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| Home > Legal > a discussion of myths and misconceptions regarding medical malpractice |
| a discussion of myths and misconceptions regarding medical malpractice | | Date Created: Feb 27, 2005, 05:09 PM |
A recent exchange with a highly educated but non-medical and non-legal colleage follows:
I'm definitely on your side as far as medical liability/tort reform, although I get the impression that the medical profession is incredibly poor about policing its own.
Not really. Not any more than other professional groups. And as you'd expect, there used to be better systems for doctors to "police each other" or at least learn from mistakes, but malpractice prosecution by free-enterprise plaintiff attorneys acting with the power of the courts have essentially shut this down. The other factor that lawyers refuse to acknowledge is that it's lawyers that are keeping bad doctors in practice. Doctors are afraid to accuse other doctors or serve on discipline or review boards because of lawyer driven litigation used by another type of plaintiff -- doctors accused of being bad doctors. There are, of course, other issues going on but the bottom line is that the current tort litigation "system" in the US doesn't police bad doctors, is incredibly inefficient and expensive, has countless unintended consequences that are making things worse rather than better, and the only ones who benefit are the lawyers (and the politicians who receive their contributions ).
My brother is a doctor and he has seen doctors who shouldn't be practicing (in his words "xxx is killing people"), but no one is willing to take any action to get them removed (this was in a university teaching hospital environment).
I could argue that I've seen that along the way too. Interesting that it's usually in a university teaching hospital setting. Can you imagine how that would be in a federal government run "university teaching hospital"? Again I use the VA as an existing example. Deciding that someone is a "bad doctor" and is dangerous and should be removed from treating patients is a complicated and difficult issue. It must be decided by doctors, not lawyers or bureaucrats or "consumer advocates" who are always politically motivated. These doctors cannot be viewed or in any way actually in competition with the accused and yet local conditions have to be understood. Things are different in Keokuk, Iowa than they are at Johns Hopkins. It cannot be done at the federal level. It's even very tough at the state level. There are no easy answers but I can assure you that plaintiff attorneys have none of them.
Another, related, issue is the problem of flunking out bad doctors or keeping them from getting licensed in the first place. I can tell you from personal experience that bad doctors don't become that way AFTER they get in practice. Clinical skills or their lack and particularly faulty ethics were evident when they were in training. The problem as I see it is that doctors with poor skills and bad ethics are rarely rewarded in the real world of clinical practice so the overall percentage of such doctors stays about the same. But for lawyers, the avaricious and unethical are HEAVILY REWARDED and thus the percentage of such lawyers (compared to hardworking and honest lawyers) will increase. Add the political power connection and you've got a real problem on your hands. And it ain't bad doctors.
From talking with him about both issues (liability and AMA not weeding out the incompetents)
You're falling in the trap of believing that the AMA is some sort of super-union of doctors. It's no such thing. It's the biggest and most visible professional organization but most doctors relate (and belong to) their specialty organizations. I don't belong to the AMA and I know few who do. I belong to five or six other professional organizations though. Each organization has rules for getting in and rules for kicking someone out but that's about all they can do. Licensing is handled by state's board of medical examiners who license doctors to practice in their state and who handle discipline and revoking licenses. They do a pretty good job (at least in Colorado) given the pressures they're under.
, I'd say that 95% of the problem is with lawyers and 5% with the doctors/AMA. Do you agree?
I can't come up with a percentage. One way to look at it though is that the changes in the law that allowed the malpractice litigation crisis have not solved anything but have made it far worse in spite of doctors today actually being better trained. That's one of the reasons that trial lawyers, advocacy groups, and the media have to create a "state of fear" (using Michael Crichton's term) in order to maintain the facade that they're helping people against all those bad doctors.
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