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DOCTORS VOICES:
THE PROBLEM WITH MALPRACTICE IS MALPRACTICE
In March 2002, the American Medical Association (AMA) announced plans
to lobby lawmakers and courts in at least 25 states and mount an ad campaign
to raise support for limits on injured patients rights to sue for
malpractice, arguing that malpractice lawsuits are the cause of our nations
health care problems. Yet many within the medical profession disagree
with the AMAs message:
Dr. Richard G. Roberts, chairman of the American Academy of Family
Physicians and professor of Family Medicine at the University
of Wisconsin Medical School, has issued his
Top 10 Myths of Medical Malpractice in which he lists 10
Truths about the civil justice system, including:
- About one in 50 hospitalized patients is injured
due to negligence, and yet only one in 10 of those files a lawsuit
and, among those filing suits, only one in 20 receives money
.
- There is more malpractice committed than is
recognized, litigated or compensated.
- Plaintiffs in most cases are not gold-digging.
The vast majority [of plaintiffs] have (medical) outcomes none of
us would want for ourselves or our loved ones.
Donald Palmisano, president-elect of the 300,000-member American
Medical Association, who founded a company that tells doctors how to
avoid malpractice suits, has drawn criticism from members of the medical
community. Palmisano has written, Although the physician may
aspire to give the best care, the law does not require the best,
and The law requires a minimally acceptable level of care, thus
my analogy to the low hurdle.
- Mitchell Rabkin, CEO emeritus of the Beth Israel
Hospital and CareGroup in Boston, said he objected to Palmisanos
low hurdle analogy. You practice medicine in order
to clear the highest hurdle, he said, and to do it every
time.
- John Baldwin, dean of the Dartmouth Medical
School, said focusing on malpractice reform will not address fundamental
economic problems in the health care system. Physicians should
be reimbursed based on the quality of outcomes rather than the number
of procedures they perform, he said. That would solve
most of the malpractice problem.
- Sidney Wolfe, a physician and liberal activist
who runs Public Citizens Health Research Group, said, Even
though you can get away with it in a malpractice suit, it may not
be helpful to the patient.
The AMA should be promoting excellence
in medicine, rather than as little as you can get away with.
Ceci Connolly, AMA Officer Sparks Ethics
Debate; Doctor-Lawyers Business Advises on How to Avoid Malpractice
Suits, Washington Post, June 15, 2002.
Dr. William M. Sage, professor at Columbia Law School, writes in
Putting the Patient Back in Patient Safety, in the June
12, 2002, issue of the AMA Journal:
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it is likely that most substandard care
never results in a lawsuit or a complaint.
Dr. Wayne Cohen, who in 1995 was medical director of Bronx Municipal
Hospital, said, The city was spending so much money defending
obstetrics suits, they just made a decision that it would be cheaper
to hire people who knew what they were doing.
Dean Baquet and Jane Fritsch, New Yorks Public Hospitals
Fail, and Babies Are the Victims, New York Times, March
5, 1995.
In 1985, the director of Maternal/Fetal Medicine at Pasadenas
Huntington Memorial Hospital told the American College of Obstetrics
and Gynecology, The greatest cause of malpractice is malpractice.
You must understand that some of the malpractice out there is so grievous,
offensive and implausible as to beggar the imagination.
Letter from Ralph Nader to Florida Speaker Mills and Senate President
Vogt (1988).
AND A WORD FROM AN INSURANCE INDUSTRY LOBBYIST
In a New York Times column called Crushed by My Own
Reform, written on October 7, 1994, Frank Cornelius, former lobbyist
with the Insurance Institute of Indiana, wrote, In 1989, I
underwent routine arthroscopic surgery after injuring my left knee in
a fall. As a result of a series of catastrphoic incidents of malpractice,
Cornelius continued, I am confined to a wheelchair and need a
respirator to keep breathing. I have not been able to work. I have continuous
physical pain in my legs and feet.
Twice, I have received last
rites from my church. My marriage is ending, and the emotional fallout
on our five children has been difficult to witness, to say the least.
At the age of 49, I am told that I have less than two years to live.
In 1975, I helped persuade the Indiana Legislature to pass what
was acclaimed as a pioneering reform of the medical malpractice laws:
a $ 500,000 cap on damage awards, and elimination of all damages for
pain and suffering. I argued successfully that such limits would reduce
health-care costs and encourage physicians to stay in Indiana
the same sort of arguments that now underpin the medical industry's
call for national malpractice reform.
Today, from my wheelchair, I rue that accomplishment.
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