Medical Malpractice Crisis from a Physician

There was a blog entry in The USA Today on April 23, 2008 written by a doctor.

The article talked about the cost of wasted health care dollars in America caused by physicians practicing defensive medicine. As a physician, I can understand the reason so many doctors order tests that they didn't order 20 years ago.

The reality of a lawsuit for a patient result which could not have been prevented is something doctors deal with on a daily basis. Medicine is indeed an art and a science but bad things happen and in surgery, there can be complications. A lot of people equate complications with "something was done wrong". Good informed consent and good communication with your patient and their family are essential to practicing good medicine and limiting the possibility of a lawsuit. There are times when that just isn't going to stop legal action when a recognized complication has occurred and the standard of care has not been breached .In those cases the best medical records and documentation are your best defense. It is very difficult sometimes to not order tests which might otherwise be deemed unnecessary. If you are ultimately involved in a lawsuit and no malpractice has occurred, the odds are greatly in your favor that the justice system will work and you will be cleared. One problem is that insurance companies sometimes settle claims which are defensible simply for economic reasons even if everyone believes the case is defensible. The cost of trying the case is deemed to be more risk than a settlement.

I remember the first time I was ever involved in a lawsuit was 2 years after leaving medical school. I was an Air Force physician living in Culver City, California. I was moonlighting at an emergency room in Los Angeles and a patient was brought to the ER who had been sandwiched between two cars at a local gas station injuring his knees. I examined him and admitted him to the hospital under the care of an orthopedist. Some months later a sheriff's deputy knocked on my front door early one morning and handed me a summons saying I was being sued for medical malpractice.

I remember looking at the summons and there was one other nurse listed by name and then Dr. John Doe III to XV and nurse Jane Doe III to XV. I was totally depressed for several months because I took it very personal and eventually two years later with me living in Washington, DC, I was dismissed with prejudice. I remember thinking that must mean I could still be sued, but of course I soon found out that that legal term meant I was totally free.

There is no way I was guilty of anything but practicing good medicine and whatever happened to that patient in that hospital occurred after he was admitted and I was caught up in the legal quagmire as is so often the case.

I now know you can always be sued and you had better make sure you have good records. Unfortunately that means doing things in your practice with the thought that you might be sued 2 years from now. The reality of being sued is very personal and if you have insurance, you probably are not going to suffer financially but emotionally it is very personal. I know I always treat my patients as I do my closest family and I give the best care possible. You never know if you are going to be sued and statistically it is going to happen. There is no question there are cases of malpractice that occur and I have seen and reviewed such cases. The liability crisis is not confined to medicine by any means. Health Care costs will continue to be partially dictated by the legal climate we work in. The cost of my paying for insurance is in excess of $25,000 per year which is probably a bargain because some physicians pay triple or quadruple that in other specialties and other states.

The solution to lost and wasted health care dollars needs to be addressed but the solution might be as complicated as solving all our problems in the Middle East.