pain and suffering can be a scam but it can also be real. The need is to separate the real from the scamwhichis why I think eliminating jury trials will work. Trying to get one physician to judge the actions of another physician outside the legal system is a nice thought but probably like trying to get into a closed fraternity. If the medical profession were actually self policing most of the malpractice issues would disappear. Instead you can almost never find cases where medical boards actually remove certification of doctors. - - - Updated - - - Really, so you are telling me that testing facilities in Florida arenot physician owned?
So you are actually admitting ordering unnecessary tests in the mistaken belief that they will protect you from lawsuits, or is it because you own the testing facility. Here is a short article you might want to read. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2955467/
I'm not saying that a physician has to "judge the actions of another physician." I am stating that for a Certificate of Merit to be valid, it should take two physicians to review a chart and explain why the plaintiff physician's actions caused the defendant harm. A plaintiff should always be ultimately "judged" by the court system. Unlike politicians, lawyers, and police officers, the field of medicine is not a "closed fraternity." For better or worse, it doesn't take much effort to find a doctor to turn on another doctor. That's why my proposal requires two physicians to sign a Certificate of Merit after explaining, in writing, the wrongdoings of the plaintiff physician. That's absurd. The medical profession self polices more rigorously than any profession. And how would better "self-policing" prevent lawyers from suing doctors for no reason? I'll use the same example as before: If a surgeon accidentally amputates the wrong leg a patient with gangrene, then why should the lawyers have a right to sue the cardiologist, infectious disease physician, ophthalmologist, dermatologist, and internal medicine physician who had absolutely NOTHING to do with the error? How would better "self policing" protect the innocent doctors from this lawsuit? Obviously, self policing is not the issue here: This issue is a corrupt civil legal system that allows lawyers to sue everyone in the chart regardless of their involvement in the alleged error? My proposal would fix this travesty of justice. I don't know about some testing facilities in some areas of Florida, but none of the hospitals in this entire country are owned by physicians, and there is no financial benefit to a physician ordering diagnostic tests in hospitals. Additionally, an outpatient physician who orders completely unnecessary tests will likely get penalized by insurance companies. Again, the reason why physicians order seemingly unnecessary tests is to rule out rare things, thereby protecting themselves from lawsuits. If you remove the ability of lawyers to sue physicians for adhering to the standard of care, then you will get rid of the unnecessary, and costly, testing.
Doctors order seemingly unnecessary tests to rule out rare things for the purposes protecting themselves from lawsuits. For example, let's say a 28-year old patient comes in to the ER with chest pain with inspiration and movement. He is healthy, does not smoke, and has no significant family history. His vital signs are perfect. An EKG (cheap) and cardiac enzymes (relatively cheap) are done and return negative. However, after being reassured that his pain is likely bronchitis, costochondritis, or merely anxiety, he becomes angry and still complains that he is having pain and demands a definitive explanation of his pain. In this case 9 out of 10 ER doctors will order a CT scan (expensive) of the chest to rule out a pulmonary emoblism, even though the patient is at a very low risk of having a pulmonary embolism. When you have an angry patient, who will likely sue over any error (or perceived error), you are forced, as a doctor, to go above and beyond and order every test imaginable to protect yourself. If we had a system that protected doctors for following the standard of care, then there would be no reason for us to order expensive CT scans for a patient with a very low risk of pulmonary embolism. *Sigh*. I am a hospitalist (e.g. internal medicine physician who is employed by a hospital and works in a hospital setting). Physicians OBVIOUSLY cannot own a hospital. I have never heard of physicians owning a lab facility, and thus I am certain it is extremely rare, and if there are physicians that own labs, then they certainly do not represents the average physician that practices medicine in the country. Again, physicians that have a financial stake in a laboratory do not come close to representing the average practicing physician. Thus, the article is irrelevant to our discussion. It would be like having a discussion on the declining median income of the average African American family, and then arguing that the salaries of African American NBA players are higher than ever.
Since you continually assert physicians have no ownership stake in prescribing unnecessary tests an article that proves your statement to be incorrect is totally relevant in demonstrating your lack of knowledge.
Try to confuse testing facilities with hospitals. Oh, and guess what, most medicine and testing doesn't happen in hospitals. And have you heard of for profit hospitals?
Here is an article on. "Medical Malpractice Myths" you might want to read. http://www.medmalfacts.com/facts-and-myths/ Feel free to post sources to debunk any claims made.
The overwhelming majority of physicians who order tests do not have any ownership stake in laboratory companies whatsoever. Hence, you are being extremely dishonest by trying to state that a handful physicians in Florida (who actually do have ownership stake in a lab company) is the norm, when this could not be further from the truth. In fact, it is as dishonest as using a Black NBA player's salary as representative of the average salary for all Black people in America.
Testing done in America's hospitals account for hundreds of billions of dollars annually. You are again showing your utter lack of knowledge on this subject.
These are not facts: This is heavily biased nonsense written by a bunch of self-serving lawyers (the website was sponsored by Legislative Policy Committee of Pennsylvania Association of Justice). There is not a single citation on the website that buttresses any of its "facts." The next time you search for actual facts about medical malpractice, it would benefit you by actually finding websites a little less biased than those written by greedy trial lawyers.
Note your inability to respond to actual issues. Try to rebut the sources I have listed instead of trying rather pathetically to claim personal knowledge. You small fish in tiny pond with no actual knowledge of the medical system in the United States. Post data or go home.
I have responded to every point that you have made (or attempted to make). You haven't posted any sources. Organizations of trial lawyers, such as Legislative Policy Committee of PA, do not come close to counting as valid sources of information. Try again. Yeah. God forbid you hear physicians' firsthand accounts of the horrors afflicted onto the healthcare system by our broken civil legal system. LOL! I deal with the medical system EVERY DAY: I am a physician. You are not a physician. Yet, you somehow have the audacity to say that I have no knowledge, even though you have provided no sources to buttress your argument, nor have you presented even a logical defense of your argument. By doing this, you are displaying the highest level of ignorance. It would be like a civilian with no military experience saying that three-star general has no knowledge about the military. Take your own advice.
Here are two actual sources I posted previously that prove you wrong. http://www.medmalfacts.com/facts-and-myths/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2955467 So far the only source you seem to be able to come up with to support your opinion is your own opinion. If you actually have data on the cost impact of tort reform from a reliable source feel free to post it.
Here is the CBO (Congressional Butget Office ) study on tort reform. If you bother to read the article it will tell you the estimated impact of tort reform on total medical spending is estimated at 0.2% http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2955467/ Insurance spending as a percentage of total medical cost in the United States is about 2% so the CBO estimate is that tort reform will actually only reduce insurance cost by about 10%. Now if you have a better and less biased source of data than the CBO feel free to post it.
And again, I have already responded in my prior posts that this website is sponsored by Legislative Policy Committee of Pennsylvania Association of Justice, an advocacy group of lawyers, and does not present facts and is certainly not an objective source of information of any sort. There are no links or citations to primary sources of information. The website makes references to debunked studies, such as their claim that the "Harvard School of Public Health examined over 1,400 closed medical negligence claims and found that 97 percent were meritorious." If one were to actually look at the "study" (and I use this term extremely loosely) from the Harvard School of Health, it is clear their there methods of this "study" are entirely absurd: The "researchers" define the term "meritorious" as whether or not patient experienced any type of physical harm or death. This "study" does not even attempt to provide evidence that a physician was the cause of the patient's harm or death. Hence, a 95-year old patient with end-stage COPD and metastatic small cell lung cancer could be hospitalized and die during his hospitalization by natural causes, and if a crazy family member and unscrupulous lawyer sues the physician who kept him alive for the past 30 years, the "study" by the Harvard School of Health would deem this case "meritorious." Thus, this "study" is more worthless than that paper that it was printed on. I already addressed this in prior posts. The fact remains that the vast majority of physicians have no ownership stake in a laboratory. Additionally, Medicare/Medicaid and private insurance companies will not reimburse for unnecessary testing of this sort. Again, I have provided data from every country from Europe and other countries, such as Israel, that have similar populations and similar prevalence of diseases, but yet their per-capita spending on healthcare is a fraction of what we pay in the USA. The one major difference that comes to mind between these countries and the USA is our utterly broken civil legal system where doctors can be sued for literally ANYTHING. Also, I have logic on my side: If physicians, especially ER physicians and physicians that deal with hospitalized patients, were not scared to get sued for anything that could conceivably go wrong, they wouldn't give every patient a million-dollar workup. Again, you are giving me a Catch-22. We have not passed true tort reform on a state or federal level in this country. Thus, how in the world can you ask me to provide data on the "cost impact of tort reform" when real tort reform has never been enacted, even on a state level?
You didn't provide a link to the CBO: Your link is to the study, "Laboratory Test Ordering at Physician Offices with and without On-Site Laboratories." Try again.
Sorry, here it is although if it doesn't work a google search is trivially easy. https://www.cbo.gov/sites/default/files/10-09-tort_reform.pdf Results still show only a 0.2% impact of tort reform.
First of all, this is nothing of the legal tort reform that we have been discussing. In your article, the CBO defines "tort reform" using the following criteria: 1. A cap of $250,000 on awards for noneconomic damages 2. A cap on awards for punitive damages of $500,000 or two times the award for economic damages, whichever is greater; 3. Modification of the “collateral source” rule to allow evidence of income from such sources as health and life insurance, workers’ compensation, and automobile insurance to be introduced at trials or to require that such income be subtracted from awards decided by juries; 4. A statute of limitations—one year for adults and three years for children—from the date of discovery of an injury; and 5. Replacement of joint-and-several liability with a fair-share rule, under which a defendant in a lawsuit would be liable only for the percentage of the final award that was equal to his or her share of responsibility for the injury. The most important aspects of the legal tort reform that I have been talking about aren't even mentioned in the CBO's criteria. These aspects were, of course, that civil law should mimic criminal law, and trial lawyers should have the burden to prove beyond a reasonable doubt that a physician's failure to adhere to the standard of care caused the plaintiff's injury. Also, plaintiffs' lawyers should be required to have Certificates of Merit signed by two physicians of the same specially of the defendant before a lawsuit can be filed, and that these physicians who sign these Certificates of Merit must explain in detail why the case has merit. If the CBO included the real tort reform stipulations that I included above, then there is no doubt in my mind that tens of billions or hundreds of billions of dollars would be saved, and the practice of defensive medicine would be a thing of the past. Second of all, by saying "results still show only a 0.2% impact of tort reform" you are only providing a selectively edited portion of the CBO's results. If you read the sentence in the CBO report that immediately precedes the "0.2%" figure), you will see that the CBO estimates an annual saving of $11 BILLION. If you ask me, an $11,000,000,000 annual saving with the most meager of tort reforms proves my point that if we actually implemented the significant changes to our broken civil legal system that I referred to, then we will save many times that amount.
I forgot to mention in my prior post that the CBO does not even take into account the cost of defensive medicine when trying to calculate savings from medical malpractice reform. In your article, the CBO calculates savings by "estimating the direct costs that providers will incur in 2009 for medical malpractice liability—which consist of malpractice insurance premiums together with settlements, awards, and administrative costs not covered by insurance." Nowhere in this analysis of costs is an estimation of the cost of defensive medicine (and savings in defensive medicine would be the most important aspect of medical malpractice reform) . Hence, the CBO's analysis on tort reform is as worthless as an analysis of the USA's annual homicide rate that neglected to include firearm-related deaths. This is not a big surprise coming from the organization that underestimated the cost of the Affordable Care Act by a factor of more than 2.
Well we are happy there is no doubt in your mind. I have provided solid data on impact of tort reform as recognized by most advocates. If you believe your proposals make any additional impact it is incumbent on you to prove significant additional savings. - - - Updated - - - As I said feel free to provide any evidence.
Again, even your heavily flawed CBO study states that the most meager of tort reforms would lead to $11,000,000,000 in annual savings. I don't need any additional studies: The CBO study that you provided proves my point very nicely. It is merely applying basic logic that if extremely modest tort reforms would save $11 billion, then actual reforms to the civil legal system would save a significant amount more. Here ya go. http://www.aaos.org/news/aaosnow/dec10/advocacy2.asp http://www.jacksonhealthcare.com/media-room/surveys/defensive-medicine-study-2010.aspx http://www.forbes.com/sites/realspin/2013/08/27/defensive-medicine-a-cure-worse-than-the-disease/
The CBO study does include effect of reduced testing on medical expenditures. And I would not put too much faith in physician surveys since their responses are easily construed as self serving. As previously posted there is significant evidence that excess testing is caused by other factors than just defensive medicine.
Here is a good source for debunking common myths about medical malpractice: http://www.medmalfacts.com/facts-and-myths/
Not true: In your article, the CBO calculates savings by "estimating the direct costs that providers will incur in 2009 for medical malpractice liability—which consist of malpractice insurance premiums together with settlements, awards, and administrative costs not covered by insurance." I see no section on where the CBO calculates the overall costs of defensive medicine and the effects of these meager tort reforms on the cost of defensive medicine. Again, even these extremely minor changes to the tort system amount to $11,000,000,000 in annual savings, as per the CBO. Thus, logic dictates that more significant changes (e.g. actual tort reform) would yield more substantial results. First, if you are dismissing evidence without even looking at it, then you might as well acquiesce to defeat. Even I entertained your "evidence" from lawyer advocacy sites (e.g. http://www.medmalfacts.com/facts-and-myths/), and provided explanations on how information from such sites were entirely bogus. Second, how is the world is a mere survey from physicians about defensive medicine "self-serving"? A physician answering "yes" to a survey asking him if he practices defensive medicine is in no way benefiting from answering in such a way any more than if he answered "no.". Hence, it is clearly not "self serving". In contrast, the absurd website that you tried to used as "evidence" (http://www.medmalfacts.com/facts-and-myths/ is sponsored by trial lawyers and is clearly "self-serving" by the very definition of that word (since their sleazy livelihoods depends on suing physicians for as much money as possible). I thoroughly debunked your ridiculous theory that excess testing comes from doctors who own laboratories (like I said many times, the overwhelming majority of doctors have no significant financial stake in laboratories). I'll put a nail in this coffin: From the sources that I provided, defensive medicine is attributed to $650,000,000,000 annually. Let me now ask you, how much money is wasted by doctors who order excessive labs tests from their own lab? If you are able to find this amount, somehow I doubt that it will come anywhere close to $650 billion.
I already addressed this in Post #65. This website is sponsored by Legislative Policy Committee of Pennsylvania Association of Justice, an advocacy group of lawyers, and does not present facts and is certainly not an objective source of information of any sort. There are no links or citations to primary sources of information. The website makes references to debunked studies, such as their claim that the "Harvard School of Public Health examined over 1,400 closed medical negligence claims and found that 97 percent were meritorious." If one were to actually look at the "study" (and I use this term extremely loosely) from the Harvard School of Health, it is clear their there methods of this "study" are entirely absurd: The "researchers" define the term "meritorious" as whether or not patient experienced any type of physical harm or death. This "study" does not even attempt to provide evidence that a physician was the cause of the patient's harm or death. Hence, a 95-year old patient with end-stage COPD and metastatic small cell lung cancer could be hospitalized and die during his hospitalization by natural causes, and if a crazy family member and unscrupulous lawyer sues the physician who kept him alive for the past 30 years, the "study" by the Harvard School of Health would deem this case "meritorious." Thus, this "study" is more worthless than that paper that it was printed on.
