I’m curious to hear your thoughts about just how deep this emotional involvement with one’s own performance runs for most physicians. Specifically, does it run so deep that malpractice reform isn’t the only thing that needs to happen before we can establish a uniformly high rate of physician self-reporting of medical errors.

Some advocates for malpractice reform are emphasizing that physicians will never voluntarily report errors if they feel like they’ll be sued as a result. So let’s assume that we implement reforms such that admissions of error will never be usable in malpractice suits.

Would this be enough to substantially increase the rate of physician reporting of mistakes?

I read a toss-off statment in a paper the other day that “physicians often view mistakes as a moral failing” and that this often keeps them from admitting mistakes even when their admissions are insulated from lawsuits.

I’m not sure how to react to this (obviously overbroad) statement. Many physicians take their performance so seriously that they do seem to view mistakes as a species of moral failing. But how prevalent is this?

In order to achieve high rates of physician reporting of mistakes, would we also have to have a system of anonymous reporting, to go along with protections from malpractice lawsuits?

The public might be much more willing to accept malpractice reform if they also felt that physicians were leading the efforts to reduce medical error.

In the USA Today article cited above:

“Malpractice lawyers, led by the Association of Trial Lawyers of America, counter that rising premiums have more to do with the insurance industry than jury awards. They say tighter regulation of the industry is needed.”

Listen very carefully.

THAT. IS. A. LIE.

Let me make sure you understand this.

THEY. ARE. LYING.

I will not say they are wrong or misinformed. The studies have been commissioned by Jeb Bush in Florida, got a commission of mostly lawyers, including Donna Shalala, as you may recall formerly head of HHS under Clinton. Now she’s president of a college in Florida (University of Miami? not sure). The conclusion of that study was that the primary driver of premium is the size and frequency of awards, not the insurance investment climate or any particular practice of insurance companies.

Senator Richard Durbin, who represents the American Trial Bar in the Senate, and in his spare time represents the people of Illinois, commissioned a GAO study of the same issue. The General Accounting Office came to the same conclusion.

At the time the study came out, a tort reform bill was in the Senate. The bill had passed the House, the President indicated he would sign it. The bill died in the Senate on a pure party-line vote.

Senator Durbin commissioned the study, along with some House members of a similar philosophical bent. Faced with a study he commissioned, with results that his paymasters in the American Trial Lawyers Association would not like, the fine Senator from Illinois suppressed his own study until the bill died in the Senate, and THEN he allowed the report to be released.

Now imagine another scenario, where the GAO report concluded that the cause of rising premium was more malpractice than historically. How fast do you think Durbin would have released that study?

Imagine still another scenario where, say, a REPUBLICAN Senator commissioned such a study with conclusion that the cause of rising premium was more malpractice, and the REPUBLICAN Senator suppressed that study? We’d be hearing about that “scandal” daily in the press. How many of you know Durbin even did that?

So yes, maybe before these studies came out, you could say the trial bar was just misinformed. These studies have come out, and the trial bar is still making claims proven to be untrue.

They are lying.

it’s personal because we work so damn hard to get it right.

it’s personal because we often make mistakes when we the system forces so much overhead cost on us that we need to work like dogs to take home a paycheck. ( the lawyers love the system..the more dysfunctional it becomes, the harder we have to work to make ends meet, the more likely a mistake occurs or a patient gets angry becuase we had to rush.)

it’s personal because we care.

it’s personal because the expectations of excellence don’t fit with the demand that we work like short order cooks.

it’s personal becuase of the years and years we put on hold to be able to get where we are at.

the only practical solution seems for physicians to conceed that we cannot do good work on every occassion on everyday/night on every deciion on every patient.

then we need to stop kidding ourselves that we can be excellent practitioners in this system so highly prized by multimillion dollar CEO’s and litigation lawyers.

we need to stop begging legislatures for relief and just withdraw from this insane dyfunctional system.

insanity is to continue doing the same thing over and over again hoping that a different outcome will be gained.

Edwards Legal Experience
Edwards specialized in putting doctors out of business.