Tag Archives: medical malpractice
Posted on 07. Sep, 2013 by wisdom.
Previously on this blog I have discussed some of the issues with medical malpractice in the United States and some potential alternatives. In this post Potential Alternatives to the Current Medico-Legal System in the United States I talk about some possible alternatives such as having some agreement directly with the physician and hence avoiding trial lawyers. In this provocative post How to Improve Your Chances to Win a Dental Malpractice Lawsuit I discuss the 4 elements you need to win a malpractice suit in the U.S. and a possible suggestion to help improve your chances of doing so.
Last year, Kevin Pho known as “social media’s leading physician voice” discussed in a post written on July 16, 2012, titled “The New York medical malpractice crisis: Who’s to blame?,” how some financially struggling hospitals are going without medical malpractice insurance and just going bare as they say. He describes how if hospitals don’t have malpractice insurance than lawyers and patients will go after doctors who may have individual policies.
Kevin says that conservatives have failed in their effort for tort-reform by focusing only on non-economic damage caps. Physician groups such as the AMA, ADA, and AAOMS have also seemed to focus more on this effort which I have touched on before such as in this provocative post The War on Healthcare: Patients Who Hate Doctors.
Kevin also argues that progressives favor the interests of trial lawyers and attorneys and ignore the impact of medical malpractice on health providers and those providing care. Clearly no one wants to see doctors and hospitals risking bankruptcy while providing needed care to patients.
Kevin does mention how medical malpractice reform has been re-framed for the patient’s perspective recently in New Hampshire by mentioning their early offer system. The website for NH Early Offer is located over at http://www.nhearlyoffer.com/.
On the website it states
“Individuals will be able to resolve their case fairly and quickly – in just four to six months – instead of suffering through several years of litigation, stress, and the risk that they could ultimately lose in court. NH Early Offer also dramatically reduces the cost of resolving medical injury claims. The trickle-down cost savings lowers healthcare costs and benefits businesses and medical offices.”
The site offers some useful insights into how the current malpractice system works for those interested. The site further states
“Once a case is settled under the early offer, the healthcare provider pays the medical bills and wages right away, and all future bills and wages as they become due. If the injured person and the provider prefer to “roll” all of the future payments into a lump sum payment, they can do so.”
This approach seems to assume that the person who received the medical care is working and hence has lost wages that can be paid. The issue I see with this approach is for those still in school such as college and are not yet working a real full time job then how would they be fairly handled by the system?
The NH Early offer program is just an option, patients can still pursue the traditional system.
Posted on 18. Feb, 2012 by wisdom.
On my site I discuss numerous issues with the current legal system and how this relates to the medical system with a focus on third molar (wisdom teeth) removal. See http://www.teethremoval.com/legal_system_medical_malpractice, http://www.teethremoval.com/legal_standpoint.html, and http://www.teethremoval.com/dental_malpractice.html.
One issue is that there are a host of different damage caps (non-economic ‘pain and suffering’ awards) in different states throughout the United States. This can sometimes limit the amount a patient can receive even if there was gross negligence by the dentist or oral surgeon. Hence this can prevent fair compensation from being awarded.
Another issue with the legal system is that sometimes when patients suffer complications and problems due to negligence they will not be able to sue due to the case not being able to get a very large settlement amount. In addition, these legal cases can drag on for years and years and take a toll on the health of the patient and the doctor.
Unlike in the airline industry for pilots, doctors don’t have their own skin in the game so to speak. If a pilot crashes a plane then the pilot may be seriously injured or even die along with the passengers. When a doctor performs a poor surgery that patient is the only one who suffers.
In order to have doctors have more skin in the game and to help restore trust between doctors and patients I feel that the current legal system in the U.S. should be altered substantially.
One such solution I was thinking about recently would just be to get rid of lawyers in cases where patients suffer pain and lasting complications from surgery.
For example, perhaps an oral surgeon was to charge $5,000 to remove 4 wisdom teeth (much higher than the prices currently today in the U.S.). The patient would then bring cash or a check to the surgeon and enter into an agreement with the oral surgeon. This agreement would stipulate that if the patient was still having lasting pain and problems as a result of a complication from the surgery (which could be reasonably proven or shown) than the surgeon would be required to pay the patient something like 20 times the amount of the surgery and hence pay them $100,000.
Now one would ask how the surgeon would make any money with such an arrangement? Well the surgeon would have to make sure they do a good job and would have substantially more incentive to improve quality than they do now where they have real money tied to real negative outcomes on the line.
Of course the surgeon would hopefully only have a small number of cases like 2 or 3 % that resulted in a lasting complication from the surgery where they would have to pay out. If this is the case then they would still come out well ahead and make money.
Of course lawyers would not like it if they were no longer involved in malpractice cases and certainly insurance companies want to be involved as well. Even so the current system does not provide enough incentive for doctors to improve quality and for mutual trust to be formed.
Another solution more in tune with the current system I have been thinking about to help make sure you receive quality care when having wisdom teeth removed is just to bring in a bunch of cash and pay or oral surgeon substantially more than the rate he charges. At the end of the day I feel most people are motivated by seeing a bunch of cash which they can have if they do a good job. So if you are looking to help improve your chances to having a good outcome with oral surgery you way want to think about paying your surgery much more than he or she charges.
Posted on 19. Sep, 2011 by wisdom.
Dr. Maurice Bernstein on his Bioethics Discussion Blog has an interesting discussion going on about people who hate doctors and their reasons. Reading through the large number of responses located at http://bioethicsdiscussion.blogspot.com/2005/06/i-hate-doctors.html , a common theme emerges: those who are well educated and particularly those with a PhD really hate those with an MD degree.
This is no surprise to me as the current American healthcare system pits patients vs. doctors in a battle.
Here a few snippets from the comments:
1 of the comments:
“I hate arrogant, sadistic, amoral, money-grubbing scumbags, and unfortunately, it seems far too many of these types have weaseled their way into the medical profession. I am one of the millions of people with chronic pain in this country who is at the “mercy” of the American medical profession, and thus cannot get my pain treated.”
Another comment snippet:
“Yes it is true, WAKE UP AMERICA…!! THERE ARE MORE DEATHS IN THE US EVERY YEAR, DUE TO “MEDICINE” & DOCTORS…THAN IN ANY WAR GOING ON!!
THAT is why people “hate” “Dr.s”…becuase they are Killing people!!! They & the AMA are also arrogant, narrow minded & dumb. To think that drugs & only drugs are going to heal somebody & to block out ALL other modes of healing from the practice ie: alternative modes such as Herbs, Accupuncture, Supplements etc…is Assinine, & totally insane!”
“It’s clear that medicine is only about money, about making a buck, about making as much profit as possible for the least amount of risk.”
Yet another snippet
“Lying to prevent malpractice when a heartfelt, humble apology would do? Then it goes too far. Exactly how does an apology protect, legally, against a suit? That’s utter nonsense and yet another backwards step in the entire health care crisis. We are fast approaching a time IMO when the general public will go to war against the health care system.”
As eloquently put by someone who suffered a chronic headache after having wisdom teeth removed just like myself
“In our society, protection from liability is primary, profit is secondary, preserving the posterity and ego of the medical profession is tertiary, and treating the patient is somewhere further down priority chain.”
Hence it is absolutely no surprise that when you go on to American Association of Oral and Maxillofacial Surgeons (AAOMS) Grassroots Action Center http://capwiz.com/aaoms/home/ the first thing you see is Urge Congress to Reform the Medical Malpractice System.
Well that sounds like a good idea especially if you review my site and can clearly see how too little is being provided to patients who have been injured by a doctor in terms of a non-economic damage award and only around 2% to 3% of patients who suffer from negligent care even file a lawsuit http://www.teethremoval.com/legal_system_medical_malpractice
In my case I had my wisdom teeth extracted after I just turned 20 and was extremely healthy and was never told that scientific evidence does not support the removal of healthy wisdom teeth. Nor was I told sufficient information to make an informed choice. Even so due to the the U.S. legal system that rewards doctors for malpractice I never received any compensation for my injuries.
In fact AAOMS and also the American Medical Association are trying to support something called HEALTH Act (S. 218/H.R. 5). See also http://www.teethremoval.com/legal_standpoint.html and http://www.gpo.gov/fdsys/pkg/BILLS-112hr5ih/pdf/BILLS-112hr5ih.pdf for further description.
The quick important details is from http://www.citizenvox.org/2011/05/11/hr5-medical-malpractice-gop-patient-rights/
“H.R. 5, which would give virtual liability immunity to the medical industry for reckless conduct. Included in its repertoire is a national $250,000 cap on non-economic damages, restrictions on punitive damages against pharmaceutical and medical device companies that engage in reckless conduct, limits on the time period for a patient to file a lawsuit to seek compensation for injuries and other obstacles that would deter meritorious cases from going forward.“
I encourage you to review the complications that can happen from wisdom teeth removal and you will come to the same conclusions as I have that a $250,000 pain and suffering damage award for particularly young patients in some instances is extremely unfair, unjust, and downright ridiculous.
Numerous physician groups such as as the AMA and AAOMS in the U.S. have clearly demonstrated that they DO NOT care about their patients.
I urge you my fellow Americans to contact Congress and tell them you WILL NOT TOLERATE H.R.5 AS IT TAKES AWAY YOUR RIGHTS PROTECTED BY THE CONSTITUTION.
Write to your Representative and make it known.
Here is some AC / DC – War Machine to help set the tone.
Posted on 02. Dec, 2010 by wisdom.
The New England Journal of Medicine has recently published an article titled “Temporal Trends in Rates of Patient Harm Resulting from Medical Care.” This article was conducted by Christopher Landrigan and 5 other researches, appeared in the November 25, 2010, edition and you can download and view it at http://www.nejm.org/doi/pdf/10.1056/NEJMsa1004404
The article explores a random sample of 10 hospitals located in the state of North Carolina in the U.S. A total of 2,341 patients were looked at from this sample and 588 of them had what was identified as a harm meaning that the patient was somehow harmed as a result of medical procedures, medications, or something else that was performed or given during their care.
“Of 588 harms that were identified, 245 (41.7%) were temporary harms requiring intervention… 251 (42.7%) were temporary harms requiring initial or prolonged hospitalization. An additional 17 harms (2.9%) were permanent, 50 (8.5%) were life-threatening, and 14 (2.4%) caused or contributed to a patient’s death.”
In addition 364 of the 588 harms (63.1%) were reported as preventable.
“Of the identified preventable harms, 13 caused permanent harm, 35 were life-threatening, and 9 caused or contributed to a patient’s death.”
The articled concludes by stating
“Harm to patients resulting from medical care was common in North Carolina, and the rate of harm did not appear to decrease significantly during a 6-year period ending in December 2007, despite substantial national attention and allocation of resources to improve the safety of care.”
While it is clear that patient harm is problem in North Carolina this study did not explore other states in the U.S. and was limited to hospitals. It would seem that patient harm is similar in other U.S. states but of course further evidence would be needed to support or refute this.
Posted on 27. Aug, 2009 by wisdom.
According to a paper by David A Matsa. who is an economics professor their is an effect on medical malpractice liability damage caps. In other words, the amount of money you can get if you sue a physician if something goes wrong is capped and you can only get X amount back as determined by a law in your state. (I have discussed this issue on my website about the legal standpoint of wisdom teeth removal.)
Matsa finds that “Back-of-the-envelope calculation using estimates presented… implies that the enactments of damage caps are responsible for approximately 17 percent of the increase in frontier rural specialists in these states since 1970.” Even so, Matsa finds that there really is no significant effect on physician supply for most Americans (those who do not live in rural areas).
If you are interested in the entire paper you can access it through several sources through the Social Science Research Network. http://papers.ssrn.com/sol3/papers.cfm?abstract_id=920846. The paper dates from June, 2006, and is titled “Does Malpractice Liability Keep the Doctor Away? Evidence from Tort Reform Damage Caps. “