Why patients file medical malpractice lawsuits

Time to turn our attention to an unpleasant topic: Lawsuits.

Who files them?

Why? And what actually happens?

There have been oceans of ink spilled about medical malpractice. An oversimplification of the various positions on malpractice and malpractice reform goes something like this:

  1. (+) Malpractice suits are good. They keep healthcare professionals and hospitals on their toes; if the threat of a big payout improves safety and quality, then lawsuits provide an important regulatory function. Also, they give the vulnerable patient a chance to rectify an error, a mishap, or an injustice.
  2. (-) Malpractice suits are detrimental. Yes, there are outliers, but 98.5% of medicine is practiced safely and effectively. Bad outcomes happen as part of the natural course of medical practice. As long as patients are informed beforehand about the risks inherent in any medical undertaking, they must understand that there are no guarantees in life.

Here, too, is an oversimplification of the politics of malpractice reform:

 

  1. (+) Democrats: Trial lawyers defend the little guy, seek redress and justice, and obtain compensation fairly where it is due (not to mention contributing mightily to our political campaigns).
  2. (-) Republicans: Trial lawyers are opportunist ambulance chasers. They drive up the cost of doing business with their frivolously filed lawsuits, demanding unjust compensation from hardworking professionals, and have thereby created a culture of overly expensive and defensive medicine. We need malpractice reform, consisting of caps on jury awards and/or a fair and reasonable compensatory scheme for damages.

As you might imagine, the truth lies somewhere in between.

For several years, I’ve sat on our hospital’s Medical Liability Committee. We meet once a month to discuss claims against the hospital. The committee consists of risk managers, hospital lawyers, and more than a dozen doctors representing different subspecialties.

We review the claims in detail, and make recommendations about what strategy to pursue: continue defending, offer settlement, or get more information. Our panel of doctors are wise and experienced–both in medical practice and claims analysis. From the perspective of a doctor named in a suit, obtaining this type of expert advice is very helpful, and can really bring comfort if the committee opines that the standards of medical care practiced were met. Validation from peers can soften the blow of being named in a suit.

Suits come from patients (or their families) that have experienced a bad outcome. Bad outcomes range from inadvertent loss of a tooth during a medical procedure involving intubation or endoscopy (breathing tubes or fiber optic telescopes put through the mouth), all the way to death.

The difficulties in a suit involving death are myriad: Death can be an inevitable consequence of a disease process; however, if the patient (subsequently the family) is not aware of that, the death feels “wrongful.” Emotions are always raw in death, all the more so when a suit is filed since it prevents everyone involved from achieving closure.

This is why communication, or lack thereof, is at the core of most suits. Angry patients and families are the ones that sue.

Patients that have received excellent communication about their conditions, and the risks and benefits of treatments vs. non-treatment (opting out), are seldom if ever disappointed with their medical care. Even when a bad outcome occurs, patients and families are grateful for the efforts on their behalf, and for honest and open communication.

Lawsuits take years to bring to fruition. There are inevitable delays, as evidence is gathered, the parties to the suit are deposed, and experts are retained to offer their opinions.

For suits that go to trial, the hospital’s lawyers work with outside counsel to mount the defense. There is simply too much other legal work (not just lawsuits) for the hospital lawyers to handle the defense.

Malpractice patterns and payouts vary by locality, so the hospital lawyers and risk managers have to stay abreast of local developments in the legal community.

Interestingly, there’s a growing body of knowledge about hospitals adopting a culture of apology, assuming less defensive postures. The early experience indicates there is greater satisfaction on both sides with this practice.

John Schumann is an internal medicine physician at the University of Chicago who blogs at GlassHospital.

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  • stargirl65

    Patients file suits because:
    1. They are angry.
    2. This is an opportunity to get lots of money from a faceless insurance company.
    3. The cost of the mistake will cost the injured and their families so much over their lifetime that they need money to make it work. They may not even be angry or blame anyone.

  • http://www.MDWhistleblower.blogspot.com Michael Kirsch, M.D.

    I agree that good communication, which is the right thing to do anyway, will decrease legal risk. Nevertheless, the public at large, including our patients, increasingly believe that an adverse outcome means that something went wrong and someone should pay for it.. Good communication and rapport can fade over time and can be eroded by anger and other folks promoting litigation for something that ‘should never have happened’. There is also a pervasive sense of entitlement to be compensated when any adverse event develops, regardless of culpability. When someone is clumsy and trips in a department store, guess what happens.

  • http://myheartsisters.org Carolyn Thomas

    I was sent home from the E.R. in mid-heart attack with an acid reflux misdiagnosis, despite textbook cardiac symptoms like crushing chest pain, nausea, sweating and pain radiating down my left arm.

    Sure, everybody makes mistakes, but I suspect that the middle-aged E.R. doc who sent me home was practising what Dr. Jerome Groopman describes in his book ‘How Doctors Think’ as “The 18 Second Rule”. That’s how long he claims docs will spend before interrupting their patients with diagnoses and recommendations for treatment – right or wrong.

    We also know that the overall chances of being misdiagnosed in mid-heart attack in the average North American E.R. are about one in 50, UNLESS you are a woman under the age of 60, in which you are seven times more likely to be misdiagnosed and sent home.

    Where do your colleagues on the Liability Committee stand on providing as much “comfort” to us tragically misdiagnosed patients as you feel compelled to offer to these doctors?

  • http://www.instant-painrelief.com/category/Blog/ Girl Gone Healthy

    Disagreements and lawsuits are almost always rooted in failed communication or lack thereof between the patient’s family and doctor. Medical malpractice lawsuits are more than inevitable when a pracitioner fails to conduct his job properly (ie doing surgery under stress/drunken state).

  • Grieving

    My life has been dis-improved by 3 surgeons. The first was in a hurry and hurt me. The second fixed the first’s error, but left me worse off than before. The third did not disclose what was, in retrospect, a failure rate that probably would have kept me off the table, until after he failed. Bad surgery, bad communication – it all ends the same. I’m not the person I was. The surgeons go on with their lives as before, I do not.

  • http://residencyfacts.com Dr.v

    Most people who file lawsuits against doctors for emotional reason not legal or medical ones. Healthcare is a two way street. You only get out what you put in. If you don’t see your doctor annually, give a adequate history, and know your medications, you will receive sub standard care.
    Dr.V residencyfacts.com

  • http://drpullen.com Edward Pullen MD

    There are lots of reasons patients sue. The real question is whether our tort system is beneficial to us as a society. I’d argue it is not. It increases the cost of medical care and there is no evidence it improves medical outcomes. Outside medicine we as a society spend vast amounts on insurance to prevent devastating lawsuit liability. Personal umbrella insurance, product liability costs, etc. In medicine examples are the cost of childhood immunizations. DTP and OPV vaccines used to cost pennies, now to fund the federal liability pool they cost dollars. IUDs used to cost a dollar or less wholesale. Now they cose hunderds of dollars. The same is true across other industries. Is there any wonder why we as a society have become non-competative? But asking our elected officials, who happen to be mostly attorneys to change this is not happening soon.

  • W

    See previous comments regarding the importance of communication.

    The moment that I requested a copy of my records and asked a few reasonable (I thought) questions, largely out of personal curiosity and nothing more, every communication I attempted was forwarded straight to the clinic’s legal department. Replies were written by the attorneys, in legal-memo format (no salutations, just subject lines), no attempt at courtesy, using language that deftly avoided the possibility of being interpreted any specific way. All concluded with the order that I was NOT to contact anyone else with questions except the legal department.

    Seems to me that modern medicine doesn’t know what it wants from patients. You try to be a “partner” in your care and they flag you as a risk and kick your backside onto the street.

    Keep the lawyers out of it. It’s not going to eliminate the problem, but will still be a hell of a lot better for everyone.

    • anonymous

      Unfortunately, the response you got is a result of our society being so litigious. Not trying to defend them, just saying their response is predictable.

      • Matt

        Don’t most providers simply hand over the records without comment (other than a bill for copies?) So why would it be predictable this one wouldn’t?

  • PJ

    Patients also sue because they don’t want whatever happened to them – poor outcome, complication, or actual malpractice – to happen to anyone else. As many physicians seem to feel that peer review is only appropriate for “bad” physicians (drunk, mentally ill, incompetent, etc.), not for them, I see why patients don’t think peer review adequately addresses suboptimal care, let alone actual malpractice.

  • Matt

    Several unsupported claims in the comments:

    “increasingly believe that an adverse outcome means that something went wrong and someone should pay for it..”

    There is no evidence that this is true. Overall, tort claims are down over the last decade. Nor does Dr. Kirsch have any idea how many med mal filings there are and whether they are up or down significantly. Most evidence shows that the number of malpractice claims are quite small compared to incidents of malpractice and the even greater number of adverse outcomes. The predictions of society’s demise are premature.

    ” It increases the cost of medical care and there is no evidence it improves medical outcomes.”

    A malpractice claim does not increase the cost of care. Nor should we expect it to improve medical outcomes since that’s not the goal. The goal is to determine in that specific case if there was error and compensate for it. Not to improve medicine as a whole (in the vast majority of cases). If medicine is improved, that’s an ancillary benefit.

    ” Outside medicine we as a society spend vast amounts on insurance to prevent devastating lawsuit liability.”

    This is an odd statement. Should we not buy insurance? Is there a set percentage of income our insurance should cost us? Costs for damages will remain the same regardless of insurance, although arguably it might be shifted to the taxpayers if the at fault parties didn’t have insurance.

    ” Is there any wonder why we as a society have become non-competative? ”

    We have the most dynamic economy in the world, but it is true we are losing manufacturing. But this is primarily due to cheaper labor elsewhere. Not the strength of our legal system, which allows us to enforce contracts, protect copyrights, etc.

    • rezmed09

      Matt,
      I routinely over test in order to be perceived as “doing everything” and “being thorough” even when the Dx is very unlikely and the testing is not cost-effective and maybe goes beyond the ever-changing guidelines. I am thanked by patients for being more thorough and careful, but I often waste more resources than I should. We do not practice medicine in a vacuum; instead we are deeply influenced by fears of suits, and accusations of incompetence – this is expressed in dollars (tests) and time (tests are often what patients want because they are objective).

      There is a reason ER care is so expensive and packed with over-testing – it is because of the one in 50 chest pains sent home inappropriately. It is expensive because patients do not know the quality of the provider they are seeing, but they do believe in all those tests.

      Unexpected diagnoses and deaths are frequently associated, in my experience, with accusations of malpractice. In some cases I may make the diagnosis earlier, but often do not change the outcome.

    • Matt

      ” instead we are deeply influenced by fears of suits, and accusations of incompetence – this is expressed in dollars (tests) and time (tests are often what patients want because they are objective). ”

      I see the claim that you overtest due to fear of claims and that if there were this or that reform you wouldn’t overtest so much. Two thoughts though. One, you have no idea if the testing reduces your liability exposure. Two, even when you get the requested reforms, the volume of testing doesn’t decrease. So I have a hard time putting much stock in it.

      As to the second reason, patient satisfaction, I think that’s a reflection of the payment model, where there’s no downside to either the provider or the recipient for doing the test. Only a change to that payment model will affect that.

      • rezmed09

        Well Matt, here’s a toast to the status quo. We have an incredibly expensive health care system without being much better than many other countries.

        We need payment reform, and tort reform, but the real problem will be patient expectation reform. I think many patients want more tests and procedures and if the outcome is bad they want revenge/justice. This is an expensive and wasteful system. In 20 years, every patient / provider interaction will be recorded. Suits will require a fine tooth comb review of video and audio of every minute of every patient visit. He said/she said will be a thing of the past. No patient will get into an office with a provider without a battery of computer screens of legal descriptions of what they are requesting or refusing. What do you think?

  • http://www.MDWhistleblower.blogspot.com Michael Kirsch, M.D.

    Is there no case too absurd for an attorney to accept? I guess not. http://www.guardian.co.uk/media/pda/2010/jun/02/google-maps-lawsuit

    • Matt

      Not sure what a random lawsuit has to do with the discussion any more than if someone posted stories about drunk physicians on the job. Dr. Kirsch, you seem to form opinion via anecdote. Not a good practice.

  • http://myheartsisters.org Carolyn Thomas

    Old nurses’ riddle:

    Q: What do you call the student who finishes at the bottom of the class all through med school?

    A: “Doctor”

    • http://dinosaurmusings.wordpress.com/ #1 Dinosaur

      Old joke. Straw man. Given that every single student admitted to that medical school beat out fifty to one hundred others, all of whom were equally competent, if you insist on rankings someone will always, by definition, come out at the bottom. There is such a thing as “good enough,” and by the time you get through the medical school admissions process and medical school itself, everyone deserves the title of Doctor.

  • SarahW

    BOgus. Patients sue because they believe they were injured through sloppy practices – especially when you have blamed them for your error.

    They aren’t necessarily looking for anything more than compensation for the tooth you knocked out because you were rushing – not to save their life, but for no good reason except to git-r-done as fast as you can. Tooth loss is a big deal – its an irreversible loss, ugly, it hurts, it costs a mint to repair function and appearance and the procedures are themselves painful and time-consuming.

    Those sharp pains after surgery mean – you’re a whiner (oops, sharp scissors left behind in your gut, actually). Patients sue because you cost them their last best chance, misdiagnoses them because of bias/thinking error or cost containment efforts. Patients sue because you left them with avoidable scars, or avoidable disability, and because you wouldn’t listen.

  • MillCreek

    As a healthcare risk/claims manager for 27 years, I have worked up thousands of claims in my career. I am the first to agree that good communication, rapport, courtesy and apologizing when a bad outcome occurs is important. I am also the first to agree that these are not magic bullets and will by no means dramatically drive down claims rates. The four factors listed above plus an early offer has the potential to drive down claims rates, but is only feasible in those claims of clear-cut liability. Sometimes, the issue of liability is not particularly obvious and does need investigation, discovery and expert consults to figure out what happened and did liability occur. Laypeople often find it hard to understand that the law recognizes the principle that bad things can happen to good people, and just because a bad thing happened does not mean that the clinicians were negligent.

    I do believe that the combination of a significant adverse outcome (whether or not it was due to error that reaches the level of malpractice), significant wage loss or loss of future earning potential, lack of explanation and support from the treating clinicians, and the desire to hold people accountable are the foundation of most medmal claims. Laypeople often also think that medmal claims have some sort of prophylactic effect in preventing future similar bad outcomes, and in my experience, the filing of claims rarely accomplishes this goal.

  • http://www.healthcaretownhall.com JEngdahlJ

    What pressures face new companies in medical professional liability insurance? More on this, other medmal questions at http://www.healthcaretownhall.com/?p=2661

  • http://www.MDWhistleblower.blogspot.com Michael Kirsch, M.D.

    I assume, Matt, when you use the dismissive term ‘anecdote’, you really mean ‘experience’, which is an aggregate of anedcotes. Yes, you are quite right that I rely upon them. Most clinical issues I face, and many other issues in life, do not have hard data that specifically addresses the issue at hand. Therefore, I use my experience and others’ to guide me. Additionally, many issues are so self-evident, that no study is required. Life experience may be worth much more than hard data, in many circumstances.

  • Matt

    Life experiences are useful in forming an opinion. But one of the downsides of life experiences are that they are limited to just one’s life. To think that one can rely solely on their own life experiences in reaching opinions on issues is arrogance. Particularly when those narrow life experiences are contradicted by rather clear hard data. I’m reminded of a person I know who won’t get vaccinated because they believe they got really sick when they were vaccinated and know 5 or 6 other people who did as well. That’s their “life experience”.

    In the absence of hard data, one must work with what they have. However, when it is present and easily reviewable, well, ignoring it becomes willful ignorance.

  • Molly, NYC

    Bit of speculation here: Is it possible–perhaps by scouring public court records–to identify patients who’ve filed unusually high numbers of civil suits? Presumably patients who file frivolous suits in general will file frivolous medical suits.

    In fact, considering what a legal minefield medical practice is, such people might consider every clinical encounter like a kid in a candy store.

    Anyway, (1) could such overly litigious dirtbags be identified (either from their own civil-court histories, or possibly profiled?) and (2) if they could be identified, what could be done with the information?

    • Matt

      ” Presumably patients who file frivolous suits in general will file frivolous medical suits.”

      Doubtful – at least doubtful with an attorney. The thing people don’t realize about medical malpractice claims is that they’re not cheap. Filing truly frivolous ones doesn’t make sense because of the high entry costs. And, to have a valuable case, you’ve got to have a pretty significant damage. No one wants to have a “good” medical malpractice case. Why? Because you’re probably in a lot of pain. Your data mining is unlikely to turn up many repeat med mal litigants.

      “In fact, considering what a legal minefield medical practice is”

      It is? Are they sued any more often than any other occupation? Most studies show that the vast majority of medical errors never even see a claim file.

      • Molly, NYC

        Filing truly frivolous ones doesn’t make sense because of the high entry costs.

        Riiiight. Which is why there are no frivolous medical suits.

        It is? Are they sued any more often than any other occupation?

        Uh, there’s a reason why docs sink major bucks into malpractice insurance, while (for example) waitresses, cops, code monkeys, actors, stevedores, musicians, letter carriers, hookers, newsies, proofreaders, gardeners, bar backs, writers, cooks, jockeys, commercial fishermen, theatre ushers, receptionists, prison guards, coal miners, merchant seamen, plumbers, butchers, forest rangers, air traffic controllers, florists, spies, graphic designers, hotel clerks, janitors, stand-up comics, loggers, garbage collectors, and people who perform at kids’ birthday parties don’t bother.

        • W

          One reason why docs sink major bucks into malpractice insurance is because they aren’t allowed to join the big group clinics without it. The clinic administrations are concerned about protecting themselves, not the doctor or the patient.

          It’s an industry like everything else. There are insurance companies out there promoting a product (malpractice insurance) by whatever means will get them a sale. Marketing people — of which I am one, in another industry — are quite skilled at manipulating statistics to mean anything they want. And the lawyers just want to get their hands on that insurance money.

        • http://myheartsisters.org Carolyn Thomas

          Well, this is true, Molly. The difference is that waitresses, cops, code monkeys, actors, stevedores et al are working for employers who will fire them in a heartbeat if they turn out to be negligent, incompetent, unskilled, or a danger to others.

          Insurance is not unique to physicians. I have car insurance, and if I drive in a fashion that causes others harm and am then found legally negligent, I need that insurance to pay for the harm I have caused through my negligence. How is that different from malpractice insurance?

          • Molly, NYC

            Carolyn,

            People have car insurance because auto accidents are pretty common. Physicians have malpractice insurance (and clinical positions require it) because malpractice suits are pretty common.

            I know no waitresses (nor can I find a report of any on Google) who have been sued in their professional capacity. (Fired, yes; sued, no.) Conversely, how many physicians–and not bad ones, either–do you know who’ve been sued?

          • Matt

            Molly being sued doesn’t mean you’re a “bad” physician. It means someone is alleging you made a mistake. A wonderful driver may still accidentally run a red light.

        • Matt

          I’m going to assume you’re joking with that last paragraph.

          And I didn’t say that there have never been frivolous med mal claims. I just said it’s unlikely you’ll find one person who has filed a bunch of them and be able to sanction them and generate a lot of savings.

  • http://www.MDWhistleblower.blogspot.com Michael Kirsch, M.D.

    Matt, I offer you own statement, Most studies show that the vast majority of medical errors never even see a claim file’, as one piece of evidence that the system is failing.

  • Matt

    And you’d be right Dr Kirsch. But don’t be deceptive. Neither your profession nor your backers in the insurance and other members of the tort reform lobby are interested in making it easier for MORE victims to be compensated. Your false anguish is belied by the nature of your proposed “reforms”.

  • surgical resident

    @ Matt

    “In the absence of hard data, one must work with what they have. However, when it is present and easily reviewable, well, ignoring it becomes willful ignorance.”

    I think part of the problem is that there is limited hard data. When people state that reforms haven’t decreased “defensive medicine,” I’m never shocked for several reasons. First, it takes a long time to change practices of individual physicians. That’s not going to happen overnight. Second, the public wants all these tests to be performed and there is no downside for the physician. Finally, the reforms may not be adequate to provoke a change in practice. Also, what type of hard data do you expect? Ideally we would take two populations, one with medmal reform and one without, and compare them over 50 years controlling for other factors (which would be impossible). Without this sort of evidence, you will never “prove” anything.

    I can’t speak for all MD’s, but I personally don’t want to eliminate med-mal. If someone cuts off the wrong leg, then they probably should be sued. However, my own anecdotal evidence, suggests that most lawsuits are retarded from a medical standpoint. I leave the term frivolous to the lawyers. What I mean by this is that I completely understand what the MD did and believe he/she did the right thing. I could give examples if you’d like. Look at the kidney transplant case last week. I don’t know all the details, but from my educated perspective leaving a kidney in place when the donor had endometrial cancer seems fairly reasonable. No one knows the risks of leaving it. In retrospect, it was the wrong thing to do, but it certainly wasn’t malpractice. Yet a lawsuit occurred nonetheless.

    I don’t know the solution to the problem. Perhaps if we required the losing plaintiff to pay for court costs, etc. that would help. Maybe special courts would help. I don’t know. I do know that this is a problem and its worse for MD’s than most other professions.

    • Matt

      “I think part of the problem is that there is limited hard data. ”

      There’s a ton of hard data. But your insurers aren’t really interested in releasing unredacted data. But they have all you’d ever need – it’s part of how they price their risk.

      ” First, it takes a long time to change practices of individual physicians.”

      We’ve had the reforms in some states for nearly 4 decades. How long do you need? The reforms don’t work because they’re not really intended to change the practice of physicians. They’re sold that way, but the purpose isn’t to improve medicine or reduce defensive medicine, or reduce the cost of healthcare.

      “Second, the public wants all these tests to be performed and there is no downside for the physician.”

      This is the crux of the issue.

      ” and compare them over 50 years controlling for other factors ”

      Is 40 years not enough?

      ” do know that this is a problem and its worse for MD’s than most other professions.”

      I keep hearing this is a “problem”. I’m not sure what that means – that physicians don’t like it? No one likes having to explain their actions. But then, physicians aren’t going to like any review system, are they?

  • rezmed09

    The US system of litigation means we deal with bad outcomes and quality control through fear, anger, threats, revenge and lottery style compensation.

    We could do better. Other countries seem to.

    • Matt

      Clearly you’ve not been involved in a trial. Fear, anger, threats, revenge, much less “lottery style compensation” (the value of a case is typically a direct reflection of the harm). But if you think other countries do better, please explain how they do better and why you think that is.

  • surgical resident

    Matt,

    I understand many of your points, but have a few issues.

    1: Saying the insurers have all the data isn’t fair. Neither you nor I have seen that data. In addition, I want data showing how different reforms work or don’t work. I don’t think anyone has this data.

    2. Sure some states have had “reform” for a long time. However rates have still been going up for many MD’s. So I would probably just call these variations among the states. I personally don’t think capping rewards does a whole lot of good. Again I don’t have a solution.

    3. I think you are selling many MD’s short. I don’t want to eliminate med mal. Heck if I injure someone as a result of malpractice they probably deserve compensation. However, the current system isn’t working. It isn’t right for the average OB resident to have two lawsuits hanging over them on completion of their residency. Do we really believe that everyone coming out of that field is that incompetent? Of course not. In addition, if they are following the standard of care then the case should be dismissed quickly. The problem is that lay people are unable to judge what malpractice is.

    I guess my point is that it is a problem. It isn’t fair that we get sued when we haven’t breached the standard of care then can’t dispose of the frivolous lawsuit quickly and efficiently.

    Finally, most of us have no problem reviewing our actions. Heck i stand up every Friday in front of 50 surgeons and explain my complications and how I hope to avoid them. This is part of our training.

    Sorry for the typos and poor grammar. I’m on my iPhone I can’t review what I tried to thumb on here.

    • Matt

      “Neither you nor I have seen that data.”

      You’re right, I have not seen that particular data. I have, however, seen the kind of data they keep for car wrecks as I handled a bad faith matter. All medical records are tracked across all cases, bills are tracked to see what doctors are charging more or less, claimant’s information, jury verdicts and settlements by injury, age of victim, economic status, etc. I find it very unlikely that med mal insurers, who are usually looking at higher damage claims than auto insurers, wouldn’t do the same.

      ” However rates have still been going up for many MD’s. So I would probably just call these variations among the states. ”

      Or more likely, it’s that the cost of the damages have gone up because that’s what drives awards – medical bills. So if they’re significantly higher now than 30 years ago, that’s going to have an effect. But you asked for a large data sample – I told you we have had 30 years to estimate the impact of the reform championed by physicians. And it’s not been shown to do anything you claimed it would.

      ” It isn’t right for the average OB resident to have two lawsuits hanging over them on completion of their residency”

      Show me where this is the average. I’d venture to say 99% of docs don’t even know how many lawsuits are filed annually, much less paid on. There are probably 1 billion physician-patient interactions. Every physician claims there are too many lawsuits, but none know how many, and none will ever say how many they’d expect there to be given that.

      “t isn’t fair that we get sued when we haven’t breached the standard of care then can’t dispose of the frivolous lawsuit quickly and efficiently.”

      “frivolous” is a subjective term, so let’s put that aside. Remember, the point of a lawsuit isn’t just to hammer the negligent party. It’s to determine who is negligent. In order to do that you often have to put them under oath and hear what they have to say. But you’re not the only one who would like it to go faster. The only one who benefits by slowing it down is YOUR insurer. The plaintiff and their lawyer certainly doesn’t. So if that’s your gripe, it would seem that taking it to YOUR insurer would be the key.

      “The problem is that lay people are unable to judge what malpractice is.”

      Why do you believe that? You think that they can’t be educated on a particular area of medicine and make a call? I understand you want to be judged only by your own, and that’s fine. But will you extend that to all occupations? For example, physicians routinely sue health insurers – will you allow those cases to only have a jury of health insurance execs?

      At the end of the day, though, your only solution for 40 years has been more caps. Which really doesn’t address ANY of your complaints.

  • MillCreek

    So, if there are such profits to be made in malpractice insurance, you would think that the lawyers would flock to create, control or own such companies. Think of the good that can be done in terms of controlling costs, compensating patients, improving care and reducing premiums to the insureds.

    • Matt

      What makes you think there aren’t lawyers in that business? But just because one might be a good attorney doesn’t mean they can run a business. I know lots of smart attorneys who are horrible businessmen, and I’m sure you know many physicians like that.

      • MillCreek

        Matt, this was more of a wry comment regarding those plaintiff counsel who rant about the obscene profits the medmal insurers are making, and how they they exist primarily to extort money from the insureds and cheat the injured. You would think that if there is such money to be made and reforms instituted, perhaps the plaintiff counsel should own, operate or control these companies to see if they can do a better job.

  • http://tjgmd99@wordpress.com doctor sabelotodo

    the old saying is true…there are patients who sue and doctors who get sued…as stated above, good comunication is the key at all levels..i have seen/heard of good doctors with poor social skills being sued and bad doctors with charming personalities who never get sued!!!