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So, if this is true, why is the president (and, for that matter, many Republicans and Democrats right here in Illinois) only talking about going after the trial lawyers? (link via here and here)

Experts retained by the Bush administration said Tuesday that more effective disciplining of incompetent doctors could significantly alleviate the problem of medical malpractice litigation.

The experts, from the University of Iowa and the Urban Institute, came up with this idea:

Randall Bovbjerg, a researcher at the Urban Institute, said, “If you take the worst performers out of practice, that will have an impact” on malpractice litigation. “Most doctors have few or no claims filed against them. But within any specialty, a few doctors have a high proportion of the claims.”

You gotta wonder how many of those white-coated docs surrounding the president in Collinsville this week were part of the problem, not the solution.

Massachusetts has adopted an approach that experts say may provide a model for other states. Without waiting for a complaint to be filed, the Massachusetts Board of Registration in Medicine conducts a clinical review of any doctor who has made three or more malpractice payments to patients, as a result of jury verdicts or settlements. Nancy Achin Audesse, executive director of the board, said: “Three is a magic number. Doctors who have to make three or more payments are also more likely to be named in consumer complaints and to be subject to discipline by hospitals and the medical board.”

And here’s the kicker:

In Massachusetts during the last 10 years, Audesse said, “one-fourth of 1 percent of all the doctors â€” 98 of the 37,369 doctors â€” accounted for more than 13 percent of all the malpractice payments, $134 million of the $1 billion in total payments.”

Amazing. Thirteen percent of the malpractice payments were generated by just a quarter of a percent of all the doctors in the state, yet the solution is to cap non-economic damages. So, if a dirt poor single mother of three is blinded because of a medical error, she gets the capped amount and almost nothing else (if she can find an attorney, and if she then wins her case). If a corporate CEO is similarly blinded, she gets millions in lost income on top of the relatively paltry cap amount.

It would be interesting to see how the numbers work in Illinois, but the state’s website is of little help.

Here’s a good summary of what the Urban Institute’s Mr. Bovbjerg recommended in a recent article:

The current medical liability system works poorly for patients and physicians, the authors say. Because of steep increases in malpractice premiums, physicians tend to practice “defensive medicine,” ordering unnecessary medical tests, procedures, and referrals for their patients. Not only are patients exposed to unnecessary physical risk, but health care costs rise even further. Meanwhile, large numbers of Americans continue to suffer preventable medical injuries.

Bovbjerg points out that in the mid 1980s, anesthesiologists adopted “practice guidelines” that “drastically” reduced patient deaths and insurance premiums.

He also recommended several legislative solutions (highlighting mine):

* States could implement physician licensure requirements, such as the risk management training required by the Massachusetts Board of Registration.

* Insurance regulators could provide premium discounts on malpractice insurance based on doctors’ performance â€” an up-front investment in quality improvement that would reap savings in the long term.

* Tort reform could be contingent on reporting of errors, or implementing specific activities that increase patient safety.

* Health plans, Medicare, and Medicaid could provide partial subsidies of physicians’ premiums in return for specific safety enhancements.

* Doctors could invest in tools such as electronic prescribing aids and automated systems for tracking of tests.

* Better information on patient safety could be collected and reported to facilitate safety improvement and physician involvement.

But just when you think you’ve got it figured out, you read articles like this and you see the other side. (Registration and fee required, but well worth it.)

A new leader is emerging among Chicago’s powerful medical malpractice plaintiffs lawyers, 50-year-old Kevin G. Burke, who operates with a distinct advantage over his better-known competitors: his eight years spent on the other side, defending doctors and hospitals.

That experience, all but unique among the city’s top medical malpractice plaintiffs’ lawyers, helped Mr. Burke secure verdicts and settlements last year totaling $89.8 million, tops in Chicago.

Man, that’s a lot of dough. Here are his top three verdicts:

Evelyn Arkebauer, et al. v. Northwestern Medical Faculty Foundation, Northwestern Memorial Hospital, et al.
Settlement: $35.0 million
Allegation: Plaintiff’s son was rendered permanently disabled after a delay in treatment.

Misty Campbell, et al. v. St. Francis Hospital and Health Center, et al.
Verdict: $32.0 million
Allegation: Plaintiff’s son suffered brain damage and blindness after the medical staff failed to recognize signs of fetal distress.

Heather Duvall, et al. v. Evanston Northwestern Healthcare, et al.
Settlement: $15.0 million
Allegation: Plaintiff’s son suffered brain damage after physician applied excessive force during delivery.

posted by Rich Miller
Thursday, Jan 6, 05 @ 11:12 pm

Comments

“verdicts and settlements last year totaling $89.8 million”

Yeah, that’s a lot of money, and I think that our med-mal system needs some work (I would start by making apologies from medical service providers inadmissable in court) but I have never read a single jury verdict or settlement, med mal or otherwise, where I thought, “That’s a pretty good deal. I would accept that injury in exchange for that sum of money.”

Brain damage, blindness, permanent disability — would anyone exchange that suffering for the sums of money awarded.

No one I would want to know.

And lets not forget — most of the money awarded is for future medical treatment. The family gets one payout once, i.e. the money awarded has to pay for treatment of the child for the rest of his or her life. And the cost of medical care is skyrocketing (chicken or egg?)

And lets face it, those white coats are being used to hide Bush’s actual agenda - making corporations unaccountable in court.

End rant.

Comment by So-Called Austin Mayor Friday, Jan 7, 05 @ 9:11 am
“i am sorry” is covered in all of the proposed reforms rejected by the med society in Illinois. Those cases cited by Cap’tBlog sure look like “junk law suits” to me.

Comment by Anonymous Friday, Jan 7, 05 @ 1:31 pm
With what we all observed during the summertime session of the General Assembly, and with what people in this part of the state have been experiencing with regard to our doctors, it would have been inappropriate for President Bush to not have come here and deliver a speech like that.

While President Bush has failed to take firm stances for our principles on many issues, it is good that on this vital matter, he is taking a stand. At times like this, it is relieving to realize that Jon Edwards isn’t President (or VP).

Comment by Aakash Friday, Jan 7, 05 @ 7:44 pm
The Democratic party and the trail lawyers better come to grips with this situation before the 2006 election. And, they better get serious about it - no bandaids.

I’ve got a politically divided extended family, and this issue of doctors curtailing their practice or even leaving Illinois has hit home within the last six months. I’ve had 5 extended family members who have been directly affected by this “loss of choices” in obtaining medical services during that time period, and as a result, you’ve got average everyday non-political types who get flat-out angry when this issue comes up. And they’re not going to forget anytime soon.

And for better or worse, from their viewpoint, it’s not the doctors and it’s not the insurance companies who are the bad guys - it’s the Trial Lawyers. This may not be a big issue in Chicago, but it is fast becomming a big issue outside Chicago.

As a Republican, we’ve given the Democrats some amazing political gifts over the last few years (George Ryan & Alan Keyes both come to mind). Looks like the Democrats are going to return the favor by “driving doctors out of Illinois”. True or not doesn’t matter - the average, everday citizens (voters) are starting to get angry.

Comment by Anonymous Sunday, Jan 9, 05 @ 7:13 pm
Let’s get a few things straight. Yes, there are bad doctors. Just like there are bad cops, bad lawyers, bad politicians and bad priests.

A simple solution has been opposed by the Med Society for years: make malpractice insurance experiential. Just like bad drivers, bad doctors should see their premiums go up, not the rest of us. But the med society bills everybody in the same county the same rate, and has opposed legislation in the past to make rates based on a doc’s record.

Why? One can only guess, based on the results, that their goal is to fuel an ongoing crisis in their blind pursuit of caps. They might succeed, but Illinois doctors would be better served if they could learn to think for themselves, instead of letting a small band of conflicted leaders do the thinking for them.

Comment by Anonymous Tuesday, Jan 11, 05 @ 5:30 pm