- Joined
- Jul 4, 2004
- Messages
- 274
- Reaction score
- 0
I was wondering how MD/MBA's would use their MBA's to try and control the costs of malpractice?
Any ideas or brainstorming?
Any ideas or brainstorming?
Slaying Malpractice Demon
- Thread starter Aucdoctobe
- Start date
mward04
SDN Moderator
Moderator Emeritus
Partner Organization
10+ Year Member
5+ Year Member
15+ Year Member
- Joined
- May 21, 2004
- Messages
- 419
- Reaction score
- 2
Seriously, I think there are so many facets to Malpractice that it's a daunting task. First of all, I don't think that capping awards at $250K is the answer. I'm sorry, but if a doc really screws up and you are permanently disabled as a result, you deserve a helluva lot more.
I think a more serious problem is the number of frivolous lawsuits. There are no ramifications for bringing a faulty claim against a doctor. Insurance companies are incredibly willing to settle rather than go to court. In addition, this suit is a black mark against the physician regardless of the merits. I think if you make it harder to bring lawsuits plus you couple that with the fact that faulty claims (without merit) are made to pay legal expenses etc. you will see the number of claims drop dramatically. Let the legitimate suits stand and punish those who are trying to get a free ride.
I don't have specific numbers, but I am willing to bet that it's the settlements that are dramatically increasing the cost of malpractice, not the number of big payouts which still remain low.
- Joined
- Jul 4, 2004
- Messages
- 274
- Reaction score
- 0
As usual, Michael has presented some excellent answers.
Now, I want to put in my 2 cents. This comes from someone who worked/slaved as an auto and property adjustor for 5 months. During that time, I learned a lot about insurance.
Most doctors are only exposing their lack of understanding if they believe that capping malpractice suits is the complete answer to the problem. Not so. This was attempted in the auto industry. It worked temporarily. However, it ultimately failed to stop auto insurance premiums from rising. The reason is because the number of claims continued to go up! Just do the math. Compare 2 claims that cost 100K a pop with 45 claims that cost 5K a lawsuit. You can see the amount of money lost. Also, this doesn?t even begin to take into account extra charges: for example, more manpower equaling higher wages. This really did happen in states like New Jersey and Texas. Plus, it?s happening in other states as well. People are greedy.
So, the key is a lawsuit deterrence strategy not monetary cap. I would use my knowledge of business and litigation to install these controls:
1. In medicine, there is still an original contract between the doctor and the patient. The contracts must begin to include lawsuit deterrence strategies. I can?t think of one successful business industry that does not include lawsuit deterrence strategies in their contracts. Medicine is the only one I can think of that does not do that. There is a lot that can be done when you enter into a contract with someone. This needs to be done.
2. I would recommend creation of a nonprofit medical lobbying group that specifically negotiates with insurance underwriting to set premiums and determine policies. I also recommend that the local state department of insurance govern these agreements. This will give validity to their agreements. Right now, I have seen nothing like this. Insurance is regulated mainly by the state.
In other words, doctors need to work with insurance companies to determine policies that lower premiums. The policies then need to be approved by the state department of insurance.
3. Both doctors and insurers need to push legal reforms that will make it harder to bring about malpractice suits. Certain states did this with auto insurance, and those are the states with the lowest premiums. Doctors and insurers are two very powerful groups. In this case, they can work together and get it done.
These are my beginning suggestions!
By the way, the people negotiating these agreements will need to have an excellent view of all sides. Might I suggest that MBA/MD?s be used for this purpose.
Now, I want to put in my 2 cents. This comes from someone who worked/slaved as an auto and property adjustor for 5 months. During that time, I learned a lot about insurance.
Most doctors are only exposing their lack of understanding if they believe that capping malpractice suits is the complete answer to the problem. Not so. This was attempted in the auto industry. It worked temporarily. However, it ultimately failed to stop auto insurance premiums from rising. The reason is because the number of claims continued to go up! Just do the math. Compare 2 claims that cost 100K a pop with 45 claims that cost 5K a lawsuit. You can see the amount of money lost. Also, this doesn?t even begin to take into account extra charges: for example, more manpower equaling higher wages. This really did happen in states like New Jersey and Texas. Plus, it?s happening in other states as well. People are greedy.
So, the key is a lawsuit deterrence strategy not monetary cap. I would use my knowledge of business and litigation to install these controls:
1. In medicine, there is still an original contract between the doctor and the patient. The contracts must begin to include lawsuit deterrence strategies. I can?t think of one successful business industry that does not include lawsuit deterrence strategies in their contracts. Medicine is the only one I can think of that does not do that. There is a lot that can be done when you enter into a contract with someone. This needs to be done.
2. I would recommend creation of a nonprofit medical lobbying group that specifically negotiates with insurance underwriting to set premiums and determine policies. I also recommend that the local state department of insurance govern these agreements. This will give validity to their agreements. Right now, I have seen nothing like this. Insurance is regulated mainly by the state.
In other words, doctors need to work with insurance companies to determine policies that lower premiums. The policies then need to be approved by the state department of insurance.
3. Both doctors and insurers need to push legal reforms that will make it harder to bring about malpractice suits. Certain states did this with auto insurance, and those are the states with the lowest premiums. Doctors and insurers are two very powerful groups. In this case, they can work together and get it done.
These are my beginning suggestions!
By the way, the people negotiating these agreements will need to have an excellent view of all sides. Might I suggest that MBA/MD?s be used for this purpose.
mward04
SDN Moderator
Moderator Emeritus
Partner Organization
10+ Year Member
5+ Year Member
15+ Year Member
- Joined
- May 21, 2004
- Messages
- 419
- Reaction score
- 2
Only one slight correction...the number of claims has remained steady over the past decade but the payouts have increased approximately 70% from around $2.9B to $4.9B. So why are juries paying out more or are lawyers being more selective in the cases they try?
Also, I don't believe that settlements are covered in this figure...maybe more cases are settled and the ones that have more "merit" go to trial and get reported in this figure...I don't know.
source: http://www.ama-assn.org/amednews/2004/06/07/prca0607.htm
Also, I don't believe that settlements are covered in this figure...maybe more cases are settled and the ones that have more "merit" go to trial and get reported in this figure...I don't know.
source: http://www.ama-assn.org/amednews/2004/06/07/prca0607.htm
- Joined
- Jul 4, 2004
- Messages
- 274
- Reaction score
- 0
Interesting Michael..
I would like to see some of the statitical controls and parameters for those figures.
It does seem counter intuitive to a degree.
I would like to see some of the statitical controls and parameters for those figures.
It does seem counter intuitive to a degree.
- Joined
- Jan 19, 2003
- Messages
- 1,535
- Reaction score
- 3
I think any attempt to better healthcare through litigation and regulation is misguided.
For one things, regulations will only serve to handcuff healthcare providers, hospitals, and insurers. In addition, I think it is hopeless to try to regulate effectively and efficiently in an industry like medicine that is so tied with the state-of-the-art. Patient care is a constant educational process, and the inability of policy to keep up with patient needs is a major concern.
Also, litigation creates a silo mentality among doctors and insurers; this mentality encourages the hiding of mistakes. In a field as critical as healthcare, mistakes cannot be hidden. They must be recognized and fixed. I do think malpractice lawyers play an important role in our healthcare system -- poor care must be punished. However, the effect that malpractice lawsuits have on the psyche of doctor-lawyer relations helps no one.
I think an open-ended move would be best. Set up a system of care whereby the quality of service (measured in terms of health improvement, decreased mortality, etc.) would dictate compensation. Instead of having a system where poor care is sometimes more profitable, we need to incentivize the progress towards good health.
Sure, there are lots of details that need to be worked out (how to place values on care and quality of life, for example), but I think that they can be.
Sorry, I might have gone off on a tangent. Hopefully, I contributed something of interest.
For one things, regulations will only serve to handcuff healthcare providers, hospitals, and insurers. In addition, I think it is hopeless to try to regulate effectively and efficiently in an industry like medicine that is so tied with the state-of-the-art. Patient care is a constant educational process, and the inability of policy to keep up with patient needs is a major concern.
Also, litigation creates a silo mentality among doctors and insurers; this mentality encourages the hiding of mistakes. In a field as critical as healthcare, mistakes cannot be hidden. They must be recognized and fixed. I do think malpractice lawyers play an important role in our healthcare system -- poor care must be punished. However, the effect that malpractice lawsuits have on the psyche of doctor-lawyer relations helps no one.
I think an open-ended move would be best. Set up a system of care whereby the quality of service (measured in terms of health improvement, decreased mortality, etc.) would dictate compensation. Instead of having a system where poor care is sometimes more profitable, we need to incentivize the progress towards good health.
Sure, there are lots of details that need to be worked out (how to place values on care and quality of life, for example), but I think that they can be.
Sorry, I might have gone off on a tangent. Hopefully, I contributed something of interest.
- Joined
- Jul 14, 2004
- Messages
- 886
- Reaction score
- 8
ortho-mdmba said:
I have been very outspoken about these issues... from other posts on studentdoctor.net and other sites:
In lieu of last week's Supreme Court validations of ballot initiatives for several medical malpractice issues in FL make me excited yet nervous at the same time.
The good:
The Medical Liability Claimant's Compensation Amendment Ballot Summary:
http://www.citizensforafairshare.org/
Proposes to amend the State Constitution to provide that an injured claimant who enters into a contingency fee agreement with an attorney in claim for medical liability is entitled to no less than 70% of the first $250,000.00 in all damages received by the claimant, and 90% of damages in excess of $250,000.00, exclusive of reasonable and customary costs and regardless of the number of defendants. This amendment is intended to be self-executing.
The bad:
Physician Shall Charge the Same Fee for the Same Health Care Service to Every Patient
http://election.dos.state.fl.us/initiatives/initdetail.asp?account=35169&seqnum=11
Current law allows a physician to charge different prices for the same health care provided to different patients. This amendment would require a physician to charge the same fee for the same health care service, procedure or treatment. Requires lowest fee which physician has agreed to accept. Doesn't limit physician's ability to provide free services. A patient may review the physician's fee and similar information before, during or after the health care is provided.
The UGLY:
Public Protection from Repeated Medical Malpractice
http://election.dos.state.fl.us/initiatives/initdetail.asp?account=35169&seqnum=8
Current law allows medical doctors who have committed repeated malpractice to be licensed to practice medicine in Florida. This amendment prohibits medical doctors who have been found to have committed three or more incidents of medical malpractice from being licensed to practice medicine in Florida.
-------
Do these two ballot initiatives seek to run all doctors out of the State of Florida? Will this election be doctor vs. trial lawyer!?
If you are in Florida, this is the time to get involved.
Any thoughts? Does dentist = physician in the eyes of the law? Do we all just sail west for calmer seas?
-Mike