Surreal: EM legend and Temple chair Robert McNamara loses $6.4 million lawsuit

[Colbert]

This one is even worse

Cop dies during 3-way sex; widow wins $3M lawsuit
http://content.usatoday.com/communi...3-way-sex-widow-wins-3-million/1#.T9YyKOJYsiN

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[RustedFox]

Exactly. There is little utility in the rapid strep (sensitivity of 80%??) but people expect it to be done. If you don't do the little swab thing and send the test, people assume that your care has fallen below standards.

Americans assume that more tests = better care.

Yep. Its because Americans by and large don't understand that the tests themselves are fallible. They think in binary "positive" or "negative" terms... and the test HAS to be right.

Worse yet, the refuse to move from this position of thought because .... science is hard. Understanding the idea of "false positives/negatives" requires actual thought, and they don't like that... so THAT concept is rejected, and therefore... doesn't exist.

 

[GeneralVeers]

Yep. Its because Americans by and large don't understand that the tests themselves are fallible. They think in binary "positive" or "negative" terms... and the test HAS to be right.

Worse yet, the refuse to move from this position of thought because .... science is hard. Understanding the idea of "false positives/negatives" requires actual thought, and they don't like that... so THAT concept is rejected, and therefore... doesn't exist.

I don't think they are even that involved in thought. Americans watch ER and House and see all this fancy testing done by doctors with mood lighting and dramatic music. That becomes their expectation for the medical experience, and anything which deviates from their expectation is inferior.

 

[docB]

Exactly. There is little utility in the rapid strep (sensitivity of 80%??) but people expect it to be done. If you don't do the little swab thing and send the test, people assume that your care has fallen below standards.

Americans assume that more tests = better care.

This is a good statement of an insidious problem. This is true. It drives up costs and causes morbidity with false positives and diagnostic related complications.

A good example of how poorly the public understands the utility of diagnostic testing is in how often we have patients that get angry when we tell them we can't rule out stroke, MI, arrhythmia induced syncope, etc. in the ER.

 

[VA Hopeful Dr]

No they shouldn't. If you decide to treat based on Centor criteria, then treat. Otherwise don't treat. You can treat strep with lollipops for all I care, but the test is expensive, and the culture is worse.
And, important for this thread, we spend far more money testing and treating strep than we save in preventing rheumatic fever (since we don't have a rheumatogenic strain in the US). But we do it to prevent lawsuits and increase our Press Ganey.

Fair enough. I'm just kinda ticked because a local MD (urgent care, but that's part of our local ED) took a patient who told him she had mono, diagnosed at my office, and gave her amox for strep. She didn't take it, but if she had and shown up in my office with a body-wide rash I'd have been even more annoyed than I already was.

As for the Centor criteria... at best that's only got a 60% PPD. My $50 rapid strep beats that handily.

 

[dotcb]

What can actually be learned from this ridiculous case?

On chest pain cases, need to mention decision making Re: ACS, PE, dissection EVERY time and why you didn't think these were present. Same w/ big killers for HA, back pain, Abd pain cases, etc.

Beware of high risk chief complaints who you're discharging - spend a little more time charting on those cases. Read the Bouncebacks book.

Close the loop by writing good DC instructions on ALL cases - need to include who to follow up with, when to follow up (a specific # of days), and reasons to come back to the ER.

Get familiar with your malpractice coverage and the medicolegal climate in your state. Protect your assets legally and financially. I learned I'm fortunately in a $250K cap state.

Nobody's perfect. and all EP's are busy, but we do the best we can. I know I spent a little more time charting yesterday.

 

[Socrates25]

Makes the chart look pretty in case of bad outcome, though. It's sad that everyone outside of academics and Texas has to practice such absurdity. Don't just blame the lawyers - blame the industry-sponsored literature that pushes the requirement for diagnostic imaging and the professional societies that establish this as the "standard of care".

I agree with you generally, I just want to point out that although the courts say you must break a "standard" of care to be guilty of malpractice, in reality the only thing thats required is one hired gun expert ***** whose opinion differs from yours.

If courts were serious about "standards of care" they'd eliminate the ridiculous expert witness system and use specialty board guidelines instead. Sure, those guidelines are sometimes BS, but they are much less BS than one guy who is getting paid to be contrary and disagree with you on management.

 

[deleted109597]

As for the Centor criteria... at best that's only got a 60% PPD. My $50 rapid strep beats that handily.

Yet my free Centor criteria, which may underdiagnose strep, also saves patients the cost of an antibiotic, the cost of toilet paper from their diarrhea, and prevents the occasional life threatening allergic reaction.

 

[keeping-it-real]

This is a good statement of an insidious problem. This is true. It drives up costs and causes morbidity with false positives and diagnostic related complications.

A good example of how poorly the public understands the utility of diagnostic testing is in how often we have patients that get angry when we tell them we can't rule out stroke, MI, arrhythmia induced syncope, etc. in the ER.

But why do they need to be admitted? All they wanted was to get checked out.

 

[OccupyTheED]

This one is even worse

Cop dies during 3-way sex; widow wins $3M lawsuit
http://content.usatoday.com/communi...3-way-sex-widow-wins-3-million/1#.T9YyKOJYsiN

Some of the comments on this article are unreal. Hard to believe people can be that dumb. I start residency on July 2 and I'm already plotting my escape from clinical medicine.

 

[gutonc]

Some of the comments on this article are unreal. Hard to believe people can be that dumb. I start residency on July 2 and I'm already plotting my escape from clinical medicine.

It's USA Today...I'm kind of shocked to learn that those people know how to type.

 

[OccupyTheED]

It's USA Today...I'm kind of shocked to learn that those people know how to type.

Very true, but unfortunately there's no filter to stop those with IQ's < 70 from pursuing, and possibly winning, baseless litigation.

 

[RustedFox]

It's USA Today...I'm kind of shocked to learn that those people know how to type.

I hate to sound elitist. But really. I just don't "want to work" for people who don't appreciate what is being done for them because "they think that they know better". One of the things that absolutely kills me (I may have said this before, but it bears repeating) is when they say - "Well... I KNOW my body."

No. No you don't. In actuality, you don't know d!ck about your body, anyone else's body, or the body in general. Sure, you can tell me "how you feel", but that's about where it stops. If you really "knew your body", you would go fix yourself, now wouldn't you ?

 

[gman33]

What can actually be learned from this ridiculous case?

On chest pain cases, need to mention decision making Re: ACS, PE, dissection EVERY time and why you didn't think these were present. Same w/ big killers for HA, back pain, Abd pain cases, etc.

Beware of high risk chief complaints who you're discharging - spend a little more time charting on those cases. Read the Bouncebacks book.

Close the loop by writing good DC instructions on ALL cases - need to include who to follow up with, when to follow up (a specific # of days), and reasons to come back to the ER.

Get familiar with your malpractice coverage and the medicolegal climate in your state. Protect your assets legally and financially. I learned I'm fortunately in a $250K cap state.

Nobody's perfect. and all EP's are busy, but we do the best we can. I know I spent a little more time charting yesterday.

Thanks for the insight.

 

[docB]

Get familiar with your malpractice coverage and the medicolegal climate in your state. Protect your assets legally and financially. I learned I'm fortunately in a $250K cap state.

Just a quick point about caps. We all like them but they are no guarantee you won't get fleeced for millions (i.e. forced into bankruptcy). Pretty much all caps (CA, NV, etc.) are on "non-economic" damages AKA "pain and suffering" awards. If a person can show real economic damages then the sky is the limit. That's how John Ritter's wife sued for $88 million. He actually had that earning power. If someone has children that will have to be taken care of (as in this case) then they can ask for untold riches to establish trusts, college funds, etc. And juries are notably generous with your money.

I hate to sound elitist. But really. I just don't "want to work" for people who don't appreciate what is being done for them because "they think that they know better". One of the things that absolutely kills me (I may have said this before, but it bears repeating) is when they say - "Well... I KNOW my body."

No. No you don't. In actuality, you don't know d!ck about your body, anyone else's body, or the body in general. Sure, you can tell me "how you feel", but that's about where it stops. If you really "knew your body", you would go fix yourself, now wouldn't you ?

 

[Hamhock]

As for the Centor criteria... at best that's only got a 60% PPD. My $50 rapid strep beats that handily.

Wow!

If we can't even explain this stuff to other doctors (an FP in this case), how can we expect the general public to get it?

VA Hopeful: please read your last post in the context of DrMcN's posts and X's posts...then reconsider.

HH

 

[RustedFox]

Another concept (or two) that the public at large has that absolutely kills me is/are:

1.) The idea that auscultation alone "clears" them cardiac-wise when the doctor doesn't say anything after listening to the patient's chest... or worse yet... says - "Sounds normal." I frequently see patients with poorly controlled diabetes/hypertension, a smoking "career", and multiple other cardiac risk factors for their chest pain, and they frequently say something like - "Well, my doctor said my heart was FINE when he listened to it!"

2.) The concept of the doctor as "mechanic". People genuinely believe that the two are similar in that when the car is broken.... you take it to a mechanic... get it "fixed", and the problem is no more. Similarly, when the body is 'broken'... you take it to the doctors and get it "fixed", and the problem is no more. Thus, they are free to return to their irresponsible lifestyles (smoking, cocaine, peanut-butter and honey sandwiches on white [no joke, had a poorly controlled diabetic tell me that she eats several daily]... until the body "breaks" again... at which time, if they "can't be fixed", then its the DOCTOR that is at fault.

 

[OccupyTheED]

Another concept (or two) that the public at large has that absolutely kills me is/are:

1.) The idea that auscultation alone "clears" them cardiac-wise when the doctor doesn't say anything after listening to the patient's chest... or worse yet... says - "Sounds normal." I frequently see patients with poorly controlled diabetes/hypertension, a smoking "career", and multiple other cardiac risk factors for their chest pain, and they frequently say something like - "Well, my doctor said my heart was FINE when he listened to it!"

2.) The concept of the doctor as "mechanic". People genuinely believe that the two are similar in that when the car is broken.... you take it to a mechanic... get it "fixed", and the problem is no more. Similarly, when the body is 'broken'... you take it to the doctors and get it "fixed", and the problem is no more. Thus, they are free to return to their irresponsible lifestyles (smoking, cocaine, peanut-butter and honey sandwiches on white [no joke, had a poorly controlled diabetic tell me that she eats several daily]... until the body "breaks" again... at which time, if they "can't be fixed", then its the DOCTOR that is at fault.

I think that personal accountability is severely lacking in our society, we're just in the unfortunate position of being held liable for the actions of others who don't prioritize their own well being until it's too late, if at all. Only in America can you blow off f/u appointments, any attempt at preventive care, ignore common sense, inhale cheeseburgers and 44 oz sodas until you croak and as a result set up your family for generations to come.

 

[la gringa]

Another concept (or two) that the public at large has that absolutely kills me is/are:

1.) The idea that auscultation alone "clears" them cardiac-wise when the doctor doesn't say anything after listening to the patient's chest... or worse yet... says - "Sounds normal." I frequently see patients with poorly controlled diabetes/hypertension, a smoking "career", and multiple other cardiac risk factors for their chest pain, and they frequently say something like - "Well, my doctor said my heart was FINE when he listened to it!"

2.) The concept of the doctor as "mechanic". People genuinely believe that the two are similar in that when the car is broken.... you take it to a mechanic... get it "fixed", and the problem is no more. Similarly, when the body is 'broken'... you take it to the doctors and get it "fixed", and the problem is no more. Thus, they are free to return to their irresponsible lifestyles (smoking, cocaine, peanut-butter and honey sandwiches on white [no joke, had a poorly controlled diabetic tell me that she eats several daily]... until the body "breaks" again... at which time, if they "can't be fixed", then its the DOCTOR that is at fault.

spot ON yet again RF... i also love the "well i just had a physical"/saw my pcp/whatever. today is a different day, different story, and you're here in the EMERGENCY department. i have no margin of error, so yes, if you tell me you have crushing substernal chest pain associated with n/sob/palp/sweating/aggravated by fighting with your no-good family... you need TESTS. your 6 mo old has a temp of 104 and no source? yes, the horror of a urine cath and the sky-high radiation dose of a chest x-ray are appropriate in this scenario. no, it's not a good idea to wait til Monday to see your Medicaid pediatrician (who won't see you unless i magically get them on the phone - many of them mean well but that system is beyond broken!)

my new favorite phrase "what were you expecting/wanting (depending on situation) when you came to the emergency department?".

 

[StevieStud]

This one is even worse

Cop dies during 3-way sex; widow wins $3M lawsuit
http://content.usatoday.com/communi...3-way-sex-widow-wins-3-million/1#.T9YyKOJYsiN

a better article:

http://www.11alive.com/news/article/243312/1/Cop-dies-during-3-way-sex-widow-wins-3-million

with the quote at the bottom:

11 Alive spoke with Dr. Gangasani by phone.
He said he would like nothing better than to defend his professional reputation, but referred us to the attorney handling his upcoming appeal of the verdict.

That attorney, Page Powell of Atlanta, sent us a statement which reads in full:


"Dr. Gangasani did everything he could to prevent Mr. Martinez's death. Mr. Martinez had a well-documented history of not following his doctors' instructions. Here, after examining Mr. Martinez, Dr. Gangasani recommended follow-up cardiac testing, and he offered Mr. Martinez an appointment for the next day to have the testing performed. Mr. Martinez refused, and instead he scheduled the testing to take place one week later-the day after the sexual encounter that he had planned. Dr. Gangasani also specifically told Mr. Martinez not to engage in any strenuous activity, but unfortunately Mr. Martinez ignored this warning. Dr. Gangasani also gave Mr. Martinez appropriate medications, including aspirin, nitroglycerin, and cholesterol-lowering medications, and told Mr. Martinez to go to the emergency room immediately if he experienced any further chest pain. Thus, while Mr. Martinez's death was a tragedy, it could have been prevented if he had simply followed Dr. Gangasani's recommendations and instructions."


My only thought/question...

IM/FP/ED etc are commonly requested to provide a work excuse. Been doing it for a long time and it won't stop any time in the future.

(come on, admit it, your ED has a sign posted advising the patient to request the work excuse when the patient sees the physician or NP)

So.... if I was a cardiologist.... and I told a member of law enforcement (or fireman, ditch digger etc) to avoid strenuous activity..... doesn't that warning/advice also normally include a work excuse until such time as I have cleared the patient to return to full duties?

I am guessing, but I suspect the note was issued.... along with the nitro and let me schedule your stress test for tomorrow AM.

And if I provided said excuse... and the idiot goes out and has a 3-some with a hot hooker (or other female other than his wife).... why should I be responsible for his demise if the note clearly told him that he was unfit for work?

 

[southerndoc]

Georgia has a gross negligence clause for emergency providers, including on-call specialists who admit/consult on emergent cases. Unfortunately this doesn't apply since the patient was seen in the cardiologist's office.

 

[VA Hopeful Dr]

Yet my free Centor criteria, which may underdiagnose strep, also saves patients the cost of an antibiotic, the cost of toilet paper from their diarrhea, and prevents the occasional life threatening allergic reaction.

I think its a great tool for ruling out, I use it all the time to explain to a patient why I don't think they have strep. I just don't think that, by itself, its a good idea to decide to treat just based on centor score.

Plus, I'd love for you to send that sort of stuff back to me without treating it in the ED.

 

[VA Hopeful Dr]

Wow!

If we can't even explain this stuff to other doctors (an FP in this case), how can we expect the general public to get it?

VA Hopeful: please read your last post in the context of DrMcN's posts and X's posts...then reconsider.

HH

I know exactly what he's saying, I just don't agree with it. That said, each specialty thinks about the same problems differently. In your shoes, especially as pt satisfaction is a bigger deal, who's to say I wouldn't act the same way.

 

[Old Grunt]

If this country ever goes to single payer, I wonder if Doctors will have sovereign immunity?

 

[link2swim06]

Just a quick point about caps. We all like them but they are no guarantee you won't get fleeced for millions (i.e. forced into bankruptcy). Pretty much all caps (CA, NV, etc.) are on "non-economic" damages AKA "pain and suffering" awards. If a person can show real economic damages then the sky is the limit. That's how John Ritter's wife sued for $88 million. He actually had that earning power. If someone has children that will have to be taken care of (as in this case) then they can ask for untold riches to establish trusts, college funds, etc. And juries are notably generous with your money.

Even in states like Texas? I was pretty sure they include both economic and non-economic caps.


In a medical malpractice action filed on or after September 1, 2003, regardless of the number of causes of action asserted, non-economic damages are limited to a total of $250,000 from all doctors and other individuals. Non-economic damages are limited to $250,000 from each hospital or other institution and a total of $500,000 from all institutions. Tex. Civ. Prac. & Rem. Code. § 74.301 (Westlaw 2007). The cap applies to each "claimant," which includes everyone seeking damages due to one person's injury or death. Id.; Tex. Civ. Prac. & Rem. Code. § 74.001(a)(2) (Westlaw 2007). A constitutional amendment authorizes this legislation. Tex. Const. art. III, § 66.

In a medical malpractice action for wrongful death, damages (both economic and non-economic) are limited to $500,000 (in 1977 dollars) plus the cost of any necessary medical or custodial care. Tex. Civ. Prac. & Rem. Code. § 74.303 (Westlaw 2007). The predecessor of this statute was intended to apply to all medical malpractice, but was held to be unconstitutional except for causes of action created by statute, like wrongful death. Rose v. Doctors Hospital, 801 S.W.2d 841 (Tex. 1990). The cap is adjusted annually for inflation, § 74.303(b), and is now approximately $1,650,000. In actions filed on or after September 1, 2003, this limit applies to the total recovery, not separately to each defendant, and includes exemplary damages. § 74.303(a).

In any action not based on certain types of intentional criminal conduct, exemplary damages are limited to the larger of the following amounts: (a) non-economic damages (up to a maximum of $750,000) plus two times economic damages, or (b) $200,000. Tex. Civ. Prac. & Rem. Code Ann. § 41.008 (Westlaw 2007).

Per http://www.mcandl.com/texas.html

 

[deleted109597]

I think its a great tool for ruling out, I use it all the time to explain to a patient why I don't think they have strep. I just don't think that, by itself, its a good idea to decide to treat just based on centor score.

Sure, do what you want. Just don't tell me I'm wrong.

Plus, I'd love for you to send that sort of stuff back to me without treating it in the ED.

I'd love if your patients could just go to you for their non-emergencies, instead of showing up in the ED. How exactly did the case you're referring to happen anyway? You dx with mono, then they went to the UC? For what, something you didn't treat well enough?

I know exactly what he's saying, I just don't agree with it. That said, each specialty thinks about the same problems differently. In your shoes, especially as pt satisfaction is a bigger deal, who's to say I wouldn't act the same way.

Just you wait. Once HCAHPS starts showing that patients aren't satisfied because they can't see their PCP in a timely fashion, then the government will move on to you guys too.

 

[deleted109597]

If this country ever goes to single payer, I wonder if Doctors will have sovereign immunity?

Unlikely. They don't have it in the UK.

 

[AmoryBlaine]

What can actually be learned from this ridiculous case?

On chest pain cases, need to mention decision making Re: ACS, PE, dissection EVERY time and why you didn't think these were present. Same w/ big killers for HA, back pain, Abd pain cases, etc.

Beware of high risk chief complaints who you're discharging - spend a little more time charting on those cases. Read the Bouncebacks book.

Close the loop by writing good DC instructions on ALL cases - need to include who to follow up with, when to follow up (a specific # of days), and reasons to come back to the ER.

Get familiar with your malpractice coverage and the medicolegal climate in your state. Protect your assets legally and financially. I learned I'm fortunately in a $250K cap state.

Nobody's perfect. and all EP's are busy, but we do the best we can. I know I spent a little more time charting yesterday.

I second all of this. Having done a few depositions I can tell you that where gaps exist in the medical record the blood sucking plaintiff's attorneys fill them in with gross negligence and stupidity.

I recently had a dep where a huge part of the frivolous claim involved a delay in recognition of a clinical deterioration. My note from the time was written in prose something to the tune of "immediately upon hearing that Mr. Plaintiff had fallen to the floor I sprinted into the room behind the tech who called for help."

My attorney was having a hard time holding back her evil grin, while the plaintiff's attorney tried to quibble with what "immediately" meant.

"Well sir it means right away."

 

[AmoryBlaine]

What can actually be learned from this ridiculous case?

On chest pain cases, need to mention decision making Re: ACS, PE, dissection EVERY time and why you didn't think these were present. Same w/ big killers for HA, back pain, Abd pain cases, etc.

Beware of high risk chief complaints who you're discharging - spend a little more time charting on those cases. Read the Bouncebacks book.

Close the loop by writing good DC instructions on ALL cases - need to include who to follow up with, when to follow up (a specific # of days), and reasons to come back to the ER.

Get familiar with your malpractice coverage and the medicolegal climate in your state. Protect your assets legally and financially. I learned I'm fortunately in a $250K cap state.

Nobody's perfect. and all EP's are busy, but we do the best we can. I know I spent a little more time charting yesterday.

Actually after hearing a med mal lecture I started doing this exactly even on simple cases. Migraine? "If you are not feeling better in 24 hours you need to be seen, if you cannot be seen by your PMD you should return to this ER."

 

[Apollyon]

Close the loop by writing good DC instructions on ALL cases - need to include who to follow up with, when to follow up (a specific # of days), and reasons to come back to the ER.

Roja and I posted this almost 6 years ago:

DC instructions that EVERYONE gets are: nausea and vomiting, if you are worse in any way, or you think you need to be seen again. These are in conjunction with anything specific to the complaint.

If someone is throwing up, they can't take any PO meds you've prescribed. If they are worse in any way, or think they need to be seen again, that (legally) helps you a little bit, as it's difficult to answer: "If you were worse, why didn't you go get seen?" or "If you thought you needed to be seen again, why didn't you go?"

As Corey Slovis and Keith Wrenn from Vanderbilt wrote: "Good discharge instructions are better than an accurate diagnosis."

So, so so true. This has saved my rear on a couple of cases. We CQI all 'return within 24'-ers. I have had two that came back because of solid discharge instructions and was found to have done nothing wrong (not having the diagnosis initially) because of 1-good charting and 2-good discharge instruction.

EM is not about finding the diagnosis 100% of the time. Its about figuring out whose sick, who needs to come in, who can go home and when to come back.

In this thread.

If you think I know about what I'm talking, listen to me. If you think I'm a douche and a blowhard, listen to me.

Good discharge instructions are better than an accurate diagnosis. Put it in plain English - if you write "APAP q6h prn", you might as well have written "juxap x6a1 brapp" - because it means the same to the patients. Spell it out clearly!

 

[Old Grunt]

Unlikely. They don't have it in the UK.

Interesting. Thanks.

 

[deleted109597]

If you think I know about what I'm talking, listen to me. If you think I'm a douche and a blowhard, listen to me.

Nah. Now Corey, he might be both of those (depending on what day of the week it is). Keith I never spent enough time with to know well.

Good discharge instructions are better than an accurate diagnosis. Put it in plain English - if you write "APAP q6h prn", you might as well have written "juxap x6a1 brapp" - because it means the same to the patients. Spell it out clearly!

Absolutely. However, the caveat with discharge instructions are: 1. It must be readable by someone with a 6th grade education. 2. It must be one page long. Anything longer or harder doesn't get read.

 

[EctopicFetus]

If this country ever goes to single payer, I wonder if Doctors will have sovereign immunity?

One has nothing to do with the other.. For proof Obamacare..

 

[GeneralVeers]

One has nothing to do with the other.. For proof Obamacare..

Exactly. The Democrats are paralyzed by the trial lawyers, and will not do anything to upset a huge donor to the party. We are going to have the worst of both worlds: Being indentured servants to the government with no autonomy AND practicing in a high liability environment with no protections.

 

[Aesculapius]

Is there any location where boilerplate discharge instructions that are likely to be read and understood by patients and provide good medmal protection can be found? I know that most EMRs/EDs have a system where you can simply print out instructions, but those don't necessarily fit those criteria that well.

 

[deleted109597]

No, because one size fits all doesn't work. What to one prudent layperson means "come back if you're worse" means "come back regardless" to another, and means "only come back if dead" to a third.
So really, you aren't going to win unless the jury happens to understand it like you want them to. Juries are very different depending on location.

 

[VA Hopeful Dr]

Sure, do what you want. Just don't tell me I'm wrong.

I never said you were wrong, I just didn't agree with the approach you were taking.

I'd love if your patients could just go to you for their non-emergencies, instead of showing up in the ED. How exactly did the case you're referring to happen anyway? You dx with mono, then they went to the UC? For what, something you didn't treat well enough?

We'd all be happier if they did that. As best I can tell, the lady I'm talking about developed symptoms at 5:05 on a Friday.

Just you wait. Once HCAHPS starts showing that patients aren't satisfied because they can't see their PCP in a timely fashion, then the government will move on to you guys too.

Looking forward to it, what could possibly go wrong?

 

[NinerNiner999]

No - but in the UK the loser has to pay all costs to the winner. If plaintiffs in this country had even a little skin in the game it would make a huge difference...

 

[turkeyjerky]

No - but in the UK the loser has to pay all costs to the winner. If plaintiffs in this country had even a little skin in the game it would make a huge difference...

Isn't that the casein Texas now? In my opinion, things like that are much more likely to improve the current environment and will probably be easier to pass than caps on damages.

 

[WilcoWorld]

No - but in the UK the loser has to pay all costs to the winner. If plaintiffs in this country had even a little skin in the game it would make a huge difference...

I would rather see this than caps. If someone gets royally screwed, well, then perhaps that person should get a big settlement. It's the roll-the-dice-for-big-money-regardless-of-merit-because-the-lawyers-work-on-a-contingency-basis that bothers me.

 

[Birdstrike]

.

 

[RustedFox]

Welcome back, Birdstrike.

 

[8654Marine]

+1 on the return, BS

 

[Daiphon]

Birdie! w00t! d=)

Sent from my DROID BIONIC using Tapatalk

 

[EctopicFetus]

Great post birdstrike.. For the residents.. take note.. dont practice in states with terrible med mal environments. you can be the ones to make the change we need.

 

[AmoryBlaine]

For the youngun's reading this:

Birdstrike is right in many ways.

However it is VANISHINGLY rare that a decent, competent physician practicing within the standard of care would lose their own money in a med mal lawsuit. Most hospitals are insured to the tune of millions of dollars and if a lawsuit has merit the hospital will often settle.

Med mal trials are comparatively rare and physicians win most of them. I doubt that a large university hospital went to trial with a chairman's personal wealth on the line. Maybe it happened but I doubt it.

I am in no way defending our med mal climate, I think it has utterly poisoned the MD-pt relationship.

 

[OccupyTheED]

For the youngun's reading this:

Birdstrike is right in many ways.

However it is VANISHINGLY rare that a decent, competent physician practicing within the standard of care would lose their own money in a med mal lawsuit. Most hospitals are insured to the tune of millions of dollars and if a lawsuit has merit the hospital will often settle.

Med mal trials are comparatively rare and physicians win most of them. I doubt that a large university hospital went to trial with a chairman's personal wealth on the line. Maybe it happened but I doubt it.

I am in no way defending our med mal climate, I think it has utterly poisoned the MD-pt relationship.

Do you say that it's rare b/c most settlements are far less than the one million dollar cap or is that more of a commentary of the high win rate of physicians in these cases?

 

[AmoryBlaine]

Do you say that it's rare b/c most settlements are far less than the one million dollar cap or is that more of a commentary of the high win rate of physicians in these cases?

Many docs are dropped from lawsuits and the suit ends up being against the hospital. Settlements >$1M are pretty rare. Also the vast majority of med mal cases never really leave the starting gate.

 

[southerndoc]

The hospital may not help out if you're an independent contractor.

 

[AmoryBlaine]

The hospital may not help out if you're an independent contractor.

Very true, and another reason to think carefully about those arrangements. That said the malpractice for ICs is not generally bought and paid for by those individual ICs...