Contemplating medicine and the health care system
via KevinMD and White Coat Notes - MMS First-of-its-kind Survey of Physicians Shows Extent and Cost of the Practice of Defensive Medicine and its Multiple Effects of Health Care on the State
“This survey clearly shows that the fear of medical liability is a serious burden on health care,” said Dr. Sethi. “The fear of [...]
Standard of Care Remains a Moving Target in Medical Malpractice Cases
Courts in 21 states adhere to a local or community standard of care in medical malpractice cases, slowing implementation of evidence-based, resource-based, nationwide standards.
So said Michelle Huckaby Lewis, M.D., J.D., of Johns Hopkins and Georgetown University, and colleagues in a commentary in the June [...]
The RWJ has a new blog which featured a series on health courts yesterday. The first entry gives the links to the remaining ones - Reforming Medical Justice
I have written about this issue many times. As I continue to consider this issue, I am struck by the ethics of our current system. [...]
This is my 14th year in Birmingham. I love living here for many reasons including: the people (very nice), the climate (great for golf), the size (easy commute) and my job (great medical school). This morning I am scanning the NY Times for medical articles, and instead I find this ode to my [...]
Another jury gets duped
So KevinMD posts about a settlement in a cerebral palsy case, because the obstetrician did not do a C-section. The first comment comes from our old pal - CJD - who as usual resorts to sophistry and avoids data.
Malpractice lawyers are felt to be a major factor in the increase in [...]
Kevin MD has a classic post - More ATLA: “Defensive medicine is a hoax”
Please read his column and (if you can handle it) the comments.
Here are my thoughts on defensive medicine. First, physicians and lawyers probably cannot have a constructive discussion on this point because we do not share a common understanding of vocabulary. [...]
Regular readers know that I favor special health courts as the best method of addressing medical malpractice. Last week the Senate had hearings on this subject. Common Good features these hearings on their web page - Senate Hearing on Special Health Courts
Professor Studdert testified at the hearing. He is the author of [...]
JK left this comment. Since many readers do not go through all the comments, I have taken db’s prerogative to reprint the comment (and say a word or two myself).
CJD,
I have read your posts on a number of number of blogs, I have have to say that you just don’t get it. You keep [...]
You have to give this guy his due - he named his blog correctly - Judges Who Sympathize With Doctors - Who Needs Tort Reform?
Now many readers might ask - why do I give this guy any publicity? Well I do believe in the free market of ideas. He disagrees with me, and [...]
This innovative program may improve judging of malpractice cases. I wish everyone could read this entry, but I will excerpt some key paragraphs. Judges hit classroom to learn about medicine
“The objective in this was to give judges a feel for the span of judgment that physicians and other health care providers have to [...]
I periodically feature malpractice on this blog, but I certainly focus as much on other issues. This new blog (thanks to Kevin MD for the “heads-up) focuses solely on malpractice. This makes me sick!!. It makes the cut and gets added to my links!
Medical Malpractice: Yes on I-330
Earlier this year I found myself staring at my computer screen reading and re-reading an e-mail I did not want to send. I knew that once I clicked “submit” I would be locked into a path that I didn’t want to go down, because at the end of it I would [...]
Global look at tort struggles offers glimpse of reform options (membership required)
Physicians around the world say the medical liability system is faltering in a number of countries, hobbled by high premiums in some places, hindered by ineffective approaches in others.
Medical leaders, attorneys and others traveled from as far as Australia, Kenya and South Africa to [...]
1) Would the plaintiff still be able to use testimony from his own expert witness? Or would these court-doctor’s opinions be the only ones heard?
I am guessing here - but I am certain that a plaintiff could ask for an expert witness. I have previously written about the problems of the current expert witness [...]
The legal attack responses have me frustrated, because I feel like they have not read my words. I believe (and cannot cite data) that most malpractice cases that go to trail result in the physician being found innocent. Some of the suing patients deserve compensation.
I do not believe that we should assume that [...]
A reader sent me this link. Malpractice ‘specialty courts’ a threat
THE Seventh Amendment right to a fair and impartial jury of one’s peers has been described as “the essence of justice.” But now the medical establishment wants to tip the scales of justice by replacing our constitutionally guaranteed right to trial by jury with [...]
I appreciate all the comments that I receive on this blog on a variety of topics. I do read all the comments even if I do not immediately respond.
While my rant on Vioxx was about that specific case, the comments quickly developed into a malpractice debate. I have been admonished to be more [...]
House passes liability reform bill — once again (for AMA members)
In a prelude that has become familiar to physicians, the House of Representatives last month, in a 230-194 vote, passed a tort reform bill that would limit noneconomic damages in medical liability cases to $250,000.
The House has passed similar measures several times in recent years, [...]
Hidden Costs of the Liability Crisis
This links to a short blog entry. The author (a substitute at the Point of Law) contends that malpractice carriers should do more to encourage high quality standards. The implication is that improved quality will lead to less malpractice.
His hypothesis is very interesting, however, in internal medicine I [...]
Costly Insurance Fuels Defensive Medicine, but Not Relocation
In May 2003, Dr. David M. Studdert, from Harvard School of Public Health in Boston, and colleagues surveyed 824 Pennsylvania-based physicians who worked in six specialties at high risk of litigation (emergency medicine, general surgery, orthopedic surgery, neurosurgery, obstetrics/gynecology, and radiology). Pennsylvania was chosen because of dramatically rising [...]
I will never leave this issue - because this is the real solution to malpractice.
Let Doctors Think Like Doctors
“Special health courts might let doctors think more like doctors again and less like lawyers,” said Daniel Henninger, Deputy Editor of the Wall Street Journal editorial page, endorsing Common Good’s proposal on the Nightly Business Report (WPBT-TV, [...]
Finally, a brilliant essay on the vegatative state. Terri Schiavo and the Reality Gap
It is through the lens of my father’s death that I have watched the Terri Schiavo case in horror.
First is the Reality Gap. Medical marvels that can save lives have also blurred the line between life and death. But [...]
One pleasure of blogging comes from the comments we receive. GruntDoc has received numerous comments (many from one lawyer) on a recent malpractice rant - Texas MedMal in the News
Having a lawyer and a law student in the family, I often have discussions about the differing viewpoints that our professions take on issues. [...]
Now this is interesting - The Doctor’s Court?
Apparently, magazine Legal Affairs sponsors weekly debates on legal issues. This week’s debate focuses on special health courts. The participants:
Philip K. Howard is Founder and Chair of Common Good and the author of The Death of Common Sense: How Law is Suffocating America. Stephanie Mencimer [...]
I know my spam filter is all screwed up. It thought Rangel was a porn site or something (insert huge grin).
Chris makes this important comment:
Another benefit of special medical courts would be that they could be set up in each state thus bypassing the Constitutional problem of over-reaching Federal power which is generally limited [...]
Common Good directed me to this interesting column about malpractice. The author believes that President Bush has missed an opportunity to propose truly creative solutions:
Better Justice: Bush’s Missed Opportunity
As I believe this link will degenerate over time, I will quote liberally:
Unless radically revised, the malpractice bill will once again die in the Senate because [...]
Medical lawsuit diagnosis
When a friend told me recently he was to undergo a painful medical procedure to see if he has cancer, it reminded me of a time years ago when I faced a similar prospect. The testing in my case would have painful and risked infection.
Fortunately, it was a two-part [...]
Long time readers know that I admire Common Good’s approach to tort reform. Apparently the NY Times had good things to say on their editorial page a couple of weeks ago - unfortunately I missed it and am not willing to pay to read the entire editorial.
Common Good comments - New York Times: It’s [...]
A Push in States to Curb Malpractice Costs
As state legislative sessions open across the country this week, Republican governors and lawmakers in many states are mounting major campaigns to control medical malpractice insurance premiums by limiting civil litigation.
In Georgia, Missouri, Washington and more than a dozen other states, Republican legislators have made malpractice premiums a [...]
The AMA has this issue “spot on”. Delegates target courts for liability reform expansion
Doctors believe that setting stricter parameters for who is allowed to testify in the courtroom and what information is allowed before a jury can help alleviate some of the medical liability insurance problems they’ve seen.
“Holding these experts accountable is both necessary [...]
Spirited discussion going on in the comments section (nice to see real comments rather than spam).
I would like to answer a few questions and clarify my position.
First, I have testified in a malpractice case for the defense. I have also given a deposition.
I call malpractice a lottery because of this definition:
“An activity or event [...]
"For every complex problem, there is a solution that is simple, neat, and wrong." - HL Mencken
"I hear and I forget. I see and I remember. I do and I understand." - Confucius
"The good physician treats the disease; the great physician treats the patient who has the disease" - Sir William Osler
"Those are my principles, and if you don't like them - well, I have others." - Groucho Marx
"It is hard enough to remember my opinions, without also remembering my reasons for them" - Friedrich Nietzsche
"Anyone can make the simple complicated. Creativity is making the complicated simple." - Charles Mingus
"Not everything that can be counted counts, and not everything that counts can be counted." - Albert Einstein
"A foolish consistency is the hobgoblin of little minds, adored by little statesman and philosophers and divines. With consistency a great soul has simply nothing to do." - Ralph Waldo Emerson
"This ain't no party, this ain't no disco, this ain't no fooling around." - Talking Heads, Life During Wartime
"What is hateful to you, do not do to your neighbour. This is the whole Torah; all the rest is commentary. Go and learn it." - Hillel, Talmud, Shabbath 31a
"You will never understand bureaucracies until you understand that for bureaucrats procedure is everything and outcomes are nothing." - Thomas Sowell
"An idealist is one who, on noticing that a rose smells better than a cabbage, concludes that it will also make better soup." - HL Mencken
"If you only have a hammer, you tend to see every problem as a nail." - Abraham Maslow
"A great teacher is one who realizes that he himself is also a student and whose goal is not to dictate the answers, but to stimulate his students creativity enough so that they go out and find the answers themselves." - Herbie Hancock
"There are no facts, only interpretations." - Nietzsche
"An education isn't how much you have committed to memory, or even how much you know. It's being able to differentiate between what you do know and what you don't." - Anatole France
