DB'S MEDICAL RANTS

Internal medicine, American health care, and especially medical education

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Hearing on special health courts

Regular readers know that I favor special health courts as the best method of addressing medical malpractice. Last week the Senate had hearings on this subject. Common Good features these hearings on their web page – Senate Hearing on Special Health Courts

Professor Studdert testified at the hearing. He is the author of the NEJM article which so many have misinterpreted. I have blogged previously on the article – 40% of malpractice cases are totally unwarranted and More on unwarranted malpractice suits. In his testimony Professor Studdert makes his interpretation very clear.

Pointing to his most recent study on malpractice claims published in the New England Journal of Medicine (read more about the study here), Professor Studdert said that while the current system does a reasonable job at directing compensation to the right people, compensation is only one goal. More importantly, he suggested, the current system fails in four critical areas. First, the process is too costly. More than 50 percent of the money in the system goes toward overhead expenses, a much higher rate than other compensation schemes such as workers compensation. Second, only about 3 to 5 percent of injured patients have any contact with the legal system, leaving a large “invisible population” that the current system fails to help. Third, while it is difficult to estimate the cost, there is solid evidence that defensive medicine exists. Fourth, the current system is not compatible with efforts in quality improvement. Professor Studdert suggests that health court pilot projects would be an excellent way to evaluate whether alternative compensation schemes could provide better results. Click here to access Prof. Studdert’s testimony.

I am ready for the predictable cries that special health courts are unconstitutional. First, I hope the Congress allows them, then we can have the expected Supreme Court challenge. Asserting that something is unconstitutional does not mean that it is unconstitutional. It only reflects the asserters opinion. Until the Supreme Court has a chance to hear arguments and vote on an issue, we have opinions and speculation. I suspect that both sides can make convincing arguments.

Aside from that objection (which trial lawyers will wear like the flag), I can see no reasonable argument against special health courts. More patients would receive compensation; processes for improving quality would be enhanced; and physicians would likely practice less defensive medicine. Physicians and patients deserve a predictable system. They deserve judgements based on the medical data, not the skills of the lawyers.

Kevin, MD had a great rant on this subject yesterday – David Studdert testifies for health courts

Now I prepare to read the comments.

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