January 3, 2012
We have heard so many tales of woes about how medical malpractice lawsuits are ruining the medical health of this country by making healthcare expensive for all and by causing the exodus of doctors from the so-called “judicial hellholes” (of which Illinois is supposedly one) toward States where there are limits on justice that a victim of a doctor’s carelessness can hope to obtain.
The problem with that proposition is that it is simply not true. What causes medical malpractice lawsuits are not patients and/or juries and their verdicts or lack of caps on those verdicts, but medical malpractice. The best way to prevent a lawsuit based on medical malpractice is to not commit carelessness.
Note that here, we are not talking about things that may go wrong in the natural progression of a treatment: there are times when a treatment goes wrong through no fault of the medical provider and/or the attending physician. Things may go wrong because Medicine is an art. What we are talking about here are actual damages caused to individuals that are the direct result of carelessness–that is different from simply not getting the intended result. For example, damages that could cause for failure of a doctor to simply read objective tests that are performed and that are ready to be reviewed but the doctor simply decides not to avail himself f the useful information those tests provides him. That is when medical malpractice lawsuits may be expected.
Nearly 4,000 tests for heart disease performed over the last three years at Harlem Hospital Center – more than half of all such tests performed – were never read by doctors charged with making a diagnosis, hospital officials acknowledged Tuesday.
The echocardiogram tests, a type of ultrasound used to evaluate heart muscle and valve functions, were ordered by doctors at the hospital. The tests were stored on a computer and basically forgotten, officials said. The lapse occurred because the cardiology service at the hospital had developed a system by which technicians were given the responsibility to scan all tests and flag any that looked abnormal, so that they would be given priority when doctors read them.
It appears, officials said, that the tests that were not flagged were put aside and forgotten.
The city’s Health and Hospitals Corporation, which runs the public hospital system, including Harlem Hospital, and Columbia University, whose medical school supplies the cardiologists who work at Harlem Hospital Center, acknowledged the problem in a joint statement on Tuesday, after being asked about it by The New York Times.
“While the process the doctors followed may have alerted cardiologists to those echocardiograms that were most likely to be abnormal, the failure to read the echocardiograms in a timely manner is inexcusable and may have placed patients at risk,” Alan D. Aviles, hospitals corporation president, said in the statement. It was unclear who developed the screening system, hospital officials said.
June 15, 2010
“Our nation’s 46 million uninsured often delay or forgo needed healthcare because the cost is prohibitive,” said study author Julie S. Darnell, PhD, MHSA, then of the University of Chicago and now with the School of Public Health at the University of Illinois at Chicago. The mean cost for a doctor visit for uninsured patients is around $50, Darnell wrote.
Traditional sources of care, including public clinics and federal health centers, both charge fees and bill patients. “Aside from cost considerations, care is frequently difficult to find, especially for those with the least resources,” Darnell added. For many poor, uninsured, and underserved patients, the only sources of care are emergency rooms or free clinics.
At the time of the survey, 1,007 free clinics were known to be operating throughout 49 states and the District of Columbia (Alaska was the lone exception).
April 21, 2010
That common sense conclusion is the recent finding from the RAND Corporation, a think tank and research center.
In a recent study, the group finds that when patient injuries were reduced in California hospitals there were fewer medical malpractice claims.
The cries for tort reform to limit a patients’ ability to bring an injury claim, frequently fail to look at the impact an improved patient safety picture can have on reducing malpractice claims against doctors.
The research group analyzed medical malpractice insurance records in California from 2001 to 2005. California was chosen because it initiated medical malpractice reform 35 years ago and any fallout would not be recent. It also has a large and diverse population.
Researchers studied medical malpractice claims – that is claims by patients who had received poor care such as contracting a hospital infection, having a surgical instrument left in them, and receiving the wrong medication, among other preventable adverse events.
Using the records from four of the largest medical malpractice insurers in the state, researchers analyzed 365,000 adverse safety events and 27,000 malpractice claims that followed.
April 14, 2010
With the near omnipresent discussion about Tort Reform, one can’t help but begin to think that there are too many “frivolous lawsuits” being filed, and even won. Just about the only law suits the news reports on are the ones where someone got a ridiculous verdict for a tiny accident. Are these true? Maybe some of them. But, by and large, they are exaggerated or have missing facts that the news didn’t bother to include. Most people do not realize that there are methods in place to keep truly frivolous suits from being filed – and certainly from going to a jury and being won. But that’s another blog for another time.
What is not discussed very often is frivolous defenses. For example, when a doctor does an operation on the wrong leg and gets sued, then files a defense saying that somehow his treatment was not outside the standard of care. As if it could ever be reasonable to do surgery on the left leg when the order clearly states the right leg is the injured one. But this happens much more often than one might realize. And when it does, it costs everyone a lot of money. Because the doctor has filed a defense, the lawyers and parties for both sides must go through hours and hours of discovery, hire experts (often costing the injured plaintiff thousands of dollars) and prepare to go to trial only to have the doctor settle at the last minute when he should have offered the settlement before the Plaintiff even had to hire a lawyer.
But the media does not like to talk about this aspect of lawsuits. After all, Plaintiffs are the ones starting the suit. And no one likes overly litigious people. But our legal system is set up so that people can have some recourse when they are wronged. Money is the only thing an injured person can get to “make up for” the damage. Unfortunately, even the highest court in the world could not give someone a new leg. And it is regrettable when a plaintiff must spend years in litigation and thousands of dollars because of a frivolous defense.
March 16, 2010
For every injury or illness, there are a range of possible treatments. The (very crude) drawing below represents that range. At the left end of the scale is to “do nothing” and see if the injury gets better on its own. At the far right end of the scale is immediate surgery to try and correct the problem. The bracket in the middle represents treatment within the permissible standard of care for a hypothetical injury. For this hypothetical injury, it would be inappropriate to do nothing, and it would also be inappropriate to take the patient to surgery immediately. Medically appropriate treatments might include administering drugs, ordering an inexpensive diagnostic test, and ordering an expensive diagnostic test. Doctor Smith may be conservative with his treatment and decide to order an inexpensive diagnostic test, while Doctor Jones may be aggressive and order the administration of drugs and the expensive diagnostic test. While both doctors treated the same injury in different ways, neither doctor committed malpractice. More importantly, if Doctor Smith is afraid of being sued and orders the expensive test, we cannot say that his fear of being sued led him to order a medically unnecessary test. The worst we can say is that the tort system nudged the doctor towards being more cautious.
March 16, 2010
Myth No. 1: Rising healthcare costs can be tied to malpractice claims
According to the most reliable of sources, the projected costs of healthcare spending in 2009 were approximately $2.5 trillion – with a T. Of that, even including the costs of insurance premiums – figures that other studies have conclusively shown to be inflated without being tied to actual claims experience – the amount assignable to malpractice litigation is a mere 2 percent of the total.
The claim of inflated expenses due to so called defensive medicine, tests designed to get at the root of a problem and ensure for the patient as accurate a diagnosis as possible, are immeasurable and cannot be properly brought into the discussion without resorting to wholesale speculation.
Myth No. 2: Madison County-Judicial Hellhole
Reality sometimes intrudes on fantasy, and this is one sure case. Contrary to the popularly held belief, the Courts of Madison County have been among the most hostile to malpractice Plaintiffs in the State of Illinois. Case filings are down dramatically, even while announcements of new arrivals of physicians, the opening of hospital wings and the expansion of oft times competing specialty services fill the newspapers.
Truth be told, with the current litigation climate and juror attitude, no place is more hospitable to the negligent hospital or the clumsy surgeon than the Courts found in Edwardsville.
Myth No. 3: Malpractice premiums can be related to claims filed
Doctors in the Metro East have been consistently abused by their own captive insurance carrier, the Illinois State Medical Insurance Exchange – (ISMIE). Rates were set without regulation, and were naturally raised without remorse. Rather than focus on the real culprit, the strawman of the “frivolous lawsuit” – truly a myth given the oppressive costs involved for any such case – was created to deflect attention.
March 4, 2010
To preserve brand identity and maintain secrecy, many businesses use groups like the Chamber to launder money for political means. For instance, health insurance companies lied and told the public all last year that they were supportive of reform — while simultaneously funneling up to $20 million dollars for attack ads through the Chamber (the other $80 million spent on Chamber attack ads against health reform is still unaccounted for).
Although reform would benefit the business community at large by controlling insurance costs and improving worker health, the Chamber is taking a rigid, ideological approach. Indeed, the Chamber is known to have become increasingly partisan under the leadership of Tom Donohue; an analysis by the Wonk Room found that the Chamber’s board is dominated by Republican donors. The Chamber seeks to kill large progressive reforms in order to kill progressive policies in general. Chamber officials have even gone on record noting they hoped to block health reform as a tactical measure to kill clean energy reform, a priority of many Chamber member companies.
January 7, 2010
the US Chamber of Commerce has consistently engaged in disseminating false information to the masses. At some point they should stop doing that.
A spokesman for the Chamber, Mark Szymanski, told us the ad began airing “nationally” in late December and will continue to air until the end of January. But he would not disclose the amount of money the Chamber Institute for Legal Reform is spending on the ad.
Szymanski said the source for the ad’s claim is an October 2005 study, “Impact of Litigation on Small Businesses,” conducted for the Small Business Administration by Klemm Analysis Group Inc. of Washington, D.C. But that report says nothing of the sort. In fact, it found that less than 15 percent of federal lawsuits target any business entity at all, and that roughly half of those, or fewer, involved small businesses.
This is not the first time we’ve caught the Chamber making an inflated claim about the impact of lawsuits.