Potential Alternatives to the Current Medico-Legal System in the United States

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.