07-17-2012, 04:15 PM
lafinfil wrote:
No offense to you personally, because I am sure that you are a good doctor. As I see it one major problem with the malpractice "crisis" is the refusal over the years for the medical profession to police itself and rid itself of the bad actors instead of looking the other way (primarily state medical licensing) Get rid of the revolving door of drug addicted anesthesiologist, the sloppy surgeons, etc... would be a start. Letting them walk away to go practice in a different state may solve a local problem but not a systemic one. In all your years have you ever questioned the actions of a peer? If so did you speak up ?
I was an observer from within for 15 years and an observer / advocate from the patient side for more than that (still am) If my mother or uncle is in need of care, I work my list of old contacts and ask for "non-recommendations". Who should we avoid, and then who should we see. Docs I know were complaining about the same (malpractice) over 30 years ago so this is nothing new IMHO - just a new convenient target. It's one of those "heal thy self" things but the overseers of the profession don't seem willing.
First off, the so called, 'bad' doctors (i.e. those with many malpractice losses) are frequently taking care of high risk patients. It is ONLY the plaintiff attorneys who label these doctors as, 'bad'. I sit on my hospital's peer review board--and yes, mistakes happen--but there are almost always extenuating circumstances. Very rarely do I find a doctor who has done something truly egregious, but to answer your question, yes, I've fired those extremely rare 'bad' physicians (only 1 or 2 over a 15 year experience in administration). It's far trickier than you imagine, as there are always grievance meetings and due rights from human resources. Also, hospitals are not allowed to arbitrarily deny privileges to doctors--unless there are specific and substantiated reasons, if a physician presents the appropriate credentials and meets the standards, the hospital is obligated to grant privileges. (BTW- these rules and regulations were created by other lawyers who make the cost of doing business more expensive.)
To address the issue of legitimacy of malpractice suits, if I recall correctly (I'll try to find the reference), Harvard law school's study many years ago demonstrated that only one third of all malpractice settlements and judgements were in fact as a result of malpractice. Furthermore, of the cases of legitimate malpractice, only 40% of the patients actually ever sued. The data was based upon closed cases and peer reviewed data, and the Harvard Law team had the Harvard Medical team review the medical cases. When that study was released, it quickly became apparent to me that lawsuits mean nothing about the quality of the physician. Nothing.
What the Harvard study meant to me was that lawyers are far worse at screening out 'bad' lawsuits. If there is a profession which needs to be brought under control, it is law and judisprudence. I think that the entire law profession should be required to do a top down review of their practices and policies to ensure that only legitimate cases are brought to trial.