My mentor once told me there is a saying that before a resident finishes his program, at least one patient will have died as a result of the resident's actions. The saying was not meant to frighten residents, but rather to sober them to the reality of practicing medicine. Patients die because of unaccountable circumstances, unfortunate and unforeseeable reactions to treatments, and sometimes even avoidable mistakes.
Currently, medical mistakes have brought forth a battle between physicians, attorneys, politicians and insurance companies. While all parties insist they are working in the best interests of the patient, the patient seems to be losing out the most.
Medical malpractice insurance has reached unbearable levels for physicians in many states. In high risk fields such as obstetrics, doctors have been hit especially hard and many have started to lash out against lawyers. While many of these people are quite intelligent, their frustration has led to nonsensical actions.
In the spring, Dr. J. Chris Hawk, a South Carolina surgeon, proposed in a meeting of the American Medical Association that doctors should no longer treat attorneys in non-emergency settings. Brilliant!
According to a June 14, 2004 USA Today article, "Medical-malpractice battle gets personal," a nurse was fired earlier this summer from a Texas hospital solely because her husband is a lawyer in a firm that handles malpractice law, while he himself is not a malpractice attorney. The tactical genius who fired her both lost a nurse that was by all accounts excellent, and brought forth a great deal of negative publicity for that hospital.
Additionally, a group of radiologists set up a website www.doctorsknowus.com that had a database of plaintiffs and attorneys who sued for medical malpractice. Many people thought the site was a blacklist, while the radiologists claimed that it was a means of discouraging frivolous lawsuits.
The frustration on the part of the physicians is far from unfounded. Medical malpractice premiums were so high in West Virginia that in January 2003 there was a physicians' work stoppage that shut down four of the state's largest emergency rooms. Many doctors were dependent on a costly state plan to insure them for malpractice, and premiums reached intolerable heights for many specialties. In Maryland, there has been historic jump in malpractice insurance premiums of a combined 80 percent in the last two years, enough to force some physicians into early retirement or to move to a different state. The AMA claims that 20 states are currently in a "crisis" situation because of the high malpractice premiums.
The AMA supports a cap on punitive damages in medical malpractice suits. Several individual states already have implemented caps, including California which has had the Medical Insurance Compensation Reform Act since 1976. This act limits the damages against medical providers for malpractice, restricts attorney's fees and puts a time limit for claiming medical negligence. According to Dr. Sanjay Gupta, Health Correspondent for CNN, this cap has largely been successful with insurance premiums in California increasing only 167 percent while the rest of the country increased 505 percent since that time. Additionally, many physicians claim that there is often ambiguity in determining between medical malpractice and acceptable medical risk and leaving the delineation to an inexperienced jury causes much of the problem.
On the other hand, the American Trial Lawyers Association states that the AMA is exaggerating the crisis designation of the states, and show through vague statistics that the number of physicians has increased in several of these states. However, the Web site is lacking in key facts such as the specialty of these physicians, areas of need, and distribution of physicians.
Many lawyers state that a cap is unnecessary claiming that a weak economy and poor investments by insurance companies have caused recent jumps in malpractice premiums. The verdict and compensation should be decided by a jury and a judge as in any other court case, which they claim is in the best interest of the patient. Ironically, many of these same attorneys receive upwards of 40 percent of the plaintiff's award.
Attorneys point to a physician's inability to earn as much money as they could in previous years due to factors such as managed care as the reason for their current frustration.
While some dissatisfaction may come from the lack of earnings, it is asinine to ignore the many problems in the health care system, including the malpractice premiums.
Dr. Claudette Dalton, a University anesthesiologist and a member of the Counsel of Medical Education in the AMA, said she sees how field of medicine has changed.
"We've all been raised to define professionalism as everything we do is about the patient, but today you can't take care of the patient if you don't take care of the system as well," Dalton said.
Realistically, both physicians and lawyers are to blame for their years of silence and lack of cooperation. Until a more balanced medical system is created, we will all lose out.
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