It still won’t be limited for those with means to go out of the government system, though.

It hasn’t happened after 30 years of “reform” that physicians said would have the same result. Why should we believe you now?

Tell you what, how many neurosurgeons will you guarantee per person if we give you immunity? And how long do we have to wait this time? Your promises have not been fulfilled in the past, so give us a guarantee. If it doesn’t happen, we’ll repeal it and give injured patients a fighting chance again, ok?

The studies generally say that it’s rare that a cause can be determined, but it does not say that it’s impossible for malpractice to cause CP. You say OBs are sued “quite frequently”? How often? In 10% of the CP cases? 3%? 1%? No one knows. It may be even less than you’d expect.

“Would you say that our disagreement revolves around the definition of negligence? Few would argue that bad physicians who are truly negligent shouldn’t be sued.”

Actually, I think our disagreement stems from your second sentence. You are not a bad physician if you are negligent one time. No more than you are a bad driver if in a lifetime of driving you cause one wreck. You made a mistake, that’s all. However, simply because you’re a good person and a generally good physician or driver doesn’t mean you don’t have to pay for your mistakes.

” someone is always willing to point the finger at the physicians.”

This is not really true. Do you really think that most all malpractice results in a claim? Or even the majority of it?

” Can you honestly say that’s not a fishing scam to manipulate people into bringing ANY suit to your attention? That guy in the commercial isn’t looking out for patients.”

It’s not his job to look out for patients, or healthcare in general. It’s his obligation to look out for his clients. Now, do I like TV advertising? No, no more than you like Dr. 90210. Is he looking to have people call him with cases? Absolutely – but most med mal plaintiff’s lawyers will tell you they pass on most of the cases brought to them. It is their money and time on the line, and it’s simply not good business to waste either on questionable cases.

“why not apply it across the board to all healthcare costs.”
I do. About 30% of our health care dollars go towards ‘futile’ end of life care. A premie infant who’s too small to live but the parents want everything done. A 100 year old great grandparent who’s neurologically devastated from multiple strokes and kidney failure and the family insists of putting her through surgery for a perforated bowel. No chance of survival, but we pump massive amounts of dollars into a few days worth of torture for these patients. When I lived in England, people were much more honest about death, medical limitations, and the expectation of a miracle.

Like it or not, healthcare is a limited resource. There is limited money, and even if there weren’t limited money, there is limited staff, rooms, equipment. Allocation and wise use of such resources is partly the responsibility of the physician, and efficiency of the system ought to be everyone’s goal. If I send you to CT just because you want it (and almost no one is paying out of their own pocket, so that argument is bunk), then when a trauma comes through my doors, he has to wait for you to finish your unneeded test. Many tests have real risks, such as significant radiation exposure. Maybe you want a CT scan, but if you end up getting cancer later on, I’m willing to bet you’ll blame me for ordering a dangerous, unnecessary test.

We are lucking in this country to have such things readily available, but that doesn’t mean physicians or patients should waste time and money ordering unneeded frivilous tests.

I see plenty. OBs deal with this sort of thing all the time. Take a diagnosis like cerebral palsy. Most data now indicates that CP does not result from intrapartum care, yet OBs are sued quite frequently over this outcome. Same thing with shoulder dystocia resulting in nerve damage. Frequently the child is brought into the court room and paraded around. It’s heartbreaking. The fact is that a certain percentage of normal deliveries will have this result, and no physician or health care provider is at fault.

Would you say that our disagreement revolves around the definition of negligence? Few would argue that bad physicians who are truly negligent shouldn’t be sued. However, what upsets me (and physicians in general), is that you can follow the standard of care and the outcome can still be bad. Sometimes, shit happens, and it’s not always someone’s fault, but someone is always willing to point the finger at the physicians. Moreover, there’s always someone who would do something differently and multiple ways of approaching a problem. Maybe that expert physician was right in that particular instance. Knowing the end result helps say so, but it doesn’t mean things were done inappropriately the first time.

Look at the TV commercials you see. Money falling in the background. A well dressed man telling you that if you’ve been injured you have a right to money. Can you honestly say that’s not a fishing scam to manipulate people into bringing ANY suit to your attention? That guy in the commercial isn’t looking out for patients.

Again, you show no understanding of economics in another industry:

“In our current system, if someone files a $3000 case against you, you have to determine whether it is worth your while to pay $20,000 in legal fees to prove you’re right or to just pay the damn $3000, lick your wounds, and move on with your life.”

If someone files a $3,000 case against you, it is most likely in small claims court, where an attorney is not required. What attorneys are charging $20K to defend a case of that size?

” And if the “loser pays” system is so bad, why do most other countries keep it around instead of switching over to an “Americanized” system of tort law?”

Again, you are speaking about subjects which you know little. One, almost every state already has loser pays. Two, it doesn’t work in other countries like you think it does. Here is an article that will educate you a little – if you’re open to it, that is:

http://medicaleconomics.modernmedicine.com/memag/article/articleDetail.jsp?id=111474

That’s a false question. I mean, if you believe that, why not apply it across the board to all healthcare costs. For example, why spend money caring for someone who has outlived their life expectancy when we can apply it to preventing heart disease for an example? Your question assumes that there is a finite pool of money for healthcare we’re all dipping in to. Right now, and maybe not for much longer, that is not the case.

If I pay for every test under the sun, and pay out of my pocket, that’s MY money to spend how I’d like. If I contract with my insurer to pay for those services, that’s OUR agreement. Really not your concern.

“Your firm doesn’t take cases that it doesn’t think it can win. Should it be accused of malpractice if another firm ultimately accepts and wins the case? After all, you were wrong in your decisionmaking.”

This statement reflects a misunderstanding of the elements of malpractice. The firm had no duty because it didn’t take the case. And, there are no damages. You have to have both.