I guess he is serious

Moof,
I’m not sure I understand the point of any of your paragraphs. “And even then–guess who’ll they’ll blame”. Who is they?

The reason most doctors don’t consider being lawyers is because we’d have to spend more money going to a second professional school. Additionally, if we had wanted to do that for a living we would have gone to law school to begin with. It is much easier to get into. Lastly, the motivation for each is different. Most doctors I know continue to have a drive to help people. Most lawyers I know think about success in terms of money. This may be a generalization, but it seems to ring true to me.
b

B … I’m sorry, I wasn’t aware that I was being vague, but from your comment, I certainly must have been.

In a nutshell – the general public doesn’t have a clear understanding of what’s happening in health care today. They expect perfection in their care (and their physicians,) and they feel entitled to whatever it is they believe, falsely or not, that medicine can offer them – not to mention that they’d really rather not pay for it, if they can possibly get away with it.

Heaven help a physician who makes an honest mistake … or even one who didn’t make a mistake, but ended up with an unhappy patient all the same …

Meanwhile, lawyers are using that attitude as a cash-cow.

When all of this comes back and bites us where it hurts, the very people who helped create the problem are going to blame the health care providers.

The line about physicians becoming lawyers was … *cough* … sarcasm.

Adminstrative process has lowered cost in almost every area when it has been used and lawyers almost always fight it. My lawyer wife works on the public side and when they brought it to her area the whole process began to smooth out.

And yes, the private attorneys fought it since they lost a payday. They would really hate the $250,000 pain and suffering limit I would place on any finding at this level, but they would get billable hours.

Steve Lucas

Steve Lucas

“Heaven help a physician who makes an honest mistake … or even one who didn’t make a mistake, but ended up with an unhappy patient all the same …

Meanwhile, lawyers are using that attitude as a cash-cow.”

This statement is simply untrue.

I’m also curious as to this belief in these boards. Won’t they be more susceptible to political pressure than a jury? When a Democrat is in office and picks the board, then the physicians will complain that they are pro-lawyer, and vice versa when a Republican picks them.

So where’s the advantage? And who presents the evidence to the board? Do they just review the medical records? How is this a cost savings, and not just another hurdle for the plaintiff with the legit case?

“The savings is the hundreds of thousands of dollars that are paid to prepare for court.”

Since you would have already prepared your persentation in terms of the medical evidence on both sides, how do you get to “hundreds of thousands of dollars in savings”?

It actually is unusual, in most states, for $300K to be spent before trial. Even the highest figures quoted by the insurance industry in their tort reform ads put trial cost at $100K. Of course, since the vast majority of cases settle, the average is much, much lower.

“Money drives these cases, not the desire for truth. ”

Yes and no, but to a large extent, yes. Truth doesn’t pay your medical bills or your lost income. To a lesser extent, most people who represent these people will tell you that a majority of people who come in just want an answer and have been stonewalled by the provider at all levels. Of course, the point of a civil suit, with certain limited exceptions, is to assess blame and provide compensation for harm in the form of money. Money is, unfortunately, all we have, since we can give the victims of malpractice back what they want most – which is to be health.

“One of my patients, a defense lawyer, is currently working on a case where 7 physicians are being sued. The pre-trial costs are now well into 500,000 dollars.”

I’m sorry, but I’d have to see that bill. Unless you’re throwing in insurer overhead, or it’s a multiple victim claim, or this guy is screwing the insurer, this number has to be false. At best, it’s an anomaly.

An insurer would offer to settle a single victim malpractice case if the costs were literally that high.

“As many lawsuits involve more than one physician, the costs become well in excess of 100,000. ”

Considering 90% of all suits are settled, that number remains a rarity. How you can make such a conclusive statement I don’t know. A fellow law school grad’s father is the preeminent med mal defense lawyer in my state, and he will tell you that on average, taking a med mal case to trial costs $30,000.

“It is important to know that only a very small percentage of cases of malpractice are actually medical malpractice and many cases of malpractice are not ever brought forward”

Certainly true. But I’ve yet to see a tort reform proposal that received any legislative traction which involved MORE people getting compensated.

“As for truth not paying bills….this seems like a violation of ethics….if a lawyer knows that the truth is being hidden or distorted to win a case… the lawyer should be sanctioned. ”

If simply finding the truth were the only point of the trial, no one would undertake them. In fact, the elements of med mal REQUIRE damages. The vast majority of people see lawsuits as a last resort. In fact, studies have shown that if physicians would work harder at communicating with their patients, that would be the most effective way to eliminate claims against them.

Common Good’s plan is nice, but again, it’s not really about getting more money to the victims. Which is not surprising, given who its founder is. And, so far, its star chamber plan has no serious backing in any legislature.

The best criticism of the current system is that the process is too expensive for smaller cases. Yet no one is really advocating MORE payouts to more victims, are they? Certainly not the insurers who would actually be doing the paying. Every proposal is designed to limit either the amount paid to legitimate victims or to eliminate or curtail the constitutional right to a jury trial. Everything else is pie in the sky dreaming.

“Obviously it does harm the trial lwayers whose high payoffs drive the system of excess litigation. ”

I think this is where we go off track – when it becomes personal. Physicians are well compensated, and their own reason for engaging in this discussion is their financial bottom line. That can’t be denied. So let’s leave the “greedy” attacks aside and stick with the merits of the proposals, shall we?

“Both in Texas and Georgia where tort reform has recently passed there has been a significant drop in the number of malpractice cases filed . ”

Sure, because many cases that would have been filed over the next year or so had tort reform not been enacted, or maybe worked out via settlement, were filed early to beat the deadline. If, on the day prior to the effective date of the legislation, I had a case within a week of settling, I would still file it to avoid the settlement falling apart and my client having their damages arbitrarily capped. And, if I had a case which I thought might have merit, but I had plenty of time before the statute of limitations ran and would normally try and negotiate it before filing suit and might have filed it the next year, I would have filed then, again to avoid the arbitrary cap. That statistic is a false one, and tells you nothing about the relative merits of the legislation.

“Unfortunately, what motivates these types of lawyers is the possiblity of making it big.”

Again with the personal attack. Do you work for free? If, as you claim, to try a med mal case costs in excess of $100,000, and you had no guarantee of recovery, would you take a case with a person who was healed and had maybe $20,000 in medical bills? On contingency? Of course you wouldn’t. So don’t call others greedy for doing exactly what you would do yourself.

“The board then determines if the mistake has reasonably led to any harm. ..and they determine the financial compensation.”

Why should the Sixth Amendment be put aside, and a board set up by the people who will be paying the bill get to decide how much the bill is? How about this – if you get hit by a guy who runs a stoplight today, leaving you unable to walk, would you allow the executives of his insurer and two others to determine your compensation?

There’s nothing to prevent better systems analysis right now. Who do you think insists on confidential settlements? The patient? Of course not. Some specialties have already done it, though, by working with their insurers.

Who do you think runs Common Good? A lawyer who works for major companies and insurers who have a direct financial stake in tort reform. Do you think their interests are really aligned with yours? Do you really think their goal is to pay more people faster? Speaking of pie in the sky. . .

“the drop of of cases both in Texas and Georgia was cited by practicing med malpractice lawyers to be related to limits on nonecomic damages. ”

Of course it is – there were fewer cases to be filed in the year following because they’d already been filed. But I’ll admit those limits did make it harder for those who don’t have lost wages, like stay at home mothers, children, and the elderly, to find attorneys, since it capped the amount of money they would receive for their harm. Doesn’t do much to stop truly frivolous suits, though. The economics are that a noneconomic cap only hurts the weakest members of our society – those without wage losses.

“I would say that that if a lawyer or legal firm opts to take cases that will only have big payouts then these lawyers are not practicing for anything more than self greed.”

So is it your position that they should actually lose money? That they should go in the hole so you can presumably earn more? Would you do that? Would you spend $100,000 of your own money on a case where the damages would not reach that even if you won? And there is no guarantee you would win? If so, how often?

I don’t see how anyone who goes to bat for legislation that only benefits insurers and hurts the weakest members of our society can say they have a “clean conscious.” Nor do I see how they can get too high and mighty with the attorneys who put their own money and time up to help these people get money to pay their medical bills (which go back to you) and reconstruct some minimum quality of life. Again, no one in this debate works for free or doesn’t have a financial stake in it (or at least think they d0), so spare me the sainthood speech.

I simply stated a fact about Common Good. I’m sorry you didn’t know that and apparently don’t like it, but it remains the truth. They’re not embarassed by their clients, in fact the particular firm lists them proudly. So how is that a personal attack?

“but wait a minute …did you not get done saying just a few posts ago…that cases rarely cost above 30,000 dollars to prepare?”

I’m using your figures. Are you telling me now they are no good?

“very odd….to most people having a clear conscious means being honest.”

If you’re going to continue to use the term, it’s “conscience”. And define it however you want. Most people do define their morality to fit their particular actions.

“www.cgood.org has a lot of supporters, do you preume to know each supporter?”

I don’t doubt they do – I never said they didn’t. Lots of people are for closing the courthouse door because they never think it will be them on the losing end of someone else’s negligence, nor do they appreciate the history and importance of a right to a jury trial.

“Should I castigate the Michcigan Bar association because it is supported by medical malpractice lawyers? By your logic I should.”

Not at all. And I have not castigated Common Good. You seem upset because I informed you who was behind the organization. Do you prefer not to know such things? If I were to cite ATLA statistics and studies to you, would you not want to know who was behind my source?

Either you don’t know what Maine has or you don’t know what CG is proposing, because they are very different.

“Again, you change your “facts” to win . I guess winning at the expense of truth is important to some people.”

Those were YOUR numbers. If they weren’t truthful, then the lie is yours.

“You add unrelated arguments “Closing of court doors” has nothing to do with pre-trial hearings.”

I think the problem here is that you keep referring to the Maine and CG proposals as the same – they are not. But yes, the overall goal of tort reform is to reduce the exposure of corporations and insurers to juries. And one of the ways they do that is by making it harder for individuals to find lawyers. Tell me, have you ever seen a tort reform proposal that limits a company’s damages? Or that limits what a defendant can pay its attorney?

“I can see how if you readily modify definitions according to your needs, you can lose sight of such a straightforward concept as “conscience.””

Exactly – when your principles and/or conscience include an embracing of tort reform, it’s clear you’ve lost sight.

“again, I false argument…no where did I imply or state any displeasure or angst about who supports http://www.cgood.org”

You called it a personal attack, so I assumed you thought it was an insult to acknowledge who they were. Perhaps you misspoke.

” I do favor the health court idea to a much higher level than Maine’s pre-trial board.”

Of course you do. Who wouldn’t want a panel of their cohorts to judge everything they do. Insurers would love to have nothing but insurance adjusters on juries. Home builders would love to only have home builders on their juries. Luckily, the founders recognized the downside of these star chambers and gave us the 6th Amendment. Right now there is a class action involving 900,000 physicians against health insurers over reimbursements. Should that jury consist solely of insurance execs?

“My friend, it is clear that you have something very great to lose if the tort reform is modified. ”

Just as you believe you’ll make more money if it is enacted. The only difference is, you’re looking out solely for yourself, whereas at least I, if for no other reason than you can’t file a case without a client, have to look out for the clients as well. No patient has ever saved a dime in health insurance or medical costs as a result of tort reform.

And I won’t lose much with med mal tort reform. Even with overall tort reform, I’ll just go work for the defendants. Tell me though, if you eliminate all the plaintiff’s lawyers, who will advocate for you? Or are you indestructable? Will your wife, your children, never be in a devastating car wreck? Never be the victims of fraud? If so, you’re very lucky to already know that.

“I , as a physician, always look to improvements and change in medicine.. I value improvements of diagnosis, therapy as well as positive changes in the sphere of medical liablity. ”

And I as a patient don’t want you to improve? Is that what you’re suggesting? Listen, we patients have no way to differentiate one physician from another, so we want all of you to improve.

When tort reform has anything to do with improving the quality of your services, let me know. There is nothing right now that prevents you from doing all those things. From reviewing your insurer’s case files and seeing common mistakes. In fact, the anesthesiologists did just that and improved the quality of their services and lowered their premiums, and didn’t need to screw the legitimately injured.

So, if you can do all those things now, and juries already find in favor of the physician 3/4 of the time – why exactly do we need your star chamber?

“The health court scenario as proposed by http://www.cgood.org would be comprised of professionals who have no stake in the outcome. You are quick to attack an idea , not based on its merits, but on spurious assumptions. ”

Read closer – I did attack it on its merits. A star chamber of physicians judging other physicians is not appealing for the same reason that you would not want insurance execs deciding if your reimbursements were fair.

” Are family courts “Star Chambers” are “Bakruptcy courts” Star Chambers? You seem to link ideas to misleading phrases like “Star Chamber” or”Closing court doors’.”

I don’t think you quite understand what you are talking about. For one, bankruptcy courts are a creature of statute and thus not subject to the 6th Amendment, and other bankrupt parties don’t make the call, nor do the creditors. Family courts are courts of equity, and one cannot receive monetary damages in them – thus a jury is not utilized and the 6th does not apply. You’re comparing apples to oranges.

“You may as a patient want a physician to improve, but as a med malpractice lawyer improved medical care represents a loss of income. So again your argumentation is a bit weak. ”

I’m not a med mal lawyers. I’ve handled 2 or 3 (I can’t remember which) med mal cases in 8 years of practice, which settled for an aggregate total of less than $50,000.

“I suggest you spend a few minutes of time to read http://www.cgood.org proposal on health courts .”

I’ve read it. Again, it offers nothing, other than the star chamber, that cannot be done right now. Insurers have every bit of information you could possibly need to improve quality if that were the true goal.

Professionals who have no stake in the outcome? Perhaps – so then I guess you would agree to insurance adjusters as the jury for any claim you may have against an insurance company that is not theirs? Or other home builders when you home is constructed poorly? After all, they’ve got no financial stake in the outcome, do they?

“Unfortunately we live in a day when advocacy for the individual trumps the advocacy for the common good.”

Who defines the “common good”? Is the common good not served when a responsible party pays its damages? When that party pays for the future medical bills of a person who is the victim of malpractice and is no longer insurable? Or is it in the “common good” if the taxpayer picks up that tab since the individual can no longer work?

If you were that victim, would you want someone to advocate on your behalf? Or the “common good” as defined by lobbying organizations? Or do you believe that these people are eager to write checks for millions in past and future medical care, and if we just had health courts they’d hand it over if you asked? Since you know that there is a possibility you may be on the wrong side of negligence, what good does it do to make it harder for you to get a lawyer?

I’ll ask you again, do you really believe that the financial backers of CG want to pay more people quicker? In your experience, is that how insurance works?

I believe you should support health courts if that is what you want. But let’s stop pretending you need them to reach any of your claimed goals. The only goal of health courts, like most tort reform, is to preserve the profits of insurers – who have apparently convinced some that we should legislate the risk out of insuring risk.

At the end of the day, it appears your support is based on faith alone. And like any healthy dose of faith, I’m not going to shake you from it with reason. So you may have the last word. It was a pleasure discussing this with you once we left the greed attacks behind.

Cordially,

CJD