No, this was deep into the conversation and we had already reached agreement on many key points. He actually said it to make the point that he acknowledged that there were many meritorious claims that deserved compensation in some form. Like I said, the thing that bothered him was the widely disparate results.

I do think that juries can vary pretty dramatically in terms of their willingness to award damages (that is you, folks, not the lawyers) and this affects pretty dramatically how willing lawyers are to take marginal cases. So his point is a good one, I think.

So who sets up the rules? I know doctors have been clamoring for years that malpractice cases need to go before specialized juries, in the same way that patent law and other similar "expertise" issues do, only to run into opposition from...you guessed it...the American Bar Association.

My second complaint about malpractice involves the "profitable" suit. In other words, a bad result with a 40-yr old man with four kids will be snatched up by about any attorney regardless of what happened with the medical care because the potential reward is so high, and it will likely be settled out of court. This kind of thing could be controlled by expert preselection committees-groups of experts chosen to evaluate the merits of cases--this again has been strongly opposed by the American Bar Association.

And then there is the standard used. I truly believe the vast majority of doctors are doing the best they know how to do. But even the best makes a mistake. If I pay for a service and the provider of that service makes a mistake, that's an expected part of a human system. Grossly negligent mistake? Different story. Why isn't gross negligence the universal standard for malpractice? Are there other industries that are held to this strict of standard? (This is an honest question--I admittedly don't understand the law.)

Fix these three problems and medical costs will plummet. You have no idea how much CYA medicine costs.

THe profitable suit idea was included in what the guy I spoke with was tlakign about. What do you find objectionabel about that? If you make a mistake that kills a 40 year old provider for a family why should you not pay for it? Why should you get off th ehook as long as it wan't gross negligence (whatever that is; I suppose you would let the doctors decide what that means?)

You can say what you want, but it is a jury that awards the cash, not the lawyers.

As to other industries, you should ask people that make products what their standard is. It's called strict liability. So yes, other industries face similarly long (or longer) odds.

Our system is not perfect, and lawyers should shoulder their share of blame, but as to malpractice suits, the guy was right: the biggest cause of such suits is malpractice.

The problem is how outrageously large the awards they can be and how much in annual premiums doctors have to pay as a result.

Furthermore, what really is the most expensive end result of malpractice suits is it results in defensive medicine.

If there was a medical mistake involved, I absolutely think there should be significant compensation. If you look closely at the original question, I wrote "regardless of the medical care involved". Many lawsuits are picked up without any regard to whether a mistake was made or not, but with an eye to the potential out-of-court settlement. All I ask is that someone with any sort of expertise in medicine take a look at the case to decide that. Why are attorneys fighting this? If it's not greed, I'm not sure what it is.

The gross negligence standard is being tried in several states and has substantially reduced malpractice costs. That may or may not be desirable to you (I can see the argument against it), but it would decrease costs.

In the words of a most beloved poster here: Link? DO you have nay evidence of just how outrageously large the awards are (IOW, we all assume they are unjustifed; can you prove it)? And do you mena that such awards shouldnt happen ever, or do you mena they are only outrageous if they don't involve the death of a 40 year old father of 4, for example? And do you include awards in states where there are limits on malpractice awards for pain and suffering?

Moreover, the awards are from the juries. People like you (maybe not like you becasue you are, well, unique, but you get the idea) vote for them.

I like how people decry defensive medicine. But I WANT defensive medicine when it comes to treating or examining me or my family. I realize the odds say that I probabyl don't need some of these tests, and a prudent use of resources might not support it, but I don't want to be the loser in that game of chance. I prefer the thought that the doctor will check out possibilities becasue if he guesses incorrectly he might get sued.

I realize the cost of malpractice insurance is a problem, but I am not sure we really want to solve that problem without addressing other issues as well.

If I'm a liability insurer, I observe the range of possible claim amounts. In response to the claims distribution, I need to charge premiums sufficient to cover me if I get hit with particularly adverse claims experience.

When awards can reach the 8 figure level, that results in a siginificant amount of additional "risk premium" the insurer will charge its policyholders.

For example (and I'm just making up numbers for illustrative purposes), if the average malpractice claim cost per doctor per year is $100,000 but with a standard deviation of $600,000, you're going to see premiums well above $100,000 being charged.

The answer to the question of whethger medical care was faulty is the ultimate question. If you are contending that suits lacking any merit whatsoever are settled so frequently and for such significant sums that they dramatciually effect malpractice rates I would like to see the support for such a claim. I highly doubt this is true. If it is true, then your carrier needs to suck it up and try a few cases, becaseu a case lacking any merit will be defensed.

More likely you are talking about cases that you think have little merit but becasue the damages are so significant the small risk of an adverse liability result makes doctors pressure theiur carrier to settle before trial. This is reasonable conduct, of course, and is based not on a claim that lacks any merit, but is based on a claim that may be hard to prove or not have much meirt but which a jury, using the reasonable person standard and applying the burden of proof, might find professional negligence.

This is a very complex issue, and almost none of it is as black and white as you suggest.

I am sure it does reduce costs. I don't like it, becasue I don't think an access issue (which is what we started this thread talking about) should be solved by denying compensation to vicitms of mistakes. But I also admit I have not studies this at all (I do not practice MedMal) and so could be persuaded upon reviewing the approaches that are tried and how they work.

Sure, that's obvious, but that begs the question of what you mena by outrageous. What makes it outrageous? I assumed you meant unjustified. Do you mena anything large is outrgaeous regardless?

You THINK you want defensive medicine...

Your 3 yr old falls off the bunk bed. No loss of consciousness, small lump on the head, vomits once, but is now acting fine. You're scared because it's your kid so you bring him into the ER.

In Detroit, your kid gets a head CT. No way your child leaves the ER without one. Doesn't matter what your kid looks like. Doesn't matter what you want. You sign out against medical advice if you don't want one, and your visit will therefore likely not be covered by your insurance.

In Indiana, your child is examined. The doctor decides that the likelihood of your child having a significant head injury is low (say <2%--it's NEVER zero) and gives you instructions for watching him at home and what to watch for.

Now fast forward 30 years. In Detroit, your child develops a deadly thyroid carcinoma. You've totally forgotten about that head CT that likely caused it so you're not suing the doctor--you just write it off as something that happens.

Oh...and I didn't mention the little old lady who feels a little dizzy and is in the waiting room waiting for your kid to get out of the CT scanner so the doc can examine her, send her to discover her cerebral hemorrhage that will kill her. If only the doc could have gotten to her sooner. Oh well...avoided the lawsuit.

Oh yeah...there's also the increase in insurance premiums due to your kid and a thousand others that's going to make the blood pressure medicine unaffordable to the man who will die of a heart attack.

These are all huge issues that we face every day. I assure you I'm not painting the worst case. I've worked in Detroit and that is EXACTLY what happens. I've seen people die in the waiting room because the CT scanner was tied up with bullshit. We've all seen insurance premiums go up. And there are studies coming out every day about the dangers of radiation exposure from medical testing.

Defensive medicine is good for no one. But our hand is forced. After all, tests costs me nothing. Malpractice costs me a lot.

I could think of a hundred similar examples, I assure you. I practice this every day.