Really? I would have thought they were independent contractors, and thus, not liable for the acts of the physicians.

This sometimes comes up when I am consenting patients for surgery. They request that no residents touch them. My response, which has always worked, is that my surgical assistant will either be a surgical resident (who typically graduated top of their college class, graduated from medical school, and has some surgical skills already) or a surgical technician (who typically only has a high school degree). They always have opted for the resident…

No “patient advocate” is going to change that. If I were confronted by an unreasonably demanding patient, advocate or not, I would tell them to take their business elsewhere. One troublesome patient just isn’t worth the headache, and they could take their “advocate” with them.

In this instance, the State of Ohio is giving teaching physicians the same coverage in teaching settings in university hospitals that the same doctors receive from the Federal government when they are teaching at a VA hospital, which many academic doctors also do. This is hardly a sweeping liability reform, nor does it prevent the filing of claims. What it does do is remove from the academic institutions the costly burden of insurance–now usually done by a self-insured trust in most places with an umbrella policy–and placing that insurance burden on the state. I think that is fair. Teaching hospitals have usually accepted all referrals regardless of ability to pay, and eat a large share of undercompensated Medicaid and uncompensated uninsured and uncollectable work. They usually take desperate and high-risk patients that many private doctors would not take. Their insurance costs are high, and as a result, the ability to properly pay staff is affected by the insurance burden. This measure properly places some of that burden of liability back onto the community that substantially benefits from the availability of expensive large academic medical institutions that have the mission to refuse no one.

If this is an accurate legal interpretation of the “bottom line” then patients need to demand a priori that there are no students present at the time that any procedure is being performed. Perhaps they should take it as far as brining in their own “patient advocate” to help prevent the situation in which their provider lies to them about the presence of students during the course of conduction of a procedure (one would hope that most patients have finally gotten a clue and realized that their physician is only a patient advocate when the advocacy for the patient serves the physician first and foremost).

Once everyone quits blowng smoke over this the simple reality will become clear. Patients and lawyers still have a deep pocket to sue. Docs are thrown a bone to continue to work at below market incomes at academic centers. And patients who value the ability to directly sue their physicians will know to seek care elsewhere.

Many are closing up shop early.

No fear from me, just fighting back against the frivolous torts seems to be striking fear into you. I guess you’ll have to downgrade from your S500 to an E320. We all pity you guys.

I mean it is great if you happen to have an academic attachment to the state system in Ohio, but this pathological aversion to malpractice suits in general ignores the fact that negligence torts fulfill an important social function. If the system is defective in implementation the solution is to improve the system, not simply remove doctors from it entirely.

He said there are cases when the body responds in an unpredictable fashion to modern medicine … You say, “well if medicine usually does no good then why should we pay you more…”

Do you see how this might leave people joining this thread very confused…