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Wednesday, July 09, 2003"Most doctors don't get sued," says Annas, referring to a 1990 Harvard study showing that only one in eight malpractice victims ever takes his or her case to court. "Compare that to patients who worry about being killed; it's not even in the same league." Over the course of a life time, most doctors experience at least one claim filed against them. And in Florida, if those doctors are neurosurgeons, they have a 1 in 1 chance of being sued. The suit might not go to trial. It might be dropped by the plaintiff's attorney after filing, when he realizes there's no case, but it's still a suit. And it still takes time and money to marshall a defense until it's dropped. Dr. Marcia Angell, former editor of The New England Journal of Medicine and now a professor at Harvard Medical School, is not surprised. "[Doctors] are not economists. They don't think in terms of how a business makes up for a loss of profits. They have been at loggerheads with the trial lawyers for so long that it's always a knee-jerk reaction." Moreover, she observes, many lawsuits arise due to the lack of a social safety net. "As long as we have a system based on avoiding sick people and not taking care of them, you leave sick and injured people with very little alternative other than to sue and to get some care that way," says Angell. Huh? Does Dr. Angell really believe that people sue their doctor to get better access to care? Large punitive damages serve one purpose only - revenge: Linda McDougal, the Minnesota woman whose breasts were mistakenly removed after she was incorrectly diagnosed with cancer because her files were mixed up with another patient's, suffered few quantifiable economic losses. She had health insurance, and her employer covered medical bills and lost wages. But "she will have to go through life mutilated for no reason," says Carlton Carl of the Association of Trial Lawyers of America. And since she can’t physically mutilate the person who mixed up her biopsy specimen, she’d rather financially mutilate them - or at least their insurance company. And that's exactly the way many people - and lawyers - think. I once had a patient who told me she was suing her best friend after they were in an auto accident together. The friend was the driver, and my patient wanted pain and suffering money. The amazing thing was, she couldn't understand why her friend was no longer speaking to her. Her exact words were, "I'm not suing her. I'm suing the insurance company!" Then there’s the oft-repeated claim that the bad doctors among us are to blame: Far more effective than an arbitrary cap on damages would be a more systematic effort to weed out bad doctors and prevent malpractice in the first place. Dr. Sidney Wolfe, director of Public Citizen's Health Research Group, says, "You should protect patients with doctor discipline and protect good doctors with low premiums." Public Citizen ranks state medical boards according to their records of disciplining negligent doctors. "Five percent of the doctors account for 50 percent of the malpractice payouts," he says. "The primary failing is at disciplining doctors. A lot could be remedied by taking bad doctors out of practice." Judging from the lawsuits that I've heard about from my colleagues, and from my own experience with a frivolous lawsuit, I find it hard to believe that better discipline is going to make much of a dent. “Five percent of doctors accounting for 50 percent of malpractice payouts” just doesn’t ring true. I’d like to see the data that supports that assertion, but Public Citizen never offers it. Obviously, like Dr. Angell, it’s been a long time since Dr. Wolfe has spent any time among practicing physicians who face the risk of being sued everyday - even when they do everything right. This argument that bad doctors are responsible for the medical malpractice crisis is the most infuriating argument out there. Especially when the legal profession acts as if there is no room for improvement in their unethical habits. Ask any attorney, and they'll admit that it's common practice to slap everyone whose name appears on a medical chart with a lawsuit, without any attempt to determine who was at fault before filing. Once a suit is filed, that claim is on a doctor's record forever. That's just wrong. The legal profession needs to take steps to start acting responsibly when it comes to lawsuits. The author concludes: If the AMA succeeds in passing a $250,000 cap without a provision forcing insurance companies to pass their savings on to doctors, rates may well continue to climb, in which case growing numbers of obstetricians will stop delivering babies, more neurosurgeons will retire early or shy away from risky procedures, and more mutilated patients will be denied compensation. And in the end, Karl Rove and his buddies in the insurance industry will be laughing all the way to the bank. I don’t know if Karl Rove has buddies in the insurance industry, but one thing’s for sure, if caps don’t pass, Congressional Democrats and trial lawyers will be laughing all the way to the bank. posted by Sydney on 7/09/2003 12:32:00 PM 0 comments 0 Comments: |
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