p.s. The final paragraph is pretty circular: opinions shouldn’t drive public policy, but opinions drive behavior, and that behavior raises concerns. And how should those concerns be addressed in this case, if not through public policy?

The answer ought to be obvious: There is no way malpractice lawuits can improve medical care.

Such lawsuits, most of which are frivolous and meritless, generate fear and anger, tending to drive away from practice some of our best and brightest physicians, and with a number of them shying away from high-risk, life-saving procedures. That has happened in a number of states where the malpractice climate has become brutal.

We have available much better mechanisms to improve health care, without fracturing the physician-patient relationships. These include strict peer reviews, tough credentialing policies, recertification, and vigilant state medical boards.

Now that students are aware of the problems vexing medicine, fewer are attracted to a medical career. Medicine traditionally attracts the best from our young student6s, and the prospective loss of this manpower ought to worry our medical educators.

This is not to say the malpractice climate alone has brought about the rising dissatisfaction in medicine; there are other elements most of us are familiar with. You mix all of these and we have got a bitter brew that is not salutary to good patient care.

To ROSS,

According to Dr. Palmisano, who was AMA president last year, there are about 125,000 medical malpractice lawsuits clogging U.S. courts on any given day. 70% of these are closed with no payments. Of the remaining that go to trial, 80% are won by physicians.

Those statistics, which appeared in the AMA News sometime in February or March this year, clearly suggest the vast number of them are frivolous or have no merit.

These numbers are important to keep in mind since defending a lawsuit nowadays, no mmatter how frivolous, may now cost upward to $40,000 jor more. You and I know that these frivolous lawsuits are filed to shake down physicians for settlements.

There is a significant difference between “closed with no payments” and frivilous. For example, a case may be opened in large part because of anger and confusion following a health care provider’s failure to offer a sufficient explanation for an adverse outcome. (which leads to a clarification — when I said “cases are filed merely for a bad outcome” above, I meant for a patient and their attorney to knowingly pursue a case where they know there is no question as to why something occurred.)

Furthermore, quoting me statistics from the nation’s #1 advocate for tort reform is dubious evidence at best.

And the fact that 80% of cases are won by physicians has as much to do with the horrible jury system you deride as the large verdicts you loathe.

Malpractice cases are filed only 5% of the time malpractice occurs, which means the vast majority of the time, substandard care does not result in a lawsuit. An instance of substandard care, unfortunately, also does not often lead to improvement of medical practice. Creating a cap would do nothing to improve care, and in fact would further remove physicians from consequences for poor practice.

Our system can be improved, but a cap isn’t the way to do it.

The reason that lawsuits by homeless or prisoners are rare is that they can’t command the high jury awards that more sympathetic plaintiffs can, and lawyers are therefore reluctant to pursue them (John Edwards never sued on behalf of a child who died; live but disabled kids are much more lucrative). Nursing homes are unfortunately attracting a lot of attention from trial lawyers. Quite a few nursing homes have been sued into bankruptcy, and many of the survivors have difficulty getting physicians to take care of their residents because of the liablity premium surcharge that most insurance companies tack on if the doc sees nursing home patients. My Google search for Nursing Home Lawsuits brought up 96,000 hits.

arf,

That’s not accurate. You’re assuming the 95% of cases not being filed are being replaced 1-for-1 by so-called frivilous claims. They’re not. There should also be no surprise that docs win the majority of cases which go to trial — a large share of cases the docs might lose are settled out of court, first of all, and second, physicians are able to (or had been able to until very recently) command the best, most experienced med mal attorneys for their defense, and generally present themselves very well in court, with community-based experts to back their side.

Malpractice Reform—the real health care issue.
Medical Rants has really been on a roll lately on the malpractice Issue. Read DB’s Medical Rants »this post and this post (especially the comments, particularly the last one) to get an understanding of why Dick Cheney blasted the Kerry/Edwards…