Why not share the plain reality and not one of greed. Tell the so called injured patients the only real beneficiary is the plantiff attorneys! Oh yeh, the defense attorneys who drag the cases on for billable hours as well.

Please let the public know how much plantiff attorneys really take if there is an award plus the injured party pays all expenses from the award. Let's not forget to mention that of all medical malpractice filed cases, les than 3% of all the cases is there actual deviation from the standard of care.

I still have yet to see an attorney cure a patient or provide a patient with the confidence to heal...famiiar with the placebo effect. It accounts for up to 30-40% of all cure. So tell me how greed heals again?

Keep pushing physician's out of the industry and having fewer brilliant minds going into medicine...what will be left. Your fancy car, vacation home, boats and big bank accounts. The real problem is this country is all about greed and your profession now sells money as a cure.

When you or a family member needs a physician, I hope you will find a good one.

1) The cost of malpractice premiums, which follow the costs of jury awards, are ultimately passed on to patients. An $8 million settlement against a surgeon, which recently happened, would result in an $800 surcharge to the next 10,000 patients of that surgeon to cover the cost of this settlement. (Fortunately, this award was reduced to $2 million, but that will still be a $200 surcharge on the next 10,000 patients).

2) Unlike lawyers, physicians are held to a high ethical standard. The American Bar Association still has not stated that it is unethical for a lawyer to sleep with his client. If a physician were to sleep with a patient, that would be actionable.

3) Why are physicians sued? Like the old joke, "that's where the money is". How about having a national medical injury compensation fund? People who sought money for injuries sustained in a health-care setting would submit their request to a board of arbitration, who would then disburse money based on the validity of the complaint. This would cut out the lawyers, the insurance companies, and the compassionate but not always well educated juries. Kaiser Permanente uses arbitration to limit their malpractice costs - why don't we adopt this model nationally?

Tom & DB:

I think you are both missing a crucial element of legal representation and how it positively impacts the medical profession. By pointing out mistakes, it helps physicians do their jobs better. While attorneys do not have the skill or training to physically cure or heal patients, an attorney does have the ability to heal the patient by holding a negligent physician accountable for an unnecessary injury or disability. DB, you say lawyers do not have high ethical standards, but what about physicians who violate their ethics of doing no harm? If an attorney is caught sleeping with a client, they are sanctioned by the bar association of their state, resulting in hefty fines and potentially the loss of their license. As for why physicians are sued, it's because they cause great harm and damage when they make mistakes. People die every day from medical negligence, nearly 200,000 people per year. I am sure doctors do their best, but someone should be accountable for the shear number of preventable deaths. Finally, insurance premiums have little to do with malpractice as noted by a number of studies.

Claim: Capping damages is the most effective way to reduce doctors’ medical malpractice premiums.

Reality: There is actually a weak relationship between caps on damages and medical malpractice premiums. While caps may reduce the amount insurance companies have to pay out to some injured patients, other factors also affect premiums and there is no guarantee that insurers will pass along savings to doctors in the form of lower premiums.

* A study by Weiss Ratings found that caps on pain and suffering damages reduced the amount medical malpractice insurers had to pay out between 1991 and 2002, but these payout reductions did not lead to lower premiums. In fact, the median annual premium during this period increased more in states with caps (48.2 percent) than in states without caps (35.9 percent). (Weiss Ratings, June 2003)

* Medical malpractice premiums largely reflect regular boom-and-bust changes in the insurance market. During “soft” markets, insurers keep premiums stable as they compete for market share. Investment income can allow insurers to keep premiums below what they expect to pay out in claims. But “soft” markets eventually turn into “hard” markets. In a “hard” market, insurers typically raise premiums, sometimes substantially, to build up reserves to account for higher-than-anticipated payments on claims or loss of investment income. Medical malpractice insurance experienced a hard market in the mid-1980s, a soft market through the 1990s, a hard market during the early part of this decade, and is now moving into a soft market again.

More ...

Devon: I've read the comments. Ignorance and greed seem to prevail. So what is the truth.
1. Taking responsibility for one’s professional mistakes is the cornerstone of a democratic system of self-governing.
2. It’s been repeatedly shown that malpractice premiums and verdicts have no relationship; there is a direct relationship of malpractice premiums to investment returns in the stock market.
3. Awarding an injured patient damages is a democratic principle; whereas not awarding damages for pain and suffering or limiting those awards is a principle of a communist system of governing.
4. People who post comments without using their full legal name have been shown to have conflicts of interest that they would rather not publicly disclose.
5. Those same anonymous people use trigger words to influence the court of public opinion, make bold assertions that impress the less educated and never have their facts right. Thus they have to hide their identity.
6. Those same people, who oppose rights for injured people, when injured, argue the rules don’t’ apply to them.
7. Blaming the plaintiffs bar for the cost of malpractice premiums is akin to blaming doctors for the prevalence of cancer.
8. The money saved from paying patient awards from malpractice is being used for more lavish medical facilities along with other brick and mortar projects.
9. The myth that doctors will quit the practice of medicine or leave states that don’t protect their pocketbooks is just that a myth. No doctor can identify even a single physician who has left the state. I invite any doctor to name three.
10. Insurance covers the cost of damages awarded by a jury or judge. The patients are not assessed an additional cost when responsibility is assessed through the civil justice system. Surcharges are a myth. Malpractice premiums are related to what the market dictates doctors will pay.
11. Doctor’s that practice bad medicine like to be angry with lawyers that sue them to hold them responsible. Those doctors emotionally say lawyers, as a group, are unethical. In reality intelligent physicians know who the bad physicians are and are happy they were sued and held to be accountable.
12. Arguing doctors are sued because of being a deep pocket is nothing more than a distraction from the main issue. Doctor’s can’t be sued and damages assessed if there is no wrong. In 99.99% of the cases a medical expert is needed to prove any medical malpractice case; meaning some doctor believes a patient’s care was substandard that resulted in unnecessary injury to the patient.
13. No doctor that complains of the cost of malpractice insurance will show you their income tax returns because the premium paid pales in comparison to the amount of income they are making.
14. The first casualty of any war is truth, and this one is no different.
15. Vote for tort reform and you vote for legal irresponsibility and take away your own rights at a time when you need them most. Then you have no one to blame except yourself. Good responsible doctors know this is true and that’s why they will never vote for tort reform and to give those doctors who practice bad medicine the right to kill and unnecessarily injure patients without corresponding legal responsibility.
16. If you practice medicine correctly and according to recognized medical standards you have nothing to fear.

1. Taking responsibility for one’s professional mistakes is the cornerstone of a democratic system of self-governing.
2. It’s been repeatedly shown that malpractice premiums and verdicts have no relationship; there is a direct relationship of malpractice premiums to investment returns in the stock market.
3. Awarding an injured patient damages is a democratic principle; whereas not awarding damages for pain and suffering or limiting those awards is a principle of a communist system of governing.
4. People who post comments without using their full legal name have been shown to have conflicts of interest that they would rather not publicly disclose.
5. Those same anonymous people use trigger words to influence the court of public opinion, make bold assertions that impress the less educated and never have their facts right. Thus they have to hide their identity.
6. Those same people, who oppose rights for injured people, when injured, argue the rules don’t’ apply to them.
7. Blaming the plaintiffs bar for the cost of malpractice premiums is akin to blaming doctors for the prevalence of cancer.
8. The money saved from paying patient awards from malpractice is being used for more lavish medical facilities along with other brick and mortar projects.
9. The myth that doctors will quit the practice of medicine or leave states that don’t protect their pocketbooks is just that a myth. No doctor can identify even a single physician who has left the state. I invite any doctor to name three.
10. Insurance covers the cost of damages awarded by a jury or judge. The patients are not assessed an additional cost when responsibility is assessed through the civil justice system. Surcharges are a myth. Malpractice premiums are related to what the market dictates doctors will pay.
11. Doctor’s that practice bad medicine like to be angry with lawyers that sue them to hold them responsible. Those doctors emotionally say lawyers, as a group, are unethical. In reality intelligent physicians know who the bad physicians are and are happy they were sued and held to be accountable.
12. Arguing doctors are sued because of being a deep pocket is nothing more than a distraction from the main issue. Doctor’s can’t be sued and damages assessed if there is no wrong. In 99.99% of the cases a medical expert is needed to prove any medical malpractice case; meaning some doctor believes a patient’s care was substandard that resulted in unnecessary injury to the patient.
13. No doctor that complains of the cost of malpractice insurance will show you their income tax returns because the premium paid pales in comparison to the amount of income they are making.
14. The first casualty of any war is truth, and this one is no different.
15. Vote for tort reform and you vote for legal irresponsibility and take away your own rights at a time when you need them most. Then you have no one to blame except yourself. Good responsible doctors know this is true and that’s why they will never vote for tort reform and to give those doctors who practice bad medicine the right to kill and unnecessarily injure patients without corresponding legal responsibility.
16. If you practice medicine correctly and according to recognized medical standards you have nothing to fear.

1. Taking responsibility for one’s professional mistakes is the cornerstone of a democratic system of self-governing.
**Actually, I thought 1) the maintenance of individual liberties, 2) the promotion of order and national unity, 3) the ability of individuals to influence national decisions, and 4) the promotion of economic security. (paraphrased from The Design of Democracy). Or, a free press and an informed electorate. Or free markets and free ideas. Or transparency, predictability, and accountability (referring to the government, I believe).

2. It’s been repeatedly shown that malpractice premiums and verdicts have no relationship; there is a direct relationship of malpractice premiums to investment returns in the stock market.
**Hmm, what about physician-owned malpractice insurance companies? Also, most investigators seem to think that MICRA (a California law limiting pain and suffering awards) has markedly limited malpractice premium increases in the state. Texas enacted a similar law and saw their malpractice premiums drop. Many other states have adopted similar laws based on this belief. We have many misinformed representatives.

3. Awarding an injured patient damages is a democratic principle; whereas not awarding damages for pain and suffering or limiting those awards is a principle of a communist system of governing.
**Again, this has nothing to do with malpractice. China has certainly awarded parents money for their children who died in shoddily constructed schools, whereas many European countries sharply limit jury awards. Is China democratic and Germany communist?!?

4. People who post comments without using their full legal name have been shown to have conflicts of interest that they would rather not publicly disclose.
**Or perhaps they simply fear internet-savvy lawyers digging up information on google to be used against them in a civil proceeding. From LA Times, “Virtually every medical blogger acknowledges in his or her posts the case of Flea, a physician blogger who anonymously posted on his practice, including damning details of a malpractice suit against him. In the course of the case, the plaintiff's attorney -- recognizing the doctor by the details in his posts -- confirmed he was the author and used his own words against him.”

5. Those same anonymous people use trigger words to influence the court of public opinion, make bold assertions that impress the less educated and never have their facts right. Thus they have to hide their identity.
**Trigger words like “democratic” and “communist”. Avoid saying “always” and “never” - they are too bold.

6. Those same people, who oppose rights for injured people, when injured, argue the rules don’t’ apply to them.
**I agree to binding arbitration when I sign contracts. I've never sued anyone, though I've had cause.

7. Blaming the plaintiffs bar for the cost of malpractice premiums is akin to blaming doctors for the prevalence of cancer.
**And yet studies have shown that the greater the concentration of medical specialists in a given area, the greater the cost of medical care in that area. Could the same be true for lawyers and personal injury lawsuits? Probably.

8. The money saved from paying patient awards from malpractice is being used for more lavish medical facilities along with other brick and mortar projects.
**Unsubstantiated statement.

9. The myth that doctors will quit the practice of medicine or leave states that don’t protect their pocketbooks is just that a myth. No doctor can identify even a single physician who has left the state. I invite any doctor to name three.
**I will take you up on your first statement. From a 10 minute google search, “Dr. David Weaver had just been recruited to Integris Bass in Enid when the local malpractice insurance crisis hit. Ironically, he had just left Las Vegas due to a similar malpractice insurance crisis there in 2002. 'About 55 OBs left Vegas,' said Weaver. 'We had been there 14 years.' “

You are partly correct. Doctors generally do not move once they have started their practice. But graduating residents will not move to states which leave them exposed to lose everything they have worked for.

10. Insurance covers the cost of damages awarded by a jury or judge. The patients are not assessed an additional cost when responsibility is assessed through the civil justice system. Surcharges are a myth. Malpractice premiums are related to what the market dictates doctors will pay.
**Where does the money from damage awards come from? The insurance companies. Where do the insurance companies get their money? From premiums paid by doctors. Where do the doctors get their money? From fees charged to patient's health care insurance companies. Where do patient's health care insurance companies get their money? From patients. Quod erat demonstrandum. Most physicians, by the way, only carry $1 million worth of coverage. Anything above that comes out of their pockets.

11. Doctor’s that practice bad medicine like to be angry with lawyers that sue them to hold them responsible. Those doctors emotionally say lawyers, as a group, are unethical. In reality intelligent physicians know who the bad physicians are and are happy they were sued and held to be accountable.
**I know of no doctor who is happy when a fellow physician is sued. It is a tragedy for everyone.

12. Arguing doctors are sued because of being a deep pocket is nothing more than a distraction from the main issue. Doctor’s can’t be sued and damages assessed if there is no wrong. In 99.99% of the cases a medical expert is needed to prove any medical malpractice case; meaning some doctor believes a patient’s care was substandard that resulted in unnecessary injury to the patient.
**Medical experts may be “Say Anything” experts, “Hired Gun” experts, or may be sincerely trying to police their profession. Both the American Association of Neurosurgery and the American Society of Anesthesiology now have judicial reviews of medical expert testimony, and have sanctioned several medical experts for giving bad testimony, essentially ending their careers as medical experts.

13. No doctor that complains of the cost of malpractice insurance will show you their income tax returns because the premium paid pales in comparison to the amount of income they are making.
**For safer specialties this is true, but for Obstetrics and Neursurgery, this is definitely not true. No person who works their butt off and makes good money goes around advertising their income. They would be setting themselves up for lawsuits and crime.

14. The first casualty of any war is truth, and this one is no different.
**We can only hope to have an informed electorate.

15. Vote for tort reform and you vote for legal irresponsibility and take away your own rights at a time when you need them most. Then you have no one to blame except yourself. Good responsible doctors know this is true and that’s why they will never vote for tort reform and to give those doctors who practice bad medicine the right to kill and unnecessarily injure patients without corresponding legal responsibility.
**I don't know of a single doctor who is satisfied with our malpractice system in the US. Half of all doctors are sued in the US. Are half of all doctors incompetent?

16. If you practice medicine correctly and according to recognized medical standards you have nothing to fear.
**Which is why doctors receive “Notices of Intent” and are then dismissed from the case 8 months later, after the emotional toll on them and their family has already run its course. File a countersuit? What is the likelihood of success? Nil. I would like to be paid for the hours I spend worrying and losing time with my family, only to be dismissed from a lawsuit. Moreover, lawsuits take time away from patient care.

Like making laws and making sausages, the less one knows about lawsuits, the better one sleeps.

1. Taking responsibility for one’s professional mistakes is the cornerstone of a democratic system of self-governing.
**Actually, I thought 1) the maintenance of individual liberties, 2) the promotion of order and national unity, 3) the ability of individuals to influence national decisions, and 4) the promotion of economic security. (paraphrased from The Design of Democracy). Or, a free press and an informed electorate. Or free markets and free ideas. Or transparency, predictability, and accountability (referring to the government, I believe).
RESPONSE: I was referring to licensed professionals self-monitoring their own professions through licensing boards, like the Iowa Board of Medicine and I’m sure you’d point to the Iowa Board of Ethics and professional Practice. I wasn’t speaking so broadly as to being referring to a nation. Although those are important goals they have little to do with your right to practice medicine and mine to practice law. If doctors and lawyers take that privilege serious enough then the “conspiracy of silence” would not practiced.
2. It’s been repeatedly shown that malpractice premiums and verdicts have no relationship; there is a direct relationship of malpractice premiums to investment returns in the stock market.
**Hmm, what about physician-owned malpractice insurance companies? Also, most investigators seem to think that MICRA (a California law limiting pain and suffering awards) has markedly limited malpractice premium increases in the state. Texas enacted a similar law and saw their malpractice premiums drop. Many other states have adopted similar laws based on this belief. We have many misinformed representatives.
RESPONSE: What about physician-owned malpractice insurance companies? They are still insurance companies and that charge premiums and invest premiums and reserves. Let’s talk about MICRA. How do you know premium increases have been limited? Base on what data. They insurance industry closely guards that data.
But accounting aside, are you arguing a person should only be compensated for out-of-pocket expenses so that doctors can buy more expensive homes, cars, vacations, jewelry, etc? Lawyers, dentists, nurses, engineers, architects and all other licensed professionals don’t make that argument. And I dare say they would be ashamed to make such an argument. When they cause injury to a client they pay for damages, including pain and suffering which their error caused. Why do doctors think they are immune or should be exempt from what all other professionals are required to pay? What makes doctors any more special than an engineer or nurse or other licensed professional? Or is that the point you’re arguing? That for some reason doctors should be treated differently? Like I said show us your income tax returns and we’ll talk.

3. Awarding an injured patient damages is a democratic principle; whereas not awarding damages for pain and suffering or limiting those awards is a principle of a communist system of governing.
**Again, this has nothing to do with malpractice. China has certainly awarded parents money for their children who died in shoddily constructed schools, whereas many European countries sharply limit jury awards. Is China democratic and Germany communist?!?
RESPONSE: Yes it does have to do with civil litigation to which you’re arguing for an exemption. In a democratic society we are all equal when it comes to being held responsible. There are not Czars or Emperors or Kings. We are all just people. Please don’t argue Chinese media presentations as the truth. How much did China pay those few people they sent to a news conference? If you’re going to argue China’s treatment of it’s people then know your facts and present them openly. Did you read the Wall Street Journal article about the Chinese people being poisoned by industrial waste and lead? Did you see how those people were treated by their government? China isn’t an open media society. Free speech is not a cornerstone of the Chinese system of government. You can’t believe what they tell you or what you read about China.
4. People who post comments without using their full legal name have been shown to have conflicts of interest that they would rather not publicly disclose.
**Or perhaps they simply fear internet-savvy lawyers digging up information on google to be used against them in a civil proceeding. From LA Times, “Virtually every medical blogger acknowledges in his or her posts the case of Flea, a physician blogger who anonymously posted on his practice, including damning details of a malpractice suit against him. In the course of the case, the plaintiff's attorney -- recognizing the doctor by the details in his posts -- confirmed he was the author and used his own words against him.”
RESPONSE: You haven’t answered you’ve just reflected and are trying to distract from the fact you are hiding your identity and where you earn a living. What Flea did was blog during a medical malpractice trial in which he was the defendant. He made personal remarks about the lawyers, which had nothing to do with the facts of the case. It was his own lawyer who was defending him that recognized and asked if he was the blogger; which he admitted and then they ran in and settled the case. This post by Mittleman has nothing to do with any ongoing trial. The fact remains you’re not willing to disclose your identity; you’re hiding behind a pseudonym. And the reasons
5. Those same anonymous people use trigger words to influence the court of public opinion, make bold assertions that impress the less educated and never have their facts right. Thus they have to hide their identity.
**Trigger words like “democratic” and “communist”. Avoid saying “always” and “never” - they are too bold.
RESPONSE: Nothing to respond to.
6. Those same people, who oppose rights for injured people, when injured, argue the rules don’t’ apply to them.
**I agree to binding arbitration when I sign contracts. I've never sued anyone, though I've had cause.
RESPONSE: If you are agreeing to binding arbitration then without a doubt you will someday be in a lawyer’s office whining about how the arbitrator the company selected screwed you. And, like insurance adjusters it will be waaa, waaah, waaa, waaah.
I suspect you are a doctor, and earn a decent living. Unlike the other 95% of Americans you have every kind of insurance imaginable. You don’t have to sue anyone because you’ve got every risk insured. Those who are not so fortunate have as their only recourse to engage the civil justice system to help them get back to even. Now if you can set aside your own interests for those that are less fortunate, then you will begin to see what is wrong with your argument.
7. Blaming the plaintiffs bar for the cost of malpractice premiums is akin to blaming doctors for the prevalence of cancer.
**And yet studies have shown that the greater the concentration of medical specialists in a given area, the greater the cost of medical care in that area. Could the same be true for lawyers and personal injury lawsuits? Probably.
RESPONSE: Once again you’re deflecting rather than directly respond to my point. The medical profession loves to blame the plaintiffs’ lawyers. It’s not the lawyers who create the negligent act and damages. Just as the doctor doesn’t create the cancer we don’t create the malpractice event.
As for the specialties and the number of lawsuits, it goes hand in hand. Specialties require a higher skill and a higher standard of practice. That’s why it’s called a specialty. With a higher standard and higher skill goes higher risk; thus the higher pay. It’s basic risk-reward analysis. You show me the earnings of the specialist versus what they are paying in insurance premiums and we can talk. Until then it’s just one more person arguing without facts to back it up.
8. The money saved from paying patient awards from malpractice is being used for more lavish medical facilities along with other brick and mortar projects.
**Unsubstantiated statement.
RESPONSE: How many medical related brick and mortar projects are going up in your city or town? What is the per square foot building cost? Just tell me what town you work in and I’ll look it up.
9. The myth that doctors will quit the practice of medicine or leave states that don’t protect their pocketbooks is just that a myth. No doctor can identify even a single physician who has left the state. I invite any doctor to name three.
**I will take you up on your first statement. From a 10 minute google search, “Dr. David Weaver had just been recruited to Integris Bass in Enid when the local malpractice insurance crisis hit. Ironically, he had just left Las Vegas due to a similar malpractice insurance crisis there in 2002. 'About 55 OBs left Vegas,' said Weaver. 'We had been there 14 years.' “

You are partly correct. Doctors generally do not move once they have started their practice. But graduating residents will not move to states which leave them exposed to lose everything they have worked for.
RESPONSE: Once again if you point out a doctor who moved I’d want to know what he was earning versus what the new employer that recruited him is paying. No doctor grossing $5,000,000.00 and earning themselves $750,000.00 to $1,000,000.00 per year quits and moves over a $100,000.00 insurance premium. As Jerry McGuire says, “Show me the money!!!”
10. Insurance covers the cost of damages awarded by a jury or judge. The patients are not assessed an additional cost when responsibility is assessed through the civil justice system. Surcharges are a myth. Malpractice premiums are related to what the market dictates doctors will pay.
**Where does the money from damage awards come from? The insurance companies. Where do the insurance companies get their money? From premiums paid by doctors. Where do the doctors get their money? From fees charged to patient's health care insurance companies. Where do patient's health care insurance companies get their money? From patients. Quod erat demonstrandum. Most physicians, by the way, only carry $1 million worth of coverage. Anything above that comes out of their pockets.
RESPONSE: That’s not true about how much coverage doctor’s carry. Most doctors sold their practices to hospital systems that carry $10,000,000.00 to $50,000,000.00 or more of coverage. Basic principles of insurance are that the risk is spread across the entire body of those insured. It’s not as simple as saying if they pay out $1,000,000.00 then that doctor’s patients will be charge a certain sum of money tacked onto their bill. The insurance companies invest the premium and reserves. One study showed the insurance industry hadn’t even paid out the interest they’d earned on the reserves and premiums with all that they’d paid in losses. In other words they still had all the premium dollars after they paid out the accumulated losses. Let the insurance industry open their books and show us how much they are paying in executive bonuses, perks and to insurance agents as commissions. Then we can talk.
11. Doctor’s that practice bad medicine like to be angry with lawyers that sue them to hold them responsible. Those doctors emotionally say lawyers, as a group, are unethical. In reality intelligent physicians know who the bad physicians are and are happy they were sued and held to be accountable.
**I know of no doctor who is happy when a fellow physician is sued. It is a tragedy for everyone.
RESPONSE: Then you don’t known many doctors or you are exaggerating.
12. Arguing doctors are sued because of being a deep pocket is nothing more than a distraction from the main issue. Doctor’s can’t be sued and damages assessed if there is no wrong. In 99.99% of the cases a medical expert is needed to prove any medical malpractice case; meaning some doctor believes a patient’s care was substandard that resulted in unnecessary injury to the patient.
**Medical experts may be “Say Anything” experts, “Hired Gun” experts, or may be sincerely trying to police their profession. Both the American Association of Neurosurgery and the American Society of Anesthesiology now have judicial reviews of medical expert testimony, and have sanctioned several medical experts for giving bad testimony, essentially ending their careers as medical experts.
RESPONSE: Have you, assuming you’re a physician ever reviewed a case and testified against a follow doctor? Or are you saying doctor’s never make mistakes?
13. No doctor that complains of the cost of malpractice insurance will show you their income tax returns because the premium paid pales in comparison to the amount of income they are making.
**For safer specialties this is true, but for Obstetrics and Neursurgery, this is definitely not true. No person who works their butt off and makes good money goes around advertising their income. They would be setting themselves up for lawsuits and crime.
RESPONSE: Well it’s nice to see we can agree on some things. We are not asking your profession to advertise their income. We are asking you to be honest about what doctors make and that percentage wise it’s a small cost of doing business. A cost well worth the protection it gives your patients.
14. The first casualty of any war is truth, and this one is no different.
**We can only hope to have an informed electorate.
RESPONSE: Open the financial records and show us the true percentage of gross income and there will be no question about the alleged “burden” insurance premiums are imposing on the medical profession.
15. Vote for tort reform and you vote for legal irresponsibility and take away your own rights at a time when you need them most. Then you have no one to blame except yourself. Good responsible doctors know this is true and that’s why they will never vote for tort reform and to give those doctors who practice bad medicine the right to kill and unnecessarily injure patients without corresponding legal responsibility.
**I don't know of a single doctor who is satisfied with our malpractice system in the US. Half of all doctors are sued in the US. Are half of all doctors incompetent?
RESPONSE: No, half of all doctors are not incompetent. Where did you get the fact that half of the doctors in the United States are sued? And over what period of time are you referring?
16. If you practice medicine correctly and according to recognized medical standards you have nothing to fear.
**Which is why doctors receive “Notices of Intent” and are then dismissed from the case 8 months later, after the emotional toll on them and their family has already run its course. File a countersuit? What is the likelihood of success? Nil. I would like to be paid for the hours I spend worrying and losing time with my family, only to be dismissed from a lawsuit. Moreover, lawsuits take time away from patient care.

Like making laws and making sausages, the less one knows about lawsuits, the better one sleeps.
RESPONSE: I’m sorry to hear you were sued. Perhaps you could view what happened a different way. The patient thought they were injured by your care. Obviously if the suit was dismissed they were not injured by something you did that fell below the standard of care. Of course I’m assuming they had a competent attorney and a fair opportunity to obtain an expert; one not engaged in a conspiracy of silence. We’ll make that assumption for this discussion.
Now do me one favor, and pretend that one of your children is the injured plaintiff. When it’s someone you love and care about it’s not so easy to dismiss the Plaintiff’s efforts or to punish all other injured patients just because the doctor’s feelings are hurt. Like I feel for my clients you should feel for your patients, even those that sue you because of a bad result. They call it the practice of medicine or the practice of law for a reason. We strive for our entire professional lives to get it right. There are those times when are judgment could have been better but there are those times when our judgment is just plain off the mark and we will be sued. In those instances we, as professionals, must appreciate the privilege we have been given to practice a profession in America. We are highly compensated for what we do. We have great business opportunities and admittedly, we can make mistakes. I’m sure you’re a fine physician. One mistake doesn’t say anything about you overall as a professional. Professional careers aren’t about one day’s efforts, or the first or last day we practice. Careers are about the journey. Forgive your patient for suing you and move on. There are many other patients who need your attention.

I will not undertake a point-by-point response. I will make a few general statements and respond to a few points.

The malpractice system in the U.S. is adversarial. If a physician has a poor outcome and pre-emptively notifies his insurance company, the first instruction from his insurer or lawyer will be “Don't talk to anyone about this event.” Many discussions outside of a formal QA meeting (and even perhaps some inside formal QA meetings) are discoverable, and could hurt a physician's defense. Moreover, insurance companies have an interest in hiding malpractice judgements because they feel that knowledge of these judgements could be beneficial to plaintiffs.

What we should have is a national no-fault malpractice system, preferably using arbitration (like Kaiser Permanente) to justly compensate for actual economic losses and minimize medical expenses due to malpractice claims. Such a system would be able to collect data on malpractice claims which could then be used to educate physicians on risky areas of practice, perhaps enabling them to exercise greater caution in these areas. This system could actually improve patient care. In our current system, mistakes are hidden for fear of litigation, and can be repeated over and over by different physicians.

2. Oregon implemented malpractice pain and suffering caps in 1987, which were then struck down by the state Supreme Court in 1999. Insurance premiums for Internal Medicine increased in 1988 to about $12,000 (due to cases that were already in litigation or appeals), but then decreased from 1989-1998 to about $4800 (all figures inflation-adjusted). After the state Supreme Court struck down this law, premiums increased to over $12,200 in from 1999-2004 (higher than in 1987 even after adjusting for inflation).

I make no arguments regarding whether physicians should be sued or not, only that pain-and-suffering awards are essentially a hidden tax on healthcare in the U.S. Pain and suffering caps were the initial subject of this blog. Incidentally, I know of no other profession which pays such high malpractice expenses as certain physician specialties.

3. Wow! $5 million!?! Even $1million!?! I know of no physician who makes that much money a year practicing medicine (although physicians can be secretive about their incomes). I should move to your state! The wealthiest physicians in our community were joking about a newspaper article claiming they made $1 million a year – the joke being that they didn't know anyone who made that kind of money.(They may make half that amount, after expenses, but before taxes, however).

As for malpractice expenses, in Florida, in 2004, for Obstetricians and General Surgeons malpractice premiums exceeded $275,000/year. In California, which has MICRA pain-and-suffering caps, the premiums were $70,000-$90,000 – about 1/3 of the Florida premiums.

I assure you, these savings passed on to patients, not retained by physicians (health care is too competitive, and the government controls too much reimbursement, to retain these savings).

10. Again, I don't know what state you practice in, but in the area where I live, most physicians carry $1million per incident coverage/$3 million total physician lifetime coverage. If a physician loses a lawsuit for $2 million, he could lose his home (or at least most of the mortgagable value). This should give pause to anyone thinking of a career in medicine.

DB: I'm not sure in what state you practice but I live in Iowa. The specialties in this state make a lot more than the family practice doctors. They also practice medicine with a higher risk to the patients and correspondingly pay a higher premium for malpractice insurance. GP and FP's do not earn anything close to $1m. GP/FP's earn between $145,000.00 and $275,000.00. That doesn't include benefits and 401K contributions. Surgeons and cardiologists earn a great deal more.

I have to agree that a malpractice premium of $275,000.00 or more is a steep price to pay for doing business. But who are these physicians? What area are they practicing in and what is their loss experience? If those specialties would open up about their incomes, gross charges and loss experience it would do a lot to put it all in perspective for everyone. Hearing that suggestion the retort is, "Well no one else discloses their incomes so why should we?" And the answer is, "Because you're asking to be exempt from legal responsibility."

I've said for a long time that doctors are fighting with the wrong group. Lawyers have no control over insurance premiums, nor does either profession have the information we need to make a sensible appraisal of what is really going on with medical liability premiums. So long as the insurance industry keeps us fighting with each other they avoid disclosing financial information that we all need to come up with a sensible solution. We all know that as investment returns weaken insurance premiums increase. There is a inverse relationship.

It’s not true that civil trial attorneys take the position we do because we have a vested interest in earning fees off of the few awards or settlements that make headlines. There are a few plaintiff lawyers who have made a great deal of money on pharmaceutical cases and on medical negligence work, but they are a minority. The majority of civil trial lawyers don't make even six figures in a year. For the majority our concern is for the clients we see that are injured however that may be; and whose lives are economically devastated. No expert can predict the exact amount of future expense and reduced earnings. It's tragic but it's what we face in trying to prove their losses. Without pain and suffering damages they will never have enough to pay for those unexpected medical costs that seem to continue to exceed normal inflationary trends. So when they run out of money where does the money come from to pay the medical bills? Society pays and we all know it. If you take away pain and suffering damages where will the money come from to pay the legal fees and the litigation costs? Last I checked no doctor will treat my family for free. The bank still charges my family for a mortgage and I’m expected, like you, to buy my groceries. It’s easy to talk in the abstract and to talk about taking away rights from someone that isn’t a real person. We have clients who are real people with real problems and talking about taking away their rights may be popular but its bad government and societal policy. Because sooner or later the losses may be your own and then who is left to speak for you? If you don’t pay the lawyers they will do something that allows them to pay the bills.

I look around my small community (West Des Moines, Iowa) and see two new hospitals being built, a new laser eye surgery center, a multi-story building to house cardiac surgeons, a new day-surgery center and several other new medical facilities. There are new doctor's offices being opened in several strip centers. There seems to be plenty of money for brick and mortar projects indicating the health care system is in fine shape financially.

On the other hand I don’t see lawyers building new court houses or new office buildings to house legal service businesses.

So who is better off financially? And why? Fifteen or more years ago many doctors sold their practices to hospital systems. I predicted this would come back to haunt them and I believe we are seeing the answer to “And why?”

I don't know your specialty but I suspect its OB-GYN. For OB-GYN I have no information concerning gross billings, net profit for OB groups and pay to physicians, but I can assume it's pretty healthy otherwise they would be disclosing it publicly. I'm not asking you for your personal earnings information but realistically without knowing those numbers it's difficult to rationalize why changes need to be made in legal responsibility to the claim the costs are skyrocketing. To make a rational decision we have to know why the insurance industry is charging what some physician's claim they are being charged. We need to know the loss experience with those physicians. We have none of that information.

In the practice of law we deal in facts. Claims are made all the time, those are assumptions people ask us to make based on allegations or unsubstantiated assertions. As lawyers with clients whose lives would be impacted we can not join the few physicians who claim they need relief without having the facts that substantiate these claims.

[Old saying: The person with the longest explanation is the guilty party (?or the one with the 'agenda'?)]

Problem: Separating the bad outcomes of good doctors from lousy doctors. The plaintiff's bar and physicians (societies and state boards) and hospitals have been notoriously poor at this.

Some years ago I read of a suggestion about creating specialized courts consisting of legal, medical and citizen experts to address bad results. Maybe time to give it a try!

we tried that in michigan 10 years ago in ADR proceedings and we could not consistently get doctors to participate.the JURY system creates citizen experts.we trust juries to determin life/liberty issues in criminal matters why do you think they can't get dollars/cents right in civil cases? notice how short my response is - no agenda here - just information!