Lawyers and Doctors

[Halyanne]

I read this in the USA today and thought it was just well, interesting to read. I don't agree really with what doctor's are doing, but I can see the need for something to happen.

How do our resident lawyers feel?

Lawyers and Doctors, who gets treatment?

[Aristotle]

One word: unconscionable.

Some doctors are refusing medical treatment to lawyers, their families and their employees except in emergencies, and the doctors are urging the American Medical Association to endorse that view. Professional medical societies are trying to silence their peers by discouraging doctors from testifying as expert witnesses on behalf of plaintiffs. And a New Jersey doctor who supported malpractice legislation that his colleagues opposed was ousted from his hospital post.

[Graeblyn]

Originally posted by Aristotle
One word: unconscionable.

All the more unconscionable when you know what the proposal is that the NJ doctor lost his position for supporting.

The only "sacrifice" it requires of doctors is a yearly state fee of $75, but the same proposal calls for lawyers to pay the exact same amount every year, too.

The reason the doctors claim to be pissed off was that the proposal doesn't limit jury awards.

Here is a link about the proposal, which, by the way, has now been signed into law.Link to Newark Star-Ledger article

The fact that the doctors won't even TRY to work with the other stakeholders in this issue by compromising is rather disgusting. But then, it really isn't surprising. NJ is the same state that has "doctor strikes" periodically, requiring sick people to go to the E.R. for however long it takes the doctors to finish throwing a collective temper tantrum and return to patient care.

[Talsek]

While I think most people would agree that some sort of limit to pain & suffering rewards is generally a good thing, employing refusal of treatment to lawyers and their kin as a 'wake up call' goes a bit beyond hardball. This excerpt from the modern Hippocratic Oath seems particularly relevant here.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

[Gilgamar]

While I agree with their intent, their methods are wrong. refusal to treat a medical condition because a patient has such-and-such job is the equivalent of refusal to treat blacks, whites, mexicans, koreans, Irish, whatever, because a high number of that ethnicity has sued.

I agree that medical malpractice lawsuits should have a cap though. Too many lawyers hear "I went to the doctor and I came back with " and the first thought to enter their brains is that they're about to hit the Lawyer Super Lotto.

Awarding a patient Millions of dollars of which the lawyer gets a percentage is just not helping anybody. While it is politically correct to scream out "What about the victim!" I have to think about this question though. "How many lives could that doctor save if he isn't destroyed financially because of sky-rocketting malpractice lawsuits?" WAY more than a single victim and that victims lawyer.

Malpractice lawyers, led by the Association of Trial Lawyers of America, counter that rising premiums have more to do with the insurance industry than jury awards. They say tighter regulation of the industry is needed.

This is such a blame passer it's not even funny. The insurance industry has to raise the costs of their premiums or go bankrupt because they are paying out so much money in bullshit lawsuits. While I'm not a lawyer or a doctor I am a tax-paying citizen of the United States of America who has to pay for his own health insurance. My insurace has a max it will pay depending on the circumstances. (Whether hospitalized, emergency care, elective surgery, etc...) The costs that doctors pay in increased premiums is immediately passed on to my insurance company. Who in turn raises their premiums that I have to pay. It all trickles down to the lowest common denominator. Me, and every other person who ever has to go see a doctor, dentist, or whatever.

But, i suppose that's a kind of thing.

[Katidyd]

Ditto to Gilgamar.

I think we should respond with boycotting use of all doctors and lawyers till they both lower their excessive bills!

[Frobozz]

I don't agree that there should be a cap on how much money can be recieved from a medical malpractice lawsuit. I think there should be a higher threshold for being able to make a case as a matter of law, in other words to get their cases into court. To be found liable for medical malpractice, right now, doctors in most jurisdictions have to have done GROSS MALPRATICE (negligence)... So it irritates me some that doctors are trying to bitch and whine about patients who try to recover, not from something going wrong in a tricky operation, but from a doctor doing something that he shouldn't --- like cutting off the wrong foot, leaving a scalpel in, not closing an artery.

Some medical treatements are so advanced that the chance of success is very low, but that shouldn't protect doctors from medical malpratice lawsuits if they do something horribly negligent.

[Yatar]

I disagree strongly with what these doctors are doing. It goes against everything physicians are supposed to be about - to treat people regardless of their background, whether they are criminals, uninsured, or people of opposing political or religious views. The statement the one surgeon made about it being ethical just seemed like a load of crap trying to justify the whole idea.

The thing that gets me is this has got to be patently illegal. Firing someone for who their husband is? Surely that's contrary to employment laws. Not treating someone because of their political views? While I'm at it, why don't I deny care to Republicans, or people that don't support universal health care, or criminals, or Jehovah's Witnesses? When you start picking and choosing who you treat based on political or other concerns, you are opening a big can of other prejudice that can occur.

As far as the malpractice thing though, I sympathize. The current system could definitely use some work. When you have entire regions without obstetricians because malpractice insurance is so high, you know something's wrong. Creating money caps is probably a start, but it isn't biting at the deeper problem. After all, it's perfectly reasonable for legitimate, gross malpractice suits against bad doctors to have large rewards. However, what isn't reasonable is when un-legitimate suits are won simply because of courtroom maneuvers. Two sample problems:

1) Physician up for malpractice lawsuit. Victim's law team finds "expert doctors" to support their position, even though the medical community at large would probably disagree. Jury rules in favor of victim.

2) Physician up for malpractice lawsuit. Victim's law team uses jury selection to remove all moderately educated people from the jury. The remaining jury understands the medicine less and sympathizes more with the mommy whose kid came out badly. Jury rules in favor of victim.

Money caps don't solve either of these problems. It might be wise to have the court find the experts, for instance, or for the jury to be medical professionals (though that brings up issues of its own). But I don't know that much about law, so maybe the legal among us would know more.

[Quotox]

First of all, they cannot cap the amount you can receive as part of the actual injury phase. You are entitled to value of your actual injury. The effort is to cap punitive damages. The first phase of all of these verdicts determines the value of the injury. This means if I loss my job for 10 weeks due to the doctors mistake. They would be liable for those loss wages, plus the cost of correcting the injury, any cost of future treatments for an injury, plus any other related costs--these are your compensatory damages.

Punitive damages are additional costs levied against the doctor for either punishment or 'pain and suffering.' These are the ones that have really are just what the jury feels is reasonable given the behavior, lack of care, or even what they few as the suffering endure or will be endured by the victim. The hope is that this will keep the doctor or other people from making the same mistake. Of course, they are non-quantifiable... Lawyers play up dramatic aspects of testimony and make them as scary as possible... and they are frequently reduced on appeal by an appellate court.

The effort to reduce these is to limit court costs and to put these juries in a box so they cannot just decide a ridiculous number, and the injured doesn't win a lottery because he had something bad happen to him.

If you need any examples of this, look at OB/GYN's. This is one of the most sued and frequent 'victims' of this punitive damages issue. They are sued saying that cerebral palsy is caused by doctor mistake during birth was the result of this. (FYI, this is how Senator John Edwards made a big name for himself). Turns out the cause these big money cases lost by physicians were wrong and that subsequent studies proved that they where was no link between what the doctor was accused of and cerebral palsy. Another example of similar problems was the suit against Dow in the early 90's in regards to silicon breast implants and there relation to connective tissue disorder. Turns out several subsequent studies showed that both is it difficult to breach the implant but silicon (which is naturally present in the body) is simply absorbed by the body. The result is that there is no link between the disorder. By this time though, Dow had been run out of business. The FDA continues to be reluctant to allow non-mastectomy use of them because they are concerned about longer-term studies.

This has huge social costs these punitive damages. Last year's graduating class at the University of Maryland Medical school, not one person in the class went into obstetrics, despite it being one of the highest demand fields. In Ohio, a large hospital pays 150,000 per anum per doctor for malpractice insurance for OB/GYN’s. The case of Dow a major manufacturer of medical supplies was closed down along with the jobs. So, capping these punitive costs would have some serious benefits to society.

Second after my long rant, this was one guy who got run by the vast majority of colleagues. While many (well all the ones I know do) doctors hate malpractice lawyers, they aren't stooping to that level just yet where it’s all out war. I just think they feel like anyone would who feels they worked 12 years on an education, wanting to help people and make a nice living but feel powerless and unappreciated for what they do. And these are people who like to be in charge too, so this was one guy’s idea of getting some of that back.

[Damieux]

Originally posted by Gilgamar
This is such a blame passer it's not even funny. The insurance industry has to raise the costs of their premiums or go bankrupt because they are paying out so much money in bullshit lawsuits.

You are assuming that the cost of defending against medical malpractice claims is driving the increasing cost of premiums. Its not surprising that you make this assumption since it is being so strenuously advocated by insurance companies these days.

The opposing postion would point out that, in fact, on national average only 21% of medical malpractice insurance premiums are spent on defense costs. More importantly, the opposing position would reply on the historical experience of California, which experimented with both compensation reform and insurance reform.

In 1975, California passed the Medical Insurance Compensation Reform Act (MICRA), which set a $250,000 cap on the amount of compensation that a medical malpractice plaintiff could recieve for non-economic injuries, limited attorney's fees for medical malpractice cases and imposed other reforms that favored medical malpractice defense. However, medical malpractice insurance rates in California continued to increase at roughly the same rates as the national average. During the mid-1980s, the premiums increased by roughly 20% annually. Basically, the amount doctors were paying continued to increase with the only difference being that the money was now going to the profits of the insurance companies and the insurance defense firms instead of to the victims of the malpractice.

In 1988, California passed Proposition 103 which rolled back excessive premiums and then regulated insurance premium rates. This finally stabilized medical malpractice premiums in the state. As far as I am aware, there are still insurance firms in California that are able to do business offering medical malpractice insurance.

By the way, in contrast to the national average, California insurance companies paid an average of 35% of the money they collected in premiums on defense costs between 1996 and 2001.

Here is a link to an information sheet put out by an advocacy group.How Insurance Reform Lowered Doctors' Medical Malpractice Rates in California I found this document persuasive, but it is an advocacy group, so I won't pretend it is impartial.