- Joined
- Aug 21, 2007
- Messages
- 7,846
- Reaction score
- 13,502
Any of our legal eagles or Capitol Hill Bills want to comment?
House passes medical malpractice bill
House passes medical malpractice bill
Last edited:
I'm not EM but if there is a big shift towards lower cost providers, I bet its short lived. The various specialties that cover ED call may think y'all are pains in their asses now but just wait til every ED is staffed with FPs and midlevels who consult twice as often for half the acuity cases. They will be begging for EM-trained folks to come back and since the hospitals listen when their cardiologists and orthopedists complain...It would likely run into a 10th Amendment challenge from the states. If it passes, it will be interesting for the courts, since conservatives generally favor states rights and put more emphasis on the 10th Amendment. (See the current healthcare debate and the desire to give states flexibility.) Liberals favor the right to sue with no damage limits but also like federal power. IF it passes, it would be a case with a good chance for the Supreme Court to take since it involves an issue that is getting some attention. It would be interesting how they would vote on it because as I said it puts both liberals and conservatives in a situation where their most basic beliefs are in conflict.
However, the more I see the more I have a feeling that big malpractice awards might just be our best friend. That is what keeps hospitals in many cases from hiring specialty trained physicians over mid-levels or lesser trained physicians. Without that concern, it makes the lower cost labor source more attractive. It is all about the bottom line, if you think they care about "quality of care" you are insane. They are also not generally really smart at looking at efficiency and more indirect costs. If they think they can hire some guy with "state minimum training" for half the cost with no downside, they will do that. Or more likely, a guy with a Family Med residency for 75% of the cost.
I also think the elimination of "joint and several" liability is bad for physicians - particularly EM physicians - and probably comes from the hospital lobby. Now, even if it is a big award, EM physicians are generally in the clear because attorneys will go after the "deep pockets" of the hospital when it comes time to collect. If it is based on degree of fault, that puts a much bigger target on the physician, and if they don't have any other choice they will go after the physician's assets. Now it almost never happens because it is not worth the effort, and there are more fruitful targets. So that is a very bad provision for us.
There is one fundamental rule of medical economics: Things never work out the way you expect. What you often think is you best friend ends up your worst nightmare (see Anesthesiologists and CRNA's.) I just have a bad "spidey sense."
However, the more I see the more I have a feeling that big malpractice awards might just be our best friend. That is what keeps hospitals in many cases from hiring specialty trained physicians over mid-levels or lesser trained physicians. Without that concern, it makes the lower cost labor source more attractive. It is all about the bottom line, if you think they care about "quality of care" you are insane. .........
.........
I also think the elimination of "joint and several" liability is bad for physicians - particularly EM physicians - and probably comes from the hospital lobby. Now, even if it is a big award, EM physicians are generally in the clear because attorneys will go after the "deep pockets" of the hospital when it comes time to collect. If it is based on degree of fault, that puts a much bigger target on the physician, and if they don't have any other choice they will go after the physician's assets. Now it almost never happens because it is not worth the effort, and there are more fruitful targets. So that is a very bad provision for us.
In a way, it might be a good thing for Texas, as it will allow physicians to spread out across the US instead of localizing into Texas for the tort reform protections, thus reducing the number of EM docs here, leading to a shortage, and thus increased $$/hr. Atleast thats my convoluted way of looking at it. Keeping in mind that this only caps non-economic damages, juries can still place punitive damages on hospitals for negligence.If you already live in a state with those caps, like say, Texas, or Michigan, I don't think it will change anything.
Sent from my iPhone using Tapatalk
My favorite part of the Texas deal isn't the cap – it's the willful and wanton standard in the Emergency setting.
I also think the elimination of "joint and several" liability is bad for physicians - particularly EM physicians - and probably comes from the hospital lobby. Now, even if it is a big award, EM physicians are generally in the clear because attorneys will go after the "deep pockets" of the hospital when it comes time to collect.
No way that national tort reform will be constitutional. It is a state issue.
Can someone explain this more? I don't see why the debt collectors woudn't go after the hospital and the physician.
Could you please explain what that means? I know what it sounds like in plain english but maybe a little bit more in legalese? TIAMy favorite part of the Texas deal isn't the cap – it's the willful and wanton standard in the Emergency setting.
It is easier/cheaper to get a judgement paid by a corporation rather than an individual. (Or more specifically, a "real" corporation with actual assets.) It is essentially the same reason why physicians write off so much debt, except on a larger scale. With "joint and several" the hospital is fully on the hook, and it is tougher for them to evade the judgement. To go after a person - even a physician - is expensive. That is the reason why debt collectors buy debt at a very deep discount. That is also the reason why plaintiffs almost always eventually settle for coverage limits, even when they get a bigger judgement.
Fundamental rule: Lawyers always follow the path of least resistance.
Could you please explain what that means? I know what it sounds like in plain english but maybe a little bit more in legalese? TIA
H.R. 1215 is interesting, and will be challenged for sure. I think it's dead in the water in the Senate though. I'm very active politically, and I have been told this is not likely to pass the Senate and may not make it out of committee.
Rep. King claims that Article I, Section 8, Clause I (the Spending Clause) and Clause 3 grants Congress the ability to pass uniform laws that remove barriers to trade and facilitate commerce nationwide. Article I, Section 8, Clause 9; Article III, Section 1, Clause I; and Article III, Section 2, Clause 2 grants Congress authority over federal courts.
In theory, this may be enforceable if it passes and Trump signs it into law. This is especially true of anything in federal court, but most of this is handled by the states.
The CBO estimates this will save the federal government $50 billion over 10 years.
Will be watching this as it makes its way through the Senate. It was referred to the Committee on the Judiciary. I have a feeling Feinstein (who is a ranking member on the committee) will have a lot of vocal opposition. I will discuss this with Sen. Isakson's health legislative assistant next week.
This isn't always true. Sometimes plaintiffs go after physicians and their groups and not the hospital. I am aware of one such case recently.
Some states also allow awards based on percentage of liability. One case where a physician ordered a wrong medicine led to an award above his malpractice limit. He was found 90% responsible and the hospital nurse 10% responsible for not double checking it. The award exceeded his malpractice coverage by more than 300% and is currently in appeal.
How many times can this sort of thing be appealed? Where the heck is a doctor going to come up with 3 million dollars? Certainly this lack of capital would be a factor in an award, right?
Which is ironic, because the $250k limit on non-economic damages has been CA law for four decades, just overwhelmingly upheld by CA voters via referendum in 2014.Will be watching this as it makes its way through the Senate. It was referred to the Committee on the Judiciary. I have a feeling Feinstein (who is a ranking member on the committee) will have a lot of vocal opposition. I will discuss this with Sen. Isakson's health legislative assistant next week.
Which is ironic, because the $250k limit on non-economic damages has been CA law for four decades, just overwhelmingly upheld by CA voters via referendum in 2014.
The award exceeded his malpractice coverage by more than 300% and is currently in appeal.
I got an AAEM notification that this bill got voted on and passed on wednesday? at least if I'm reading it correctly. im a little sleep deprived but I think thats what it says. it says "the provisions would apply to healthcare lawsuits where coverage was provided or subsidized by the federal govertment. th bill would preempt state laws". does this mean then it only applies to VA type settings?
Any CMS shop likely.I got an AAEM notification that this bill got voted on and passed on wednesday? at least if I'm reading it correctly. im a little sleep deprived but I think thats what it says. it says "the provisions would apply to healthcare lawsuits where coverage was provided or subsidized by the federal govertment. th bill would preempt state laws". does this mean then it only applies to VA type settings?
It should be noted that most of these are reduced to policy limits on appeal.
Do you have a source for this? Although I know anecdotally that personal assets are rarely (if ever) at risk, I would love to be able to back the point up for a lecture I'm preparing on litigation in EM.
I got an AAEM notification that this bill got voted on and passed on wednesday? at least if I'm reading it correctly. im a little sleep deprived but I think thats what it says. it says "the provisions would apply to healthcare lawsuits where coverage was provided or subsidized by the federal govertment. th bill would preempt state laws". does this mean then it only applies to VA type settings?