How suing can destroy doctors: “It is devastating to try your best to help someone and end up hurting them instead. Doctors carry tremendous guilt and self-doubt when they make a medical mistake. A malpractice suit compounds their self-flagellation with risk of financial ruin and public humiliation, which can drag on for years. For physicians who feel unfairly blamed, the predominant emotions are often anger and fear. ‘I told her to go for a colonoscopy and she didn’t go. So why is it my fault that she got cancer?!’
All physicians who have been sued are deeply, negatively affected. Some lose their passion for medicine. Some no longer trust their patients. Many fantasize about leaving medicine and opening a flower shop or a Bed and Breakfast.”
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{ 19 comments }
“‘I told her to go for a colonoscopy and she didn’t go. So why is it my fault that she got cancer?!’”
That’s not necessary malpractice. However, when you’re talking about clear malpractice, while I’m sure the physician feels bad, and it obviously wasn’t intentional, what of the patient?
Is the physician offering to pay the patients future medical costs out of their pocket? How about the lost earnings? Is the physician going to offer a sum for their lost quality of life?
How should the injured patient pay for these things? Sit around and hope your insurer decides to offer within the statute of limitations? Or even more unlikely, that this “deeply, negatively affected” physician steps up to pay for their mistake?
What’s the human cost to living with a debilitating injury because of malpractice? Do you think the victim loses any of their passion and trust? Think they ever fantasize? Not about something like running a flower shop, but just a pain free existence?
In the rare case where the physician actually faces “financial ruin” (how many physicians have ever been literally ruined financially by malpractice judgment) at least they still have their health and can likely work doing SOMETHING. A big malpractice judgment is usually a lifetime injury to someone who formerly had a pretty good earning capacity. What of their financial ruin?
Beyond the occasional soon-forgotten newspaper article, how many people in the public actually know about a malpractice case? Contrasted to the likely obvious injury of the patient to the public?
bad link in post
I am MRI tech, had to have re-do discectomy because I rehreniated in the RR, doc says I am one of the ‘UNLUCKY” 10%. Had the redo two weeks later, did PT and at 4 weeks out the therapist did a traction technique, felt a pop and have been in constant pain going on one year. Decided to do ‘back boot camp’ 12 weeks of intense and grueling PT…did not help with the pain. I did get stronger but pain is constant, Doc tells me I am one of the unlucky 10%.
One doc wants to implant a nerve root stimulator, but there goes my career. I am having an EMG next week to see if I have “Failed Back Surgery Syndrome vs RSD”.
I have never thought of suing, but I am sick of hearing how ‘unlucky” I am.
I guess some people are born suers…many of my co workers ask are you going to sue?…its just not in me.
HMMM. Should only perfect doctors with 100% perfect outcomes practice medicine? I guess we shouldn’t have any then.
What about the patient CJD asks?
Unfortunately bad outcomes happen. That is what disability and and life insurance is for. Yeah, it sucks every 6 months when those premiums come due, but it is all about being prepared.
I can only speak for myself and my group (my group is large enough to be self insured, and I sit on the board) but when there was “true” liability we try and settle and compensate the patient. However, more than half of claims are clearly not malpractice, and a smaller group genuinely very debatable.
The poisoned legal system puts these very debatable cases into an expensive cat and mouse game. There is probably better models out there regarding dealing with medical malpractice (such as New Zealands)
CJD, what is your profession doing to improve the system and to help compensate patients? What ideas are out there. Otherwise the belief persists that you are only going to care if there is a potential for a big $$$$$$ payday (think John Edwards)
If a group practice grossing $5 million has four lawsuits, it is all upset. If a welding business grosses $5 million, it likely has 400 lawsuits all the time. Walmart has 10,000 Lawsuits Everyday.
Doctors are among the most privileged of defendants. They set their own standards. Only the tiniest fraction of negligent care gets second guessed by a lawyer. When it does, there is nowhere to find a plaintiff expert who is not a broken down derelict, laughed at by the jury. The justice system favors doctor defendants in 75% of claims, from dismissal on first pleading, to jury verdicts, to appellate decisions.
Doctors have virtual immunity.
As a patient, subject to a life threatening error every day in the hospital I favor:
1) ending medmal; it is a bunco scheme to enrich lawyers, and does nothing to protect patients;
2) privileging every fact of error immediately disclosed from discovery in any future litigation or regulatory punishment;
3) Deming. Continual improvement demands the hospital wing be closed until the multiple factors contributing to the serious error have been found and stopped. This is like the assembly line at Toyota stops until the part fits.
Doctors will miss the days of weak medmal claims and second guessing by know nothing lawyers. This hellish regime of oversight by insiders gets enacted, with zero tolerance for carelessness as the norm.
As a patient, I want the games to end, and the safety to start.
“HMMM. Should only perfect doctors with 100% perfect outcomes practice medicine? I guess we shouldn’t have any then.”
Who said that? No one. We’re simply talking about who pays for the consequences of their negligence. Should only people with perfect driving records have a car? Or should we simply make those who are negligent pay for their mistakes?
“Unfortunately bad outcomes happen. That is what disability and and life insurance is for. “
We’re not just talking about bad outcomes. We’re talking about bad outcomes as the result of someone’s negligence.
Only someone who has no concept of how the people on the low end of the financial spectrum would make such a statement. What disability policy pays for hundreds of thousands in future medical care – you know, money to you. What’s the premium on that policy?
If that’s your position, why not apply it everywhere. For example, you don’t get to sue the guy who runs the red light and renders you a paraplegic. Or the drunken trucker who runs your kid down. No, you should be stuck with just your disability insurance. Are you on board with that?
“but when there was “true” liability we try and settle and compensate the patient.”
I’m sure you guys rush to report every mistake and you rush to pay the full measure of damages without suit being filed, don’t you? “True liability”? I guess that’s in your opinion, huh? How about when you are run over, and the other driver said he had a green light and you didn’t, his insurer gets to decide if their insured was “truly liable”. That sound fair?
And thanks for the New Zealand reference. Tell me, do they have universal healthcare? Because when you cite to the liability models there, you never seem to mention the deep social safety net these countries have which renders the mountain of medical bills an American victim of malpractice faces moot.
“CJD, what is your profession doing to improve the system and to help compensate patients?”
We make sure when your insurer tries to avoid liability, that your victim gets a day in court. As to the victims of our own negligence, money out of every state’s bar dues goes to a victim’s compensation fund. Do people still get screwed? Sure. There are bad apples in every profession. But we’re not asking that people be denied their day in court and requesting lobbyists for the insurance industry set their damages arbitrarily.
You act like it’s bad for a lawyer to work for money. Do you work for free? Do you front money out of your pocket for your patients to they can get care? How come it’s only when other people earn money that doctors think its bad?
Being sued sucks – I’ve been sued and it’s no fun, and it was just a partnership dispute although the damages requested were not covered by insurance and far more than my ability to pay. I’m not denying that. But crying about how bad you have it when the victims have it far worse is a little much, don’t you think?
It’s rare that a physician ever pays a dime of a judgment, it’s even rarer that they’re prevented from earning a living. Think the victims are that lucky?
But without the money we fought for after our daughter (yeah, the blonde) was paralysed by a surgeon’s mistake, her life would have been ruined. The settlement was to ensure she could afford medical treatment, therapy, and necessary pain treatment. No one around here is driving a porche…but she is walking. I have the highest reguard for the doctor. it’s the system that sucks.
It’s always an interesting contrast between watching physicians comment on medical issues that are extremely traumatic to the patient and the families around them and listening to their comments on legal issues.
If grandma is dying, and there’s a debate about the lengths to go to keep her alive, the physicians calmly and cooly discuss how life must end, expensive procedures won’t prevent that, the best use of scant medical resources, etc. And we’re talking about the beloved family member of those making the decision, literally life and death.
Let a physician get a summons, which he’ll almost certainly never pay a dime on, will at most give maybe one deposition and answer some questions under oath, and even more remote, maybe sit through a week long trial, and they are “destroyed”, “devastated”, “stunned”, etc. Such a travesty calls for immediate legislation, they may have to move to a non-lawsuit nirvana, they will have to quit performing X,Y, and Z procedures, people in rural areas will not get the benefit of their wondrous skills if they ever decide that living in the sticks is for them. In short, it will be the end of the known medical world if this outrage is not immediately ceased!
It’s kind of funny.
“We’re not just talking about bad outcomes. We’re talking about bad outcomes as the result of someone’s negligence.”
Yes, If we can agree if that is what we are talking about. Most of the time plaintiffs and lawyers don’t know. In a large percentage even medical experts will be divided on the issue, so the your green light/red light analogies are way too simplistic.
“You act like it’s bad for a lawyer to work for money.”
No, something is wrong when multimillions are profited and taken out of the system on junk science and courtroom theatrics
“Do you work for free?”
Once a week at an indigent clinic. A good analysis in 2000 or 2001 estimated the average ER doc provided 125K annually in uncompensated EMTALA related care. That would certainly be higher now. Yes, we are fronting a liability premium to see those patients treated for free.
“Being sued sucks”
And yours was just a professional dispute. I have been through 5 or so lawsuits and they read as personal attacks of incompetence, recklessness, etcetera. That is why I have chosen to transition out of clinical practice. That is the point of the original post. The emotional cost is just too high. You can say something like “Just suck it up, quit whining, that is the way it is”. Does that make it better and tolerable because CJD said so? I can say I am tired of that so I will quit and do something else.
It’s my opinion that the fear and emotional cost of physicians are aggravated by misapprehensions about the law that could be remedied with a little education, or even self-education.
I’m no way implying fear or anger or an inordinately defensive style of dealing with patients would vanish altogether, but these harms would be better managed if irrational and ignorance-based reactions could be reduced.
I’ve seen so many physicians with fanciful notions of what tort liability is, rely on “protections” that don’t exist, imagine liabilities that don’t exist as well. One notable, much blogged-about case had a physician in near panic because he was served with sue papers, which he so misconstrued that he thought he was charged with a crime of manslaughter. He could not tell the difference.
Sometimes I think physicians want to stay ignorant of the law because understanding it scares them. They don’t want to give up that sanctified feeling of injustice, as if it somehow was protective or, that to react less strongly would be to give up an important method of manipulating a more advantageous position than currently enjoyed.
I say give up willful ignorance and help yourself NOW. If you still hate the law after understanding it, at least then you are operating from reason.
SarahW,
Then likewise patients should only complain about the medical system if they understand everything about it. That is know all about medicine, its costs, physiology, all risks and benefits of procedures, HMO and reimbursement rules??????????????
“Most of the time plaintiffs and lawyers don’t know.”
I guarantee you that attorneys who specialize in medical malpractice know far more about what constitutes negligence than you think. Contrary to popular belief, you don’t take these cases on and just collect a check. The attorneys who handle these on both sides are very intelligent, and know their subject well, if for no other reason so they can perform an effective cross examination.
As for the patient, you’re right. But patients know little about medicine because the providers aren’t really inclined, or incentivized, to tell them much. That’s why they end up in a lawyers office many times – because no one else will take the time to explain to them what went wrong.
“No, something is wrong when multimillions are profited and taken out of the system on junk science and courtroom theatrics “
A devastating injury as a result of malpractice will have damages in the millions. And it’s often money that goes right back to medical providers in the form of future care, or health insurers for subrogation. So I guess it’s profitable for you guys. Now, you can yammer on about junk science and courtroom theatrics, and that’s all well and good, but unless you’ve got some cases that have been paid on that you’ve reviewed the records in you’re just talking with no knowledge.
If you’re mad about the lawyers making money, would you have them front tens of thousands of dollars and hundreds of hours preparing for and trying complex cases for free? Against an opponent funded by an insurer?
” A good analysis in 2000 or 2001 estimated the average ER doc provided 125K annually in uncompensated EMTALA related care.”
That’s about the cost in time and expenses fronted of one malpractice case taken to trial.
“Yes, we are fronting a liability premium to see those patients treated for free.”
How much among how many of you?
“Does that make it better and tolerable because CJD said so? I can say I am tired of that so I will quit and do something else.”
No, it doesn’t make it more tolerable and I don’t expect it would. Kudos to you for being one of the physicians who actually does something about their problems rather than just complain.
“Do you front money out of your pocket for your patients to they can get care?”
Physicians sometimes do this. When I was working at the local University, I once fronted a patient $12 so she could get her prescription filled at the University pharmacy. She later paid me back.
CJD: If you are a patient, peace be with you.
If you are a lawyer, shut your foul, hypocritical mouth.
Do you or do you not support ending all the self-dealt immunities of the lawyer and of the judge from accountability for their carelessness in torts? Should the privity obstacle to legal malpractice claim by the adverse third party be removed by statute?
If torts are so great for everyone else, why are the lawyers and judges depriving themselves of their great benefits?
Until you answer that question, everything is puffery and unseemly hypocrisy.
“That’s about the cost in time and expenses fronted of one malpractice case taken to trial.”
With a chance for payout. There is no payout to EMTALA care. Contrary increased risk exposure for zero payment.
“How much among how many of you?”
About $15 per patient/physician seen for “free”. Add in billing/overhead it is about $35 to treat a patient that won’t pay.
“I guarantee you that attorneys who specialize in medical malpractice know far more about what constitutes negligence than you think.”
If they are so smart why do they lose 80% of the time?
I have a friend who was the victim of malpractice due to a botched surgery. He has been and will be in agony for the rest of his life. He developed fibromyalgia as a result of lack of sleep and the stress of being in constant pain, and eventually lost his job, his house and his family, going from a solid middle-class citizen to a welfare recipient in a matter of years. He is now on SSDI, which it took him 4 years to get. He has to take narcotics to cope with his pain but like most people with chronic pain, can’t find a doctor anywhere who will give him an adequate dose and most of his limited SSDI money goes to pay for this and other drugs. He has been libeled as a “drug-seeker” by more than one doctor, and accused of hysteria and hypochondria by others. His overall health has declined dramatically, and he is constantly depressed and has considered suicide.
The doctor “apologized” for the negligence that led to all this, but still fought him in court over the malpractice and in the end he got a grand total award of $150,000 to compensate him for a lifetime of suffering and all the bills it would entail.
I’m just wondering if you think the money that doctor saved on his malpractice insurance by fighting this guy was worth the human cost? I am wondering if the money is worth the human cost when a doctor who has destroyed a person’s life through negligence or incompetence sends the bill to his victim and threatens legal action if he doesn’t pay?
I wonder if it’s worth the human cost when a patient is denied medical care because his name has been added to a blacklist because he sought compensation for his injuries?
I can see where a doctor with a heart and soul would be severely distraught if he destroyed a person’s life through a medical error. I know I would be. But I can’t see him trying to claim our sympathies when he then fights that guy in court to deny him the compensation he needs to try and hold his life together afterwards.
When an increase in your malpractice premium means more to you than the life of a human being you’ve injured, you’ll get no sympathy from me.
Payne: You point to some remedies to the lawyer bunco operation that is med mal.
1) Blacklist, not just the patient, but the lawyer and the judge that attacked clinical care to plunder it.
2) If the aim of torts is to make the patient whole, as opposed to enriching the lawyer, then it’s Medicaid. Medicaid for injured patients, and nothing else.
3) As a patient myself, I want the stolen $150,000 back. I want it to be spent on changing the way of doing things in the OR so that the errors cannot be repeated.
Your friend sounds sleazy. He typical of the undeserving plaintiff rejected by juries in most cases.
“1) Blacklist, not just the patient, but the lawyer and the judge that attacked clinical care to plunder it. “
Hey, blacklisting dissidents worked for the Soviet Union, why not try it here?
“2) If the aim of torts is to make the patient whole, as opposed to enriching the lawyer, then it’s Medicaid. Medicaid for injured patients, and nothing else. “
Yeah, let the government pay for doctor’s negligence. That will encourage them to do something about the epidemic of preventable medical “errors” in this country. How about we just eliminate malpractice insurance altogether and make doctors pay out of their own pockets whenever they screw up? You know, “personal responsibility” and all that, or does that little mantra of wingnutdom only apply to the little people?
“3) As a patient myself, I want the stolen $150,000 back. I want it to be spent on changing the way of doing things in the OR so that the errors cannot be repeated. “
The only thing that was stolen was my friend’s life. Unfortunately no amount of money can buy it back for him. Every dime of that $150,000 has been put back into the medical system with interest, so in the end, the system as a whole actually made money on it. We already spend over $2 trillion a year on the medical industry in this country, if you think spending more is going to somehow convince the medical profession to finally start paying attention to medical errors with something other than tort “reform,” you need to get a clue. Doctors handwriting errors alone kill over 7000 patients a year in this country ad injure hundreds of thousands more. It is safe to say there probably isn’t a single prescription-writing doctor in the US who hasn’t killed or injured someone. That’s over 70,000 Americans killed in 10 years, more than were killed in a comparable time in Vietnam, proving that the pen is indeed mightier than the sword.
The majority of these deaths could be virtually eliminated by the adoption of electronic medical records or at least by low-cost e-prescription devices that will print out legible scripts with proper dosages for the doctors to sign. But despite the massive yearly body count from medical errors, less than 14 percent of doctors have adopted EMRs and many are actively opposed to them because of the cost, which I’ve read would be $20,000 per doctor which comes out to less than $20 billion total, a drop in the bucket compared to the $2 trillion we already spend. Unfortunately, the American medical system is not about saving lives, but about making money, so the only way to get the attention of many doctors is to kick them in the wallet. Racking up a personal body count apparently doesn’t leave them feeling “destroyed” or “devastated” enough to make them deal with the problem..
“Your friend sounds sleazy. He typical of the undeserving plaintiff rejected by juries in most cases. “
For authoritarian fascist types, the victim is always to blame and the perpetrator always to be rewarded if not worshiped. Why don’t you move somewhere where they kill women for being raped? Your mindset would fit in better there than it does here.
Payne: The data are not with you, as they have deserted the left for 100 years. There is no benefit from the EMR, either in cost or in safety. That is settled. Anyone stupid enough to have bought the EMR propaganda has returned to written records, poorer by $100’s of 1000’s in lost money and time.
Speaking of pain, I am telling my story to a typing doctor. I throw the laptop from the window, “Doc, I’m over here, and this is where is hurts. Fix it. I do not care if your record is a squiggle. That record bull is lawyer intimidation.”
Your friend would have been better off with a Medicaid card. He could have skipped stressful litigation. Litigation would have only served the purpose of animus. He did not even see any money.
I have a feeling you left out plaintiff negatives from your biased case report. In the absence of personality disorder and motivation to fail for disability/litigation/workmen’s comp purposes, 90% of pain patients are functioning well and satisfied.
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