It was gratifying to see President Obama recently acknowledge the role malpractice plays in our failing health system, as well as admitting the presence of defensive medicine.
Furthermore, The New York Times, whose editorials I’ve taken exception with in the past, wrote a reasonable opinion on the issue. As they admit, “The current medical liability system, based heavily on litigation, has a spotty record. It fails to compensate most victims of malpractice because most never file suit. When cases reach the courts, some juries do a decent job of sorting out whether there was negligence or preventable error; others are swayed to grant large damage awards based more on the severity of a patient’s injuries than on clear evidence of negligence.”
It’s good to see that the idea of fixing the malpractice system is entering the reform debate. There’s no doubt that it’s the best way to garner physician support, and with costs at the forefront, one additional way to rein in costs.
Indeed, as this recent piece in The New England Journal of Medicine writes, although “[defensive medicine] costs are notoriously difficult to estimate, and analysts disagree about the magnitude of their contribution to overall health expenditures . . . trimming even 1% of total health care spending would save around $22 billion per year — not a trivial amount, particularly in lean times.”
Related posts:
- Will reforming the malpractice system be a deal breaker for health reform?
- Is Obama serious about medical malpractice reform?
- Medical malpractice verdicts
- Will medical malpractice reform be included in the final health bill?
- Can you reform health care before reforming malpractice?
- Op-ed: Injured patients deserve medical malpractice reform
- Physicians don’t trust the malpractice system and why doctors order too many tests
{ 49 comments }
Physicians should be careful about trimming around the edges and arguing “lean times”. They may find someone wanting to cut their pay, which is a much more clear cost driver.
Yes, in the last three weeks alone as a patient I have identified at least three critical errors; in the wording of an ultrasound report, in a technician’s failure to correctly read instructions for blood work, and being in set up in the system and labeled as the patient of the wrong physician at an MRI facility.
Personally, I don’t think that the president is serious about tort reform, and it would never get through the Senate. I think that Obama was ‘playing’ the AMA when he said that he felt our pain and wanted to help us. Imagine how miuch money is wasted on litigation that seems to enrich only one constituency. This comment is linked to a post describing my joy as a physician who has just discovered he is a defendant in a med mal lawsuit. This case raised the term frivolous to new heights (or depths).
Americans and their lawyers will never give up their right to sue doctors. They will only choose not to sue when it is no longer lucrative, eg physician salaries are so low that they can no longer to pay for malpractice insurance.
Or when we have universal health care and the malpractice victim isn’t faced with mountains of future medical bills. Or when physicians and their insurers step up when their negligence injures someone and pays what is owed in a timely manner. Kirsch is wrong about who the current system really benefits. The vast majority of negligence is never pursued due to the hurdles to winning a malpractice case.
First one is probably more likely.
How come “fixing malpractice” never focuses on reducing malpractice?
To build on “Matt’s” simple but poignant question…Restricting injured patients’ rights to be compensated and hold those who harmed them accountable is not the kind of “reform” America needs. Moreover, everyone from the Congressional Budget Office to insurance experts themselves have consistently shown that malpractice premiums and claims are each a tiny percentage (1-2 percent) of overall health care costs. If we really want to bring down health care costs, let’s stop talking about trying to solve health care problems on the backs of patients, and let’s start talking about how we stop medical malpractice. http://tinyurl.com/l7czhv
Here are some facts. Most true medical negligence is never discovered. Most physicians who are sued are either dismissed or found not-guilty. Who wants to defend a system with such a low performance level?
Defensive medicine, run-away jury awards and frivolous lawsuits are unfortunate and costly symptoms of America’s broken medical liability system. Without enacting effective medical liability reforms to eradicate these symptoms, we cannot truly reform the health-care system.
The AMA supports proven reforms like caps on non-economic damages, but we are also committed to exploring innovative solutions like health courts, early disclosure and compensation programs, expert witness qualifications and a liability safe harbor for physicians who follow evidence-based guidelines. The goal is to keep physicians caring for patients, while still allowing access to the court system.
The AMA is very pleased that the president has expressed an openness to medical liability reform as part of comprehensive health reform. Liability reform is clearly needed to help doctors implement best-practices in patient care and reduce unnecessary health costs.
J. James Rohack, M.D.
President, American Medical Association
Is the goal of physicians to compensate more people who are harmed by malpractice? Because all their “reform” proposals are about further limiting the ability to recover regardless of whether there was malpractice.
Your criticism is valid, so what are your solutions and why are they more likely to pay more victims of malpractice in a more timely manner?
Mr. Rohacks reply illustrates my question to Dr. Kirsch in that caps are not about compensating more victims of negligence or reducing malpractice. They are simply more government inrusion in individual relationships where lobbyists decide te value of cases without seeing the evidence. They benefit the insurance industry and that’s about it. Why the physicians largest lobbying group goes to bat for insurers time and again is curious. The AMA claims to be committed to early disclosure yet the legislative record there is pretty light if not nonexistent yet you could fill buildings with their work in support of arbitrary caps on patients ability to recover.
If caps are “proven” to reduce defensive medicine, after three decades of caps in California how much cheaper is healthcare there? How much less defensive medicine is practiced there?
Forget med malpractice reform. How about opening the legal profession to the same standards to which the medical profession is subjected? Every action that is overturned on appeal is evidence of someone (defense or prosecution) of not doing their job to perfection. Every wrongly convicted felon (who is later exonerated by dna for example) should be able to recover from both the prosecution (state) and his presumably incompetent defense. Once the legal profession gets a taste of their own medicine it will make our heads spin how “effective” malpractice caps are.
*Shift to medmal ‘event’ policies, to become the patient’s cost burden and choice.
*Patient must sign contract to abide by this medmal event policy.
*Policy demands: dispute settlement by arbitration, fast-track medical records discovery, and swift resolution.
*Let the patient choose from a menu of $$$ capped policies amounts, but $$$caps are based upon patient’s proven earning potential.
*Policies pay out amounts designed to pay for fixing problem, and provide disability compensation.
* NO compensation for ‘pain and suffering’, mental anguish’, loss of consortium… (unless ATLA agrees to stand aside for legislation allowing for such damages in cases of attorney malpractice (including abuse of process and malicious prosecution)).
*When inevitable test case, funded by ATLA, occurs, insurer must indemnify unlucky guinea pig doc from costs and losses.
*Doc will need to countersue patient and counsel(business partner, if on contingency) for breach of contract(original contract signed with doc to abide by terms of medmal event policy).
Actually things being overturned on appeal are usually due to a judges mistake. Physicians should probably focus on reforming their industry rather than one they know little about and understand even less.
One should be aware that with a true national health care plan, all physicians would be government employees, and thus exempt from lawsuits. Ask members of the military what happens in the event of medical malpractice while they are in the armed forces… Go ahead, look it up!
twaw:
Are your suggesting that every doctor who has a patient take a turn for the worse or die is subject to a malpractice suit? If not, then your analogy that every lawyer whose client fails to win his or her case should be subject to a malpractice suit is specious.
There are no guarantees in the legal profession, just as there are no guarantees in medicine. However, both professions have their incompetents, the difference being that all too often the local medical boards simply revoke hospital privileges for negligent doctors, allowing the incompetent doctor to move on to another community to do damage. Perhaps if physicians policed their own, instead of keeping a vow of silence, there would be fewer negligent doctors and, thus, fewer medical malpractice lawsuits.
Imagine the world of medicine if transacted under conditions enjoyed by legal profession:
*Docs could cherry-pick clients (You don’t look so good, I don’t like your chances. Please seek alternate medical representation).
*Docs could keep a cash-paying client only until client’s funds are depleted.
* Docs could go on blogs and badmouth attorneys griping about liability for abandonment of no-pay clients who can still sue attorney.
*Docs could still always be sued for malpractice, but damages recoverable, allowed by law, would always be exceeded by expenses of the lawsuit.
*Docs could go on blogs and badmouth attorneys griping about how legal malpractice is deliberately kept amorphous, ambiguous, and is defined arbitrarily by whichever expert witness clicks the best with a particular jury on a particular day.
*Docs could go on blogs and badmouth attorneys griping about being forced to take pro bono assignment of all public defender jobs as a condition of licensing. (There just aren’t enough public funds to pay for that inherent right of all Americans: legal representation).
*Judges might quit, now being personally liable for mistakes no prudent professional would have made under similar conditions: the very definition of ‘overturned on appeal’. States would save much in pensions and health benefits.
In the late 1970s, California capped medical malpractice awards for pain and suffering. The idea was that it would reduce the cost of medical malpractice insurance. It did not. Doctors in California still pay high premiums, and the state of health care in California is a disaster with hospital closings, doctors suing Blue Cross on civil RICO claims just to get paid, and on and on. ….. It did not go unnoticed that the doctors were more than happy to hire lawyers to pursue their claims against Blue Cross.
Regardless, blaming the legal profession for the sorry state of health care in this country is simply misplaced. That old dog won’t hunt no more! More importantly, if doctors fall for that red herring, AGAIN!, they will lose even more than the last time this issue was addressed in 1993.
“the doctors were more than happy to hire lawyers to pursue their claims against Blue Cross”
And lawyers are more than happy to hire doctors when feeling ill, doctors whom they call murderers and incompetents in the course of lawyering.
What’s your point?
But we were talking about the legal profession.
Why is there no significant legal recourse for frivolous medmal litigation?
Regarding the first of Susan H’s thoughtful comments: In non-emergent care, doctors can (and some do) cherry-pick. That practice has been addressed before by doctors on this blog, and I have encountered it personally. I obviously cannot and will not suggest that it’s common, but when it does happen it pretty much sucks.
susan
btw you missed being paid for the professional time investment (or portion thereof)in the same manner as attorneys are paid. I would be willing to keep the current med mal with all its flaws if I got paid for all the defensive paperwork/phone calls/coordination of care/curbsides/ patient trackdown (”oh I forgot to tell you I moved and changed my number” )etc. This would obviously not decrease health care costs, but at least we would be able to measure some of the cost of defensive medicine (which in some quarters does not exist because it is not measurable).
The Abattoir
“Come in, We offer Justice, and The Truth will guide your tour”
(The Guides will need retainers, before you hit the door).
And the Guides will need continuance, though it cost you dearly to be delayed,
And the Guides must be Rewarded, and the Guides must be Obeyed,
And The Truth is ever-changing, as determined by the Guides,
(The Guides will champion The Truth on ever-shifting sides),
And if dragged in screaming innocence you still must pay the Guide
For the chance of emerging, partly intact, on the other side.
It’s a uniquely American experience, this Kafkaesque Bete Noire…
Welcome to the Abattoir,
AKA: Court of Civil Law.
Matt … your simplistic rejoinders are strikingly disingenuous. How about physicians consult trial lawyers to suggest the best choice of therapies prior to the bad outcome? May as well get your payments upfront. Of course, we’ll have to introduce a new concept – Managed Law in which a third party payor determines your worth.
To Tom,
The FTCA (Federal Tort) protection does not mean, Federal Docs are not named in suits. Payments are made by the feds but names go into the Data Bank, reputations are hurt, agonizing over the case occurs, and compensatory over testing still results.
By the way, very few folks are advocating a system whereby all docs become federal employees.
Doc99 I’m not sure what exactly you’re referring to but I imagine you’re making some reference to the crappy manner in which you are paid v other professions. I agree it is poor although to be fair it ha made physicians the highest paid profession by far. But given that the way you are paid is something that negatively impacts you in a real, negative way every minute of the day I wonder why physicians and their lobbying organizations are spending so much time on something they barely understand and has relatively minimal impact on them like tort “reform”.
The nation is on the verge of taking it’s first huge step toward European style care which will completely change your life and you’re fussing about lawsuits? Are you working for the insurance industry or yourselves?
Susan:
There is “significant” legal recourse against lawyers who file “frivolous” medical malpractice lawsuits. There are sanctions, lawsuits for defamation and attorney’s fees, and for repeat offenders, there is disbarment.
In spite of your strident statements, it is important to note that the vast majority (perhaps 99.9%) of the medical malpractice cases are taken on a contingency basis. Most lawyers would be insane to prosecute a medical malpractice case, spending a great sum of money on the case, in which s/he has no possibility of winning because it is frivolous. If you have been a defendant in a medical malpractice lawsuit, and your attorney told you that there was no recourse against the lawyer who filed the lawsuit, it is probably because the lawsuit had some merit and it was NOT frivolous.
I suspect that his blog is being used by the legions of lobbyists recently hired by insurance companies to scare off the public in regard to health care reform.
*You failed to mention the Fair Report Privilege which shields lawyers from recourse for defamation.
*I failed to find any example of sanctions you described, in a cursory search of attorney registration and disciplinary committee website.
*As you know, certification of merit (anonymous, and not necessarily by same specialty practitioner) makes a medmal claim ‘meritorious’ ‘by law’.
*When a policy demand is issued by claimant, the doc is given a choice to put all his net worth at risk in face of 8-figure pain-and-suffering-demands(exceeding his malpractice coverage), or writing a letter asking his insurance company to settle. That letter seems to assure a countersuit, damages not limited by statute, if the doc were to file a malicious prosecution lawsuit.
*As you know, the inherent conflict of an attorney representing both the defense of a doctor and the malpractice insurance company often results in the defense attorney favoring that client writing the checks, and the doctor’s best interest compromised. Attorney fees pressing a judge for sanctions in favor of doctor would be paid by…?
*Malicious prosecution damages are limited, exclude attorney fee recovery, and thus require a doc to spend far more than he may recover, by law, on pressing such a suit.
*Abuse of process suits have similar characteristics, and few medical personnel can afford to pursue such actions on principle.
*The expenses you mention only accrue after that initial phase, in which the case’s settlement value is assessed by malpractice insurer according to factors more related to risk/reward formulae than…other factors. What does it cost a personal injury attorney to get a case to that point (aside from a few unbillable hours)?
*I agree with your last statement…and supect legal comments on this blog may be by some of the legion of lobbyists hired by ATLA to keep public from being educated on the practices of the medmal legal industry.
Let’s not allow this ‘dialogue’ in the comments suggest that there is a true controversy. There isn’t. The tort system is abusive and unfair as every objective and fair-minded individual would conclude. Lawyers, including those who have opined here, cannot (or will not) separate their own interests from the public interest. While physicians are not immune to pursuing self-interest, the scale that we do so is orders of magnitude less than our legal brethren. Would we champion a medical device that hurt more patients than it saved? Yet, tort law advocates support a system that helps very few and harms many more innocents. These are the inescapable facts.
Will ATLA pay me? I didn’t know that.
Susan, how can you even propose reforms to something you barely understand?
“The tort system is abusive and unfair as every objective and fair-minded individual would conclude. ”
Wait a minute. Why would every “objective and fair minded individual” conclude that a system wherein disputes are settled by twelve people with no skin in the dispute after hearing both sides put forward their best case “abusive and unfair”? Can you think of a system of solving disputes that is more fair?
“Lawyers, including those who have opined here, cannot (or will not) separate their own interests from the public interest. ”
The people who wrote the Declaration of Independence and the Constitution would argue that a right to a jury trial IS in the public interest, and so important it is enshrined in both documents. How is it that you reach an opposite conclusion? A lawyer’s job, by definition, is to act in his client’s best interest, not yours.
All tort reform is about advancing the physicians’, and their insurers’, interest. It has little to do with the public at large. If they benefit, which is arguable, it’s an unintended consequence. If tort reform worked as physicians claim, California would be physician and patient nirvana after three decades of it. But we all know the truth. Physicians should not rush to drape themselves in the mantle of selflessness. It can only come back to bite them.
“Yet, tort law advocates support a system that helps very few and harms many more innocents. These are the inescapable facts.”
Ah, here’s the problem. You believe that because you say something, it is an “inescapable fact.” And that you know, without ever seeing the facts of a dispute, which side is “innocent”. And I think that’s where physicians lose their way. Your beliefs do not equal facts or objective truths simply because they’re your beliefs. If they did, we would not need trials at all, we’d simply put every dispute to you, and you would inerrantly decide what happened as a fact. Unfortunately, your infallibility is still an open question.
But the question comes back to you, Mr. Kirsch. You believe most medical negligence is not reported. Where is your legislative proposal to pay MORE people, and pay them quicker? Where can I find that bill in a state or federal legislature? What will its costs be? Since it undoubtedly involves physicians judging their own, what other individuals will get to decide for their peers whether they’re at fault? Since you’re interested in fairness and all, I assume you would want everyone to have that privilege, wouldn’t you?
To Matt:
“Can you think of a system of solving disputes that is more fair?”
Read the comments in this blog postings and thousands like it. Do you think most Americans are satisfied with our litigious society.
“A lawyer’s job, by definition, is to act in his client’s best interest, not yours.”
Quite true. Lawyers are obligated to serve their clients. Physicians are obligated and are trained to seek the truth. Our profession have different missions.
“All tort reform is about advancing the physicians’, and their insurers’, interest. It has little to do with the public at large. ”
This is just silly. No rejoinder needed.
“But the question comes back to you, Mr. Kirsch.”
Matt, you can use the title ‘Mr.’ if you like. I never insist on the more formal title ‘Dr.’
“Read the comments in this blog postings and thousands like it. Do you think most Americans are satisfied with our litigious society.”
That doesn’t really answer the question. What system would you prefer for resolving disputes? As for our “litigious society”, the vast majority of suits filed are business disputes. Tort filings are down and have been declining for awhile. “Litigious society” is simply a lobbying term, meaning nothing other than “what follows will be protection for whoever the speaker works for”, since no one has ever defined what would constitute a “non-litigious society”.
“Physicians are obligated and are trained to seek the truth. Our profession have different missions.”
To seek the truth? There is very little objective “truth” in the world, and physicians are not spending every day chasing it. Where is the “truth” in plastic surgery?
“This is just silly. No rejoinder needed.”
Again, you’ve confused your beliefs with facts. Every tort reform proposal pushed by physicians into legislatures is about arbitrarily deciding the value of cases and hopefully saving the physicians money in premiums. There is nothing in the legislation about saving patients money, there is nothing in there about making sure there is less malpractice, there is nothing in there about working harder to get rid of bad physicians, and there is nothing in there guaranteeing anyone will get this or that specialist in there area. Those are actual facts, and one need only read the tort “reform” bills passed to confirm them.
“Matt, you can use the title ‘Mr.’ if you like. I never insist on the more formal title ‘Dr.’”
OK, and you can call me Matt. And the question remains – if you’re so selfless, where’s your legislation to help patients, or even save them money? And again, if our legal system has failed so badly, and the tort reform physicians champion is necessary, why hasn’t it worked after 30 years? Where are the patient savings? Why aren’t there neurologists in every tiny little burg in California?
Okay Matt,
Presumably, we both agree that a worthy goal is minimizing and sanctioning true physician negligence. We also agree that patients who have been harmed through negligent medical practice should be compensated. We also agree that some oversight system should provide an incentive for physicians to practice higher quality medicine. I believe that the current tort system fails to accomplish these three objectives. Most true negligence is not captured by the system. Most doctors drawn into the process are innocent. Paradoxically, the current tort system decreases medical quality by leading directly to costly and unnecessary testing.
” I believe that the current tort system fails to accomplish these three objectives.”
Fails is probably the wrong word, because you haven’t established a baseline for passing. Does it catch all, or even most, negligence and compensate the victims? No, but then it’s not set up to do that. In fact, it’s not even set up to catch all negligence, just negligence that causes damages.
If you are looking for the “tort system” (putting aside the fact that there is not a specific “tort system”) to do that, it will never meet your expectations. Why? Because our civil justice system is designed only to resolve disputes brought to it by specific individuals. Physicians have bought into this “system” way of thinking for everything, to their great detriment, in my opinion.
Physicians don’t and shouldn’t wait on someone else to root out bad physicians. They should. They don’t need to wait on someone else to compensate the victims of negligence, just do so. Most physicians don’t care for even state medical boards to review their work, and often fight those findings.
” Most doctors drawn into the process are innocent. ”
Innocent is a criminal term. You mean not negligent, but how can you know this? The vast vast majority of claims are confidentially settled.
“Paradoxically, the current tort system decreases medical quality by leading directly to costly and unnecessary testing.”
How so? It’s the “system’s” fault that physicians claim (and that’s all it is) that they act in a certain way in response to a threat that they have little understanding of and cannot accurately assess? Physicians have no idea if X test reduces your exposure by X%, or if Y test does. Why should we make policy on physicians’ reactions to what is at best anecdotal information.
And even if we could all agree that this procedure or that procedure is defensive medicine (which physicians can’t even do, because this physician’s unnecessary test is that physician’s needed test) where is the evidence that tort “reform” would reduce it? It hasn’t for decades.
And finally, why are physicians wasting all this time and lobbying money on this. As I said in another thread, this time in US history should be physician nirvana. The largest and wealthiest population bloc in our history is getting ready to need you guys. Yet you’re locked into this crazy payment schedule that neither rewards you based on time or your competence relative to your peers. Your lobbying groups crow about nibbling at the edges and getting you a few pennies here and a few pennies there. And you guys spend all your time bitching about malpractice, which in the scheme of things has a tiny, tiny impact on your lives. It truly makes no sense.
I maintain that the tort system, with respect to medical malpractice, if more dysfunctional that the health care system. Physicians spend our time attacking it because we are victimized by it unfairly. We physicians readily admit that there are many flaws and defects in our own profession. I write about many of them in my own blog and have take some heat for it from my colleagues, You, in contrast, don’t seem able or willing to acknowledge any of our points as reasonable or legitimate. I think that your categorical defense of the med malpractice system erodes your credibility as it would a physician who states that health care needs no reform. Do you really believe that the current system is as fair as it should be? Would you modify it if you could? How so?
You can maintain that. Everyone has a right to their opinion. However you’ve yet to show me a legislative proposal from a physician that pays more legitimately injured people faster with less admin cost. And you won’t. Because that’s not what tort reform is about.
Is our system perfect? Of course not. No human system other than Halle Berry’s skin is perfect. But I have yet to see a system for adjudicating disputes any better.
Dr. Kirsch:
No, I do not believe that the current medical malpractice system is as fair as it “should” be. And, it never will. It is, however, as fair as it can be. In the past thirty years many states have enacted Medical-Legal Screening Panels and caps on pain and suffering. It is not perfect, but it has been an ongoing process for some time. No doubt there will be other “reforms”.
On the other hand, what sort of system would you propose when a thirteen year old girl discovers three years after her appendix was removed that her ovaries were also removed in that surgery? What sort of system would you propose when numerous patients discover that they contracted hepatitis C when undergoing a routine test at a certain hospital? And, what sort of system would you recommend when a physician stricken with Alzheimer’s continues to perform surgeries and his contemporaries will not put a stop to it?
I will listen to your suggestions as long as they address the issue of how to make these victims as whole as possible. Otherwise, these rants concerning the legal profession is nothing more than fallacious arguments and an attempt to avoid personal responsibility.
Dr. Kirsch
You had the patience and decency of spirit to write conciliatory posts, in the spirit of inviting collaboration toward an end of common good.
The response you got was not in kind.
Perhaps this era is experiencing an evolutionary process to cull the humans of the ‘what can I do to help our species?’ camp from the organisms of the evolved species with the charter: ‘what does society owe me in particular, and must be prevented from standing in the way of my getting it’.
I think the former camp is convinced of the inevitable life cycle including eventual death, and is comfortable with the idea of declining to participate in life under those new societal conditions.
Corinne, Regarding the hypotheticals in your comments, I believe that such cases should be vigorously prosecuted. Most physicians would agree with this. I know of no doctor who argues against rooting out true medical negligence. The unfair part of the process is that there is no reasonable barrier to filing a lawsuit against a physician after an adverse event. It can take years for an innocent doctor to become extricated from the legal labryinth. We need a higher threshold of reasonableness so that most of the innocent will be filtered out and not injured.
Dr. Kirsch, your own comments contradict your latest claim. You say the vast majority of negligence never results in a claim so some screening must be getting done. There is no system where every case that gets through will be considered meritorious by physicians, especially the defendant. Wherever you put your “filter” there will be a defendant complaining it shouldn’t have gone that far.
Matt, Right now there is no meaningful filter in place to prevent cases without merit from being filed. In addition, there is no quick exit from the process for these innocent physicians. I agree with you that a physician who is being properly sued, might feel that the process is not working fairly. However, if there was a reasonable filter, instead of a sieve, then the physician community at large would be supportive.
Corinne:
re: “However, both professions have their incompetents, the difference being that all too often the local medical boards simply revoke hospital privileges for negligent doctors, allowing the incompetent doctor to move on to another community to do damage. Perhaps if physicians policed their own, instead of keeping a vow of silence, there would be fewer negligent doctors and, thus, fewer medical malpractice lawsuits”
What year do you live on? Not 2009. Have you ever heard of primary verfication? Over the last decade, every hospital and state that I have ever applied to for licensing/privledges require primary verfication review of every single place I have worked at, every single state I have practiced in, and every malpractice carrier I have had. Throw on top of that the National Practitioner Data Bank. The will typically take 3-4 months before any anything is granted. Everything a doc has done since med school will be reviewed…period. Every doc knows that, since you know nothing aboutthe subject Iguess you don’t. But feel free to ponitificate given you lakc of knowledge on the subject. Yeah, slimeballs get away with lying and falsifying documents. That is rare enough that it is newsworthy (and I am sure you will give me an exapmle in your response). That says something about an individual scumbag doc not about the system. The idea that docs commonly go from state to state committing malpractice then moving on and getting away with it. Well do free feel to show the national evidence. Not an ancedote or two. Because the reality of the situation for those of us who have applied for multiple state licenses and hospital associations does not bear out your statement.
Speaking of a “code of silence” I practice in arizona. Every complaint is reviewed by the board with negative outcomes (reprimands, suspensions, etc) placed under the doc in a PDF format with the specifics of the allegation. That is how it should be. Interesting, on the arizona bar site, you can barely find any outcome and certainly no specifics. Now just WHO is partaking in a code of silence?
Dr kirsch almost every attorney that practices in that area will tell you they reject hundreds of cases for everyone they take. Plus the cost of pursuing a weak case alone acts as a filter. It doesn’t get more meaningful than a cost benefit analysis.
If you want out of a case quickly step up and volunteer to be deposed as soon as all the records are gathered. Or better yet be willing to be deposed pre-suit. If you see an attorney has requested your records and you think it might be for a malpractice claim call them and volunteer. Nothing is stopping you.
Obviously there is some filtering going on as you said yourself that the majority of malpractice goes uncompensated. In fact for all the complaining about too many claims the truth is physicians have no clue what the total number of claims are. Given the number of patient interactions it may be more than you expect or it may be less. But you dont have any evidence either way yet you’ve already reached a conclusion. Doesn’t male much sense.
When you put forth a proposal in a legislature to compensate more people more quickly please let me know.
Elmo the code of silence referred to is the difficulty in getting physicians to admit a colleagues actions were negligent no matter how clear it is.
Matt, The fact that most cases of medical negligence are not discovered is not evidence of a filter. These cases never pass through any filter. They are missed entirely. The physicians who are captured pass through a filter so porous that it doesn’t discriminate the guilty from the innocent.
Matt:
I repeat what corinne typed again since reading for comprehension does not seem to be your strong suit.
re: “However, both professions have their incompetents, the difference being that all too often the local medical boards simply revoke hospital privileges for negligent doctors, allowing the incompetent doctor to move on to another community to do damage. Perhaps if physicians policed their own, instead of keeping a vow of silence, there would be fewer negligent doctors and, thus, fewer medical malpractice lawsuits”
Corinne is stating that local (actually they are state boards since they are the licensing entities, not local boards) aren’t doing their jobs and bad docs move from state to state, hospital to hospital. This flies in the face of everything any doctor who has applied for licensing or hospital priviledges knows. I am telling you that every place I have worked at requires primary verfication from every hospital and every state I have worked. Everything going back to med school (or at least 10 years). It is an onerous process that takes a MINIMUM of three months. I am also telling you that every state I have practiced in (I am not saying it is all 50 states) has PDF files of every doctor sanctioned including the specifics of the case and the sanction on the web, for all to read. That is how it should be. Of course the bar in my state doesn’t have anything near the same thing for sanctions against lawyers. Again, just who has the code of silence? The fact is you and corinne are making conclusions without any evidence to support it? Now doesn’t that sound familiar to what you are saying to the tort reformers on this site?
Elmo,
The reason you can’t find the information you’re looking for at the Arizona Bar Association’s website is because that isn’t what the Bar does. The Bar Association is a voluntary organization. The Arizona Supreme Court regulates Arizona lawyers, and I would bet they have the information you are looking for on their site, along with information on where to file claims, etc. At a minimum you can FOI it, as their disciplinary proceedings are public record I expect. Now, I’m not promising you a state govt. website will be easy to navigate, but the information is likely there.
The only “conclusion” I made was that physicians are loath to testify against each other, which is what I thought she was talking about. On a related point, though, I think it’s kind of sad that physicians aren’t rated in some more meaningful way so that patients can choose based on peer rankings, for example. Of course, since you guys all pretty much get paid the same regardless of skill, maybe that’s why.
As for physicians policing their own, yes, the evidence they don’t is anecdotal, and I would caution anyone about making policy changes based on anecdotal evidence. It’s stories like this one below, though, which seem to belie the rigor you claim above. Of course, any system will have imperfections and people who fall through the cracks.
http://www.washingtonpost.com/wp-dyn/articles/A39677-2005Apr9.html
“The physicians who are captured pass through a filter so porous that it doesn’t discriminate the guilty from the innocent.”
I’m not sure how you determine it is “so porous”. What is the error rate now and what do you believe it should be?
DR. Kirsch got his answer on what lawyers are willing to do to address abuses by lawyers of the civil litigation system:
“WE’LL be the ones asking the questions here..”doc-tor”".
The tactic of answering questions with questions is transparent. This ‘dialogue’ between docs and lawyers never moves forward.
If progress is to be made on the reform of the legal system in America, single-minded focus on a particular goal should be applied. Direct all available resources toward the politician who will champion this goal…and toward burying the politician who stands in its way.
Legal representation in America must be a right, more so than medical care. It is a requirement of all citizens to be in compliance with a dizzying and paradoxical array of legal requirements in every aspect of civilian life.
Therefore lawyers should be made available, at nominal charge, at all times to all citizens.
Further, the damage done to a life due to legal malpractice cannot be quantifed, or limited to exclude emotional or non-accrued economic losses…there should be no limits on the amount of liability a lawyer or judge should bear for professional mistakes.
It is that simple.
Comments on this entry are closed.