Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Tort reform and integrated systems in health reform

Mitchell Brooks, MD
Policy
October 17, 2011
310 Shares
Share
Tweet
Share

Here are my next two principles of affordable healthcare reform.

First, healthcare reform cannot occur without tort reform. Anything less is akin to a drunk leaning up against a lamppost for support but insisting it is for illumination.

It is well known that fear of malpractice suits accounts for defensive medicine; e.g., performing tests and procedures and making unnecessary referrals to assure staying out of the court room. We are all familiar with the horror stories about the astronomical costs of malpractice insurance and the ridiculous suits being brought in the name of justice. More insidiously, this situation is responsible for costs estimated to be anywhere between $60 to $200 billion. One can argue the numbers back and forth, but few do not see this as a significant area for improvement. Some believe that tort reform will change physician behavior and some believe that tort reform will do little to assuage the physician’s fear of a malpractice suit. I cannot claim to have substantive academic credentials. However, in my very own practice I can honestly say that 25 percent – 30 percent of what I ordered with respect to imaging studies and lab testing was clinically unnecessary but well within the standard of care of the community; all for the sole purpose of avoiding a possible malpractice suit.

Suppose we adopted the British system of malpractice law; if you lose you pay the court costs. In addition to limiting pain and suffering awards, why not give a judge the discretion to move all punitive awards deemed excessive to an arbitration board set up specifically for such situations? Why not give the very same judge that discretion? Limiting attorney fees through an Attorney Czar may not also be a bad idea, while we are at it.

***

And second, we must utilize the single payment system to harness all relevant clinical and behavioral information into a secure and safe database. If we are to have efficiency, patients must give up what they consider their privacy.

We hear much from Washington about computerizing medical records and creating information systems readily available to a treating physician or healthcare provider. There is ample evidence that such a state of affairs would significantly and positively impact the cost of healthcare delivery bending the curve down. It would permit clinical practice analysis, medical variable assessment, complication and infection rates to name a few data flow points. The resulting interpretation would be utilized to create the basis for physician, hospital and provider scoring against acceptable standards. This all sounds nice but it is nothing more than rhetoric unless such systems are integrated into a unified and real network of care giving. Such scoring would be made public and an informed consumer with skin in the game is probably the best means to control medical costs; when it comes form your pocket, you are more selective and not as quick to insist on a test deemed unnecessary. Perhaps you might take better care of yourself and not treat your body as a used car?

The results of this initiative would ultimately reduce and eliminate duplication of testing, imaging and treatment would not only be significantly reduced, but productivity and time lost would be recoverable, adding further to the savings that can come from this vital step. Patient safety would be furthered. Mistakes regarding inappropriate medications, iatrogenically induced anaphylactic shock, identification errors and, in the worst case scenario, the wrong limb or the wrong person being operated upon could be substantially reduced and/or eliminated. A 2005 RAND Report (when we were spending only $1.7T/yr. on healthcare as opposed to $2.7T now) estimated that we could save $77B or more a year from the annual savings in efficiency alone!

The health and patient safety issues that could be addressed by such implementation could double the savings, while at the same time reduce illness and prolong life. The same report estimated that the cost of implementing such a project would run to $8B/year over 15 years assuming a 90 percent adoption rate by physician and hospital. Sadly only 17 percent of physician offices currently utilize electronic medical records (EMRs) and only 31 percent of hospital ERS and 29 percent of hospital outpatient departments currently embrace the benefits of this principle.

Mitchell Brooks is an orthopedic surgeon and the host of Health of the Nation on Talk Radio 570 KLIF in Dallas, Texas.  He blogs at Health of the Nation.

Submit a guest post and be heard on social media’s leading physician voice.

Prev

Science makes me a better doctor, faith makes me a better person

October 17, 2011 Kevin 9
…
Next

A covenant between doctor and patient

October 17, 2011 Kevin 4
…

Tagged as: Malpractice, Public Health & Policy

Post navigation

< Previous Post
Science makes me a better doctor, faith makes me a better person
Next Post >
A covenant between doctor and patient

More by Mitchell Brooks, MD

  • The creative destruction of the American family physician

    Mitchell Brooks, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Healthcare consolidation may bend the cost curve the wrong way

    Mitchell Brooks, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Large American pharmaceutical companies cannot have it both ways

    Mitchell Brooks, MD

More in Policy

  • Pediatricians grapple with guns in America, from Band-Aids to bullets

    Tasia Isbell, MD, MPH
  • Health care wins, losses, and lessons

    Robert Pearl, MD
  • Maximizing care amidst provider shortages: the power of measurement-based care

    Tom Zaubler, MD
  • Unveiling excessive medical billing and greed

    Amol Saxena, DPM, MPH
  • Chronic health issues and homelessness

    Michele Luckenbaugh
  • The impact of certificate of need laws on rural health care

    Jaimie Cavanaugh, JD and Daryl James
  • Most Popular

  • Past Week

    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • Unveiling excessive medical billing and greed

      Amol Saxena, DPM, MPH | Policy
    • Misinformed claims and the offensiveness of discrediting COVID-19 vaccine development

      Angel Garcia Otano, MD | Conditions
    • Dying is a selfish business

      Nancie Wiseman Attwater | Conditions
    • Navigating medical decision-making: Embracing limits and growth

      Benjamin Wade Frush, MD | Physician
    • Empathy and compassion in palliative care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Navigating the broken medical system: challenges faced by foreign medical graduates

      Anonymous | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • The essence of medicine: genuine connections in practice

      Jennifer Tillman, MD | Physician
  • Recent Posts

    • Misinformed claims and the offensiveness of discrediting COVID-19 vaccine development

      Angel Garcia Otano, MD | Conditions
    • Bitcoin’s role in diversified portfolios [PODCAST]

      The Podcast by KevinMD | Podcast
    • 1 in 5 doctors will become disabled. Are you prepared?

      Amarish Dave, DO | Finance
    • The pros and cons of whole life insurance for high-income earners

      Shane Tenny, CFP | Finance
    • Family support is pivotal in the treatment of schizophrenia

      Frank Chen, MD | Conditions
    • Is emergency medicine your calling? [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 5 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • CDC Advisors Endorse Maternal RSV Vax to Protect Newborns
  • Amoxicillin Alone for Acute Sinusitis Holds Up Against Broad-Spectrum Cousin
  • Despite Taboo, Med Students, Doctors Use Substances Too
  • White House Opens Gun Violence Prevention Office
  • Nurses Step Up to Bat on Educating Patients About Climate Change

Meeting Coverage

  • Loneliness Needs to Be Treated Like Any Other Health Condition, Researcher Suggests
  • Stopping Medical Misinformation Requires Early Detection
  • AI Has an Image Problem in Healthcare, Expert Says
  • Want Better Health Outcomes? Check Out What Other Countries Do
  • ERS Roundup: Cell Transplant Boosts Lung Function in COPD Patients
  • Most Popular

  • Past Week

    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • Unveiling excessive medical billing and greed

      Amol Saxena, DPM, MPH | Policy
    • Misinformed claims and the offensiveness of discrediting COVID-19 vaccine development

      Angel Garcia Otano, MD | Conditions
    • Dying is a selfish business

      Nancie Wiseman Attwater | Conditions
    • Navigating medical decision-making: Embracing limits and growth

      Benjamin Wade Frush, MD | Physician
    • Empathy and compassion in palliative care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Navigating the broken medical system: challenges faced by foreign medical graduates

      Anonymous | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • The essence of medicine: genuine connections in practice

      Jennifer Tillman, MD | Physician
  • Recent Posts

    • Misinformed claims and the offensiveness of discrediting COVID-19 vaccine development

      Angel Garcia Otano, MD | Conditions
    • Bitcoin’s role in diversified portfolios [PODCAST]

      The Podcast by KevinMD | Podcast
    • 1 in 5 doctors will become disabled. Are you prepared?

      Amarish Dave, DO | Finance
    • The pros and cons of whole life insurance for high-income earners

      Shane Tenny, CFP | Finance
    • Family support is pivotal in the treatment of schizophrenia

      Frank Chen, MD | Conditions
    • Is emergency medicine your calling? [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Tort reform and integrated systems in health reform
5 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...