Kevin, M.D. - Medical Weblog

Since California has had draconian caps for years, what's your point Kevin? Why are California doctors still doing all this "defensive medicine"? Why isn't healthcare significantly cheaper in California Kevin?

Tells it like it is? If you're a lobbyist for an insurance company, that's probably exactly how you feel it is.

Doctors continue to lack even the basics of risk assessment. Sad, really, for a group so intelligent otherwise.
 

The point, as I'm certain you are aware, is that a flood of lawsuits (non-economic damge capped or not)and the unnecessary tests they force greatly increase the cost of medicine. Unsurprisingly, you didn't adress that but went veering off in your own direction. Capped or not, lawsuits are intrusive, offensive, coercive, expensive and extremely time consuming. Even the best tort reform measures don't change those things. And those things are enough to keep doctors doing more tests than are necessary to avoid the things I just mentioned.

I'm not a lobbyist for an insurance company. The article does tell it exactly how it is. Are you financially disengaged from the topic? Thought not.

Lawyers continue to lack even the basics of honesty and integrity. Sad, really, for a group so intelligent otherwise.
 

Matthew,

When you start out with an assumption like your first sentence, any manner of nonsense can flow from there, and in your case, does.

"Capped or not, lawsuits are intrusive, offensive, coercive, expensive and extremely time consuming."

Obviously. No one wants to be involved in a lawsuit, from either side. There are more efficient ways to resolve disputes, and most disputes are resolved prior to that stage. However, some aren't, and there are some advantages to filing a lawsuit - for example, establishing priority of claims in a bankruptcy situation.

However, if, as you and the physicians here claim, lawsuits are more prevalent than ever, it's obvious defensive medicine (the must unquantifiable claim ever) isn't very effective.

The article tells it how it is in that person's opinion. No more, no less. That person may have no idea about their risk and how or if it's lowered as a result of defensive medicine. It's obvious you have no idea, nor do many physicians here.

The fact that you would run down the ethics of everyone in a particular profession because of political disagreements speaks lower of you than those you criticize. Particularly when only a fool doesn't use a lawyer at some point in their lives.
 

No one wants to be involved in a lawsuit... There are more efficient ways to resolve disputes, and most disputes are resolved prior to that stage.

Really? Please provide some concrete examples of medical malpractice claims that were resolved without a lawsuit. To date, every malpractice claim I have heard of, the physician became aware of it when he/she was served.
 

Anon,

You missed the point of the last paragraph. It was meant to show the absurdity of the first poster's last paragraph, nothing more. I'm sorry it went over your head. I obviously don't mean that every single lawyer lacks integrity and honestly, only that the sort of shot that the first anon poster took at doctors (you? not sure) was ridiculous. I'll put a sarcasm disclaimer up next time to avoid the same misunderstanding.

The comment I made about how intrusive lawsuits are was meant to(and was effective at) rebutting the silly notion that caps on runaway juries would have an effect on defensive medicine. The erroneous assumption in that line of thinking is that once there are caps, lawsuits are no longer a big deal and doctors no longer have anything to worry about. That's false on its face, and undermines the entire "substance" of the first post.

If no one wanted to be involved in a lawsuit from either side, my friend, we wouldn't have lawsuits. No one makes anyone attempt to coerce payment from another party. It's all voluntary on the part of the plaintiff.

I'm sorry you had a hard time following and interpreting my post. I'll try to be more clear in the future.
 

"Really? Please provide some concrete examples of medical malpractice claims that were resolved without a lawsuit. To date, every malpractice claim I have heard of, the physician became aware of it when he/she was served."

Many, many malpractice claims are concluded pre-suit. If the insurer doesn't tell the physician, that's not the plaintiff's fault.
 

"only that the sort of shot that the first anon poster took at doctors (you? not sure) was ridiculous."

What shot are you referring to? Doctors do lack any risk assessment skills when it comes to this issue.

"The comment I made about how intrusive lawsuits are was meant to(and was effective at) rebutting the silly notion that caps on runaway juries would have an effect on defensive medicine."

Again with the assumptions. It's like it is physically impossible for you to make an argument based on facts. Please, tell us how many juries are "runaway" and how you define that term?

"If no one wanted to be involved in a lawsuit from either side, my friend, we wouldn't have lawsuits."

Nonsense. Many businesses don't WANT to file suit, but they have no choice to collect sums owing them. Many personal injury plaintiffs would much rather have another way to pay their bills, but they have no choice. A lawsuit is a tough way to go for BOTH sides, but often, there is no other avenue for redress.

I guess you can say it's "voluntary" on the part of the malpractice plaintiff in the sense that they could choose not to have enough money to pay their mortgage, medical bills, etc. But that's a pretty silly definition of "voluntary". You could just as easily say it's "voluntary" on the part of the defendant doctor to have the lawsuit go through rather than pay what is demanded pre-suit.

Please, in the future, do try and bring some hard facts, not just solely assumptions (and with defensive medicine, the whole thing is an assumption).
 

Many, many malpractice claims are concluded pre-suit. If the insurer doesn't tell the physician, that's not the plaintiff's fault.

also:

You could just as easily say it's "voluntary" on the part of the defendant doctor to have the lawsuit go through rather than pay what is demanded pre-suit.


No. What you mean to say is that many claims are concluded pre-trial. The suit has already been filed.

If I am incorrect, please provide me with some concrete examples, or at least the mechanism by which such a claim can be made, and settled without involving the court clerk. In every instance that I am aware of, it is the physician who notifies the insurer, not the other way around.
 

Rich,

You are talking to CJD. He hasn't answered those questions in an entire year that I have read his blather. You would think that as a lawyer he would have know something about how doctors get notified about a suit, but he apparently doesn't. He will twist your words and then dive off topic.
 

"If I am incorrect, please provide me with some concrete examples, or at least the mechanism by which such a claim can be made, and settled without involving the court clerk. In every instance that I am aware of, it is the physician who notifies the insurer, not the other way around. "

Well, it's difficult to give concrete examples because you can't go look them up because the exchange of money and the release agreement typically involve a confidentiality clause.

But, were someone to come to a lawyer with a case, the lawyer, after doing his initial medical records request and having an expert review, if he has a request may send the physician a letter telling him that he has a client who he believes has a claim and would he please have his insurance adjuster contact the lawyer. If it can be settled prior to filing the claim, it will be.

The reason it's not as common in med mal as in other types of claims is the shorter (as compared to most other torts) statute of limitations and the time required to retain expert witnesses and have them review the case. But it happens all the time, and I've worked for firms that have done it. But again, I can't cite you to cases because they aren't public record. But I'm sure your liability carrier can tell you they've settled cases pre-filing.
 

More unproveable anecdote.
 

"But I'm sure your liability carrier can tell you they've settled cases pre-filing."

No, doesn't happen. If you think you have a case a lawsuit is filed. Notice is sent to the doctor. Then the doctor notifies the insurance company. I know this because I am a board member of our insurance company.

Last week everyone in my ER physician group got a certified letter notice of a lawsuit that basically said "One of you treated my client, we don't know who so we have to name you all in the suit. We don't actually know what you did and what the nature of the malpractice charge is but you were grossly negligent"

C'mon, at least do a little homework before you start throwing the sh** against the wall.
 

"No, doesn't happen. If you think you have a case a lawsuit is filed. Notice is sent to the doctor. Then the doctor notifies the insurance company. I know this because I am a board member of our insurance company."

Actually, it does, because I've done it. They were small (under $50K) claims, but I have done it and know many who have. Obviously, privilege and confidentiality agreements prevent me from naming the paying party, as I'm sure you're aware.

Why don't you scan and post a link to that letter? That's not privileged.
 

"Why don't you scan and post a link to that letter? That's not privileged"

Yes, I should have kept it for comic illustrative purposes. Once I took two seconds to find that it was not my patient and that one in the group already gave out ins. co. notice it was given the circular file.

I don't doubt that you have settled a case presuit, however I myself and my partners have been sued more times than we wish and this has never happened. The first notice of a problem is the lawsuit.
 

What about the records request from the lawyer? Maybe your insurer just has a reputation for not settling?
 

I have a similar summons, which names several physicians, as well as Doctors and Nurses John Doe 1-10 and Jane Doe 1-10. It claims that each defendant provided medical care below the standard of care.

Paragraph 10 reads:
Each of the defendants deviated from accepted standards of medical and/or nursing practice in their care, diagnosis and treatment of [the patient] which deviations proximately caused plaintiffs' injuries.

That's a lot of people who are practicing substandard care. I am certain that none of them were notified pre-suit.
 

"What about the records request from the lawyer?"

Yes, I can see that this might happen in other practice settings. As an ER doc I don't keep my own medical records, the hospital does. Someone wanting medical records would be directed to the hospital medical records departments. Even though I work in the hospital setting, I am not an empoyee of the hospital.

A guess a lawyer could still contact us and say "Lets talk" before filing a lawsuit. However, I have never heard of it in 15 or so years of practice, nor have I heard that from any of the 100 or so physician partners there are. First notice is a bullshit letter, I guess just hoping that we will be scared and open our pockets. I doubt they have even talked with an expert witness because they are so meritless.

"Maybe your insurer just has a reputation for not settling?"

Yes, less than 5% of all claims result ina payment.
 

"First notice is a bullshit letter, I guess just hoping that we will be scared and open our pockets. I doubt they have even talked with an expert witness because they are so meritless."

The letter is probably designed to let you know it's coming so you can notify your carrier. Whenever I sign someone up for a personal injury case of any kind, I let the other party know I'm representing the plaintiff and ask them to have their insurance adjuster contact me.

"Yes, less than 5% of all claims result ina payment. "

Well then, you don't have to wonder why you don't get a presuit demand.
 

Well then, you don't have to wonder why you don't get a presuit demand.

Fantastic example of circular reasoning!