This week’s New England Journal of Medicine has an article by Sens. Hillary Clinton and Barack Obama attempting to create a progressive space on medical malpractice reform. I think their ideas and proposals deserve serious consideration. Click here for free access (thanks, NEJM for making this available).
The title says it all: “Making Patient Safety the Centerpiece of Medical Liability Reform.” Phony malpractice reform, advanced by Pres. Bush, Sen. Frist, and the AMA, among others, says the malpractice “crisis” is all about irresponsible trial attorneys and “frivolous” lawsuits. This stance ignores the elephant in the room — the epidemic of medical errors, poor quality, and bad care rendered to patients everywhere. Caps on non-economic damages — advanced by the above — discriminate against all victims of bad care except the affluent, and especially discriminate against those with middle to low incomes or no incomes.
Patients and consumer groups agree the current system stinks. Only a tiny fraction of the truly injured really get help. Bush/Frist/AMA reforms would only reduce that number. Hats off to Clinton and Obama for seeking a solution that helps physicians without screwing injured patients. Here’s a sample:
In 2002, the University of Michigan Health System launched a program with three components: acknowledge cases in which a patient was hurt because of medical error and compensate these patients quickly and fairly; aggressively defend cases that the hospital considers to be without merit; and study all adverse events to determine how procedures could be improved. Before August 2001, the organization had approximately 260 claims and lawsuits pending at any given time. As of August 2005, the number had dropped to 114 (see graph). The average time from the filing of a claim to its resolution was reduced from approximately 21 months to less than 10 months. Annual litigation costs dropped from about $3 million to $1 million. The health care system has begun to reinvest these savings in the automation of its patient-safety reporting systems. Since the implementation of this program, the University of Michigan Health System has expanded the number of practicing clinicians and faculty members in high-risk fields such as obstetrics–gynecology and neurosurgery.
Let’s figure out how to improve our awful liability system AND improve patient safety at the same time. That’s a goal on which we can link arms. What say you, Mass. Medical Society? We’re game…
I’m an Ob/Gyn in practice at an inner city hosptial. There is no question that medical malpractice increases the cost of medicine. Imagine losing your life’s savings for a single error. Doctors almost always practice defensive medicine and society bears the cost.
I also do chart reviews for my state. These are significant cases and almost every one is accompanied by a lawsuit. Yet only about 20% of these “worst of the worst” cases represent real malpractice.
We have to get the huge profit motive out of legal system. There is simply no reason that if Mary Smith needs 10 million dollars to compensate her injuries, that her lawyer gets at least 30% of it.
It’s not a jury of our peers, medical experts are grossly overpaid paid to testify and the material is complex and confusing.
There are some equitable solutions that protect the patients and help remove bad physicians.
A trial lawyer I know tried to get me to be one of his “experts”. I refused and told him that my problem with what he does for a living is that he’s not trying to find the truth. He said no, i’m only here to win for my client. Where’s Justice in that?
But trial lawyers will not allow reform.
Ultimately profit perverts justice.
I agree with the senators ideas, though they may be a bit naive. It may or may not have something to do with the enormous lobbying power the trial lawyers association has on the democrats.
Our ultimate goal should be to eliminate medical error and improve patient safety. Clinton and Obama are right in that attacking only tort reform is not a full solution.
In what other profession can the courts go after a person’s personal assets? If a physician makes a mistake (and we all will, we are human after all), we run the risk of losing our homes, our savings, our retirement, our kid’s futures. This is frightening.
So however small the incidence of outrageous payouts in malpractice suits, the fear of those payouts is part of what’s driving up medical costs. A physician will order more tests than are necessary in order to avoid a disgruntled patient or missing some unlikely catastrophe. There is no wrong doing and no medical error made in these cases, yet they account for a great deal of the price of health care.
I’m all for open discussion of medical errors, we need this. We need to be able to formulate ways to eliminate error, to do so we have to talk about it. The first sentence of the last paragraph here says it best: “let’s figure out how to improve our awful liability system AND improve patient safety.”