Sunday, June 20, 2004

Med mal reform: speaking truth to power.

Bob Herbert nails the problem with med mal reform in the last third of an 800-word column that will appear in this morning's (6/21) N.Y. Times:
[T]he problem when it comes to malpractice is not the amount of money the insurance companies are making (they're doing fine) or the rates the doctors have to pay, but rather the terrible physical and emotional damage that is done to so many unsuspecting patients who fall into the hands of careless or incompetent medical personnel.

What is needed is a nationwide crackdown on malpractice, not a campaign to roll back the rights of patients who are injured. This is another utterly typical example of the Bush administration going to bat for those who are economically and politically powerful against those who are economically and politically weak.

Despite claims by the insurance industry, there is no evidence that soaring malpractice premiums are the result of sharp increases in the amounts of money paid out for malpractice claims. And, tellingly, industry executives are generally careful not to say that the tort reforms sought by the Bush administration will result in premium reductions.

This is all about greed. What tort reform will lead to, not surprisingly, is an unwarranted burst of additional profits for the insurance industry, which is why the industry is sinking so much money into its unrelenting campaign for "reform."

It would be helpful if the nation's many good doctors would blow the whistle on the insurance industry and its exploitive practices, and on the members of their own august profession who violate that essential maxim, "First, do no harm."

6 comments:

Anonymous said...

Not to defend the insurance companies, or incompetent docs, medical malpractice reform is not quite as clear-cut as the columnist would lead us to believe. As Brennan, Mello, and others have shown, there is a tendency for those who suffer harm from negligence to NOT sue, and there is a tendency for those who are not harmed by negligence, to sue. Merely capping damages does nothing to address this problem. What MIGHT help is to incentivize improvements in quality while preserving the right of the injured to sue. One way to do this would be to allow doctors who follow clinical practice guidelines to use them as an affirmative defense to a medical malpractice claim. It's not the ultimate fix, but it's a start.
DL

Tom Mayo said...

I've always liked this approach (practice guidelines as an affirmative defense), which Maine, at least, experimented with. Does anyone know what the report card has been on that system? As I understand it, the practice guidelines had to be adopted by Maine physicians in relevant specialties before they could be used as an affirmative defense.

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