Comments on: Random thoughts on malpractice

By: PointOfLaw Forum

PointOfLaw Forum — Mon, 01 Nov 2004 05:47:49 +0000

Around the medblogs
So much to read of late: * MedRants on costs of the system, fee-per-visit malpractice surcharges for patients, and assorted thoughts; * MedPundit reports that “The American College of Radiology [has] once again [taken] action against a member who has…

By: Tina

Tina — Thu, 28 Oct 2004 22:40:46 +0000

Thank you, Aaron and those like you!! I have tried for years to get my husband to quit his practice and work with my brother in the research aspect of medicine – absolutely non clinical. His daily angst of caring for his patients, making sure they get the best medical care (and they do!), has taken its toll on him. I can’t tell you the countless hours, he has spent away from his family and three daughters. But that’s OK, because he finally has called it quits. By the way, please don’t drive too fast when travelling in western Iowa on highway 80, because if you get into a car accident, there is a certain area that no longer has any trauma surgeons – my husband was the last one.

By: Aaron

Aaron — Tue, 26 Oct 2004 23:28:13 +0000

jb, that’s a rather silly test for “real malpractice”. It doesn’t matter how egregious a doctor’s error unless it can be predicted with certainly precisely what bad outcome will result?

By: john mccormack

john mccormack — Tue, 26 Oct 2004 21:09:56 +0000

would you call this an error, the attending doctor on call went grocery shopping, put his pager on vibrate went home and fell asleep, never answering any of his pagers, he knew about my daughters condition and never even bother to inquire about my daughter’s condition. They abandon and neglected my child. In my opinion they killed my daughter and got away with it. I work in Law enforcement and if I abandoned and neglected YOUR LOVE ONES, I would be fired on the spot. Your profession does have a Wall of Silence !!!!

By: pj

pj — Mon, 25 Oct 2004 23:19:01 +0000

Pres Bush had proposed a plan that encouraged all providers who committed errors to submit “incident reports” about these errors.
expert panels would review these cases and if the error really had an impact then the patient would be notified and given the opportunity for substantial immediate compensation. without the costly lengthy litigation process …awards could be reduced by enourmous amounts, the patient would get fast compensation and the provider would be much more willing to admit a mistake.
(everybody makes errors. Every body.)

By: john mccormack

john mccormack — Sat, 23 Oct 2004 23:26:49 +0000

malpractice is malpractice, I suggest that you read the Wall of Silence,The untold story of the medical mistakes that kill and injure millions of Americans,, and A Patients Guide to Preventing Medical Errors, both written by people who work in the health care industry.

By: Machi

Machi — Fri, 22 Oct 2004 13:31:27 +0000

I look in vain in this post for use of the phrase ‘insurance industry.”
Let’s talk bout their role in this . . .
http://www.economist.com/agenda/displayStory.cfm?story_id=3307016

By: jb

jb — Fri, 22 Oct 2004 01:33:22 +0000

Real malpractice is, I think, quite rare. I define real malpractice as a situation in which an independent expert, reading the chart in chronological order, picks out the error without knowing the outcome. He could prospectively identify the error that potentially will cause a bad outcome (he says to himself, “no good will come of this“ as soon as he reads it). Most malpractice cases arise from bad outcomes and patients or families who are then upset by something external to the actual care delivered- a brusque comment by a physician, misunderstood complaint from an overworked nurse, or financial stress. The “deviation from the standard of care” is discernable only in retrospect by a highly compensated hired expert. For the rare cases of true malpractice, the current system will suffice. For people who are just pissed off about a poor outcome, there should be private market insurance available. This would be no-fault, paid to the patient for any specified complication or poor outcome. Premiums paid will be determined by the patient’s underlying condition and possibly uprated for certain physicians who have especially poor records. It could be a rider on standard health insurance policies- pay extra for the policy that pays for complications, or available on a per incident basis for elective surgery. There is no free lunch. Why not make the patient pay for his potential benefit?

By: SteveSC

SteveSC — Thu, 21 Oct 2004 14:40:11 +0000

Advantage #5 is key. All the others might have a slight effect on costs and errors, but building a system to investigate and revise practice patterns would have a huge effect on the total number of errors, something everyone wants (except perhaps some trial lawyers .
Grand Rounds used to be held at most institutions (including private hospitals) to review medical errors. I remember several held when I was a medical student that drilled down to every decision in specific ‘bad outcome’ cases. In just about every one there was a chain of errors that occurred. Now Grand Rounds is usually a research presentation, often funded by a pharma company, which does nothing to assess problems in the current medical system of care.