Another malpractice shouting match

Could you please allow me to link to your website? Your articles are always very insightful and also quite engaging.

Thank you

Perhaps physicians should start countersuing for every single frivolous lawsuit, and include damages for lost earnings due to time spent working on the case, potential earnings lost due to bad publicity, negative impact on mental health, etc. You could extend that further, and start suing the litigation lawyers themselves for pushing the lawsuits, and prolonging them un-necessarily, especially in cases where reasonable offers of settlement were proposed.

I wonder if it is time for physicians to take the offensive in this issue.

You know your position is weak when you start personally attacking the other side before they even post. Good show, Dr. Centor.

Few of you have the stones to go bare – why? Because it means putting all your assets in someone else’s hands to protect them. And, your big houses are only protected so far. That’s big talk. Hey jb, how many victims of malpractice have you spoken to? How many have you told that they just want their pockets filled when they can no longer work, have mountains of medical bills already and are facing a lifetime of care? Did you tell them they only had themselves to blame?

Kevin’s post remains an incorrect, or at least, uninformed assessment. Unless, as I mentioned, he’s diagnosing via the media like the good Dr. Frist. No study out there has ever concluded that CP cannot be caused by malpractice and none of you know if that was the case in this claim.

I’m no statistics expert, but these numbers aren’t difficult, so follow along. First, none of you know what percentage of CP cases have suits filed on them (informal interviews by Dr. Centor with his colleagues notwithstanding). Not one of you can tell me that. So that means none of you have a CLUE what you’re talking about when you say there are too many.

As for the concept of “false settlements”, when even one of you have settled a bs claim with an insurer, let me know. I’m unsure how people who should know how tight insurance companies are ever came to the conclusion that they roll over for lawyers on cases with no merit.

But I guess your faith in what the AMA and your carriers tell you trumps reason.

There’s a little sophistry at the end for you to rant about Dr. Centor, since we both know you have no answer for the facts. Facts which clearly show the gaping holes in your logic.

I also enjoy reading about how C-sections have risen solely in response to lawsuits, as if physician timing and convenience had nothing to do with it.

Alien, in fact litigation has improved medical care. Consider the anesthesiologists. 20 years ago, they had quite a few claims against them. Instead of trying to harm the legitimately injured like today’s crop of physicians, they did a comprehensive review of how they deliver their services, and improved them significantly. Now they have some of the lowest amounts of claims and the lowest premiums in the physician community. It wasn’t an accident.

You know Dr. Centor, I read you quite often, quite a bit more than I comment, and you seem to have a lot of complaints. You are quick to warn about any new innovations in healthcare, like P4P, yet seem hesitant to endorse any ideas of your own.

In fact, the only thing I’ve seen you endorse is backdoor damage caps in the form of Health Courts, but even then those don’t address the real problems with malpractice litigation raised by the Studdert study (cost of entry and cost of handling claims).

You’re clearly not satisfied with the healthcare system as it stands today, so what’s your solution? I think we’re heading toward universal healthcare in which you’re all employees of the federal govt. and reimbursed by the federal govt., except for the precious few who can attract highend clients who will pay for “concierge” medicine.

I’m not real excited about that, but after reading the blogs of you and your colleagues, discussing it at length with those in the industry, and doing additional research on my own, I don’t see another way. Do you? Clearly, you’re telling us we can’t continue as we are, yet you offer only critiques, not alternatives.

And I’m not saying just you individually, I mean all physicians. The people that have the most direct stake in this, the front lines of healthcare services, can only seem to unite to demonize lawyers on behalf of their liability carriers. And with minimal returns for the phsyicians when you are successful at obtaining your “reform”, at that.

Do you not sometimes feel like pawns for your insurers? Or at least, like you’re rushing all your resources to a minor battle while the war is being lost around you?

Do you have any big picture, comprehensive proposals? Right now, 50+% of all healthcare is funded by the government – how would you change that? Right now, that government is cutting your reimbursement rates – how can we get you guys back toward the free market, instead of further away from it each year? Or do you even want that?

Or are you all just so content spending your lobbying dollars demonizing lawyers and the victims of malpractice as greedy that you really don’t care about the rest of the things that affect your practice? And before you mock that statement, tell me, how many physicians showed up in their local statehouse in support of “reform” during our last “malpractice crisis”? How many handed out fliers to their patients on that issue? Wrote letters to the editor about the evil lawyers and how they could no longer afford to practice?

Now, how many have proposed comprehensive legislation and are down there at the statehouse lobbying for that? Are informing their patients about the declining reimbursements? Are writing letters to the editor with their proposals?

Do you just need someone to demonize or it’s not worth it?

Hey CJD, if you’re so upset at your profession being demonized why don’t you just quit. I’m serious, open up a donut shop or a bakery or do whatever. Enjoy life while you can – it is shorter than you know. Let go of your hate and anger. Who cares whether docs or lawyers are demonized? Does it really matter? We’ll all kick the bucket eventually whether lawyers are keeping the docs in line or if they’re doing their job well without them. Always remember, God loves you bro, don’t worry – be happy.

“Well, other than fruitlessly demonizing attorneys.”

Oh please. That has to be one of the most ridiculous statements you’ve made. There’s a damn good reason we hate trial attornies (no, not all lawyers, just the ATLA card carrying ones), as they’ve made our lives a living hell, while they’ve enriched themselves at the expense of the “victims”. And please don’t tell me they do it for the good of the patient or to reform the system, ’cause you know no case will be taken if there’s no chance of reaping a possible financial windfall – excuse me, judgment. You foolishly think we’re pawns of the insurance companies, but you are so wrong.

Please note that not all ATLA attorneys work on the private side. Many prosecutors and other public attorneys belong. These are the people trying to put the sex offenders, murders, and even corporate raiders in jail.

CJD, I have a question. If you had to do it all over again, would still become a physician? If not, why? I’m hoping to become a physician and I like to read about what physicians are questioning in the profession today; to see what I might be getting myself into. What are your thoughts?

CJD:

Can you please explain to me how an injury award of several million dollars is going to provide any further incentive for a physician to provide high-quality medical care as compared to a lesser penalty (as you requested, I want hard facts, not opinions)?

And further, can you tell us what the explanation is for the rapid rise in the value of these awards in relation to either cost of living, or physician salaries?

And as for your comment about insurance companies settling, in fact a colleague of mine was advised to do just that by his malpractice coverage insurer when they realized that the cost of carrying the case through may be greater than settling. While this particular physician chose not to do so, I bring this up to point out that you may need to adjust your perspective somewhat.

“Can you please explain to me how an injury award of several million dollars is going to provide any further incentive for a physician to provide high-quality medical care as compared to a lesser penalty (as you requested, I want hard facts, not opinions)?”

I would never argue that it would. Most malpractice awards are not punitive damages. THe only time you’ll see punitives against an individual provider is if they’re drunk or something obnoxious like that.

The bulk of most malpractice awards go back into the healthcare system in the form of subrogation to the health insurer, past medical bills, or future care expenses. These million dollar judgments you see are primarily attached to cases with millions in healthcare expenses.

“And further, can you tell us what the explanation is for the rapid rise in the value of these awards in relation to either cost of living, or physician salaries?”

I don’t know that there has been a “rapid rise” in value. But if there has, it would be attributable to the rapid rise in the cost of healthcare. Medical expense/cost inflation outstrips regular inflation.

As to your friend, I do recognize that some physicians have that in their policies, but without knowing more about the case, I can’t really say much about it. But my perspective is based on settling hundreds of cases with insurers. I would expect in your friend’s case, the insurer thought there was at least some merit to the claim, and their experts may have disagreed with your friend.

As to your final question, the attorney takes anywhere from 33 1/3 – 50% of a malpractice claim. Of course, the client always has the opportunity to hire someone on an hourly basis, but few individuals can fund a med mal case. Most can’t even afford the expenses.

They sure do. Same as doctors. Or do you work for free?