I agree with the earlier commentator that you have set up a bit of a straw man here.

I am against health care courts (response to another comment to the post). But certainly in Maryland, plaintiffs’ lawyers would prefer a bench trial in most Maryland counties. I think the assumption that doctors would do better in front of judges is largely wrong although it admittedly would result in less variation in the verdicts.

If it were about that, physicians wouldn’t win the majority of the time, because the patient almost always has a pretty sad story.

As always, the “perfect care or available care” claim is nonsense, as we all know the availability follows the wealth of the community. It’s the driving factor by a long shot.

“There also must be a wholesale change in the “death is a preventable event” mentality.”

This is also true, and I would encourage him to take it up with the marketing departments for most providers. Because that isn’t the message being sent.

In order to get physicians and patients to collaborate, patients must have some responsibility for payment of their medical care. A system where every patient wants the best medical care that someone else can pay for is inherently unsustainable. Even if patients are financially responsible for only a percentage of their medical care, patients must have some skin in the game.
Once that occurs, physicians can help patients choose the most cost-effective approach to treatment, rather than being seen as the entity that bars access to treatment. For example, you want to have a $3000 CT scan of your head for a minor head injury? Fine. You go to the CT suite and plunk down $3000. When the test is normal, you have no one to blame but yourself. However, if you go to a doctor before getting the CT scan, the doctor can advise you that there is less than a 1 in 2000 chance of there being any abnormality on the CT scan. Then, by listening to the doctor, you make an informed decision to forgo the test and save yourself $3000. A win-win situation.

There also must be a wholesale change in the “death is a preventable event” mentality. Everyone will die. Because we will die does not mean that someone is liable for our death. However, when people die in the midst of medical treatment, the first thing that pops into most people’s minds (not everyone’s minds, though) is whether or not the medical provider screwed up. This mentality paradoxically reduces the availability of care and goes back to the “perfect care or available care” conundrum that I have previously mentioned.

I think that most if not all physicians are primarily concerned about a patient’s welfare. However, in a case like the one presented above, when the likelihood of a bad outcome is high, mindsets really do shift to doing right by the patient … but doing everything possible to avoid the possibility of a lawsuit. That may involve extra testing, multiple consults, and transfer of high-risk patients to tertiary care hospitals so that they can deal with the liability provide more comprehensive care to the patients.