Brace yourselves for a long one. I have several links to include, plus the usual commentary.
When professions collide. A great rant from Dr. Rangel. Here is an important excerpt.
from bad physicians. It exists only as a very imperfect “lottery system” to siphon money from insurance companies into the pockets of trial lawyers and to make a few plaintiffs rich. What is needed is an independent review system set up and controlled by the courts to examine cases where malpractice is suspected and to hand down compensation and punishment (including restrictions and revocation of the licenses of “bad apple” physicians) in cases where independent and non-biased “expert witnesses” (selected by the court) determine that malpractice did in fact occur. Such a system would contrast sharply with our current tort system where the objective is to win at all cost and to obtain as big an award for the plaintiff as possible.
Please go read the entire post, as it does a nice job of summarizing the problem. We now go to the ridiculous – our old buddy Bob Herbert, who apparently does not know the difference between fecal matter and shinola. Cooking Up a Crisis. He says the most preposterous things.
There is no question that malpractice insurance premiums have increased sharply over the past few years. In some instances they have skyrocketed. But, as the Congressional Budget Office has noted, there are a variety of reasons for that, including the cost of malpractice awards, decreases in the investment income of insurance companies and cyclical factors in the insurance market.
“Insurance companies’ investment yields have been lower for the past few years,” the budget office said in a report in January, “putting pressure on premiums to make up the difference.”
The disinformation campaign of the tort reform zealots, and their sustained attacks on the rights of patients who have been harmed by doctors, have been disgraceful. The proper prescription for this apparently chronic disorder is a strong dose of the truth.
Why have so many insurers retreated from the malpractice business? They would not leave the business if they were making money. Malpractice insurers are losing money.
I work at an academic medical center. We have a large enough group for self-insurance. We are not in a crisis state. Our malpractice insurance has increased 15% each of the past two years. The only reason it has not risen faster is that our malpractice committee made a decision to hold the increases to 15%.
Herbert’s arguments are ludicrous. Medpundit does a nice job on this one – Herbert Strikes Again
The definition of “frivolous” is one that is difficult to agree on, so Ms. Mortham was understandbly reluctant to make a statement. A lawyer may say that any outcome which is less than the outcome the patient expected is a justifiable reason for a suit. But a doctor may say that if an outcome is a complication that is known to happen as a result of the disease or a procedure, even if it isn’t the perfect outcome the patient expected, is not a justifiable reason to sue.
Bob Herbert has selectively presented one side of the issue, as he so often does.
The AMA also is addressing malpractice today. AMA studies liability surcharges
The hottest topic of discussion: liability surcharges. The idea is that physicians would tack a charge onto patients’ bills to help offset their insurance payment. Low Medicare and even lower Medicaid reimbursement rates combined with managed care contracts that lock in fees have left them no way to recoup increased overhead, physicians said.
“People are trying to be creative so they can do what they were trained to do,” said outgoing AMA President Donald J. Palmisano, MD.
Physicians have experienced double-digit increases in medical liability insurance rates in the past several years, with some high-risk specialists such as obstetricians, neurosurgeons and orthopedic surgeons facing increases of 100% or more. Doctors have pushed for what they see as the solution to the problem — federal tort reform that would cap noneconomic damages awarded in medical malpractice lawsuits at $250,000. But senators who support the reform don’t have enough votes to stop a filibuster. Attempts to pass legislation failed twice this year.
“Tort reform sounds great, but it’s not going anywhere,” said Washington, D.C., orthopedic surgeon Peter E. Lavine, MD. “It [a fee] gets patients’ attention and plugs them into the issue. … Patients may say, ‘I don’t want to pay this,’ and get more involved in tort reform.”
Perhaps we physicians should take dramatic actions like this one to educate the public. We want to achieve “best practices”. Our current tort system actually discourages this. We too often order unnecessary tests just to cover our posteriors. That is not good medicine.
The current system does not protect the public. Doctors and lawyers could work together to create a productive system, but the trial lawyers would not have the prospect of huge settlements. They, the trial lawyers, represent the fly in the ointment. They really do not seem to care about best practice, rather they focus on big settlements. After all, they are having great financial success with the current system. They have no incentive to change.
This ends my long malpractice rant. I suspect that I will return to this subject in the very near future, as it really is the biggest threat to our health care system.
