Even though doctors are experiencing enormous and unfortunate hikes, imposing caps and giving immunities or special prvileges to insurers, manufacturers, etc. is no cure for medical malpractice. Doctors complain that juries are not equipped to determine malpractice, but then why do insurance defense attorneys uniformly ask for juries. Instead of caps, perhaps we should have some agency similar to the National Transportation Safety Board determine if malpractice occurred, and take steps to compensate victims on that basis. Perhaps medical board could take better steps to get rid of incompetent doctors (surely you agree there are some out there?). In the meantime, tort deform is hurting your patients and will have little lasting benefit for you as doctors.

And please, give us a break about being venal. If you practice medicine solely to patient care purposes, why aren’t you out on some missionary work, working in the inner city for cheap, or giving away your services. You practice medicine for the same reasons we practive law, in part for the human benefit, in part for the challenge, and in part to make a living for our families. Give me a break with all the whining about money. Instead of doing harm to your patients that are injured, do something positive to rid your profession of arrogant and incompetent doctors. You would be doing everyone a favor.

“On the whole,” you say? Gosh, I can’t wait to be “on the whole!” MDs don’t make the so-called big bucks until after 3-10 years of training. Until then, they’re paid about the same as dishwashers, if you break it down to an hourly basis.

Show me the lawyers who “on the whole” would accept that level of compensation after graduating law school!

First, it is not my assumption that doctors are responsible for malpractice, or that verdicts in excess of $250,000.00 are warranted as a result of the serious injuries caused by those doctors. That is primarily the determination of the doctors themselves, in conjuction with their defense lawyers, when they choose to settle larger malpractice cases. Secondarily, it is the determination of the nation’s trial and appellate courts. One can also note that, despite the rhetoric from “tort reformers”, you guys aren’t presenting any case studies to back up this type of claim, let alone any you might argue are representative. Unless you can back up your claim with more than your idle speculation, you’re really just making stuff up.

As for “medical evidence” that shows one thing or another, the fact is that lawyers can’t even get into court without a medical opinion to back up their claims. (Are there any states left which don’t require pre-certification of cases by a qualified medical expert?) And doctors know how to defend themselves, and their insurance companies spare little to no expense in providing defense experts to present their side of the case. Unsubstantiated medical theories can’t get into court post-Daubert. So what you’re really complaining about is a divergence of opinion in the medical community – which isn’t the fault of lawyers.

Your argument on damages is beyond silly. You are arguing that it is fair to deprive malpractice victims of their ability to retain counsel, because their attorney receives a contingent fee? Here’s a solution – we’ll tack on an attorney fee to the award given to the victim, such that the victim gets the entire award. Oh… no good, you say? You don’t want the responsible party to pay the attorney fee? The only system that works for you is one where the attorney is underpaid or unpaid, or the victim can’t afford to litigate? [eye roll]

I was not aware that I needed to provide more of a reference than to give you the name of a speaker and the location of his speech. What more do you need? The UM Medical Center is anything but obscure, and I’m not here to spoonfeed you every time you’re too lazy to spend thirty seconds on a Google search.

I thought I referenced my source on malpractice costs as being the Congressional Budget Office’s report on “tort reform” and medical costs. Presumably you followed the link to that Jan. 2004 report. But please – if you for once want to present a fact as opposed to your standard guesswork and self-serving speculation, please share “current” figures.

On this much you are right – as long as I rely on facts and reality, and you disagree on the basis of guesswork and mythology, we are unlikely to agree.

Your final questions:

“How do huge rewards affect the doctor patient relationship?”

Few patients have any interest in going back to a doctor who has committed malpractice upon them. So there’s little left of the doctor-patient relationship to be damaged by providing fair compensation to the victim.

As you probably know, one of the leading factors in whether or not a doctor is sued for malpractice, or if the patient writes it off as a forgivable human error, is the quality of the doctor-patient relationship and the doctor’s “bedside manner”.

“What impact to awards have on test ordering?”

How many unnecessary tests do you order each year? The managed care and insurance companies which limit your fees let you prescribe whatever unnecessary tests you want, and reimburse for them? C’mon.

There’s a lot of speculation about the cost of “preventive medicine”, but (as the “study” you criticized about patient deaths attributable to poor medical care) they are speculative.

Also, there is absolutely no evidence that any such ‘preventive medicine’ will be affected by damages caps or attorney fees. So how is this even relevant to your larger point?

“How many good physicians leave practice prematurely?”

I have no idea. But the medical schools seem to be full. Go ahead and let us know.

“How many areas have insufficient neurosurgeons, or obstretricians?”

I guess that depends upon your definition of “insufficient”.

As you are almost certainly aware, Michigan has had damages caps and other severe restrictions on medical malpractice cases for years. Yet Michigan’s obstetricians still pay some of the nation’s highest malpractice premiums. Still, I haven’t had any trouble finding one to care for my wife. So… from where I literally stand, this looks like something of a red herring.

Here’s a question for you – do you agree with the studies that indicate that only 12% of actual malpractice incidents result in litigation? What system do you propose which will fairly identify and compensate all victims of malpractice, while costing less that the present system?

(Daniel – I’m not sure what point you are trying to make. Lawyers pay for malpractice insurance. Lawyers get sued for malpractice. Lawyers aren’t shielded by “certificate of merit” requirements or damages caps. Yet lawyers don’t seem to whinge all the time about how life is unfair to them because they may get sued.)

Spectacular post.

Oh, and Santa, I want a pony too.