The game of medical funding hot potato continues. Miami hospital system stops providing dialysis for indigent patients due to mounting budget losses. Instead, patients are encouraged to go to the emergency department so that Medicaid will be forced to pay the cost for the visits.
Rather than risk crowding in their hospital emergency departments, three other Miami area hospitals contributed $100,000 to pay for outpatient dialysis for one month while seeking a longer term solution
Boston Medical Center lawsuit accuses Massachusetts of illegally cutting payments to hospital for indigent care and of “financ[ing] its health insurance law, a model for national healthcare overhaul, on the backs of poor residents.”
BMC President Elaine Ullian makes similar comments in a speech to hospital donors. Massachusetts Governor Deval Patrick gets offended and writes letter to hospital’s board of directors calling Ullian’s comments “wrong” and “unhelpful.”
In other news, Ullian was then seen sneaking around Governor Patrick’s neighborhood at night carrying a carton of eggs and several rolls of toilet paper.
Need to see a mental health counselor? OK, our next open appointment is January 2015. The average wait in Polk County, Iowa is about 14 months for mental health care and can be “up to five years before some people can receive care.” At last count, there were more than 500 people on the waiting list. Cuts in services are being made as the state tries to balance its budget.
Medical malpractice judgments and settlements are now being posted online. The North Carolina Medical Board’s site is here. A story in Fox news about the innovation is here. According to the article, about two dozen licensing boards in several states publish malpractice information.
A number of years ago, there was a public outcry when a group in Texas posted names of plaintiffs who filed malpractice suits against physicians. Everyone seems content when physicians are exposed to public scrutiny.
Also interesting that the President of the NC Board, Donald Jablonski, was reprimanded by the Florida Board of Osteopathic Medicine. Amazing what you can learn on these sites.
It is an emergency department or a hockey rink? Patient punches emergency physician in the face (link from Gladwin, MI now changed to subscription only, so article unavailable). Meanwhile, a different patient punches emergency department nurse in face. Then, a mother threatens to kill ED staff then grabs security guard by throat. I need me a stun gun.
Then I read about a police officer being stabbed in the neck and killed while sitting in his car in an emergency department parking lot.
What is wrong with people?
More budget woes affect medical care. Cook County’s $75 million health care budget shortfall results in even more cuts in medical services. Nine hundred hospital positions were cut last year and an additional 450 positions will be cut this year. A patient notes that a 10 hour wait in the Stroger Hospital emergency department waiting room “isn’t bad” and that the longest wait he’s seen is 30 hours.
Gunshot victim seeks emergency care from naturopath? And the naturopath agrees? Somehow, I don’t think herbal extracts and rolfing are going to cure internal bleeding.
Increasing medical malpractice claims in Tennessee. Out of more than 3000 cases filed in 2007, only 7 went to trial and 492 were settled. The remainder “died on the vine.”
Emergency department staffing company Team Health’s IPO was disappointing, as they only opened at $12 per share rather than the $14 to $16 they were expecting. Even so, Team Health’s net income last year was nearly $2 billion. Talk about “going green” …
The article about Tennessee shows only the data up to 2007. Last year the state changed the law and required attorneys to have a signed certificate of merit from a medical specialist before filing any medical medmal case. There was a flury to file cases before the law went into effect, but it had the result of decreasing medmal filings by almost 2/3s!
Throck, that doesn’t mean the volume of cases has declined, or even that the amount of malpractice has declined (something rarely mentioned when discussing malpractice issues – for some reason no one wants to focus on actually minimizing malpractice). It merely means that a lot of lawyers did the smart thing by not costing themselves and their clients additional expenses by having to hire yet another expert and filed to beat the effective date of the law. There may well be the same number of cases in a couple of years.
What did happen is that cases that may have been in the process of being settled without a suit got filed just to avoid the event of that additional expense.
Or are you just happy that it became that much more expensive for people who have been injured by malpractice to get justice? Wonder why they never make the defendant file a certificate of merit from an independent expert with their Answer denying the claims? Must be because tort reform is about “justice”! Kind of like why people only want to cap one side’s fees.
Throck,
Its time to lay off the med mal lawyers. They are here to make life better for all of us. Just today I saw a commercial on TV for “have you or someone you know ever had Steven’s Johnson syndrome, ever taken an antibiotic, call our office blah, blah, blah.” There is a prime example of med mal lawyers being able to protect us from the extremely remote chance of contracting a serious illness by instilling fear in docs who think about prescribing antibiotics. It really doesn’t matter that there is no way to predict who gets SJS, it only matters that someone is injured, and someone needs to pay for the “malpractice”.
Someone pays for all malpractice, whether a claim is pursued or not. And if the victim becomes uninsurable or disabled, all of us taxpayers end up paying for it. Maybe you think that’s a better solution than having the responsible party do it. In that case, single payer is probably your cup of tea.
Matt at times your ignorance and ability to put your own foot in your mouth knows no bounds. Stevens Johnson is an idiosyncratic reaction to a drug that can’t determined ahead of time. It is not “malpractice” for it to occur. Why don’t you for once read before you type.
Joe,
It may be that the antibiotics are prescribed as a result of a misdiagnosis. Neither you nor I have seen the evidence in any particular cases involving these claims, so we have no basis to know if malpractice was involved or not. It may be they are pursued on a failure to warn theory, it may have been a failure to properly monitor. Or maybe, it’s merely the damages from improperly diagnosing and treating another problem.
If I’m negligent and run a light and hit you and you suffer just scratches or if you become a quadraplegic, I’m still liable regardless for the resulting harm. Maybe these are garden variety failure to diagnose cases where physicians (actually their insurers) are just unfortunate in that the mistake caused a greater harm than would be normally expected.
Long and short though, you have no idea what the legal basis for these cases are, because you have not read a single pleading. I realize that’s a novel concept these days – having facts before opinions, but it’s got some merit.
“It may be they are pursued on a failure to warn theory…”
Wow Matt, again you show not even a very rudimentary understanding of medicine. Pretty much ANYTHING can cause Stevens Johnson. It is an idiosyncratic reaction (look it up you don’t appear to know what that means). You are talking about hypotheticals that could be, may be, sort of, occur on the far side of the moon. Sorry I work in the real world not la la lawyer land. Like some of the docs here I have actually SEEN Stevens Johnson. It is not subtle. That is unless you think your epidermis separating from you dermis and thereafter sloughing off is a “subtle” finding. The problem here is eye doc gave a pretty outrageous example and you don’t even seem to understand the point he is trying to make because you have no basic rudimentary understanding of the subject.
If you want to use the failure to warn theory, well Matt, you should NEVER EVER let anything cross your pie hole. Because it could cause Stevens Johnson. End of story.
Joe I wouldn’t pretend to have an understanding of medicine. Unlike a physician, I didn’t get the degree and automatically become an expert on everything else.
All I know is what I read in a quick review when you first mentioned it, where on sites like mayoclinic.com, it appeared the most common cause is medication reactions.
You’re absolutely right I’m talking about hypotheticals, since neither of us are dealing with the facts of an actual case. You’re talking hypotheticals as well. If you’re citing a particular lawsuit involving the syndrome that you’ve reviewed, by all means share which one, and perhaps we can have a discussion in which we’re both not just speculating. At least I can admit that without seeing the pleadings or evidence I can’t tell you the basis for the lawsuit, and I’m just guessing. Apparently you don’t need evidence to reach conclusions – is your real name Bill Frist?
The decline in case filings has persisted. Since the cases are filed on a contingency basis I am glad to see that the filing attorney has a stake in determining if a case has merit. Are you not glad that attorneys have to spend some money to be sure their clients get what they deserve? I am glad that physicians in the State will have a decrease in the costs of defending cases that don’t have merit.
Again, you seem to be celebrating a case decline (which we have to take your word for I guess) but conspicuously absent is any discussion about a decline in actual malpractice.
Since the client ultimately pays the expenses if the case is successful, why would I be glad that physicians have thrown up yet another hurdle in the way of an impartial jury hearing the evidence? I guess it doesn’t bother you because you can’t imagine ever being on that side of it. Which is understandable – few people ever think bad things can happen to them.
Physicians don’t actually pay to defend the cases. Just like you’ll not find any physicians who have paid judgments out of their pocket, absent drug abuse or their insurance company dropping the ball or something unusual.
Matt: Why do you say that physicians do not pay to defend cases? Most of medmal insurnace companies are mutuals and owned by their members. Further, we pay to defend not only our cases but those brought against others. That is what the insurance does. We pay for it. The problem is we have to pay for frivoulous suits that are brought to just create a headache to force a settlement rather than ring up more and more costs. Making the trial attorney find an expert to sign off on the merit decreases the filing mills that exist. Further, dont you think if it is a true case of malpractice that it wouldnt be hard to get the certificate? Also, the attorneys pass all the costs off to the defendant anyway, so it is the defendant that loses the case that has to pay. The hurdle is that attorneys dont want to pay, and they especially dont want to decrease their ability to file frivoulous suits.
Your premiums are a function of yes, claims, but also they’re a function of investment decisions, the general market, and the status of other insurers. So you may have a great claims year in terms of low claims and still see your premiums go up. You might have a high claims year the following year and have great investment returns and see your claims stay flat or decline.
Now, you keep saying “we have to pay for frivolous suits”. Well, you haven’t defined “frivolous”, but again, it makes no sense for a plaintiff’s lawyer to file a truly “frivolous” claim, meaning no merit and no possibility of merit. It’s a waste of their money when you consider the winning percentage at trial. If you were talking about filing mills with respect to auto claims, I’d be with you. They exist, because the entry barrier is low. But show me a single “filing mill” for med mal.
The attorneys pass the costs to the defendant? Now I know you don’t know what you’re talking about.
As to how hard it is to get the certificate, that’s not really the issue. If you physicians are to be believed, finding an expert to say what you want is not that hard. Again, you’re just adding yet another cost to the injured party. You need an expert to take a med mal case to trial anyway, so why impose that cost.
If it’s about justice, how come the defense doesn’t have to get one before they deny the allegations in their answer? Are you not equally concerned about money and time wasting defense tactics? After all, between the parties, who do you think has more incentive for delay?
“Well, you haven’t defined “frivolous”, but again, it makes no sense for a plaintiff’s lawyer to file a truly “frivolous” claim, meaning no merit and no possibility of merit.”
Matt you are playing word games, but then again you are a lawyer that is what you are trained to do. Saying a “frivilous” suit has no possibility of ever having merit is analogous to medicare “never” events. The real question is whether the basis for a suit is reasonable based on any mechanism to any impartial observer. Following your “reasoning” pretty much no suit is “frivilous” But you are a lawyer, I would expect you to say that.
Joe, I am attempting the clarify the term because it’s too often loosely translated to mean “anything I don’t agree with”. Nearly every defendant thinks the case against them is “frivolous”. Should we throw them all out because one person, in your case one person who hasn’t actually reviewed the evidence but considers yourself an “impartial observer”, cries “frivolous”? I don’t know what you do for a living, but if you’re a physician, I’d expect you to think nearly every malpractice case is frivolous.
Why is the “barrier of entry” so much less with auto claims?
Don’t you think that frivolous auto claims would decline if it were a loser pays system?
And why wouldn’t some attorneys want to take a shot at winning/settling one or two multimillion dollar cases rather than a bunch of smaller cases where they make a few thousand dollars?
Your logic still isn’t holding water.
The barrier of entry is so much less because you don’t need expert testimony.
You keep harping on loser pays, but again, it doesn’t work like you think it does even in the countries that have it. Poor people can’t afford to pay the bills anyway. And, it eliminates people adjudicating disputes where there might be a close question or a genuine fact dispute based on an honest disagreement.
“And why wouldn’t some attorneys want to take a shot at winning/settling one or two multimillion dollar cases rather than a bunch of smaller cases where they make a few thousand dollars?”
You are of the belief that there are tons of multimillion dollar cases to be had for any lawyer. That’s just not the case. You read about the multimillion dollar ones in the paper, so you think there are more than there are.
You think my logic fails because your experience with the legal system consists of a couple trials, one of which you were a party to. Yet you drafted no motions, argued no cases, have no idea what the economics of a law practice are. But somehow you’re an expert at it! At least when a lawyer puts a doctor on trial, he/she has to have another doctor to put on the facts. You assume all facts when reaching your conclusions.
” The problem is we have to pay for frivoulous suits that are brought to just create a headache to force a settlement rather than ring up more and more costs.”
By the way, how many times have you ever settled a claim with an insurer? How many times have you ever seen one just settle any old dog case for lots of money, particularly in med mal? Please, tell me who these insurers are who are just handing out money every time they receive a lawsuit.
It’s particularly silly hearing a physician say that when they are filing class actions for billions (and requesting jury trials) against health insurers all the time. What for? Wrongfully denying claims essentially. Yet somehow you’re certain there are insurers who just hand out cash to any idiot who pays a filing fee.
Do you think you guys should have to get an insurance executive sign a certificate of merit first before you file? How about we assign it to a jury of the defendant’s peers – just insurance execs? Or how about we limit what you can pay your attorneys, but not what the defense can?
Does your version of justice extend to yourself?
Matt:
If the cases are not frivoulous, why is it that getting a certificate of merit decreased their number? You have not answered that but are now trying to deflect the answer. A certificate of merit should make no difference if it is all about justice. Why did you jump from medmal to disputes with health insurance companies? Stay on task. Now, if you file a suit, do you not believe that somewhere, somehow it still costs the otherside to defend? Lawsuits feed lawyers on both sides and the defense has to pay for both of them in these contingency fee cases.
Matt, if you truly want justice, then the attorney who brings a frivolous case should be responsible for the costs of both parties and subject to having all his actions in the case scrutinized. If an other attorney finds the plaintiffs attorneys actions to be questionable as to standard of practice, they should be able to file a certificate of merit for a legal malpractice case to go forward. Remember, it is all about justice. Justice for those that are injured by medical and legal malpractice.
Again, you’ve not shown that it has. You showed there was a flurry of filings before the law went into effect, and then naturally there wasn’t as many immediately after since a bunch had been filed before. There’s no evidence of a decline.
Do you spend money? Does it matter to you when you spend it? A “certificate of merit” has no bearing on the outcome. It’s not even admissable. The plaintiff still has to prove their case. It’s just another cost hurdle for them. How come you haven’t responded as to your position on certificates of merit for the defense? Your silence speaks volumes about your interest in “justice”. Likewise with your interest in “justice” when it comes to capping only what one side can pay their attorneys.
As to the comparison, your willful ignorance is humorous. You get it, don’t be silly.
It’s not clear that you understand the economics of a plaintiffs practice. You don’t get paid unless you win. In fact, you only spend money and time. So filing frivolous cases doesn’t make a lot of sense. I can go deeper into the economics of it if you need, but it seems pretty self evident. You’re a smart person, don’t play dumb. The only people who get paid no matter what are the defense attorneys – YOUR attorneys (since I know you cannot possibly imagine being injured by someone’s negligence).
I agree with your second paragraph, at least the first sentence. In fact, that DOES happen. Lawyers file motions for sanctions and judges sanction lawyers all the time. Now, what you believe is a “frivolous” case may not be truly frivolous, and I know that’s hard to understand, but it is true.
I don’t believe though, that if a lawyer commits malpractice handling your case, that you should have to get a certificate of merit to go forward with your case against the firm. Why? Because it’s irrelevant to whether you prevail. It’s just another cost you’d have to bear out of your pocket, yet it would have no meaning with respect to the actual trial. It doesn’t advance you seeking justice in any way at all.
Matt: I understand the economics very well. It is not true that you only get paid if you win. The economics are you get paid to go away. You dont have to win to get paid. Because lawsuits are about money, the laws of economics apply. If it costs more to fight than to settle, you settle. For the defense, you still have to pay whether you win or lose, the only difference is how much.
Having a certificate of merit should be an asset as it shows that you have a good case to go forward with. Since you only get paid if you win, and this money comes from the party you are suing, they are the ones paying it. What you dont like, is attorneys having to pay and justify thier claims. Since attorneys would never bring bogus suits, they wouldnt be out a cent by having to pay for an exam to get a certificate of merit. That is unless they are just filing a suit to try to get a quick settlement.
Again throck, a simple question. How many cases have you settled with an insurer? What insurers do you know of that settle patently frivolous cases?
If physicians have to file multimillion dollar class actions against insurers to get paid, why do you think it any different for anyone else?
I don’t know about Tennessee, but in my state, defendants do have to file an affidavit by an appropriately-credentialed expert that their defenses are meritorious.
And what is the tremendous “cost hurdle” necessitated by the affidavit requirement? Counsel for the plaintiff has to retain an expert, send him the relevant records to review, and discuss the case to learn the expert’s opinions. These activities are indispensable, whether or not there is an affidavit requirement. The attorney drafts an affidavit, the expert reviews it, requests changes if it does not reflect his opinions accurately, and signs the approved affidavit. If the expert’s part of the affidavit process takes as much as an hour, he’s gouging you.
A.J., if it costs $2500 (which is on the low end), and still doesn’t change the fact you have to prove your case, what’s the point? After all, it’s not like it means the defense says “Oh yeah, they’re right, let’s try and resolve this now”. It’s just another financial cost for the plaintiff, designed solely to make it harder for the plaintiff to pursue a case.
It doesn’t seem like a big deal to a defense attorney because they don’t pay it. And experts for the defense in malpractice are a little easier to come by, since they don’t have to deal with the cries of “whore” from their colleagues.
$2500 for a certificate of merit? Now who’s blowing smoke? Try $500.
The certificate of merit not only frames the allegations of negligence for the attorney, but it also protects plaintiff attorneys from allegations of malicious prosecution when their cases are shown to have more holes than a golf course.
“How could we have filed a frivolous case? Attorneys don’t know medicine. We relied on the opinion that negligence occurred rendered by the learned medical professional.”
Can’t take action against the medical professional because opinions aren’t actionable in civil court. Going after the medical professional through professional organizations causes plaintiff attorneys to cry “witness tampering.”
File away with no fear of retribution – all for the cost of a filing fee and a certificate of merit. What a bargain.
Have you purchased a lot of certificates of merit?
You say it protects the plaintiff’s attorney? Nonsense. Many states don’t even have them, and is there are rash of claims against the plaintiff’s counsel? No.
Again, whatever the cost, you can’t tell me it changes ANYTHING about the case. You got effectively a “certificate of merit” in your own case from YOUR OWN EXPERT, and you still disregarded it and went looking for an expert who agreed with you. Would a plaintiff’s certificate of merit changed ANYTHING in your case? No, just the cost to the other side. What does that have to do with “justice”?
“File away with no fear of retribution – all for the cost of a filing fee and a certificate of merit. What a bargain”
How is that a bargain? You don’t make any money for filing or getting a certificate. You still have to pay for all the other attendant costs of litigation. You continue to opine on the cost/benefit of a plaintiff’s practice with literally no clue what you’re talking about.
You’re paying $2,500 for the nominal time an expert devotes to reading and signing a certificate of merit? Srsly, dude, you’re gettin’ hosed! I’ve prepared and filed dozens of such certificates, and if I get charged as much as $200, I call up the expert and we have a talk. Usually the time involved is so negligible that the reviewer makes no separate charge for it.
So again, does it change what happens in the case any at all? One bit? You ever had an insurer settle anything after getting that certificate?
So again, hosed or not, what was the point of spending that extra money?
Yes, dozens of times. Without the certificate, it’s just a lawyer blowing smoke — why should they pay on that basis? An affidavit proves there’s at least one guy with a medical license who’s willing to put his professional credibility on the line to support plaintiff’s claims. If he’s a legit practitioner who knows what he’s talking about, that gets serious consideration of settlement in gear at an early stage.
What we really need (but unlikely to get given trial lawyers PAC power) are health courts where (like tax courts) the judges would have special training expertise in medical malpractice, the courts would hire the experts. This would result in more rapid (and more $) settlements to injured patients and more consistency to decisions. You may read more at http://www.commongood.org. This type of solution benefits everyone (best I can tell) except the trial lawyers therefore seems unlikely to pass.
Chuck, why do you want the taxpayer to foot the bill for the experts? Because the tobacco lobby (whose lawyers run Common Good) say it’s a good idea?
And how does a judge become an expert across the vast spectrum of medical issues? And why do you think insurance companies want more and faster settlements? The only reason insurers back health courts is because the proposals all include caps. What’s more, the plaintiffs will still need lawyers to present their cases. Only difference is the taxpayer has more burden.
No Matt, that is where the state medical board comes in requiring random MD’s who are trained in the given specialty in the state to review the records and give opinions. Maker it a part of being licensed. Sure it would cost but certainly less then either side pays for the hired guns (I have seen the fee schedule, thank you) Most states make us do CME to continue licensing. Would it be easy, no. Frankly it would take our time and some docs would be angry about it. But certainly fairer than the present system where either side pays for a a very pretty penny for an MD’s testimony (talk about bias). But we both know the legal PAC’s are way to strong for something like this to ever happen.
So the state board, often a group who is loathe to discipline doctors itself, gets to randomly choose a physician without any vetting by the actual parties involved, and that guy makes the call? He judges his own colleagues? That’s your version of fairness?
OK, sounds good. But here’s the deal. You have to give every industry that right. So, when physicians sue health insurers, for a prominent example, the health insurers get to pick a health insurance exec to make the call. Sound good?
And Joe,
You need to look at the “health courts” proposal. It consists of caps. If it didn’t, the insurers and tobacco industry wouldn’t be backing it.
Matt,
The difference between a claim against a health insurance company by a physician is that those claims come down to a contract dispute. Contracts are part and parcel of lawyers training. Therefore a lawyer can, independently decide if a contract case has merit. Lawyers generally have no such training in medicine. They should be made to obtain the counsel of someone with that expertise. When it comes to complicated, specialized matters of law, the is precedent for specialized courts (and lawyers). Examples include the need for a lawyer to be credentialed (in many states) to defend capital cases, the use of specialized judges for tax matters, and the use of Markman hearings to determine definitions in patent cases. All proposals involving “health courts” would do is insure that the folks truly hurt by med mal (i.e., the drunk surgeon cut off the wrong leg) are not lumped in with the folks who hire the devil’s spawn such as yourself who will try and get them money for being unlucky enough to suffer an idiopathic illness such as Stevens-Johnson Syndrome.
And you wonder were the hate springs from?
Matt,
You wrote “Someone pays for all malpractice, whether a claim is pursued or not. And if the victim becomes uninsurable or disabled, all of us taxpayers end up paying for it. Maybe you think that’s a better solution than having the responsible party do it.” So you think an individual who has no ability (again, that is no ability, no crystal ball) to predict a future bad outcome, in the case I sighted SJS, should pay? This is my point, there is no responsible party. You feel the person who wrote the Rx, with the best of intentions, should pay. The surgeon who did not have a perfect outcome, with perfect post-op course, should pay. The unfortunate reality is sometimes bad things happen, and there is no one at fault. Your problem is you think there is always someone at fault. This gives the population of patients who see this whole thing as a lottery the incentive they need.
Someone pays for all malpractice suits, and in the long run, it is all of us through either taxes or higher medical costs or higher insurance premiums or lower access. Or, most likely, all of the above.
The real problem with med-mal as I see it is very few people want to see attorneys (one of the least respected groups of people) get a “lottery prize” (or is that “lootery prize” as I started to type) big payout.
Bill,
Your first paragraph seems correct until you understand where the money from a verdict often goes. More likely than not most of it goes back to a health insurer via subro, or to future medical bills. That actually saves the other insureds money and the taxpayer money because the responsible party pays for the harm they cause rather than the rest of us. Or more accurately the insurer who took on the risk pays.
You may not like what the injured person decided to pay their attorney for his/her work, but really, what business is it of yours what two people in a contract you’re not a part of do?
As far as respect, hopefully you and yours never have any misfortune and won’t have to deal with us lowlifes. I hope you are impervious to all harm or if you’re not that the insurer will treat you honestly and fairly. Because if they don’t, you’re going to have to rely heavily on someone to help you. Most likely a lawyer.
Where is the evidence that malpractice cannot cause that? At least one presumably well credentialed expert disagrees with you. Have you reviewed the basis for his opinion?
And you are wrong about my belief. Lot of times bad things happen and no one is at fault. Bad thing have happened to all of us I’m sure where there was no one to blame. That doesn’t mean another’s negligence is never the cause.
As to a lottery, do you know any med mal “lottery” winners you would trade places with? Do you think of them as lucky?
There are people who are injured or killed by true malpractice, but there are also numerous cases where the bad outcome had nothing to do with the actions of the doctor or others. The “act of God”. That is what I am referring to. Think of John Kerry. The parents of the injured child (who, there is now evidence, had pre-natal condition) won the “lottery” versus accepting the fact that these things do happen and doctors can’t fix everything. Yes, I believe they are “lucky” vs. having the same situation without the unjustified money.
Bill, you say there are “numerous” cases where the outcome had nothing to do with the action. How many is “numerous”? Of course, there are going to be some filings where as the discovery process moves along you learn there was no negligence. That’s to be expected in any endeavor when you don’t have all the facts at the outset. And yes, sometimes there are bad verdicts, that go the wrong way on BOTH sides. But I know of no human endeavor that is perfect – do you? What we do have is a process to resolve disputes with multiple levels of review, and an opportunity to discover every bit of information needed to decide and put that information before an impartial fact finder.
As to John Kerry, I think you mean Edwards. And since I doubt you’ve ever read a single bit of evidence in any of his cases, I’m not sure how you’re qualified to determine that not only the experts involved and the jury who heard all the evidence was incorrect. Quite a bit of hubris on your part.
As to how lucky those people with kids whose intestines are sucked through a pull drain are, or the ones who are raising a handicapped child, and were facing mountains of medical bills, a child who is uninsurable, etc., well, maybe you and I have different definitions of “lucky”. Whether they got a judgment against a negligent party or not.
The evidence is well published. 40% of all filed med mal cases have no merit on independent review. Yes, these are less likely to be paid on, and will be paid less (in general), but they are still filed, still must be defended against and still invoke a “lottery mentality”. When 10% of all cases filed are paid despite a lack of error (145 cases out of 1452 in the study) how do you define it?
Oh yeah, you don’t define it you just look to be paid off it.
http://www.hsph.harvard.edu/faculty/michelle-mello/files/litigation.pdf
Fyr,
Normally I ignore you because you’re a certifiable psychopath, but I wonder if your read the study you cite so happily. It’s interesting that you routinely use the word “lottery” AND cite that study, given this quote by the author:
“Some critics have suggested that the malpractice system is inundated with groundless lawsuits, and that whether a plaintiff recovers money is like a random ‘lottery,’ virtually unrelated to whether the claim has merit,” said lead author David Studdert, associate professor of law and public health at HSPH. “These findings cast doubt on that view by showing that most malpractice claims involve medical error and serious injury, and that claims with merit are far more likely to be paid than claims without merit.”
D’oh!!
I’m with Bill on this one.
Sure it’s a tragedy for anyone to die or suffer a disabling injury. No one would wish for such tragedy.
But to parlay these bad outcomes into a multimillion dollar windfall when no medical negligence has occurred is ridiculous.
In those cases, I suspect you’d have many takers to your offer to “trade places.”
Of course you’re with Bill. You think every plaintiff is just trying to get rich. Never mind that the money goes to help pay your bill. Under your system, we wouldn’t need insurance because no one would ever be allowed to hold a doctor liable.
“But to parlay these bad outcomes into a multimillion dollar windfall when no medical negligence has occurred is ridiculous.”
How often are there “multimillion dollar” results when there is no negligence? Do tell. The fact is you don’t know. And “windfall”? Sounds like they were really lucky. With a million dollar case typically comes a million dollar injury. Again, you want to trade for that “windfall”?
“In those cases, I suspect you’d have many takers to your offer to “trade places.””
Would you? How much money would it be worth to you to have the kind of past and future medical bills that typically generate these kinds of payouts? I look forward to your answer.
“Sure it’s a tragedy for anyone to die or suffer a disabling injury. No one would wish for such tragedy.”
Do you find it a “tragedy” when the cause of that death and suffering was due to someone’s negligence? Or do you just not believe that ever happens?
Tell me, how many medical malpractice claims are there each year, and based on YOUR estimate of a billion patient-physician interactions each year, how many would you expect there to be?
I expect the crickets will be chirping for awhile.
Matt opined: “Fyr,
Normally I ignore you because you’re a certifiable psychopath, but I wonder if your read the study you cite so happily. It’s interesting that you routinely use the word “lottery” AND cite that study, given this quote by the author:
“Some critics have suggested that the malpractice system is inundated with groundless lawsuits, and that whether a plaintiff recovers money is like a random ‘lottery,’ virtually unrelated to whether the claim has merit,” said lead author David Studdert, associate professor of law and public health at HSPH. “These findings cast doubt on that view by showing that most malpractice claims involve medical error and serious injury, and that claims with merit are far more likely to be paid than claims without merit.” ”
Yawn. First off, the fact that I will state, with the benefit of anonymity over a web forum the fact that physicians consider lawyers, especially those of your ilk to be lower than rapists and child molesters does not make me a psychopath. It makes me honest. And any physician who is telling to your face that they have no problem with you or what you do is lying. But I digress.
In medicine we are taught to analyze the data and give little, if any, credence to the discussion portions of a paper. The data here are striking. Nearly 40% of filed claims demonstrate NO ERROR! That means, in 4 of 10 cases, the defendant has to bear the cost and aggravation of defense despite having done nothing wrong. How does that not insult your intellect (oh yeah, I forgot, your ‘intellect’ is bought and sold…)? Then 25% of these “no error” case are paid – to the tune of an average of $313K. In other words, for every 10 cases filed, 4 involve no error and 1 will earn roughly $100K for the plaintiffs lawyer, despite no medical error being made. Yeah, I’ll tell you what, show me the table in Vegas that pays out those kind of odds and I’ll meet you there…
Yep, as usual wordsmithing and distraction from our lawyer “friend”. He advocates a system that spends millions of your dollars uselessly and punishes and innocent person 10% of the time, but I’m the psychopath…?
Thanks for confirming your psychopath status.
Not to mention your inability to read. None of the “wordsmithing” from above was mine. It was actually the AUTHOR of the study YOU cited. I’m sorry you don’t like the conclusions the author drew. You should take those up with that wordsmith who authored and led the most comprehensive medical malpractice study not funded by a party to the debate, not me. Facts are stubborn things, though, so he may not find you that persuasive!
As to “spending millions of your dollars”, I’m not sure who the “your” is. The courts exist regardless. The insurers and the parties pay the expenses. Much of the award goes back to health insurers and medical providers. So other than the insurer’s and the plaintiff’s, whose money are you talking about? That’s rhetorical, by the way, because I know you don’t know what you’re talking about.
And, since you have confirmed yourself to once again be a nutjob, our discussion is over. Best of luck to you in finding sanity.
Let’s see. You are part of a profession that will whore itself out to the highest bidder, claims to act for “justice” but quotes a paper acknowledging that 10% of the cases filed result in an innocent person being punished and I go to work everyday to help whoever shows up at my door, without question, and to the absolute best of my ability and I’m a psychopath? Really? That is your reality? Wow. Cool.
And in your world doctors do not practice defensive medicine to avoid being one of your victims, spending millions of dollars in the actually futile attempt to reduce their liability (futile because, as pointed out in the paper, a medical error is not needed for a six figure payout) – sweet, and what color is the sky there?
And in your world all of this is o.k. because hey, lawyers deserved to be paid well for all the good they provide society? My gosh, please send me a ticket so I can visit!
And how is it again that you can, with a straight face, accuse me of being the one out of touch with reality?
I’m serious, I consider you and your ilk on par with child molesters because like them your reality is massively distorted. Like them you truly believe no harm comes to anyone from your pursuit of your own ends. And like them nothing could be further from the truth. Unlike them you should know better – which actually makes you a lower form of life – but what do I know, according to you I’m just a “nutjob”. Gosh, that must mean I’m doing something right. I feel all warm and fuzzy again…
“And any physician who is telling to your face that they have no problem with you or what you do is lying.”
Forgot one thing. I couldn’t care less about the above. Most physicians wouldn’t testify against a colleague who committed the most egregious malpractice they’d ever seen, no matter how devastating the injury. They’d not lift a finger to help the victim, even when well paid to do so. In fact, if you could screw the victim out of just compensation in the hope of saving a mere nickel on your insurance premium, you would. In fact, you do!
So your opinions on the moral fitness of the rest of the community mean next to nothing.
“Most physicians wouldn’t testify against a colleague who committed the most egregious malpractice they’d ever seen, no matter how devastating the injury. They’d not lift a finger to help the victim, even when well paid to do so. In fact, if you could screw the victim out of just compensation in the hope of saving a mere nickel on your insurance premium, you would. In fact, you do!”
Matt, Where’s your data? What study are you citing? How many cases do you know of? What is the percentage?
Oh, yeah. You just make it up. Saying things over and over doesn’t make it true. You may think Fyr a nutjob, but it is true. Real malpractice gets settled.
Actually Brett, I’ve been told that by most of the physician posters here, including Fyrdoc. Not a broad sample, to be sure, but I think indicative. Feel free to disagree, I have no problem with that.
“Real malpractice gets settled”? No case of actual malpractice has ever gone to trial? You sure about that?
“Real malpractice gets settled”? No case of actual malpractice has ever gone to trial? You sure about that?
Did I say no case? NO. But I am much more sure about it than you are sure that all cases that are filed have merit.
BTW, you think Fyr is psychopath nut job, but them cite him try and make a point. Typical lawyer so you have typical non credibility.
“Real malpractice gets settled.”
Also, the vast majority of “real malpractice” never sees a claim file. There are multiple studies addressing this.
That’s why malpractice “reform” is never really about compensating MORE victims, it’s merely about arbitrarily limiting the value of those claims that do exist.
The nice thing is single payer will eliminate all this, and physicians will still be bitching about some bureacratic process administered by HHS which will sanction them for their errors, and much more often because there will be a system review, not a system that waits for the victim to bring the claim. They’ll long for the day they had a chance to put their position before a jury, where they have a 75% win percentage.
“Most physicians wouldn’t testify against a colleague who committed the most egregious malpractice they’d ever seen, no matter how devastating the injury. They’d not lift a finger to help the victim, even when well paid to do so. In fact, if you could screw the victim out of just compensation in the hope of saving a mere nickel on your insurance premium, you would.”
Horsepucky! You and I both know (as does everyone here) that the truly egregious malpractice events get settled, and usually quickly. And you know nothing of what “we” do. Every hospital has a standards committee – privileges to practice are quickly curtailed and notification made to the national practitioner database when these events occur. The difference is that you confuse bad pathology (like Stevens-Johnson Syndrome) with egregious medical error. That just isn’t true (but you’ll file the case anyway).
I don’t directly pay my medical malpractice, so truthfully I don’t care what it costs, that doesn’t effect my bottom line at all.
But you are right, I do reserve the right to choose how I spend my non-clinical time. I do not choose to spend it lining the pockets of an attorney no matter how just the cause. That is simply not what I do. You have no shortage of whores willing to leap in bed with you, so I don’t see the problem in my not wanting to join them.
And if can’t see the moral difference between us, well, that just speaks volumes about your delusions.
And before you ask, yes, I have served on QI/QA committees. I have asked that a practitioner no longer be allowed to practice at my hospital. I have recommended to med mal carriers that they settle a case because it had merit and I have voted on committee matters that resulted in reports to the NPDB. Unlike you, I can and do see reality. Unlike you, I have enough training to recognize actual malpractice and act to mitigate it when it occurs. And unlike you, my actions are not self-serving and do not result in my earning any money off the backs of an injured person.
But again, I’m the psychopath out of touch with reality? Please. Your profession is sociopathic by definition.
And notice all, Matt hasn’t (and won’t) respond to the facts:
“The data here are striking. Nearly 40% of filed claims demonstrate NO ERROR! That means, in 4 of 10 cases, the defendant has to bear the cost and aggravation of defense despite having done nothing wrong. How does that not insult your intellect (oh yeah, I forgot, your ‘intellect’ is bought and sold…)? Then 25% of these “no error” case are paid – to the tune of an average of $313K. In other words, for every 10 cases filed, 4 involve no error and 1 will earn roughly $100K for the plaintiffs lawyer, despite no medical error being made. Yeah, I’ll tell you what, show me the table in Vegas that pays out those kind of odds and I’ll meet you there…”
So let’s recap…
Matt says: “Also, the vast majority of “real malpractice” never sees a claim file. There are multiple studies addressing this.
That’s why malpractice “reform” is never really about compensating MORE victims, it’s merely about arbitrarily limiting the value of those claims that do exist.” ”
Right, so we agree Matt, egregious cases of Med Mal are paid and no one disagrees that they should be. All proposals on caps exclude “willful and wonton” misconduct, so the wors of the worst would be excluded. As for the “simple” but significant mistake, any proposed caps are on the punitive (non-economic) damages. Medical bills and lost wages are paid. So your argument holds no water.
Next you want to chide me for not being a witness for the plaintiff. So I understand, by your logic, not only do I have to treat everyone who comes in my door under EMTALA, I now have to testify on behalf of any lawyer who asks… Out of curiosity, is it o.k. with you if I play racquetball after work or am I limited to free weights? I ask because apparently you believe that everything a physician does should be regulated – including how they spend their non-clinical time.
And lastly, of course, you still won’t answer the damning facts exposed in the study – 40% of claims filed involve no error and 1 in ten filed claims will be paid >$300K despite no error.
Instead – concentrate on discrediting me as a psychopath because I am honest about how physicians feel about lawyers. No one will notice you ignore the facts. Hey, that tactic works in 10% of Med Mal cases, why not use it here?
“The nice thing is single payer will eliminate all this, and physicians will still be bitching about some bureacratic process administered by HHS which will sanction them for their errors, and much more often because there will be a system review, not a system that waits for the victim to bring the claim.”
Already exists. It’s called an “M&M” (Morbidity and Mortality Conference). In institutions that do not use that system, formal QI/QA reviews are still required and performed.