November 29th, 2009 by Toni Brayer, M.D. in Better Health Network, Opinion
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The movement for physicians to say “I’m sorry” when things go wrong in patient care has been under debate for the past few years. In the past, physicians were advised to never admit to a problem or to apologize for clinical errors with the thought that it would lead to more lawsuits. Saying “I’m sorry” might be taken by a lawyer as an admission of guilt and malpractice. Attorneys advised, “Say nothing” but that left patients with unanswered questions and often the feeling that the doctor just didn’t care.
Numerous studies have shown that patients want physicians to disclose harmful errors and they want information about what happened, why it happened and if something has been done to keep it from happening again. There has been a gap between what patients want and what actually occurs. Read more »
*This blog post was originally published at EverythingHealth*
October 27th, 2009 by DrWes in Better Health Network, Health Policy, True Stories
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I had an interesting visit with the husband of my niece last evening. He works as an ER doctor that is self-insured group of 60 physicians that cover the ER needs of four hospitals in Clark County near Las Vegas.
What is interesting is they are self-insured to save costs. As a group, then, they know how much per patient they must collect to assure liability care for every patient that comes to their emergency rooms.
That amount is $17 per patient per visit.
Guess how much their group receives for care they render to a Medicaid patient for a “level two” visit (minor problem: ear ache, sore throat, etc.)
Fourteen dollars per visit. Read more »
*This blog post was originally published at Dr. Wes*
October 16th, 2009 by DrRich in Better Health Network, Health Policy, Opinion
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DrRich’s conviction that covert rationing is the engine that drives many (if not most) of the bizarre behaviors we see in the American healthcare system leads him to take positions on certain contentious issues that do not endear him to either his progressive or his conservative friends.
One of these issues is malpractice liability reform.
DrRich wrote about this some time ago (here and here), and as a result managed to alienate more than a few of his readers, especially the ones who are doctors. So if he were smart, DrRich would leave it alone. (After all, a lot of readers have long since forgotten precisely why they do not like DrRich, and merely harbor toward him a vague sense of unease and distrust. This, DrRich finds, he can live with.)
But a couple of things prompt DrRich to take up this topic once again. Read more »
*This blog post was originally published at The Covert Rationing Blog*
October 7th, 2009 by Happy Hospitalist in Better Health Network, Health Policy, Opinion
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Some put the figure for defensive medicine at 10% of medical expenses a year. That’s $250 billion dollars. Others claim it to be 2-3% per year or about $60 billion dollars a year.
Now ask any physician what it is. I’d say it’s closer to 30% a year. That’s $750 billion dollars a year. Why? Because I know what is going through the minds of physicians when they put the pen to the paper. In America, we strive to exclude the long tail diagnosis. Why? Because getting sued for 67 million dollars because you treated a torn aorta when all the evidence pointed to an emergent MI has a way of making doctors evaluate the possible, instead of focusing on the probable.
Defensive medicine is not about losing a lawsuit. It’s about getting sued and the lack of boundaries that protect a physician from having bad outcomes with competent medicine, even if that competent medicine was the wrong medicine for the wrong patient at the wrong time, a fact known only after the fact when a bad outcome occurs. Read more »
*This blog post was originally published at A Happy Hospitalist*
October 5th, 2009 by Shadowfax in Better Health Network, Health Policy, Opinion
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Ezra kindly responds to my post from Friday with a more reasoned stance than “just don’t commit malpractice.” His response, however, boils down to two main theses:
- Frivolous Lawsuits are not as common as generally thought, and
- Standardization can reduce the opportunity for error and thus decrease the frequency of medical malpractice suits.
Well, yes, but I’m not sure that addresses the typical physician’s complaints regarding the current med-mal system.
For example, the “frivolous” moniker is a pretty ambiguous term, especially to doctors’ loose understanding of legal terminology. To a physician, a “frivolous” case is one in which there was no error — where the standard of care was met, but perhaps the outcome was bad. Or to put it another way, doctors tend to feel that when they are vindicated in court, it’s prima facie evidence that the case was frivolous. This conviction is bolstered by the little-recognized fact that physicians win the vast majority of cases that actually go to trial, and the vast majority of claims filed do not result in a financial settlement. Read more »
*This blog post was originally published at Movin' Meat*
