The Need for Caps in Malpractice

Jacksonville Times-Union ^ | May 4, 2003

[gas_dr]

Patients in need of emergency medical care were able to get treatment in Jacksonville-area hospitals yesterday, despite the decision by some doctors to stop or reduce work because of rising malpractice insurance rates.

A special referral network established by hospitals and the Duval County Health Department facilitated the transfer of about a dozen patients from one hospital to another so the patients could get treatment.

[gas_dr]

I am a physician here in Jacksonville. This is what awaits all patients in America if we do not cap the insane non-economic damages -- essentially a lottery for lawyers. This is also what we face in the setting of federalized health care.

If you want to have the best healthcare in the world, i urge you to support non-economic caps in malpractice. There are currently 13 states identified as in crisis, where physicians are severely curtailing their practice because we cannot afford the insanity of the frivilous law proceedings we face. Remember, we will pay for any economic damages -- lost wages, medical care, and even $250,000 of pain and suffering, trial attorneys will no longer get 7 and 8 digit settlements, even if it means no more doctors...The lawyers have finally killed the goose that laid the golden egg.

[freeangel]

It would seem to be a simple solution to me. Do not put caps on patient injuries--but DO put caps on attorneys' fees. That should put an immediate end to those "one call that's all" lawyers. That would be a dollar cap-not a percentage.

[xJones]

I hear you and am firmly on your side. Dick Armey retired as my district's Congressman and in 2002 we elected Dr. Michael Burgess, a well-respected ob-gyn with a practice dating back over 20 years. He's certainly got an axe out for what you're describing, and mentioned it in his campaign.

[jimkress]

There should be no economic damages.

If malpractice is found, the responsible parties should be liable for all reimbursement costs required to fix the problem. If more punishment is desired then malpractice should be criminalzed and the offender(s) sent to prison.

Of course, the trial lawyers would hate this since they are uninterested in justice. All they want is the big fees. Criminaliztion would eliminate those.

[friendly]

Good post for an under-appreciated critical topic. The medical profession is not pulling out. Critical segments are being driven out of business by the disgusting lawyer industry.

The trauma care, emergency surgical, and obstetrical physicians in a growing number of states including Florida (plus Clark County, Nevada---Las Vegas) are being driven out of business due to massive malpractice premiums they cannot afford. There is no meaningful trauma care in many areas of these states. The obstetricians in particular have been run out of town by the multi-millionaire greed of the shysters.

There is a method to this madness. The democrats will enrich themselves (or at least their trial lawyer constituency), destroy the trauma and obstetrical system, and have the predictable gall to demand a federal takeover and universal health system to "correct" the non-functional, lawyer-ravaged system. I am absolutely convinced this will be lawyer-politician Hillary's agenda and main selling point when the time comes.

I think that the trial lawyers are only too happy to be a part of the democrat effort to destroy the health care system, so that the democrats will then trot themselves out of the shadows to claim to be saviors!. I strongly believe that national health care will be the cornerstone to a Hillary Clinton campaign.

One maddening thing (for the docs) about the med malpractice industry is that the suits and payouts generally bear no relationship to competence. Thus doctors who agree see the most high risk (sickest) patients are the most likely to be sued. Very sick patients are more likely to have adverse outcomes. Emergency trauma cases (often performed under insane battlefield type conditions) are the ones where sponges (pads to soak up blood) and other objects are left behind, something the democrats will never tell you. Another example is the gold mine (for crooked lawyers) who make mega-bucks off of neurosurgeons (brain injury almost always has some residual brain damage, by definition) and obstetricans (congenital blameless birth defects equals lawyer yachts and French Riviera condos).

My recommendations for this problem and for the unregulated lawyer plague that damages all of our lives in so many ways? The world would be a better place with:

1) Loser Pays. This is the law in the civilized democratic world. Waivers are given to the poor, as is the case with most reform proposals in the US to end the current astonishingly corrupt system. Loser pays is also just simple justice. Reform efforts grant exemptions for those poor that are not simply employees of law firms.

2) Massive tort reform on a unprecedented level

3) Widespread empowerment of paralegals for independent practice

4) An end to punitive damages.

5) An end to bogus class action suits.

6) Outlawing contingency fees (This is considered grossly unethical and is completely illegal in almost all other democracies).

7) Lawyers forbidden from running from office. They are agents of the judiciary. Practicing attorneys violate The Separation of Powers when they enrich their lawyer industry at public suffering. The Constitution mandates The Separation of Powers between the 3 branches of government. Lawyers are members of the Judiciary and should therefore not be eligible for the Presidency (the Executive branch) or the Congress (the Legislative branch). I believe strongly as a matter of ethics, that a lawyer like Hillary, Bill, or John Edwards must give up membership in the bar, if only temporarily, when serving in the Senate or seeking (God forbid) the Presidency. These vermin can always reapply to the bar after leaving office. It is an important ethical point. Actually someone like Hillary or Bill would not be re-admitted to the bar. Bill Clinton was in fact disbarred due to his illegal activities.

8) Most important: a total disempowerment of the bar associations. Lawyer discipline by true consumer control agencies. Regulated by an open governmental process, with all complaints against lawyers open for public inspection. Like any other industry. Government has, even for the most libertarian of tastes, basic functions to protect the nation. And the lawyer industry is a grave threat to our freedoms and democracy, make no mistake.

[mewzilla]

Docs also need to do a better job policing their own. I can't recall the last time I heard of a bad doc getting his/her license yanked.

[cynicom]

Doctors turn a blind eye when it comes to policing their own. The shyster lawyers have levereged this into a business.

[mewzilla]

There's plenty of blame to go around. That's why more needs to be done in addition to tort reform.

[cynicom]

Willie Sutton was asked why he robbed banks, his reply was, "Because thats where the money is". Also if you want to see a speechless shyster, ask one to take a malpractice suit against another shyster friend of his. He will nearely swallow his tongue and then throw you out.

[mewzilla]

And why are a lot of docs docs? That's where the money is. I can't recall the last time I had the pleasure of meeting a doc who was in it to take care of people.

[Sonny M]

You are definatley right, and I do believe in serious tort reform, I am dissapointed that it hasn't been enough of a priority with congress, but I'm hoping for progress. On the flip side, another reason, in addition to the lawyers for why alot of the insurance costs going up, had to do with the stock market (Insurance companies take the money and invest them in stocks, CD's etc, this is how they generate the revenue they need to make the payouts, and also profit), now, if dividents weren't taxed, the insurance companies would have a more steady and reliable stream of income, and wouldn't be forced to be proactive in buying and selling, it also helps that there wouldn't be anymore enrons or global crossings.

[cynicom]

I am all for tort reform, but lets not throw out the baby with the bathwater. Before tort reform, the government needs to police the medical field, not doctors. Doctors are benefited from government regulating the medical profession as to numbers. There are no complaints about this "intervention". However when the government intrudes into a medical practice there are screams.

Daily we are bombarded by the medical professionals about being overworked, underpaid. On and on. I know full well this is true. However, I would like to see the same effort put into demanding that the number of physicians be increased.

Even though the population of this country has increased by many millions since 1992, there has been little increase in numbers of medical students. These numbers are kept in check by the Federal government.

[gas_dr]

Well, you just met one who is in it to take care of people. I will not argue that I make a good living, because i do. But I also work nights, weekends and holidays. My group is committed to giving anesthesia in Jacksonville anytime there is a surgeon and operating room available. Eventhough we only have 3 anesthesiologists on call at a time, if there is a need for more, we go to work, even if we are not on-call. This is not to make money, but to make sure that the needs of the patient are met! The attorneys work business hours, go home, take weekends off, and never work holidays, unless they want to. I do not have that leisure. Docs also have at least 7 years training after college, unlike our the parasitic attorneys that only have 3 years after college work.

I do not deny that I am paid a good amount of money, but what you do not realize as is evident by your post is that what I bring home is a lot less than what I make. The AVERAGE malpractice premium for a surgeon in my nexk of the woods is pushing 200,000 dollars. Considering that the average surgeon in Jacksonville is making 285,000 (Jacksonville Times-Union) -- well you do the math. Now you see why people CANNOT AFFORD to practice.

Nearly every doc I know does it for the pleasure of caring for the sick. There, are of course a few snipers who do it for the money, but in general, when you take the money I make and then hold it against the time I put in, i would argue that there are many more lucrative business endeavors that would let me have significantly more time with my wife and kids...

[seamas]

FSU recently opened the first new medical scholl in this country in 30+ years.

[gas_dr]

Even though the population of this country has increased by many millions since 1992, there has been little increase in numbers of medical students

That is because, quite frankly, the demands that are place on us and the constant threat of losing everything one has for a bad outcome (WHICH IS NOT MALPRACTICE) has driven many bright people into professions that do not have the exposure. How can you possibly mandate more people go into medicine? This would dilute out medical talent for money grabbers by lowering the standards -- another sure way to screw up the profession. Furthermore, as a percentage, more people are being admitted to medical school as applicant numbers fall, PRECISELY BECAUSE OF THIS PROBLEM. What needs to happen is that physicians need to be allowed to practiuce without the fear of losing ABSOLUTELY EVERYTHING because of an attorney who brings a lawsuit, then demands settlement or blackmails us with dragging a suit out over 3 - 4 years. Instead of MANDATING more doctors let the free market work. That implies that we fix economic damages, but that you cannot collect the lottery for "mental anguish"...

[cynicom]

If I get sick on fri, sat or sun, the only alternative is the ER. Get sick after 5pm and the only alternative is the ER.

We may well have the worlds best medical care, that I do not doubt, getting it is another problem.

Re FSU, how many slots are they authorized by the Federal government???

[Nephi]

Here is another area in which Republicans could take Democrats to the woodshed, but for whatever reason...they aren't.

Hospitals are suffering too because of the federally mandated care they are forced to give to illegal aliens.

Between lawyers and illegals, healthcare in our country is under tremendous pressure.

I would also like to add that I'm glad that there is money in healthcare...that is why ours is the best in the world. Right, Moozilla?

[waRNmother.armyboots]

I agree with you. I am a nurse married to a Family physician and I can tell you that he sacrificed his family and health for his patients. His patients love him and have no problem telling me so in the grocery store or local home improvement center.
For the frustration, long hours, and declining health as a nurse who works as a midlevel provider ARNP, much less for physicians I can find other things to do and be paid equivalent.
As to other comments on this thread the government has already done its share of regulating the medical profession or health care industry to death. So many overhead costs are related to the "oversight" of the government.
Tort reform has to occur or people are just going to give up. My husband and I, just today sat and discussed how we could get out of this exhausting life.
In how many other professions do people have nightmares about the decisions the made or wake up in sweats wondering if they forgot to call that patient or order that medication or gave the wrong medication. True malpractice should be punished, but 99.99% of the time the suits are because life has risks, babies are not born perfect and people think every procedure, surgery or medication should be without any risk. For pete's sake getting in your car and driving to work each day has more risk and people accept that, but a physician or health care worker had to be perfect and make no mistakes. Even if no mistakes were made, they expect compensation for the fact that life does not come with guarantees and they have a false believe that absolutely nothing in their lives should be short of perfect.

[gas_dr]

If I get sick on fri, sat or sun, the only alternative is the ER. Get sick after 5pm and the only alternative is the ER.

I know a lot of family docs who want their patient to call them day or night. Answering services are set up to allow partners to cover for one another...the ER is not the only place. Let us assume, however, that your contetention is correct.

An ER doc evaluates you in the middle of the night, and determines that you are one of the 15% of true emergencies that present to an Emergency Room. Let's really go for the big stuff...you have chest pain. It appears to be heart related. The cardiac call team is brought in to do your angiography. It is not amenable to angioplasty, and your heart is really sick. You need emergency bypass surgery. In comes the cardiac surgeon, and the anesthesiologist. In the span of 3-4 hours, you have now been attended to by at least 5 physicians, and probable close to 30 allied health care staff (scrub nurses, circulators etc.) The emergency room is not a bad place to be in an emergency -- that is why we have them

But let's say, instead, you come to the ER because you have a sore throat for the past hour...yes, we are there for that, too. - I fail to see your point on the ER...it only strengthens my contention that we are here for you 24/7. Is the lawyer? No, but if you have pain and suffering from the throat swab, he will promise to get you a quick 10,000 and he does not get paid unless you get paid. Meanwhile he is home in bed, doing not a damn thing for the overall health of the patient.

But thanks to him, the ER may not even be available to you.

[gas_dr]

YOu are so correct, but the lawyers have convinced people that a bad outcome is bad malpractice, and extorted physicians using this premise. Malpractice presumes a relationship with the patient and only occurs when a standard of care has been violated...a rarity indeed.

I do agree, that the MD who commits malpractice out to lose his license and be drummed out of the profession...and that is something we physicians could be better at doing. But we have got to have the chance to do it without the constant threat of LOSING EVERYTHING WE HAVE. I wonder how long the lawyers would practice if literally every client they had could take them for all they are worth even if everything went or turned out all right?