Comments on: Do some doctors take on more risk than others?

By: Henry Stern, LUTCF, CBC

Henry Stern, LUTCF, CBC — Wed, 06 May 2009 14:46:00 +0000

Most excellent tax-blogger Joe Kristan braved a fiery inferno to bring us this week’s Cavalcade of Risk, and your post is in it:

http://www.rothcpa.com/archives/004752.php#004752

Please let your readers know.

Thanks!

Hank Stern

By: Payne Hertz

Payne Hertz — Wed, 29 Apr 2009 03:21:00 +0000

No mention whatsoever of the risk involved to the patient. How surprising. It would seem the only risk posed by malpractice is the risk of a doctor being sued.

By: DaveOB

DaveOB — Sat, 25 Apr 2009 01:39:00 +0000

The American culture has grown into the perfect-result model of healthcare. This is inherently flawed because as humans, disease that is unpreventable and/or untreatable WILL occur, despite our best attempts and good-willed efforts to abate tragedy. Bad things do happen and negligence is not a necessary component of that; mother nature is.

By: The Happy Hospitalist

The Happy Hospitalist — Sat, 25 Apr 2009 00:03:00 +0000

evan. My point exactly.

A bad outcome should not equal a lawsuit. But it does in America. And the whole thing feeds on itself in an irrational manner.

If bad outcomes where measure by death, then geriatricians who only treat 100+ year olds should have the highest malpractice premiums of all.

Of course we know that's not true.

By: Sharon

Sharon — Fri, 24 Apr 2009 22:06:00 +0000

Malpractice insurance has nothing to do with likelihood of making a mistake based on the profession of the individual. It has everything to do with the likelihood of any given person of that profession practicing in that area to be sued, and how much of a payout that would involve. As a family doc, most of the mistakes I make will not have lethal consequences. If I miss something, more likely than not the patient will turn up again in a few days (though of course missing something like an MI would be much more immediately catastrophic). If a neurosurgeon makes a mistake, the consequences are much more likely to be quite bad given the severity of the illness he or she treats. In addition, I am not nearly as likely to get sued in the first place, because again the acuity of what I deal with is vastly different from the acuity dealt with by a neurosurgeon. More sick patients guarantees more bad outcomes, whether or not errors are made.

By: Evan Falchuk

Evan Falchuk — Fri, 24 Apr 2009 21:59:00 +0000

For med mal, the risk is not that the doctor will actually be negligent (even though it should be).

The risk is that there will be a bad outcome that will generate a lawsuit.

That risk is substantially higher for a neurosurgeon than for an internist. This is why there is a discrepancy in premiums.

By: Matt

Matt — Fri, 24 Apr 2009 20:22:00 +0000

but risk of an event is a combination of
1) the likelihood of occurrence
2) the cost if the event does occur

So, while the likelihood of a negative event might be the same for different specialties, it would be my guess that the costs probably differ by a statistically significant amount. Those costs would primarily be the jury-awarded dollar values in a malpractice suit.

By: James Beckerman

James Beckerman — Fri, 24 Apr 2009 19:38:00 +0000

There are different types of risk to consider, however – some of which are based on systems and others on the individual, and others based upon a doctor’s circumstances of practice.

A physician who takes call and is evaluating high acuity patients in the middle of the night, a doctor who performs invasive procedures on populations at high risks for HIV or HCV, a psychiatrist who works in a prison…there are lots of different ways to think about risk…

By: DaveOB

DaveOB — Fri, 24 Apr 2009 19:38:00 +0000

I agree with you. Risk should theoretically be similar, within one’s scope of practice. I imagine that liability premiums differ based on the risk that is generated by public perception and the likelihood of litigation. What we really need is a medical jury system.

By: John

John — Fri, 24 Apr 2009 18:34:00 +0000

Parlor games.

The actuaries have cast their votes and think differently. Please provide a reason to think they are wrong.