Understanding the ‘walkouts’


Category : Medical Rants

How To Fix the Medical Liability System

NEWSWEEK?s Jennifer Barrett spoke with Dr. Donald J. Palmisano, president-elect of the American Medical Association, about the current crisis and what physicians hope can be done to fix it.

NEWSWEEK: How serious is the medical malpractice insurance problem?

Donald Palmisano: We believe the medical-liability system is broken, that the amount of awards has escalated dramatically in recent years and that there is no statistical correlation between actual negligence and payment of claims, but that there is a statistical correlation between payment amounts and disability.

Medical liability insurance has reached crisis proportions in 12 states: Washington, Oregon, Nevada, Texas, Mississippi, Georgia, Florida, Ohio, West Virginia, Pennsylvania, New York and New Jersey. Only seven states are stable: California, Colorado, Indiana, Louisiana, New Mexico, Wisconsin and Hawaii.

How do you define crisis?

We look at many factors: the fact that women can?t find a doctor to deliver their babies, the closure of a Level One trauma center, the early retirement of physicians, the limitation of practice by certain specialties and the movement of physicians to other states with more stable liability climates. Those meet our definition of crisis.

Yes, we do have a crisis. The crisis does come from a broken tort system.

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Comments (3)

The malpractice crisis is really an accelerant. It worsens an increasingly unpleasant and hostile medical practice climate, bedeviled by Medicare payment cuts, ridiculously low Medicaid reimbursement, poor payment dynamics from managed care payers and many insurers, other practice costs that have been increasing, unfunded mandates imposed on the practitioner (HIPAA and others),
and punitive and adversarial practices of DMMS (HCFA). These problems didn’t exist to the present degree thirty, or even twenty years ago, and most doctors didn’t sign up for this kind of treatment. So it isn’t hard to understand why those physicians with the resources available to retire now are increasingly electing to do so, good working years left or not. Others are choosing to dump all relationships with outside payers and their miserable requirements. Who can blame them? What the government, and the trial lawyers with their legislative pull don’t understand is that damage done to the attractiveness of the medical profession has very long lasting effects, effects that are not easily undone. Producing a trained physician is like growing an orchard, it takes ten years to bear fruit, and longer to produce a physician with both training and seasoned experience. Medical training is challenging and inviting to those with the desire and the right turn of mind, but make no mistake about it, it is also lengthy, expensive and frequently exhausting. Those prospective physicians with the qualities, the intelligence and the discipline to become good doctors have the qualities to achieve excellence in other callings as well. Would we rather they did so?

The walkouts are really of symbolic value, a few days of appointments not scheduled and elective surgeries not done. They are done to get attention of the media and to showcase the doctors’ concerns. The patients aren’t much inconvenienced, doctors and hospitals are the ones paying the price. The real threat is the gradual and progressive erosion of services that occurs as doctors in high-insurance-cost specialties go into retirement, change practice locations or drop high-risk practice activities, however needed by the community. Those events are not media events, they are almost private, out of sight of the public. But their effects are not. Like the theoretical frog in the saucepan that never notices the water temperature slowly rising until comes to boil (frogs aren’t that stupid, BTW), most communities take little notice of retirements and relocations. And that replacements don’t arrive, well, that is not newsworthy, either. The public in the United States is so used to the availability of highly trained surgical specialists in emergencies that they regard them to be almost like public utilities, always there when you need them. Not having a thoracic surgeon or neurosurgeon around to save a life after major trauma is newsworthy. And if we don’t do something soon to address this malpractice crisis, we can read all about it.

When are doctors going to stop asking that patients be victimized by bad doctors and that these doctors be allowed to get away with repititions of malpractice.
The doctor who paralyzed my face, Dr. Peter Jannetta, perjured himself in Court about the risks of facial paralysis of the Jannetta Procedure saying at 2 separate depositions, “Major and common complication” and then at triel”Unknown complication.”
The Superior Court of Pa, pointed out this testimony which was perjurious.
nevertheless this doctor received no sanctions, has never been made to correct his refusal to admit facial paralsis as a “major complication” in his texts, journal artilces, and other writings. Rather his sanction was to be nominated for Secretary of Health the month after this case was brought to a ‘iteral’ forced settlement (it was in Ciurt 14 years, 1980 – 1994.) Dr. Jannetta, known to have perjured himself by all 50 Senators and the Governor, via letters to all, never saw a sanction. The settlement is, of course, paid for by his insurance, up to the cao, and then by tha PA. CAT fund.
Doesn’t anyone wonder why doctors don’t make more effort to assure they do not hurt their patients?
The answer, to me, is clear.
Why bother to clean up their ‘act’ when they never meet with any personal consequences.
It is the patient who is the one victimized and revictimized by the medical malpractice situation as it currently exists in Pa.
If Doctors did suffer consequences the costs of insurance would most probably go down as there will be those less willing to treat patients withlack of concern about either the patient/potential consequenses.
Thank you