Best way to reduce malpractic insurance costs? Medical profession police thyself!

[JohnWxy]

5% of American Doctors responsible for over HALF the malpractice awards to patients.

http://www.accessmylibrary.com/coms2/summary_0286-2732172_ITM

Public Citizen Health Research Group
Washington DC

Just 5% of American doctors are responsible for half the malpractice in the US, according to a new analysis of federal data by the consumer group Public Citizen.

"The medical community alleges that medical liability litigation constitutes a giant 'lottery,' in which lawsuits bear no relationship to the care given by a physician," says Public Citizen President Joan Claybrook.

"In reality, a small percentage of doctors are responsible for the bulk of malpractice in the US, and only better oversight by state medical boards, not draconian limits on patients' legal rights, can reduce the tens of thousands of deaths and injuries they cause."

Public Citizen analyzed a public use file from the National Practitioner Data Bank, which includes information about malpractice judgments and settlements since Sept. 1990. The analysis found that 4.8% of doctors in the US (40,118) who have paid two or more malpractice awards to patients are responsible for 51.1% of all the reports made to the Data Bank.

Those doctors have paid out nearly $21 bln in damages, over 53% of the total damages paid. The analysis also found that 1.7% of doctors (14,293) are responsible for 27.5% of all malpractice awards; 14, 293 have made three or more payments, totaling $11 bln.
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Medical community etheir police yourself - get incometent doctors away from patients (put them in administrative positions or make them coroners)

OR,,, the Congress should make it a crime to pracitice medicine with more than two or three examples of gross incompetence and a crime to employ doctors of proven incompentence (this means Hospitals will be liable for criminal malfeasance. There will be no such defence as "we didn't know!" managers of hospitals are expected to establish a doctor is competent before allowing him to operate in your facility.)

If you weed out the incompentents you would cut malpractice insurance costs IN HALF!!

Praciticing medicine doesn't mean you can practice until you get it right.

Public Citizen report: http://www.bailey-law.com/files/5_percent_of_doctors_responsible.pdf

[Zoeisright]

1. My family has had a LOT of experience with incompetent doctors,

and the other doctors who cover it up. Including:

Failure to diagnose cancer for 6 months.

Leaving a catheter in, leading to pneumonia. The nurses were telling US it had to be removed.

The doctors who were partners of the quacks who did this covered up for them.

[Donnachaidh]

2. I've been saying this for YEARS, but the AMA and doctors want it both ways

They want to keep the maimed patient from being able to sue for damages AND allow crackpot, potentially dangerous doctors to continue practicing.

That Boustany character with his republican speech last night was sued *3* times for malpractice. Any wonder why he's now in the Congress?

I wonder how many of the ex-doctors in public office were sued? That would be something to research.

[hobbit709]

3. Sued 8 times, 3 times successfully

[Donnachaidh]

7. oh no shit! ROFLMAO!!!

Had to settle on congresscritter after he couldn't buy a title...

[JohnWxy]

4. Allowing demonstrated incompetent "doctors" to keep harming people should be treated as a criminal

act. If the medical community refuses to be responsible for those in their profession then aiding and abetting and colusion should be punished. If people cannot act responsibly you must enforce laws against irresponsible behavior - to protect members of the community.

[Altoid_Cyclist]

5. This hits close to home.

My wife was nearly allowed to die because her Cardiologist was more interested in his business and real estate transactions than his patients. Luckily, I was able to get her to the Cleveland Clinic in time to save her life but it was too close for comfort.
I have permanent neurological damage due to the incompetence of two doctors.
Even other doctors told us that in each case they had never seen such open and shut examples of MM and that we should sue. We didn't because back then we weren't the type to sue. In the future however......
I realize that MM insurance is expensive, but as you illustrated, they need to weed out the hacks and frauds.

[JohnWxy]

8. I finally found a link to the Public Citizen study results:

http://www.citizen.org/congress/civjus/medmal/articles.cfm?ID=8308.

The medical community has argued that medical liability litigation constitutes a giant "lottery," in which lawsuits are purely random events bearing no relationship to the care given by a physician. In reality, a small percentage of doctors are responsible for the bulk of malpractice in the United States, and better oversight by state medical boards could drastically reduce the damage they cause.

Public Citizen’s analysis of the National Practitioner Data Bank, which covers malpractice judgments and settlements since September 1990, found that about five percent of the doctors in the United States are responsible for half the malpractice. Specifically, 4.8 percent of doctors (40,118) have paid two or more malpractice awards to patients. These doctors are responsible for 51 percent of all the reports made to the Data Bank, and have paid out nearly $21 billion in damages, more than 53 percent of the total damages paid.

14,293 doctors, representing 1.7 percent of the doctors in the U.S., have made three or more payments, totaling $11 billion. These doctors are responsible for 27.5 percent of all malpractice awards.

Rather than a random, lottery-like pattern, this distribution very much resembles the pattern of drunk driving recidivism. Motor vehicle licensing bureaus have procedures in place to prevent or deter predisposed individuals from driving under the influence, such as mandatory counseling and license suspensions or revocations. Unfortunately, medical licensing boards do not use their authority with nearly as much vigor.

(much more)

[Altoid_Cyclist]

20. Thanks for the link.

One ironic fact that I left out was that the Cardiologist who nearly killed my wife was pretty much forced to retire after he actually was found to be responsible for killing another patient of his. The patient was another doctor and was married to my wife's cousin. Even the people who worked for this "doctor" said that he was dangerous and only cared about his real estate and other hobbies. It was known by so many people and yet nothing was done until he killed another doctor.

[ejpoeta]

6. the biggest problem with the system is this vicious cycle....

you have doctors and hospitals who are afraid to admit making any mistakes because they might be sued then the patient ends up suing because no one even admitted making a mistake. this is part of the problem. then you have insurance companies that MAKE people sue them to get a dime. then you have people who will sue anyone or anything.... like things just don't happen. I have seen the ambulance chaser commercials about patients who've had babies born with illnesses or defects or lost the baby.... while there may be instances where the doctor did something wrong, i'm going to be that is rare..... things happen. doctors can't save everyone and prevent everything!! and the biggest travesty is that even when the patient SHOULD sue... really got screwed by an incompetent doctor, the lawyer gets most of the money!!

The idea that malpractice is a main part of the problems with healthcare costs is a joke! It may be a problem, but it's a small part of the problem exacerbated by how the system seems to have been manipulated by ambulance chasers . I personally believe that most people who have had something bad happen just want an apology. Maybe I am wrong, I don't know... and they want things fixed. Like the babies that were given the adult doses of the blood thinner.... the case involving dennis quaid and his wife. I believe the families wanted the problem fixed more than anything. And instead of overworking doctors and nurses, they need to have enough of them so that we don't have healthcare workers working extensive shifts with no break.... you are just asking for trouble!!

And we need to get rid of the doctors who are not good doctors. There are those out there. Instead of covering for them, there needs to be a way to weed them out... Most doctors are good doctors and they are getting screwed because of the ones that shouldn't be there. They shouldn't be able to hide behind hospital administrators who are only out to protect their own asses. It's almost like the church who would shuffle priests around but let them keep doing what they were doing.

[stray cat]

9. You are missing half the point - doctors do more tests than needed to avoid lawsuits

driving up costs

[rhett o rick]

11. So you believe that doctors shouldn't be held accountable for their performance?

That's the corporatist view. The surfs don't get to challenge big brother CorpAmerica via law suits. Tort reform for medical is only a red herring to distract from the main issue. Law suits are less than one percent of the cost of health care.

[Donnachaidh]

14. they also do more tests than needed to drive up THEIR fees

don't forget that little ditty. They have to read all those test results, and it ain't FREE, the patient gets charged for that.

[JohnWxy]

15. doctors are getting into the business of owning the facilities that do these diagnostic tests.

So when they consider whether a test is warranted they also know if they presribe the test they will be the one to recieve payment for conducting the test.

[treestar]

18. IMO they do the tests because they get paid to read the results

Don't some get kickbacks from the labs?

And it's not as if patients don't want as many tests as possible, it could be your life you're talking about.

[wolfgangmo]

23. Kickbacks no ... however ...

... they do get paid to read and interpret the tests. In most clinics they factor the price of analysis into the lab which means that an easy result means profit and tough results means that they don't get paid quite so much. At our clinic we don't include analysis in the lab prices but rather allow patients the option of either us, or another doc interpreting them.

And no, I don't think anyone can interpret labs. It's takes education and experience to understand the relationship between lab results and individual care and prognosis.

[Lucy Goosey]

10. A bit of regulation would go a long way, too...

In Miami, the average neurosurgeon pays $ 237,000 annually for malpractice insurance; in Toronto, they pay $29,200.

http://www.tampabay.com/news/article1021977.ece

A big part of the difference is that Canadian doctors don't buy private, individual insurance plans from for-profit companies - they get their coverage from the non-profit Canadian Medical Protective Association.

[JohnWxy]

12. I've sent suggestion to WH and some on the "Hill" that they "sweeten the deal" for doctors and offer

group malpractice insurance if they participate in the Public Option so they don't have to buy it as individuals - very expensive. Your comment put's some numbers to it. Thanks.

[treestar]

19. Whoah, I 'd love to try that on the freepers

When they go ballistic about costs of national health plans.

[Joanne98]

13. All they have to do is put the complaints online and people can find out

Who to avoid but NO!

We need an Angie's list for doctors!

[Aragorn]

16. In this state

(TX) the medical board has become an arm of political prosecution, with dangerous and/or deadly behaviors overlooked if done by a buddy of a board member, while stuff gets made up if you do politically unpopular things. I have done such terrible things as: turn in a DEA agent's sister for calling in prescriptions, calling out a racist cop, calling out jailing of mentally ill people (no treatment while there and no effort to admit instead)and may times have reported incidents of elderly abuse etc. I have had complaints made for refusal to commit fraud and refusal to prescribe drugs to abusers. Let's not even include my upside down flag on main street.

That's not what the complaints said when they were first made of course. Lots of hassle to defend BS. This state even allows anonymous complaints.

I testified for free in a case where an older doc killed a patient - he got a slap on the wrist. Later I learned he is a buddy of the former board president. Etc Etc Later still I had unfounded anonymous complaints made.

BTW that former president resigned because she was found to have made many anonymous complaints against other doctors, mostly her competitors.

So I agree with this post but keep in mind, docs may have a lot of complaints because they are doing things right. A better judge of actual competence is the number of malpractice suits lost.

[treestar]

17. Are we to assume they never commit malpractice?

Sometimes that is how it seems. I think they just consider every suit frivolous. Well, some are not. Probably most are not.

They should be no more sacred than anyone else. They get too many protections.

[wolfgangmo]

24. If a suit gets to court then...

it is likely not frivolous, but most suits that are brought will never see the light of day in court and those are frivolous.

What the RWer's are complaining about is the frivolous suits. However, under a single payer system, most of the frivolous suits go away and only the ones that remain are able to be tried in court. The reason most frivolous suits go away in single payer systems is that lawyers will not take cases there unless they have merit and can be won (assuming that they are working on a percentage) and the reason they won't take frivolous cases is that the profits on filing that kind of case is functionally zero BECAUSE the medical part of malpractice suits, which is what makes them so profitable here, do not exist in single payer systems. Think about it. All health care is covered so it is not part of any lawsuit.

[treestar]

25. I don't see what the difference would be; single payer or not

The lawyer has no incentive to take frivolous cases, especially with their fee awards capped.

Frivolous cases would be more likely to be filed by people without lawyers - individuals think malpractice is any result they don't like.

[BR_Parkway]

21. You'd think they wouldn't be able to get insurance at some point

[wolfgangmo]

22. Great post and you have great points but I disagree that it is the best way.

Why do I say this.

Well, I own part of a primary care clinic in MN. And our medical director (and majority owner) just asked me to start looking into moving the clinic, staff, lock, stock and barrel to Canada if single payer doesn't happen in the US. She is tired of dealing with a broken system, even peripherally.

Here's the thing. Malpractice insurance is dead cheap in Canada. I was curious about this and so I asked the agent about it and he said that reason that it is SO MUCH CHEAPER in Canada (compare about 24K a year to 2 K a year) is that medical care, the main payout in malpractice suits in the US, is considered part of health care and so the payouts are miniscule by comparison. It turns out that malpractice is small potatoes in any country that has single payer.

But we do need to get rid of the 5% of fools who call themselves doctors. The AMA is primarily responsible for the climate wherein a "white line" exists where doctors protect doctors.

[JohnWxy]

28. Weeding out those who really aren't doctors (not 'up' to it) isn't the whole answer. see link:

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=103&topic_id=479692&mesg_id=479738

[jberryhill]

26. What's funny in this debate is...

...that lawyers are always cast as the bad guys.

Lawyers also self-regulate, and are sued for malpractice. A greater proportion of lawyers get drummed out of the profession than doctors do.

[BREMPRO]

27. Very good point. Doc's and the AMA should take responsiblity and weed out the incompetents.

[JohnWxy]

29. what i don't get is you would think they would want incompetents out. They cast a shadow over the

entire profession. All they gotta do is just make sure these guys can't treat (harm) people. Let them have administrative positions. They can still make a living. But they are not competent enough to be doctors so why let them pretend they are - at people's (great) expense (sometimes meaning death).