Sunday, November 20, 2005

Suzanne's Simple Solutions to Complex Policy Problems #3

Q: What can be done to reduce the cost of liability/malpractice insurance for doctors?

A: I am so glad that you asked. The answer does not lie in undemocratic measures such as capping the amount of money a jury may award in a lawsuit, or through state provided insurance. Nope, the answer lies square with the medical profession and our friends at the American Medical Association (AMA) themselves. First, consider the attitude of many (but not all) doctors. They seem to believe that they are infallible gods whose judgment should not be questioned by those of us outside the profession. However, in the event that their judgment proves incorrect, they cry that they are only human and therefore entitled to error. Wrong. Either you are infallible or human. It is no accident that doctors rarely see doctors when they themselves are sick. It means they have to admit that they are just like everyone else. And they don’t like getting treated the way they treat their patients. If doctors were a wee bit more humble to begin with, maybe we wouldn’t be inclined to sue their asses off when they fuck up. So a small adjustment in attitude towards us little people (patients) would help.

Second, our friends at the AMA either need to regulate the profession in a serious manner or allow outsiders, like state health departments, to do so. Currently, the AMA allows doctors to fuck up over and over again before they censure their members, let alone take away their licenses. They too closely identify with errant doctors, worrying about what would happen if they made a mistake. Once a doctor is censured, it’s damn near impossible for patients to access that information anyway. As a result, bad doctors continue to hurt people. A study in Massachusetts found that 5-10% of licensed doctors generated an astounding 90-95% of malpractice suits. The number of court cases, and thus the price of malpractice insurance for all doctors, would decrease dramatically if the AMA actually cared about patients and tried to protect them instead of covering for shitting doctors.

Consider: in the late 1990s, a woman went into labor and had a c-section to deliver her baby. Her OB-GYN, unbeknownst to the patient (who, by the way, was a doctor herself), had fucking Alzheimer’s and was known to forget where he was and what he was doing at random intervals of the day. Right after the baby was delivered, this doctor carved his initials into the patient’s abdomen because he was so pleased with the clean cut he had made that he considered a work of art that should be signed by the master. Understandably, the patient was furious. She learned that this was not the first time that he had fucked up in the delivery room, and sued. The AMA finally revoked his license, although they defended their prior inaction by noting that they felt sorry for him because he wanted to continue practicing and could understand his predicament.

Therefore, the solution to the problem of runaway malpractice insurance costs is easily controlled by merely asking doctors and the AMA to do the right thing and admit that they are human and put the interests of the patient ahead of their own career worries.

Disclaimer Yes, I realize that not all doctors are assholes. My best friend is in residency and is a wonderful person, and I have had some excellent doctors who have made a huge difference in the quality of my life. (Thank you Dr. Kummer and Dr. Kaplan!) My current GYN, whose name I am blanking on, is awesome and the most down to earth person. But I have also met some horrid shitheads, and the ones in charge of public policy at the AMA always seem to be the most self-righteous and self-absorbed.

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