Early good news in Pennsylvania?

One year's data clearly isnt enough to discern a pattern, but it looks as if some of the reforms in Pennsylvania might be taking hold:

Data released this week by the Pennsylvania Supreme Court showed a sharp drop in malpractice lawsuits since reform measures took effect in 2003. The 1,815 suits filed last year was 34 percent lower than the average number of suits in 2000-2002.

A key provision of the reforms was to stop so-called "venue shopping" in which lawyers representing alleged malpractice victims found ways to move cases to Philadelphia, where juries are notoriously sympathetic to victims. Indeed, malpractice cases filed in Philadelphia in 2004 were down 54 percent from the 2000-2002 period the Supreme Court used as a basis point.

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Wow - automated blogger comments

Dont think those existed when i last posted almost a year ago.... Let's see if the word feature blocks them.

Most lawsuits against doctors are over bad outcomes, not malpractice

From South Carolina:

Many physicians acknowledge that their profession has not done enough to reduce medical errors. They argue, correctly, that lawsuits are not the best way to solve the problem: Most lawsuits against doctors are over bad outcomes, not malpractice; and most cases of actual malpractice don’t result in lawsuits, or in any other punitive action. But simply supporting new procedures aimed at systemic errors or wishing the lawsuits would go away isn’t a sufficient answer to the problem. As long as the state operates a self-policing system for physicians, its primary goal should be to discipline that tiny minority of doctors whose carelessness or incompetence truly poses a risk to patients.

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"The best thing I have ever done"

Anecdotal evidence about malpractice driving physician movement from the Yale alumni mag (via pointoflaw.com):

If people tell you tort reform isn't important, don't believe them. The
contrast between practicing in a highly litigious area versus a low one is
incredible. While I knew it was taking a toll on my life and affecting my
practice style, I had no idea how much until I got out here. Using my clinical
judgment without the threat of second-guessing and Monday-morning quarterbacking
not only improves care, but also drastically cuts down on CYA testing. It's
great to be a doctor rather than a fearful technician wondering from where the
next hit is coming. ...

There are 2 other similar stories

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Medical Courts

I'm a little late in getting to this, but an interesting debate is taking place at Legal Affairs magazine:

George W. Bush is pushing an aggressive agenda for reforming medical malpractice law, with a focus on capping the amount of damages patients can be awarded if their doctors harm them. But some advocates suggest a completely different reform: "health courts." These jury-less courts would deal only with medical claims and be administered by trained healthcare professionals. This, supporters argue, might improve healthcare by providing quicker resolution to malpractice suits and limiting frivolous claims.

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Malpractice case payouts jump in Pennsylvania

The beat goes on in Pennsylvania...

Insurance companies and other underwriters in Pennsylvania reported a steep jump last year in payments for malpractice claims against physicians, according to a federal agency.

In 2004, insurers reported paying out $448 million, a 13.5 percent jump from $394.5 million reported in 2003, according to the U.S. Health Resources & Services Administration. The 2004 figure broke the previous record, which had been set in 2001.

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Medical review panel

From Wyoming, where voters recently authorized the creation of a review panel to try and keep frivolous malpractice lawsuits out of the courts in the first place:

The medical review panel legislation was introduced to screen
medical malpractice lawsuits in the hopes of eliminating frivolous suits before
they rack up costs that contribute to high medical malpractice insurance
premiums. Some say these premiums are driving doctors out of practice in
Wyoming.

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Watch out Vets...

...you're next. From the USA Today:

It's a typical medical malpractice case - except in this 3-year-old dispute, the patient was a sheepdog named Lucky.

Barry Silver, the attorney for Lucky's owners, says that when the case goes to trial this year in Broward County, Fla., he intends to ask jurors to award hundreds of thousands of dollars to the dog's owners, Adam Riff and his mother, Ellen.

...

The largest judgment in favor of a pet owner has been $39,000, which a jury in Orange County, Calif., awarded last year to Marc Bluestone.

His mutt, Shane, died of liver failure after a misdiagnosis. In a verdict that is being appealed by the vet, the jury awarded Bluestone $30,000 for the dog's "unique value" to his owner, and $9,000 for vet bills.

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Fighting back against frivolous lawsuits

From Ohio:

Dr. Zev Maycon has found his name attached to four malpractice lawsuits in the
past three years.

In each case, he was dropped from the suits before they went to trial. But with the last one, he'd had enough. He asked the judge to sanction the plaintiff's attorney for filing a frivolous lawsuit against him in Stark County Common Pleas Court.
Visiting Judge Roger G. Lile agreed with Maycon, finding ``frivolous conduct'' by the attorney, Catherine Little, and ordering her to pay him $6,000.

``Basically, they had no real case against me,'' said Maycon, a Canton gastroenterologist. ``The expert witness they had had no criticism of me.... When I couldn't get dropped from the lawsuit and was essentially extorted, I said, `This has to stop. This is wrong.' ''

An interesting statistic buried in the article:

Nationwide, slightly more than six out of every 10 malpractice suits filed are
either dropped or dismissed, according to the Physician Insurers Association of
America. More than three in 10 are settled before trial. Fewer than one in 10
makes it to trial, and, of those, patients prevail in only one in five cases.

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Should doctors and lawyers be on the same side?

Sherry, a reader, brings up an interesting point:

Ca was the first to institute cap laws in the 70's. ( *250k ) However, the med mal insurance rates continued (a proved cycle) until they passed Prop. 103.

Insurance reform.It is insurance reform that works, not tort reform.

Are the insurance companies getting a free ride here?

Malpractice Insurance Companies: Stop Gouging

Washington (state) orders insurance companies to refund premiums to doctors:

After years of their lobbyists calling for caps on plaintiff's damage awards, squeezing lawyers' contingency fees and trying to throw litigation roadblocks in
the way of injured patients and their families, the state's doctors may have
found a legitimate way to cut medical malpractice premiums: Get their
malpractice insurance company to quit gouging them.

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NY Times: Malpractice Lawyers are Resourceful

The New York Times published a piece on malpractice this weekend.

In states that already cap some damages - the ones labeled "pain and suffering" - the study finds that total awards have remained pretty much the same. This suggests that plaintiffs' lawyers have simply recast their cases to encourage juries to award the same amounts under different names - for, say, "lost wages."

However the study ignores cases that are settles out of court:

The new study, by Catherine M. Sharkey, a law professor at Columbia, may change
that. The study, to be published in the New York University Law Review in May,
analyzed jury verdicts in 22 states in 1992, 1996 and 2001. It did not consider
cases settled out of court. It found that the median compensatory award in
states with caps on damages was $324,000, compared with $387,000 elsewhere -
figures that Professor Sharkey found were roughly equivalent after the data was
adjusted for variables like the kind and number of plaintiffs and defendants,
the percentages of local doctors and lawyers, and jurors' wealth and ages.

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Discussion of Tort Reform Proposals

From DDL, who has posted here several times. DDL's blog debates the pro's and con's of many of the tort reform proposals that have been discussed here, and elsewhere. Definitely worth a read (or a bookmark).

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Taxing lawyers and doctors

This note, from RiskProf is about tacing lawyers and doctors to help pay for insurance. Seems as if the insurance companies are the only winners here, doesn't it? The costs are just being spread across a wider group of people. Doesn't stop the progress of frivolus malpractice lawsuits or reduce the systemic costs:

NJ is taxing lawyers $75 per capita to contribute to a med mal insurance
assistance funds which will be used to subsidize med mal premiums.
Employers are also paying $3 per employee and medical professionals are
also being subject to a $75 per capita tax.

AM Best is reporting that a NJ trial court has denied a temporary
injunction requested by the NJ bar association.

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Chipping away at the malpractice problem...

In Virginia, they are looking at excluding premature babies from the litigation process. The argument is that prematurity causes many of the bad outcomes rather than medical error:

"Proponents of the weight limit said that such injuries are a consequence of prematurity, not the birth process. Because bad outcomes in premature infants are frequently unavoidable, they should be ineligible for a program that focuses on birth-related events that can produce malpractice actions, they said.

Studies of the program, however, have warned since its earliest days that as many as a third of malpractice actions against doctors and hospitals involve premature infants."

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Meanwhile, in Arizona, they are looking at asking patients to waive their right to sue before receiving medical care. There are similar plans in many states for buying "limited tort" options for car insurance:

"The notion of shifting to a contract-law system where patients waive their litigation rights was among a handful of ideas mentioned at the Arizona Litigation Reform Summit on Friday. Other included getting doctors to lobby their patients for reform and paying injured patients over time rather than in one lump sum. "

The same article describes attempts to cap the hourly fees that lawyers can earn. Not sure if that is the right answer, but I do tend to think that $20K per hour is a bit excessive:

"Jon Kyl, R-Ariz., in explaining that he tried to pass federal legislation to limit lawyer fees to $2,000 per hour, then $10,000 per hour and finally $20,000 per hour. The bill failed after winning just 37 votes in the Senate. "

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Debate arrives here

Good to see debate on both sides of the argument:

DDL talks about how the three strikes law benefits lawyers:

"Plaintiff Trial lawyers don't like trials. That's right. Why? because they lose most of them. What they do like is the unpredictibility of a trial. Sure they will lose most of them but they could win and win big. That makes defendants want to settle. Settlements are good. A lawyer is sure to get his paycheck in a settlement, but in a trial they will most likely have to eat their court costs.Three strikes law will encourage settlements. If you are a doctor getting sued do you want to risk losing your license? of course not. you settle. This will increase the numbers of malpractice suits filed in Florida. "


An anonymous user rebuts :

"Of course, the big difference between ddl's argument and mine is that if malpractice goes away, lawyers can always make money sueing tobacco companies. What are doctors going to do if lung disease, heart disease and obesity go away? Golf all the time?

The fact is that if you believe the insurance industry argument that medical malpractice claims are driving up medical malpractice insurance rates (a questionable argument), than it makes good sense to get the handful of doctors who are responsible for the vast majority of malpractice out of the risk pool. Here in Illinois, 3.6% of docs are responsible for 47% of malpractice cases, according to federal records."

Something that we lose sight of

I recently rewatched the PBS special on what it takes to become a physcian. Surely there are easier ways to feed the kids and payback loans (or avoid them in the first place!).

Here is a note from the producer of the series:
"Years ago, when I was trying to decide what to do with my life, two passions surfaced almost simultaneously: moviemaking and medicine. In my 20s and 30s, when things were not going well in the film business, I applied several times to medical school.

Making this series of films about medical training has made me realize how fortunate I was to be turned down! I now know that I would never have survived the course. Also, I've seen firsthand how potentially all-consuming of one's time medicine can be, and I'm sure I would never have been able to achieve a healthy balance between my work and non-work lives.

It is an extraordinary privilege to be a doctor, but that privilege comes at an extraordinary price. As Luanda Grazette, one of our seven students, puts it, "Medicine is only for those people who cannot contemplate doing anything else with their lives." "


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Florida Malpractice Update

More debate onthe "three strikes" ammendment in Florida:

"The new amendment and another one - both pushed by trial lawyers - would force doctors and hospitals to release records of medical mistakes and would revoke the license of any doctor hit with three malpractice judgments. Doctors, hospitals and the state agencies say they are ambiguous and can create confusion.

The amendments are the latest twist in the medical malpractice fight in Florida. The Legislature, which approved a half million dollar cap on some types of malpractice awards two years ago to stem skyrocketing premiums and bring down medical costs, again will find itself thrust in the middle when lawmakers return to work March 8.

Doctors and hospitals are hoping the Legislature will pass bills to resolve questions they have about the amendments. But trial lawyers see the concerns raised by medical professionals as a smoke screen to get lawmakers to water down the new rules."

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