Lawyers win again, patients lose

August 14, 2007

Illinois has found another way to victimize physicians:

Kate McDonough, spokesperson for the Illinois College of Emergency Physicians, said the new amended legislation allows a jury in a civil trial to award damages for grief, sorrow and mental suffering. The original legislation prohibited jurors in a civil trial from considering those three factors, she said.

McDonough said the new bill also deleted language limiting the amount of damages that could be awarded.

I can’t really say that doctors really lose here - they can simply move to a malpractice-friendly state like Texas and continue working. The patients however, are left with a lack of physician access, making them the ultimate losers in this scenario.

Update:
Happyman puts it even more bluntly in the comments below. The runaway tort system really hurts patients more, not doctors:

And it’s much more of a problem for PATIENTS than doctors- we will always have a relatively high-paying job, but if you are in a car wreck & need a craniotomy, blame your local trial lawyers for ending up a vegetable, as threatening or suing your local ER for not getting a neurosurgeon in time isn’t gonna save your neurons.





  Follow on Twitter   Subscribe



{ 39 comments… read them below or add one }

1 Anonymous August 14, 2007 at 2:11 pm

What did doctors lose? How much would their premiums have gone down if these specific provisions had passed?

What did the patients lose? Were there physicians who had their bags packed if this didn’t pass?

2 Anonymous August 14, 2007 at 2:26 pm

Reading that article caused me to feel grief, sorrow and mental suffering. Can I sue the State of Illinois?

The Illinois legislature - the best money can buy!

3 Anonymous August 14, 2007 at 2:38 pm

National traitors abandoning existing patients in order to do no harm (haram) to their pocketbooks. Who knows. One day, the doe eyed plebeians might actually get a clue and remove the provider class from their perfidious perch of power and open up the healthcare system to obtain access.

4 Anonymous August 14, 2007 at 3:08 pm

The provider class… what the hell are you talking about?

And then after we take out the provider class which I guess is made of MD, DO, NP, PA, OD, podiatrists, DDS, etc. then we can go after the lawyer class, engineer class, liberal arts class, etc. until we have filled every position with someone else who will do it for cheaper. Yaaaa!!! Now I sound crazy too!

5 Anonymous August 14, 2007 at 3:52 pm

to anon 238

Counselor, I think you need a vacation. Thats the problem with being on the doc side of this epic docs vs lawyers battle. The lawyers are farking crazy- and a crazy enemy is a dangerous enemy.

6 Anonymous August 14, 2007 at 4:00 pm

Yeah, doctors are really sane. If arrogance=sanity.

7 Anonymous August 14, 2007 at 4:01 pm

Anon 3:08

The provider class is primarily the MDs (a few DOs). The PAs and NPs are still being strangled by their umbilical cords. BTW, if you want to “sound crazy” in a manner akin to that of Howard Jihadeen then the proper yell would be one of “yeeeeeeeeaaaaaaaaaargh.”

8 Anonymous August 14, 2007 at 4:58 pm

Kevin,

How does it “victimize” physicians to have to pay for damages caused as a result of their negligence?

The only victims would appear to be the patient injured as a result of that negligence and their loved ones.

9 Anonymous August 14, 2007 at 5:06 pm

Kevin,I amconfused.You blog against malprctice abuse,yet I see ads for malpractice lawyers on your site. Isn’t this a little hypocritical.

10 Anonymous August 14, 2007 at 6:18 pm

some lawyers have to defend doctors. Also there are a lot of anti medicine people who come on this board so maybe they are trying to appeal to them.

11 Anonymous August 14, 2007 at 6:33 pm

I wouldn’t put it in terms of ‘victimizing’ physicians, but it does put them in an untenable situation of being liable for unlimited damages which are in no way objectively quantifiable or predictable–which in practical terms means that they can not be insured against.

While these factors are real injuries in that they are real aspects of suffering, as a practical matter, it means that the practice of medicine means everyday taking a chance on being held liable for doing injury to someone for sums greater than one can ever earn, save, or buy insurance against.

The reality is that they way juries tally the economic value of injuries is simply economically unrealistic for the provision of health care. It is not a matter of how often physicians are ruined by the large verdicts beyond what they can insure for, but the fear that even the occasional such verdict creates. At some point the fear of the potential of such a verdict reaches a point where taking the risk no longer seems reasonable. Then what happens? Practice dwindles more and more to institutional physicians (dangerous neighborhoods encourage gang formation), the already destitute judgment proof, a handful of martyrs, and pigs trying to get rich in a few years before fleeing the country and any judgments with their stash. What is lost is the opportunity for physicians to practice for 30 years, charging reasonable fees with reasonable earnings securing a certain economic security in the bargin of serving his community. For him, the anxiety that he can lose it all in a moment at the whim of a jury becomes too great.

We all lose something in the bargin, because that is precisely the kind of physician all of us want. If we want healthcare at a reasoable cost that is actually available, we will all have to accept some limitation on the subjective component of medical injuries as the price for that availability, while till holding physicians accountable for economic damages of malpractice. I think it a reasonable compromise.

12 Anonymous August 14, 2007 at 8:05 pm

Well, if we have to accept a limitation on a physicians damages for his errors, simply because of physicians’ unreasonable fears, then what are you guaranteeing the patients in return?

Are you agreeing that we all get a specialist of every sort within a half-hour drive? Are you agreeing that all our healthcare bills will be discounted by 5%?

What are you promising the patients in exchange for your insurance company making more money and your irrational fears calmed?

13 Happyman August 14, 2007 at 9:34 pm

anon 8:05 - what should be guaranteed to patients is providing the standard of care for a reasonable fee, without the fear of losing your personal assets & with some shred of gratitude for my years of hard work, training, and caring - isn’t that reasonable?

it doesn’t matter what my insurer makes, or whether my fears are unfounded - if there is a lack of access, then there IS a problem.

And it’s much more of a problem for PATIENTS than doctors- we will always have a relatively high-paying job, but if you are in a car wreck & need a craniotomy, blame your local trial lawyers for ending up a vegetable, as threatening or suing your local ER for not getting a neurosurgeon in time isn’t gonna save you neurons.

This isn’t about class at all, & isn’t about “us” vs. “them” - it’s about an unwritten social contract that patients & doctors treat each other well & with the respect & empathy that both deserve.

14 Anonymous August 14, 2007 at 10:10 pm

“what should be guaranteed to patients is providing the standard of care for a reasonable fee, without the fear of losing your personal assets & with some shred of gratitude for my years of hard work, training, and caring - isn’t that reasonable?”

Why should that be guaranteed? Do you offer that to the trucker who works all their life driving groceries to your local store? If he runs over your child accidentally, but negligently, leaving that child a vegetable, is it unreasonable that he should have to pay for that, even if the care runs into the tens of millions of dollars?

15 Anonymous August 14, 2007 at 10:14 pm

“it doesn’t matter what my insurer makes, or whether my fears are unfounded - if there is a lack of access, then there IS a problem. “

Why? Physicians, including Kevin, have told us over and over that healthcare is NOT a right, and you shouldn’t have to care for people if you’re not compensated for it.

But now you’re arguing that everyone anywhere should have access to specialists? How does that square?

And if that’s what you’re arguing, what type of access are you GUARANTEEING us in exchange for having your liability capped? How many neurosurgeons is the medical community going to put into rural Mississippi in exchange for this protection? Or do we just have to take your word for it that you will?

You’re asking for something for nothing.

As for the unwritten social contract, that applies to every relationship, not just physicians and patients. I believe the receptionist at your insurance agent’s office deserves as much empathy and respect as you do.

That unwritten contract doesn’t mean you shouldn’t be responsible for the damage you cause though.

16 Anonymous August 14, 2007 at 10:16 pm

Kevin, you refer to the “runaway” tort system. What evidence do you have that it’s “runaway”? Or is it like the “runaway” physicians pay that you bristle about?

I realize you’re a lobbyist on this issue, but surely you can put more substance behind your claims than the buzzwords your liability carrier hands you. You’re no different than the single payer advocates who trade on perceived physicians’ wealth to stir up the masses.

17 Anonymous August 14, 2007 at 11:40 pm

“…some shred of gratitude for my years of hard work, training, and caring…”

Bwahahahahaha. The arrogance of the allopaths. You deserve nothing less and nothing more than any other bloke that gets sued. Should an innocent third party in a PI suit (along with medical prostitute acting as purported “patient advocate”) get some special treatment for their years of hard work, training and caring?

The types of special privileges that the provider class tries to carve out for itself is just breathtaking. The greatest threat to democracy, equality and the American way comes not from without but comes from within.

18 Anonymous August 15, 2007 at 7:16 am

Who let the marxist in? The talk of a “provider class” is quite amusing. Yes, in case you didn’t realize it, there are actually different classes in our society! Some groups of people have more skills/education/wealth than others - imagine that!. Labeling health care providers as an elite society for the purpose of engaging in classism won’t work counselor. I hope you don’t use that lame argument in the courtroom. Americans will always reward knowledge with prestige. Perhaps you should move to Cuba or North Korea, where you don’t have to worry about “provider class” oppression.

19 Anonymous August 15, 2007 at 11:18 am

And one hopes that the practice of the art of medicine is based upon more than the incorrect speculation used in your post (no counselor here). It took a bit of time and in a round about way you have agreed that the provider class is well protected by the plebeians in the courtroom. Ergo, we need not have any pro-provider only legal benefits.

20 Anonymous August 15, 2007 at 2:45 pm

Sorry for assuming you were a lawyer. I actually have respect for lawyers. I now know you are just some loser trolling about. You can go back to flipping burgers now.

21 Happyman August 15, 2007 at 3:25 pm

some responses to idiotic statements:

1-”If he runs over your child accidentally, but negligently, leaving that child a vegetable, is it unreasonable that he should have to pay for that, even if the care runs into the tens of millions of dollars?
” YES THAT IS UNREASONABLE. The effect will be (since no truck driver can afford tens of millions on the off-chance he accidentally kills a kid) that there aren’t enough truck drivers & therefore no groceries delivered. is that what you want?

2. “I believe the receptionist at your insurance agent’s office deserves as much empathy and respect as you do. ” THEN I’M GLAD YOU AREN’T YOUR PATIENT - call me arrogant (or, yikes, “classist”) but i believe my years of training & hard work merit more respect from you than that of your insurance agent’s secretary.

3.”But now you’re arguing that everyone anywhere should have access to specialists…what type of access are you GUARANTEEING us in exchange for having your liability capped?” I ARGUED NO SUCH THING - IT’S IMPOSSIBLE TO “GUARANTEE” ACCESS TO SPECIALISTS. I am merely pointing out what most do not realize - that neurosurgeons & OB/gyns don’t grow on trees, and don’t have a legal (or even perhaps moral) obligation to provide care to anyone. That means we ALL lose out, in case we need them unexpectedly (see response to point #1)

22 Anonymous August 15, 2007 at 4:39 pm

Flipping burgers? Is that really the best that you have oh scrubber of public latrines? I know it must be tough when your sacred cows get trampled, but in the long run, leaving fallacious fantasies of the provider class as anything other than oligopolists that have cornered the healthcare market through unfair practices is best left for the romper room.

23 Anonymous August 15, 2007 at 5:25 pm

1″YES THAT IS UNREASONABLE. The effect will be (since no truck driver can afford tens of millions on the off-chance he accidentally kills a kid) that there aren’t enough truck drivers & therefore no groceries delivered. is that what you want?”

Well, truck drivers don’t have liability caps, and they have run over people and had verdicts in the millions, and we still have truck drivers. It seems the facts are disproving your claims. Just as the facts have disproved the whole “lack of access” cry that physicians have been trying to use.

But let’s say you’re right. Who gets what dollar cap? And what happens with all those bills that formerly would have been paid by the responsible party? Taxpayer pick them up?

2. THEN I’M GLAD YOU AREN’T YOUR PATIENT - call me arrogant (or, yikes, “classist”) but i believe my years of training & hard work merit more respect from you than that of your insurance agent’s secretary.

Respect for your knowledge, certainly. But as far as how I treat you? Not really. You’re just a person with advanced training. Get over yourself. You’re not automatically a better person.

3. “I am merely pointing out what most do not realize - that neurosurgeons & OB/gyns don’t grow on trees, and don’t have a legal (or even perhaps moral) obligation to provide care to anyone. That means we ALL lose out, in case we need them unexpectedly (see response to point #1) “

Absolutely they don’t. And if they’re not going to give us some guarantee of access, why should society give them a guarantee that they won’t be responsible for the full measure of harm they cause?

That’s what you intentionally ignore - you’re claiming we won’t have access to specialists if your responsibility isn’t limited, but you’re not offering any access in return. So why should the victims of your negligence get their damages arbitrarily capped by insurance lobbyists if they get nothing in return? Again, you want something for nothing. Which if we agree to, would be truly idiotic.

24 Happyman August 15, 2007 at 6:31 pm

then your argument is for the status quo. Therefore see my original post, abridged here :

it’s much more of a problem for PATIENTS than doctors- we will always have a relatively high-paying job, but if you are in a car wreck & need a craniotomy, blame your local trial lawyers for ending up a vegetable, as threatening or suing your local ER for not getting a neurosurgeon in time isn’t gonna save you neurons.

congratulations, you win, I hope you never need burr holes or an emergent hysterectomy.

25 Mike August 15, 2007 at 8:14 pm

Physicians do so much free work, extra work, unreimbursed work. How many jobs can people say that about? Is the truck driver ever doing a drive for free? How many lawyers end up doing freebies (unless they were too “dumb” to weasel out of their “pro bono” work). How many insurance agent secretaries are doing freebies???

If patients need an extra hour of care in the hospital, guess what??? I stay. I suck it up. It’s aprt of the job. And its the ONLY job that that is a truism.

If the ones on here saying we deserve no more than secretaries and truck drivers can’t undertsand that and afford us the additional respect we clearly should have (and I think most reasonable patients do) then your just aprt of the problem. More pathetic souls who drag society down into a robotic inhuman state.

Not all doctors are perfect or meet this standard, but most do. Few lawyers (and other reptiles) can say that.

26 Anonymous August 15, 2007 at 9:20 pm

“then your argument is for the status quo.”

As is yours. You offer nothing to improve the lot of patients but empty promises. YOU gain from reduced liability - although more accurately your insurer does since your actual chances of ever having to pay a judgment out of your pocket are miniscule. But you weren’t offering any more access to anyone.

Don’t be angry because I wasn’t fooled by your “it’s hurting the patients” nonsense.

27 Anonymous August 15, 2007 at 9:24 pm

“Physicians do so much free work, extra work, unreimbursed work.”

And? Lots of people do volunteer work. Should anyone who does X amount of hours of volunteer work not have to pay for the harm they cause?

I worked for free all day today on getting a battered woman a protection order to get her out from under her husband’s thumb and her and the children to a shelter. Based on your theories, I shouldn’t have to pay for the damage I cause if I screw up a case today, right?

“Not all doctors are perfect or meet this standard, but most do. Few lawyers (and other reptiles) can say that.”

How do you know? Do you monitor the pro bono hours of attorneys?

Why do some of you think a medical degree makes you a fundamentally better person who deserves extra special treatment? It doesn’t, but it is more likely to make you a more arrogant person, apparently.

28 Anonymous August 15, 2007 at 10:48 pm

If anything should be FULLY government funded it should be law considering the government invented the law they should pay for all attorney fees no matter what situation you need an attorney. This will be my presidential campaign platform!

29 Anonymous August 16, 2007 at 12:24 am

I thought Moses brought us the law?

30 Anonymous August 16, 2007 at 10:04 am

Anon 09:24

“Physicians do so much free work, extra work, unreimbursed work.”

And? Lots of people do volunteer work. Should anyone who does X amount of hours of volunteer work not have to pay for the harm they cause?

The difference should be obvious to you. If I choose to do free work/volunteer my time. That is my choice/my right (which by the way I do at a low income clinic). However, when I am on the ER call schedule for self pays (which often means no pay), when medicare/medicaid/insurance denies my bill for the reason de jour, etc then I am de facto giving free care that comes out of my pocket. Additionally, though I recieve no payment, I am still legally responsible This is not “volunteer” work, this is a system that decides after work has been given to deny payment. Essentially a form of indentured servitude to the government/society. You choose to volunteer correct? Choice has nothing to do with it for us. Please do understand the difference.
PS: The lawyers would tolerate this type of system in their profession for about two seconds.

31 Mike August 16, 2007 at 10:24 am

Anon 9:24, exactly what the above physician syas.

Instead of doing volunteer work out of the office, why dont you do a bunch of free crap IN your office. Its nothing special, right? (as you say of physicians).

And “harm” is not always avoidable or forseeable, even by the best doctors. So if the best can’t get it right all the time, then why the ridiculously high standard? And please don’t say “doctors created them”. Truth is, lawyers and television created them.

32 Anonymous August 16, 2007 at 11:06 am

No one said volunteering to help others is nothing special - it’s very important. The point was simply that if that’s the standard for not having to pay for the harm caused by your negligence, why should it be limited to physicians?

As for the “ridiculously high standard”, what are you talking about? TV and lawyers don’t get to choose the standard of care, just other physicians.

33 Anonymous August 16, 2007 at 3:03 pm

” However, when I am on the ER call schedule for self pays (which often means no pay), when medicare/medicaid/insurance denies my bill for the reason de jour, etc then I am de facto giving free care that comes out of my pocket. “

That’s a dispute you have with the person you entered into the reimbursement contract with. In fact, about a million of you sued those health insurers for that very reason. You didn’t intend for that work to be free. Anymore than the lawyer who is stiffed by a client directly intended for his work to be free. Or the subcontractor whose general files bankruptcy.

“PS: The lawyers would tolerate this type of system in their profession for about two seconds. “

So why do you? Why do you re-sign contracts with payers who repeatedly stiff you?

The sub is still legally responsible for the quality of their work. The lawyer’s malpractice exposure isn’t limited just because the client stiffed them. Should they all receive limited liability for the harm their negligence causes as a result?

Did you think physicians were unique in that sense?

34 Anonymous August 16, 2007 at 9:01 pm

Anon 3:03 (ie CJD)

re: That’s a dispute you have with the person you entered into the reimbursement contract…

You really have no understanding how ER call works do you? Taking ER call has nothing to do with insurance companies, reimbursement contracts or anything else regarding the payer. It has everything to do with hospital priv. Look it up and get back to me, then we can have a meaningful discussion about the subject. Otherwise don’t waste my time when you have no clue what you are talking about.

35 Anonymous August 17, 2007 at 8:29 am

Either way, you’re not expecting to do it for free. And obviously you make enough money off the privileges that you’re willing to take what the other side requires of you to get those privileges. If you weren’t you wouldn’t sign the contract.

You do understand that most contracts you sign have a benefit to both sides, right?

Back to the point, what does your apparently bad contract with your hospital have to do with you getting reduced liability because you signed something you wish you hadn’t? Until you figure that out, your wasting both our time.

36 Anonymous August 17, 2007 at 9:12 am

CJD:
You clearly have no understanding of ER call and why it is taken. It has nothing to do with money, it is about having a place to admit and see your pt’s when they need of hospitalization. It is about having a place to do surgery. To have the priv, the hospital requires all doctor’s be in the call pool. Very simply if you do not have admitting priv if you are not in the call pool. Again, what is clear to me is that you are shooting off at the hip without understanding the situation.

PS: I have no interest in “wasting the time” of a mid-level government bureaucrat who happens to have a JD and has nothing better to do than to play on blogs all day…no need to respond with pointless sound bites

37 Anonymous August 17, 2007 at 9:35 am

“It has nothing to do with money, it is about having a place to admit and see your pt’s when they need of hospitalization. It is about having a place to do surgery. To have the priv, the hospital requires all doctor’s be in the call pool. Very simply if you do not have admitting priv if you are not in the call pool. “

It has nothing to do with money? Do you have even a basic grasp of the economics of your business? If you can’t do surgery, you can’t make money. If you can’t admit and see your patients, they become someone else’s patients and you can’t make money from them. You agree to do the ER because that’s what the hospitals requires in order to allow you to use their facilities. It’s the tradeoff that allows both of you to profit. It’s called a contract, and you signed it. Please tell me you’re not one of these physicians clamoring for the “free market”. You’d starve in a month.

I’m sorry you’re so bereft of intelligent thought that you have to make up a strawman to converse with. Best of luck with that.

38 Anonymous August 17, 2007 at 10:32 am

CJD
Do you even know what the meaning of a strawman? Because it sure does not sem like it. You clearly have no understanding of my business. Let me be clear. I do not take ER call to make money. I take ER call to give my pt’s access to a hospital when they need it for medical, let me repeat for you MEDICAL REASONS. I lose money going to the hospital that I could be making in the clinic. But that is what is best for the patients. A requirement of most hospitals (unless hospitalists run the show) is that to admit you must take ER call. Do you even have a basic rudimentary understanding of medicine and it’s business aspects? Because from this vantage point you don’t.

39 Anonymous August 17, 2007 at 11:02 am

If you could not refer your patients to the hospital, how would they get that care? And if they couldn’t, wouldn’t they simply go to a physician who does have that access? Thus, the economics of your situation dictate that you do that - ie., you make money as a result.

And more on point, again, why should the public allow you not to pay for the harm you cause because you work in the ER?

Leave a Comment

You can use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

Previous post: Nexium: "Brilliant biochemical chutzpah"

Next post: "Patient-driven"

Site Meter