think of bringing up the $500/hr. “hired gun” retired pathologist you bring in as an “expert witness” in a Neurosurgery case. “
I will bring it up. It’s a requirement that physicians initially insisted on and so we have no choice. The defense has experts as well – do you think they work for free? I’m unfamiliar with the case you’re referring to re: the pathologist – do you have a cite? Or are you repeating stories of cases you’re not really familiar with?
Anonymous
It was used as an example of the ridiculous system is this country, you greedy sodomite. Though I have a colleague who was sued for sending home a 35 year old woman with chest pain with a normal EKG and normal exam from the ER and a retired cardiologist testified for the plaintiff that the “standard of care” in ER’s is to admit all 35 year olds with chest pain and no risk factors. Like he would have any idea.
Anonymous
Your day in the life, unconfirmable stories are really sweet.
Hey, I heard about a doctor who was high when he was operating and left a woman paralyzed because he was so strung out.
Does that make us even?
Anonymous
Poor sweet Doc Charles. What a nice guy. Too bad he gets so easily misled.

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