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But the poster before said that 90% of cases are won by the Doctors!
Maybe you could site some cases that haven't ?
Most cases are won by the doctors, but after years of litigation and a lot of expense (which, btw, is extremely stressful). The actual court time may only be a week, but it is a lengthy process and there is a lot of nastiness involved.
We really need reform as to what can be brought up (or admission of some peer review prior to allowing this to proceed). Many cases are just settled bc docs can't handle the risk of going to trial...they may not be at fault at all, but they are willing to pay out instead of risk losing their homes.
As it stands right now, you can practically sue someone and say that you had a bad outcome bc they didn't do a rain dance in the middle of the examination room, and that would proceed forward. All you need is one 'expert' to agree.
Vs 2-3 years of litigation and hundreds of thousands of dollars in attorney's fees (plus reporting yourself to the board every time you come up for renewing your license)...?
You do understand that you can be sued for doing nothing wrong at all, right? Then they nitpick and comb over your chart like vultures...you will have to answer for not doing that barium enema.
Of course-I understand that they review everything from the patients records.
Can you give me an example of a case where a dr has been sued for doing nothing wrong at all?
Also, if you are working in a hopspital,how much of the costs does the hopsital pick up?
Most cases are won by the doctors, but after years of litigation and a lot of expense (which, btw, is extremely stressful). The actual court time may only be a week, but it is a lengthy process and there is a lot of nastiness involved.
We really need reform as to what can be brought up (or admission of some peer review prior to allowing this to proceed). Many cases are just settled bc docs can't handle the risk of going to trial...they may not be at fault at all, but they are willing to pay out instead of risk losing their homes.
As it stands right now, you can practically sue someone and say that you had a bad outcome bc they didn't do a rain dance in the middle of the examination room, and that would proceed forward. All you need is one 'expert' to agree.
Still no answer to my question.
How stressful do you think it is for patients to undergo unnecessary, often invasive painful distressing investigations?
And what about the monetary cost to them?
Do you carry out the same number od investigations regrdless of whether patient has private health insurance or if they are on Medicaid or medicare?
If it was you or your family would you do the same?
And lastly-what about the hippocratic oath-primarily do no harm?
Of course-I understand that they review everything from the patients records.
Can you give me an example of a case where a dr has been sued for doing nothing wrong at all?
Also, if you are working in a hopspital,how much of the costs does the hopsital pick up?
Actually, you answered your own question by saying most of the suits are found in favor of the physician (at trial). Add to that the ones that were not found in favor even though the doc upheld the standard of care (bc sometimes you just get juries who feel like someone should pay bc someone else is sad), and that number goes up.
So you have lots of examples.
Few doctors actually work for hospitals; they more likely work at hospitals, so the hospital does not pick up any of the tab. Their insurance company does up to their limit. Then they're on their own.
Actually, you answered your own question by saying most of the suits are found in favor of the physician (at trial). Add to that the ones that were not found in favor even though the doc upheld the standard of care (bc sometimes you just get juries who feel like someone should pay bc someone else is sad), and that number goes up.
So you have lots of examples.
Few doctors actually work for hospitals; they more likely work at hospitals, so the hospital does not pick up any of the tab. Their insurance company does up to their limit. Then they're on their own.
Sir if you are a MD in Texas as your bio says, then you are a liar. Texas passed tort reform in 2003 and 2005. The cases that you describe would never make it to the jury, hell they would never make it to court.
I believe your story and I'm sure the tests were extraneous. But what most people don't realize is that doctors don't like doing those extra tests either. Agreed, there are certain tests we need to do but the reason we do extraneous tests is to protect ourselves against liability.
Personal injury attorneys have ruined health care. Like I mentioned, doctors don't make money ordering those extra tests. If anything, it makes our job harder. I would love to focus on patients with real problems instead of ordering an abdominal CT and a barium study on a kid who presents with tummy ache but we have to do that in case there is that 1/1,000,000 that the kids ends up having a Meckel's Diverticulitis. When the doc in the Emergency Room orders a multiple CT's etc, he makes no additional money from that. He orders it because if a complication ensues, he will be sued. It's as simple that. It's not you "might" be suied, it's you WILL be sued. We do our best to treat patients and perform tests within reason but since personal injuru attorneys went on the rampage beginning in the 80's, it's gotten worse and we are forced to ordering tests and doing measures that are unnecessary.
If caps were lowered on punitive damages and if there was tort reform, that woud lower health care considerably but the Obama administration does not want to do that. Obama criticizes Republicans for special interests but the trial lawyer lobby is a large special interest that Obama and Democrats have been supporting as well. Obama has refused to place caps on punitive damages or to enforce tort reform.
I completely concur with you on all these points. I think we absolutely do need to address malpractice costs and tort reform, enforced tort reform, is one of the ways we need to do this.
On a personal note, my mother went through the surgery beautifully, and she is quickly recovering. She is also partly to blame for the surgeon taking his time and ordering the additional tests before surgery, because she didn't disclose to him how much pain she was in. She didn't want to be seen as a complainer, though she was sharing this information with the rest of us.
You saw this and I assume you reported this. A lawyer can lose his license for doing the very thing you say is happening on a daily basis. Sorry, I don't believe it.
You don't work in a hospital, I do. This is so common. Who am I supposed to report this to? Security..the hospital administrator? Am I supposed to call the police. Furthermore, people are allowed to visit patients. They don't have to be family or a personal contact. There is no way to prove it.
The idea here is that every patient tells his doctor of all the tests that have been taken. The doctor has no way to actually know whether a test has been taken. The assumption being why would the patient not tell the doctor the truth. In a workers comp claim a claimant may see several different doctors to get the results that he is looking for to help his claim. There are possibly two different insurance companies involved the health carrier and workers comp carrier which may not be the same. The carriers carrier have competing interests and don't really communicate. What happens is several of same tests are conducted not because the doctor is being unethical but because he is simply not aware of the other tests and there is no database to make him aware. This is a proposal in the plan to prevent this type of waste.
Your own peers state that there are too many tests done because doctors don't have the information, because they did not know about the tests.
You are using a rare example of worker's comp claim from an unethical patient and implying the majority of patients fit this profile. You mention half truths, well what do you call this example? Are you suggesting all of my peers stated this? And if a few physicians state this, does that make it true? Do you practice medicine? First of all, let's eliminate the concept that repeating tests is wrong. If you practice medicine, you understand that prior tests are often done in the distant past, or there was error involved. This is particularly true of images in which the image that was taken was poor or the radiologist provided an inconclusive read. A doctor reserves the right to repeat a test if he or she feels the patient will benefit from receiving a second image. This is a common practice and any ethical and competent physician will repeat a test if it means less harm can come to a patient.
To say procedures are not affected by financial decisions is disingenious. I will not make any value judgments towards you other than you are offering half truths. Some doctors do in fact make decisions based on how much they receive by doing a particular procedure. The article below by Harvard Medical School Surgeon states that very thing.
That's not what I said. You misunderstood my point. Your assumption is a physician will elect to perform a more invasive procedure to receive more compensation. My point was simply that reducing reimbursement for a particular procedure won't address this problem either. Those same unethical doctors that Obama referred to will simply elect to do the less the invasive test if compensation is similar for both treatment modalities. Why wouldn't this same physician settle on the treatment that requires less effort, less risk and less time or refuse to see a patient that would require intense work? Therefore, simply lowering the reimbursement for surgeries or other procedures isn't going to solve this problem like Obama thinks. Rather than assume physicians are unethical and make choices based on compensation, why not enact policy that enables physicians to better care for their patients by reducing the number of loopholes it takes for a patient to qualify for a surgery or a treatment.
Furthermore, there are risks to performing invasive procedures like surgeries. If a patient did not require a surgery and a complication ensued, that physician's judgement would be question and he could liable for any injuries that took place. If you are going to accuse me of half truths, I suggest you develop more than half knowledge as it's apparent, you are not aware of all the facts surrounding a situation.
Why we order so many tests. I am sure that it is in some situations, but again with the half truths. In the same article as cited above the Harvard Surgeon asked one of his peers in Texas why they were so many tests. Initially the surgeon said it was because of fear of litigation. Then when confronted with the fact that Texas had tort reform that reduced litigation to near zero. The surgeon admitted that Doctors were racking up charges with extra tests, and procedures. The surgeon stated that it used to be about how good a job that you do. Now...it is about how much you benefit.
Again, you accuse me of "half truths" without providing any evidence to affirm that. The best you have done is quoted some physicians. I respect those physicians' opinions but that is hardly the same as evidence. Do you practice medicine? I have a hard time believing a person who isn't a physician can claim to know what it is like to know how medical decisions are reached. What facts do you have to affirm that "litigation in Texas is near zero" Yes, relative to most states, Texas has laws that curb litiation but to suggest that it doesn't exist there is an gross exageration and misinformation.
We won't even talk about $83,000 being enough for most people in a year. I have a good idea as to what a cardiologist makes. That is at best condescending.
Tell us how much a cardiologist makes in a year? I would like to hear that. To give you the benefit of the doubt, I researched several salary surveys and the highest reported average salary for an interventional cardiologist was 468K. Yes, that is a lot of money. However, a cardiologist spends 4 years in college, 4 years in medical school, 3 years in internal medicine, 3 years in cardiology fellowship and 1-2 years in interventional training. That is 15-16 years of training. During our residency and fellowship, we earn between 35K-50K per year. A partner in a large corporate law firm earns twice that amount and unlike the physician, the lawyer underwent less training and less hours of work. They underwent 4 years of college, 3 years of law school and worked 6-8 years as an associate (earning 120-250K per year) before they became partners. And the partnership salary I referred to is for a modest firm. The largest and most powerful firms like Latham and Watkins, Cravith Moore and Swain etc, the average partner earns 2 million dollars per year. And I haven't even explored the personal injury lawyers on television who earn even more than this so don't pretend that doctors are earning too much money in light of what attorneys are earning. And how many of these lawyers are getting up at 3 AM to cath a patient in the ER on Christmas morning not to mention taking an incredible amount of risk in perforating an artery that could result in a patient's death.
The AMA supports Obama's plan as it applies to Tort reform and although the plan calls for reduction in Medicare costs...it is not really a reduction is it. It amounts to a recalculation to complicated to explain, but the hospitals in Drs. will get more even though it sounds like a reduction.
Again, do you have any proof to support this? Furthermore, do you have any evidence that states Obama has included Tort reform as a part of his health care policy. "One question submitted to Obama via the Internet came from Rep. Michael Burgess, MD (R, Texas), who asked the president why he opposed capping noneconomic damages in medical liability awards. Obama responded that he does not like the idea of caps because some patients need more protection against negligent care."
Of course-I understand that they review everything from the patients records. Can you give me an example of a case where a dr has been sued for doing nothing wrong at all?
Also, if you are working in a hopspital,how much of the costs does the hopsital pick up?
What kind of question is that? If we provided you one, you could just as easily argue the opposite side. This is subjective. What may seem like a bogus claim to me might seem like a legitimate claim to you. I'm not going to fall for your trap. What I will provide you with is this.
In an examination of win rates, Peters found that 27 percent to 30 percent of filed medical malpractice suits end in a plaintiff's verdict, the lowest success rate of any type of tort litigation
Key points reached by the review include: * Plaintiffs seldom win weak cases. They are more likely to succeed in toss-up cases and if there is strong evidence of negligence * Juries are usually able to recognize weak cases, agreeing with legal experts 80% to 90% of the time * Physicians win 50% of the cases that independent legal experts believed the plaintiff would win * A number of factors exist that favor victory by the medical defendant, such as their superior resources, social standing, and the social norm against "profiting" by injury "The data show that defendants and their hired experts are more successful than plaintiffs and their hired experts at persuading juries to reach verdicts that are contrary to the evidence," Peters said.
Malpractice juries usually side with physicians (http://www.acr.org/SecondaryMainMenuCategories/NewsPublications/FeaturedCategories/CurrentHealthCareNews/More/MalpracticejuriesusuallysidewithphysiciansDoc141.a spx - broken link)
Quote:
Originally Posted by susan42
I am far from misinformed and ignorant.
I wonder which med/surg speciality you practice in and at what level?
I'm an inverventional cardiologist. I went to college for 4 years. I did two years of research. I did 3 years of residency. I did 3 years of fellowship. I did an extra year of interventional fellowship. I have been practicing for over 10 years. I think I meet your qualifications
Quote:
You say that 90% of lawsuits are won by the Doctors- so is this because the doctor did heaven knows how many investigations or ,despite the fact that he didn't do them, it was proved that what he did do was appropriate for the history and clinical examination findings?
I saved a man's life this year. He presented to the ER with normal cardiac enzymes, a normal EKG, a normal chest X-ray, no family hx of CAD , no hx of hyperlipidemia. The only thing he complained of was brief chest pain and a back ache. He claimed he had GERD and took proton pump inhibitors. Now according to your logic and argument, I should have discharged this patient because according to evidence based medicine, this patient had no evidence of CAD and should have been sent home. I was suspicious because I know how seemingly harmless presentations can have serious underlying pathology. To make a long story short, the patient had dissection of his aorta. If I would have sent him home, he could have died. This is why decisions like this shouldn't be made by a bureacratic organization and instead it should be made by physicians and their patients. Ask the other physician Stan and he can tell you that much pathology doesn't present typically. That is why physicians get upset when a some bureacrat or uninformed people like yourself think they understand medicine and think our field is managed by strict numbers. And to answer your last statement, many physicians do manage their patients appropriately. Despite appropriate care, people do suffer from complications and die. It happens. Unfortunately, our society has become so litigious that if something unfortunate occurs, someone has to be blamed.
Last edited by azriverfan.; 07-29-2009 at 03:12 AM..
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