The Need for Caps in Malpractice

Jacksonville Times-Union ^ | May 4, 2003

[cynicom]

I would have to disagree with your causative anology.

We all approve of the market being in control. Supply and demand works wonders. In that vein, we need steady yearly increases in the number of medical student slots approved by the government. I will wait until I see the physicians of this country demanding this increase.

There is no restriction as to the training of shyster lawyers, yet there is for physicians. I know full well the family practioners in my small town would hate to see three or four new members move into town. Yet the place is crawling with shysters, like a plague.

[gas_dr]

I assume you are referring to the limits on residency positions in the state of New York. This is mandated by the state. An example of how the government does not know beans about healthcare. God forbid if they try to nationalize it.

[waRNmother.armyboots]

Sorry, hard to feel sorry for you. Those are docs in the ER taking care of you, too. My husband and I put in 12 to 14 hour days five days a week. No golf for us. We are so exhausted by the weekend that we do almost nothing on Saturday to try to recover in time to do it all over again on Monday. Most physicians leave medical school 1/4 million in debt(There is data on this). We paid my husband's last school loan in our youngest son's senior year in college. How would you like to carry that kind of debt to be altruistic and care for people? Especially people who complain how much "you" doctors make. All of our (3)cars had 250,000+ miles on them until last year when the Sunbird imploded and we had no choice, but to buy a car. They were not BMWs or Mercedes either, Pontiac Sunbird, GMC Jimmy and bought used Cutlass Cierra.
Would you want to be on call to people 24 hours a day and 7 days a week? Doctors take call for each other and if the practice your physician is in does not do that then find one that does if you want that kind of service.
My husband has been called at 3am by a patient wanting to know where she could get batteries for her glucose tester at that time of the morning. This is just a sample of the kind of calls he gets from people.
Most doctors are in it because they care about people. Otherwise they would be gone after about ten years of the abuse.

[spectre]

My husband's coworker had terrible back problems for years, including slipped and degenerative disks. He was in horrible pain most of the time. You get the picture.

He finally found the best Orthopedic Surgeon available in Little Rock, who would even consider operating on him.

Miracle, the operation was a huge success, the patient has been pain free and is doing great.

Now, the rest of the story. While in the hospital, the Orthopedic Surgeon asked him "how do you feel"..."GREAT", the man replied.

The surgeon then informed him, that this was the last operation he would perform, as he could no longer afford the malpractice insurance.

The Doctor was in his early 40's. Sad.

sw

[cynicom]

Perhaps you are misusing the term "we".

The overwhelming medical care is provided by the family physician. We all know that. Not the cardiac surgeons etc. Therefore the term of "we" is indeed a mischaracterization. Perhaps once in a lifetime does one come into contact with a cardiac surgeon.

I am on your side, having family members that are both physicians and shysters. However, there is indeed a need for more physicians, either increase the available slots or open the field to others, less trained, but capable of taking care of my sore throat you speak of.

[waRNmother.armyboots]

Good luck. The pool of applicants to medical school has dropped dramatically. I am not sure that opening more slots is the answer. But you would be welcome to try. Nursing schools have the slots and no students. People who are smart enough to get into these professions no longer have just these professions to choose from and now say why should I do this back breaking and mentally and emotionally exhausting work and short change my own life and family. Nursing is in a crisis. The average age of nurses in this country is 54 and the nursing schools are not full.

[cynicom]

Mother....

I then expect to see you and your husband leading a protest to Washington, demanding the training of more physicians.

[cynicom]

Mother...

Your premise of falling number of applicants is totally false and most medical schools admit this. The total number of applicants per available slot numbers remains in the hundreds. Many do not bother to apply, for various reasons. One major factor is because of the intrusion of the government into medicine.

[Former]

Alleluia! I love it! I am a registered nurse, former ICU nurse, married to a physician, who understands exactly what you are talking about. I used to be so tired, I thought my feet were going to fall off. The perfection that is expected of you is probably equal to the pressure of other professions, but the expectations are amazing. You have to be manic to be good at all that is required.
As a medical professional, you are also supposed to be adept at taxes, the law, psychology, technology, constantly changing hospital policies, medications (on the lookout for incompatibilities, side effects or drug reactions), financial responsibility (keep up with all patient charges, and if you are charge, you are responsible for cutting cost or staying within your budget, or at least making sure fellow nurses stay within the budget, whether you are present or not), charting appropriately without mistakes in wording and legibility, perfect wording/behavior with families and also fellow physicians/nurses, awareness and maintenance of policies re: responsibilities of fellow workers... you are responsible for the work of others who are under you, i.e., students, aides or L.P.N.s., or if you are a physician, you are responsible for all nurses caring for your patients. If they make a mistake, it is likely that you will be the one sued. Physicians are on call by families, ICU nurses, other physicians, patients, both in the hospital and out, emergencies and even those friends of yours and sometimes even friends of friends who want free medical advice. They are expected to be available and without complaint 24 hours a day and at the becking call of everyone. Perfection is also expected. You must have proper demeanor with families and you must be prepared to repeat anything you have already told them 3-4 times if necessary.
I could go on and on... it is amazing, if you work in it, and have any sense, you can understand the pressure on staff is unbelievable.

[waRNmother.armyboots]

No it is not totally false. I know because when my husband applied the number of applicants for available slots was much higher. My son looked into applying last year and the college(stateside) he was applying to had a five to one ratio of applicants per slot. So do not tell me that the number applying to medical schools has dropped. It has.
As to nursing schools, the slots available has dropped because they do not have the older, experienced nurses to teach.

[waRNmother.armyboots]

That would be great except who would take care of our patients while we are gone and we cannot afford the airfare. My husband and I have sent many a letter to our representatives in Washington and that will have to do.

[friendly]

The best and the brightest are not going into medical school these days. It's now 50% female in the med schools, up from 5% just a few years ago. The nursing schools are partially filled and contain lots of dummies, in my humble observation.

If you are smart and have high standards (but want a life) you go to research, engineering, computers, high tech, etc.

If you are smart and have a criminal tendency with no ethics and lots of greed, it's law school for you!

[waRNmother.armyboots]

Oops I meant that the number of applicants to medical schools HAS dropped. I meant do not tell me it has not dropped. Should proofread better, but I am irritated.

[Doe Eyes]

In that vein, we need steady yearly increases in the number of medical student slots approved by the government. I will wait until I see the physicians of this country demanding this increase.

I don't get it. You're waiting for hell to freeze over?

[Mamzelle]

LIke I've suggested to you many times, open a medical school if you think it's so cheap and easy. Whatever the Fed says, it'll always be expensive to educate a health pro, more so than educating other pros. Anything expensive will be scarce. It is very cheap to educate a lawyer.

Around 20% of all new US docs are foreign-educated for that very reason...we let other countries pay for some of this education, then lure them here. If there was a conspiracy to limit the number of docs, this wouldn't be happening.

[friendly]

There are less than two applicants for each med school slot, down from 5 or 6 for each slot twenty five years ago. Simce each applicant applies to multiple schools, a highly desirable school can have 50-100 for each slot. This explains the paradox observed by cynicom.

Personally I like older docs, remnants of the lost days when the doctors were the brighest intellectual lights in academia.

[waRNmother.armyboots]

I agree completely. I have had personal experience with family members in the hospital three times in the last four months and I was appalled at the level of competence of what passes for nursing care now. There was a time that nursing was moving toward B.S. prepared to be an RN, but now the hospitals are flooded with two year Associate Degree RNs this when the patients have become older, more complex and ill. But the marketplace economics dictate that hospitals hire what will fill the bill. Nurses are burdened with paperwork because of the government oversight and paperwork to prevent malpractice. Very little of the paperwork has anything to do with providing quality patient care.

[Mamzelle]

re: The best and the brightest are not going into medical school these days. It's now 50% female in the med schools, up from 5% just a few years ago. )))

This causes interesting ripples. Many of these women practice fewer years than men, and fewer hours per week. They are often attracted to primary care and some of the easier (I mean physically) specialities such as radio, anes, opthal...women seldom (though it is not unheard-of) are attracted to neuro, ortho or general surgery. Yes, maybe you know of one or two--but in general, this is not common.

Something these articles seldom touch upon is the sudden decline in the numbers of general surgeons--the younger surgeons who do most of the heavy lifting in trauma surgery.

The guys who sew you back together after your car wreck, or take care of the emergency appendectomy.

The next fun in this circus is what happens to the ER staff when they can't count on adequate surgical backup. Naturally, the "blame game" will shift attention to the ER docs who trained to be ER docs, not general surgeons. They can't leave the ER for the OR...

What a d*&ned mess!! All because we've ceded so much political power to the lawyers.

And it does boggle the mind that the general public would rather risk living without emergency care than cope with their Bill Bennett-sized gambling addiction.

[friendly]

Now the hospitals are flooded with two year Associate Degree RNs this when the patients have become older, more complex and ill. But the marketplace economics dictate that hospitals hire what will fill the bill. Nurses are burdened with paperwork because of the government oversight and paperwork to prevent malpractice. Very little of the paperwork has anything to do with providing quality patient

True and it is worse than that. High School drop out Aides now do a lot of what nurses used to do under nursing "supervision," a challenging task since the poor nurses are (as you pointed out) spending most of their time in psychosis-producing malpractice court-mandated and federal bureaucracy mandated paperwork. It is INSANE!!!!

[MarkL]

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.

I disagree... I believe that there should be a cap to non-economic damages, however, economic damages should be kept, and I believe that there should be a cap on the legal fees that can be charged against them.

For instance, if I see a Dr about a procedure, and he does something that is proven as malpractice, and ends my career as a network systems technician and instructor, he (or more importantly, his insurance company) should be responsible for "fixing me" to the point where I can go back to work. If that can't be done, then they should be responsible to my family for my medical care (should I become an invalid) and for the income lost due to the malpractice.

If someone takes away my livelyhood, due to their actions or inaction, then they should be responsible for making me whole.

Mark