The uninsured..........

[ERCougar]

Originally Posted by creekster

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.

I agree that more of these suits need to be tried, and in fact, insurers are doing this more and more frequently. Hopefully, this is a problem that may solve itself.

The pressure to settle NEVER comes from a doctor. Any lawsuit settled makes your malpractice insurance more expensive. The commonest complaint in this arena is that the insurer was not willing to fight your case.

Overall, I don't have a problem with reasonable compensation for mistakes. I just want someone knowledgeable to decide if a mistake occurred. How is this different from patent law?

[creekster]

Originally Posted by ERCougar

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 will die of a heart attack.

These are all huge issues that we face every day. I assure you I'm not painting the worse. 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.

You should have been a trial lawyer. THis is exactly the sort of emotional approach that results in the so-called outrageous results you so dislike. You know very well that the range of defensive medcine rarely includes a CT and frequently includes other types of screeingin (blood tests, etc) that are not likely to cause rare and deadly carcinomas. Moreover, I expect a doctor to tell me the risks that are known for all treatment. If a docotr believes that a possible test has risks that are equivalent to or greater than the risk of the injury that might be detected, I expect to be told that. Are you suggesting, btw, that the 35 year old with cancer should be able to sue the docotr for that test? Mayeb this would, over time, result in the elimination of dangerous defensive testing?

[creekster]

Originally Posted by ERCougar

The pressure to settle NEVER comes from a doctor. Any lawsuit settled makes your malpractice insurance more expensive. The commonest complaint in this arena is that the insurer was not willing to fight your case.

This is amusing becasue it is so wildly incorrect. DO you think that insurance companies rush to throw money at plaintffs becaseu they are nice guys? The reason carriers beahve this way is becasue if they do not protect doctors (their insureds) they will be sued for bad faith. Indeed, the fact of large bad faith verdicts against carriers that failed to settle within limits when they had a chance to do so is exactly why they choose to settle now. In the case of medmal claims, can you venture a guess who it was that sued the carrier for bad faith? Here is a clue: it wasn't the injured party.

[ERCougar]

Originally Posted by creekster

You should have been a trial lawyer. THis is exactly the sort of emotional approach that results in the so-called outrageous results you so dislike. You know very well that the range of defensive medcine rarely includes a CT and frequently includes other types of screeingin (blood tests, etc) that are not likely to cause rare and deadly carcinomas. Moreover, I expect a doctor to tell me the risks that are known for all treatment. If a docotr believes that a possible test has risks that are equivalent to or greater than the risk of the injury that might be detected, I expect to be told that. Are you suggesting, btw, that the 35 year old with cancer should be able to sue the docotr for that test? Mayeb this would, over time, result in the elimination of dangerous defensive testing?

Are you kidding me? Overuse of CT's is one of the chief differences between us and the rest of the world. That's why this debate is raging right now in medicine. We all know we're ordering way too many CT's but until the malpractice situation is fixed, we're not stopping. Failure to CT is absolutely is one of the chief causes of lawsuits--whether it's head injury, appendicitis, bowel obstruction. I bet I order 5 needless CT's a shift; and I'm on the low end.

Yes, I think the doctor should be responsible for causing the thyroid carcinoma. Problem is, that's 30 yrs down the road--he's done practicing by then. What would you do in his place?

Need another example? You're 55. You come in with chest pain. It's sharp, lasted only a few minutes, no family history of heart disease. In Indiana, you're discharged, even knowing that there's always a small non-zero chance that you had a heart attack. In Detroit, you're either admitted to the hospital, or more likely, you're watched in the ER for 6-12 hours while serial tests are drawn. No, you don't have a choice, even though the chance this was a heart attack is next to nothing. You want to go home, you sign out against advice (and you'll cover that bill yourself). Wonder why the ER's are overcrowded?

I'm just getting started. If you think these are isolated examples, we can keep playing.

[MikeWaters]

I haven't read this thread, but I will say having talked to a lawyer here in Texas that does occasional med malpractice suits as the plaintiff, that suits in Texas have gone way down since tort reform.

There is a lawsuit in practice that challenges the tort reform. It is brought by the relative of th former Dallas Cowboy who received a kidney from another former Dallas C. and is currently in a coma (?) after a minor surgical procedure.

[ERCougar]

Originally Posted by creekster

This is amusing becasue it is so wildly incorrect. DO you think that insurance companies rush to throw money at plaintffs becaseu they are nice guys? The reason carriers beahve this way is becasue if they do not protect doctors (their insureds) they will be sued for bad faith. Indeed, the fact of large bad faith verdicts against carriers that failed to settle within limits when they had a chance to do so is exactly why they choose to settle now. In the case of medmal claims, can you venture a guess who it was that sued the carrier for bad faith? Here is a clue: it wasn't the injured party.

You're really out of your realm here. The reason they're settling is the wildly disparate risk they're facing. That said, more and more are challenging them in court. I assure you that this is the chief complaint docs have about their carriers--their unwillingness to take things to court. I have yet to hear of a case of a bad-faith lawsuit. They may exist, but they're rare. I follow this issue pretty closely as ER is one of the higher liability fields--I'm sure if they were common, I would have read of several examples by now.

[Indy Coug]

Originally Posted by ERCougar

Are you kidding me? Overuse of CT's is one of the chief differences between us and the rest of the world. That's why this debate is raging right now in medicine. We all know we're ordering way too many CT's but until the malpractice situation is fixed, we're not stopping. Failure to CT is absolutely is one of the chief causes of lawsuits--whether it's head injury, appendicitis, bowel obstruction. I bet I order 5 needless CT's a shift; and I'm on the low end.

Yes, I think the doctor should be responsible for causing the thyroid carcinoma. Problem is, that's 30 yrs down the road--he's done practicing by then. What would you do in his place?

Need another example? You're 55. You come in with chest pain. It's sharp, lasted only a few minutes, no family history of heart disease. In Indiana, you're discharged, even knowing that there's always a small non-zero chance that you had a heart attack. In Detroit, you're either admitted to the hospital, or more likely, you're watched in the ER for 6-12 hours while serial tests are drawn. No, you don't have a choice, even though the chance this was a heart attack is next to nothing. You want to go home, you sign out against advice (and you'll cover that bill yourself). Wonder why the ER's are overcrowded?

I'm just getting started. If you think these are isolated examples, we can keep playing.

So what would be the approximate difference between Detroit and Indiana in charges billed to the insurer for the above scenarios?

[Indy Coug]

Originally Posted by MikeWaters

I haven't read this thread, but I will say having talked to a lawyer here in Texas that does occasional med malpractice suits as the plaintiff, that suits in Texas have gone way down since tort reform.

There is a lawsuit in practice that challenges the tort reform. It is brought by the relative of th former Dallas Cowboy who received a kidney from another former Dallas C. and is currently in a coma (?) after a minor surgical procedure.

Everson Walls and....

[ERCougar]

Originally Posted by Indy Coug

So what would be the approximate difference between Detroit and Indiana in charges billed to the insurer for the above scenarios?

Health insurer or malpractice insurer?

Damn..I've really got to go.

I'll check this discussion out tonight.

[Indy Coug]

Originally Posted by ERCougar

Health insurer or malpractice insurer?

Damn..I've really got to go.

I'll check this discussion out tonight.

Health insurer.