'They Can Sue, But They Can't Hide' 1212
An anonymous reader writes "The New York Times (free reg's yada, yada) has this article about Texas doctors running an online blacklist of patients who have sued. The searchable database is at doctorsknow.us. Nice to know that you can get blacklisted for suing the doctor that caused massive brain damage to your kid (and winning)." To add a plaintiff to the database, membership was not always required.
Re:Beat them at their own game (Score:5, Informative)
Funny how stats don't back up doctors arguments (Score:5, Informative)
I've had arguments with doctors I know who take a highly visceral reaction to malpractice suits and jury awards. Nearly every one of them rails against what they perceive as a litigious US culture, and speaks with unquestioned confidence about how lawsuits are:
- driving up insurance costs
- unfairly assuming medical perfection
- making it unattractive or impossible to practice medicing in the US
What I find amazing is the fact that NONE of the statistics support any of these positions. According to two recent studies - one by the AMA and the other by the Harvard Public Policy school (?, I believe the Harvard Medical Practice Study) - both found that:
- malpractice, at least as defined by negligence, is fairly common
- of those with valid claims, only about 1% actually bring suit against a doctor
- of those who bring suit, only 1% are successful
This means that 1/100 of a percent of incidents of malpractice actually result in an award. Then you have the fact that the review committees in every case are made up of doctors and professionals, the act that an attorney who doesn't think a case is worth his effort or will reach an award won't even bother PURSUING the case, etc.
I'm also reminded of another study conducted in NY a few years back. If I remember correctly the study found that of all malpractice claims in the state less that 10 doctors were responsible for nearly 50% of the cases. Why were they practicing? Because the medical review boards hed declined to suspend their licenses for the incidents. These are people like the guy who operated on the wrong side of his patients skull, the guy who carved his initials into his patients abdomens etc.
You would think that after 30 years of schooling doctors - SCIENCISTS - would be intelligent enough to seek actual EVIDENCE to support their absurd claims; even the AMA disagrees with them! You'd think that GOOD doctors (and there are many) would be tired of paying exorbitant fees to subsidize the negligence of their incapable colleagues. You'd also think they'd be intelligent enough to bother examining the various mergers in the insurance industry and price increases in the face of decreased competition before leaping to absurd claims regarding jury awards and civil suits.
Bottom line: I'd like to see a comparable database of every doctor in the United States with every incident of potential malpractice, lawsuits, complaints, or peer review comprehensivlely outlined and available to the public. I'd like to see doctors held to a national standard of quality, put on suspension when there actions merit it, and suspended when they cross a threshold like ANY OTHER PROFESSION (say hello to the Bar). Will we see these things in the near future? No, because doctors have no interest in policing themselves and facing up to the truth of the situation.
The whole thing just makes me ill.
-rt
Cause of high insurance rates (Score:5, Informative)
High insurances rates aren't being caused by malpractice lawsuits; they're being caused by the stock market tanking. The medical insurance companies' holdings took a massive beating and they're raising rates to compensate.
States(like Florida) that have passed caps on damages for malpratice have insurance premiums just as high as the rest of the nation.
Tort reform is about making screwups a low, predictable cost of doing business and lawyers have become convienient scapegoats for those who would like to avoid responsibility for their actions.
In the end, the biggest(and highest profile) awards inevitably end up being against companies and people that repeatedly ignored the problem. It's funny that for a readership that decries so many abuses by corporate America, an awful lot of Slashdoters seem willing to castrate one of few remaining ways an individual person can hold a corporation accountable.
In defense of Doctors (Score:5, Informative)
Unfortunately this leads to many trials that are unwarranted and yet the parents still win. Now you almost have to leave the state if you want to have a baby.
Re:This is US, kiddo (Score:2, Informative)
Blame the Doctor (Score:5, Informative)
My mom was misdiagnosed with cancer. She had chemotherapy and a hysterectomy(no more kids), but she's always suspected she was misdiagnosed. Now, 25 years later, she's have numerous and serious health problems related to the treatment that have nearly cost her life.
And while it pissed her off, she was willing to just 'get over it'.
Until she found the same doctor misdiagnosed DOZENS of women and had them undergo the same treatment. And nearly all of them are having the same health problems my mom is having now.
But hey, I guess that sort of thing just 'happens.'
Re:Difficult? (Score:5, Informative)
Re:This is US, kiddo (Score:3, Informative)
Umm... add it all up. Federal income tax, state income tax, FICA (7.5% visible + 7.5% hidden), sales tax, property tax. You're already probably giving the government about half of your income. And you're already paying the staggering healthcare costs for a most of old the sick retired people who aren't even working.
Somehow you've let people convince you that you should pay high taxes for other peoples' health coverage, but it would be somehow to your disadvantage if you were eligible for benefits under this system that you're paying for.
Why shouldn't this be available? (Score:3, Informative)
Every detail of my professional life, including my home address, any criminal arrests or convictions, lawsuits or disciplinary actions, is required by Florida law to be online.
http://ww2.doh.state.fl.us/irm00profiling/searchf
If I get arrested for DUI (not convicted, just arrested) I would have to undergo a years-long period of intensive intervention and probabtion, or I would lose my license.
If I have to undego all this, why shouldn't everyone be forced to undergo this sort of scrutiny???
Suck it up, people!
Steve
The problem with such a list... (Score:2, Informative)
The site's "Group Monitor" function, which regularly scans the DoctorsKnow.US database for specific names suggests that it's important that doctors need to be aware of any legal proceedings on the part of their patients, without placing any importance on the legitimacy of the claims.
Yes, this is merely a database of publicly available information, but by grouping the information in such a way, in such a venue, the suggestion is that doctors need to be careful about taking these individuals as patients, regardless of whether their case had merit. The thought that doctors could be using this information to turn down patients is highly disturbing.
Though there are, without a doubt, people who abuse the system, but this database groups the innocent with the guilty without any sort of discrimination. Do we really expect the doctors to, after finding a name here, to go and do further research as to whether or not the case was legitimate? Doctors are busy people and their staff are busy too. I fear that such a database will hurt the innocent who have exercised their legal rights just as much (if not more) than it will punish the guilty.
Re:Can anyone tell me where I find ... (Score:2, Informative)
http://ww2.doh.state.fl.us/irm00profiling/searchfo rm.asp [state.fl.us]
Re:I don't blame the doctors (Score:5, Informative)
No. But it still COSTS MONEY to defend the minor cases. That's the problem on the legal side.
If Joe Patient sues me because he had to have his ingrown toenail removed again, I now have to defend myself, even though the case is trivial. So my insurance blows 10K+ defending this trivial case, and I've got to pay more insurance.
When I was in Med School in Alabama, we had two lectures from Lawyers, one from a Plaintiff's lawyer and one from a Defense Lawyer. Both stated that in Alabama, only 20% of cases brought to trial in the state ended in Plantiff Verdicts. So, consider the amount of money spent defending the other 80% that went to court and the innumerable others that were settled out of court and it becomes easier to see the scope of the problem. It's one of the reasons that some in the medical field are pushing for a Medical Court or Medical Approval Board that deems whether a malpractice case can/should be pursued.
Re:Difficult? (Score:2, Informative)
Sounds like an insurance company line (Score:5, Informative)
The injured (burned) plaintiff in this case, 79 year old Stella Lieback, was not driving her car. She was seated as the passenger in her grandson's parked car, holding the coffee cup between her legs while removing the plastic lid. The cup tipped over and poured the scalding hot coffee into her lap causing third degree burns.
Before claiming something is baseless, first look at all the facts.
Re:Sounds like an insurance company line (Score:2, Informative)
McDonalds raised their coffee temperature due to customers complaining that the coffee was cold by the time they got to work.
McDonald's coffee was so hot that, if spilled, it could cause third degree burns, which would burn through skin and down to the muscle in less than three seconds.
Actually, it was 4 to 7 seconds for a third degree burn. WHo the hell would let the coffee stay against their skin for 7 seconds? Pull the clothing off, or at least away from your skin.
McDonald's has had over 700 previous claims related to serious burns from their coffee to their customers
Over how many years? And how many locations do they have? 700 seems like a lot, but of it's over 70 years, that's less than one a month. And if McDonalds has 10,000 locations, that's less than 0.07 incidents per location.
She was seated as the passenger in her grandson's parked car, holding the coffee cup between her legs
In other words, she handled the coffee INCORRECTLY, and it's her own damn fault.
The jury was so outraged at the arrogance and callousness of McDonald's that they awarded punitive damages, to punish McDonald's and to deter McDonald's from such conduct in the future. They awarded $2.7 million.
So what? Juries are stupid. I was a jury member in a civil case where a guy left the crosswalk, walked DOWN THE MIDDLE OF THE STREET, and got hit by a woman backing up (he was right in her blind spot).
He purjured himself not once but twice: He said he "never saw" the car that hit him, when from the angle he was walking down the street, he would have literally walked within arms reach of it. The second time, he claimed in court he could not do certain things since the accident, but in his sworn deposition, he said "No" to the question "Is there anything you could do before that you cannot do now".
But the other jury members bought his bullshit and awarded him over a half million dollars... Not for medical expenses- those were covered by insurance. Not for lost wages- he was the owner of 2 stores and a lampshade factory. For "pain and suffering". BECAUSE HE WALKED IN BACK OF A MOVING CAR AND GOT HIT!!!
So, a huge jury award don't mean shit.
McDonalds served their coffee up to 40 degrees hotter than other fast-food restaurants
Bullshit. It was 190 degrees. The MILK at Starbucks is 170 - 180, and the espresso they add even hotter.
first look at all the facts.
Why not take your own advice?
Abstracts of medical studies of malpractice (Score:2, Informative)
Sick people often get sicker, and sometimes die. Many (not all) lawsuits seem to me to be caused by the fact that something bad happened, and the doctor and family didn't communicate well. What's frustrating as a doctor is that the "something bad" isn't always due to something the doctor did wrong, or could have done differently.
It seems like being a smooth talker is more important than practicing effective medicine. But I guess witch doctors have known that all along -- they don't ever seem to get sued.
Anyway, two abstracts from the New England Journal of Medicine. At least the profession monitors itself occasionally.
Volume 335:1963-1967
December 26, 1996
Relation between Negligent Adverse Events and the Outcomes of Medical-Malpractice Litigation
Troyen A. Brennan, M.D., J.D., M.P.H., Colin M. Sox, B.A., and Helen R. Burstin, M.D., M.P.H.
Background We have previously shown that in New York State the initiation of malpractice suits correlates poorly with the actual occurrence of adverse events (injuries resulting from medical treatment) and negligence. There is little information on the outcome of such lawsuits, however. To assess the ability of malpractice litigation to make accurate determinations, we studied 51 malpractice suits to identify factors that predict payment to plaintiffs.
Methods Among malpractice claims that we reviewed independently in an earlier study, we identified 51 litigated claims and followed them over a 10-year period to determine whether the malpractice insurer had closed the case. We obtained detailed summaries of the cases from the insurers and reviewed the litigation files if the outcome of a case differed from the outcome predicted in our original review.
Results Of the 51 malpractice cases, 46 had been closed as of December 31, 1995. Among these cases, 10 of 24 that we originally identified as involving no adverse event were settled for the plaintiffs (mean payment, $28,760), as were 6 of 13 cases classified as involving adverse events but no negligence (mean payment, $98,192) and 5 of 9 cases in which adverse events due to negligence were found in our assessment (mean payment, $66,944). Seven of eight claims involving permanent disability were settled for the plaintiffs (mean payment, $201,250). In a multivariate analysis, disability (permanent vs. temporary or none) was the only significant predictor of payment (P = 0.03). There was no association between the occurrence of an adverse event due to negligence (P = 0.32) or an adverse event of any type (P = 0.79) and payment.
Conclusions Among the malpractice claims we studied, the severity of the patient's disability, not the occurrence of an adverse event or an adverse event due to negligence, was predictive of payment to the plaintiff.
July 25, 1991
Relation between malpractice claims and adverse events due to negligence. Results of the Harvard Medical Practice Study III
BACKGROUND AND METHODS. By matching the medical records of a random sample of 31,429 patients hospitalized in New York State in 1984 with statewide data on medical-malpractice claims, we identified patients who had filed claims against physicians and hospitals. These results were then compared with our findings, based on a review of the same medical records, regarding the incidence of injuries to patients caused by medical management (adverse events). RESULTS. We identified 47 malpractice claims among 30,195 patients' records located on our initial visits to the hospitals, and 4 claims among 580 additional records located during follow-up visits. The overall rate of claims per discharge (weighted) was 0.13 percent (95 percent confidence interval, 0.076 to 0.18 percent). Of the 280 patients who had adverse events caused by medical negligence
Re:Difficult? (Score:2, Informative)
I'm rushed to the hospital after suffering a car accident. My neck is broken, but I still have feeling in my legs (the neck is broken, but not the spinal cord). I start choking on my own blood (don't ask why, It just starts to happen). The doctor makes a mistake and moves to fast, snapping the spinal cord. If he had moved slower, if might not have happened.
Sometimes shit happens, and people get hurt. Does it suck? Yes it does. To me that is an example of a screw up that would be ok because "people just make mistakes". The doc was just trying to save your life in an extreme situation.
Re:Extorsion? [Everybody has their perspective] (Score:3, Informative)
The American Medical Association said that it had just learned of the group and that it saw no ethical issues at stake.
"There's no question that physicians are totally frustrated by the relentless assault on the medical profession by trial lawyers,"
My father-in-law is a radiologist. He's had a few suits launched against him. Is he perfect? .... no. Is he negligent? hell no!!!
Recently a chain-smoker's family (daughter) came after him (amongst others) and claims that her dad wasn't warned soon enough about his lung cancer and the risks of smoking. My father-in-law only came in on the case (medically, not litigiously speaking) later as it was. This BTW .. because cause he lost his job since they could hire a youger, less-expensive radiologist who did less prone-to-malpractice suit types of readings. He was also asked if he warned the chain-smoking dude that smoking might lead to something like lung cancer. The suit has been carried forward by one of his daughters while the rest of the family stood by embarrassed of it all. Do doctors deserve fair warning against such a patient? In my opinion, yes. Do all people who have sued and won on malpractice deserve to be 'black-listed' ... no. Do some deserve it ... I'm sure. Question is how to determine that ... ??? The only thing I can think of is full-disclosure ... on both ends!
In most cases, the insurance company & the doctor decide to settle (guilty or not) and try send everyone home as happy as is possible and without breaking everyone involved financially. That doesn't tell anything about who was or wasn't negligent. I do think however in a case that was clear negligence, the doctor needs to be yanked from the profession just like drunk drivers should have their licenses yanked until they show they are not a threat to others in that position. But we see how good we are at taking drunk-drivers off the road, right? And it appears it's not much different for negligent doctors in many cases. And let's not even start on the number of patients who take no responsibility for their own health and expect the doctor to prescribe it to them in a bottle.
It's just sickening to see America(ns) looking for someone else to blame everything on and the lawyers getting fat and rich at the continual inflow of work due to hunt down someone else on which to drop the accountability. This will continue the trend of the brightest people going where the money is ... practicing law, not into science and medicine. Where will that leave us then? With even sharper/sneakier lawyers ... great! That's just what we need isn't it!?!?!?!
The Good Samaritan Laws (Score:5, Informative)
There is probably a medical ethics law or something similar that you are thinking of.
Re:Sounds like an insurance company line (Score:5, Informative)
How can you blame the doctor for this? The hospital and its procedures are usually to blame for these kinds of infections. If you've ever had any experience in a hospital, you'll know that outside of surgery, you see the doctor for a total of about 2 minutes during your entire stay, whereas the nurses, orderlies and residents disturbing you can drive you bonkers. Although its possible to be infected during surgery, I think its more likely to be infected by bacteria entering after surgery from the skin through the operative site. The instrumentation used during surgery is thoroughly sterilized and any hospital caught violating this procedure would be shut down by JCAHO immediately.
Also, us patients are as much to blame for the virulent staph infections. Staphylococcus Aureus is an extremely common bacteria, is frequently present on the surface of the skin, and is responsible for many common skin ailments such as boils, sties, abscesses and folliculitis (infected hair follical). What causes such a problem in hospitals is that the strains found there frequently don't respond to the standard round of antibiotics, and thus become extremely dangerous to high-risk patients (like heart-attack victims). The reason for these antibiotic-resistant strains? Primarily improper use of antibiotics. There are some basic simple rules about antibiotic usage that a huge section of society can't seem to follow:
So, back to the guy who got the staph infection. Sue the hospital and not the doctor. Although keep in mind that it is just as likely he carried his own infection in with him, and that the infection only became serious due to his weakened condition.
I also hope that the doctors all lose their license and live a life of abject poverty and suffering.
It's also possible that doctors will just stop practicing medicine because of people with a chip on their shoulder like yours. How is that going to make you feel when you need a doctor and can't find one anywhere? Do you enjoy paying such high rates for medical insurance in part because of escalating malpractice costs?
You want to blame somebody for what happened? Fine. But unless you know EXACTLY where the infection came from and how, you have to consider it just as likely that this guy already had the infection when he came into the hospital, and it got much worse because his body could no longer fight it off.
Re:even better.... (Score:3, Informative)
I don't know what it is like in the states, but in Canada, the Good Samaritan Act [gov.bc.ca] is intended to protect people who help out accident victims, not to force people to help out.
Re:Difficult? (Score:4, Informative)
Really? What are you doing that exposes you to so many bacterial infections?
Most common ailments from which people suffer (most coughs and colds, the flu) are viral infections. Antibiotics don't have any effect on them whatsoever.
By taking antibiotics for those diseases, you're doing yourself no good, and probably hurting yourself. First, you're knocking out the population of healthy, symbiotic bacteria in your gut that aid digestion and do a number of other useful things for you. Second, by knocking down the healthy population of bacteria, you leave behind a fertile open ground for nasty bacteria to colonize. Then you need antibiotics, perhaps...
Please, I encourage you to consult a physician (or at least a veterinarian) before self-medicating further.
Good Samaritan laws have protection in them (Score:2, Informative)
Very often said Good Samaritan laws have protections in them which make such a scenario impossible. If your cardiologist friend lives in MA, for example- he needs to speak with a lawyer, because he was fully protected.
I imagine even if he wasn't, its the sort of thing that wouldn't raise his insurance premiums one iota(at least not directly). Sorry, but I'm -really- tired of hearing doctors, driving $100,000 cars, living in multi-million-dollar homes, with trophy wives and 6 weeks vacation on some private island...whine about how rough it is that their insurance just costs so gosh darn much.
Ever looked at medical stats? We have shit for medical care in this country- some of the highest malpractice, fatality and complication(ie, go in for one thing, come out with something else) rates in the world; our doctors and nurses are, for the most part, completely incompetent by modern standards. Some(staph infection, for example) are simply because doctors are --too fucking lazy-- to wash their hands properly. At a DC doctor's conference on infection control, barely 1/4 of the mens room users even so much as washed their hands under running water!
Re:They are already going... (Score:1, Informative)
http://www.brown.edu/Departments/Philosophy/tar
Re:even better.... (Score:1, Informative)
Re:even better.... (Score:5, Informative)
Before a patient victimized by medical malpractice may file a lawsuit in Nevada District Court, the patient must submit a claim to the Medical Dental Screening Panel, consisting of six professionals - three doctors and three attorneys.
Before a patient victimized by medical malpractice may file a claim, another doctor must sign an affidavit under oath that medical malpractice occurred and caused injury to the patient.
In medical malpractice claims, Nevada has a loser pays system. If a patient victimized by medical malpractice loses at the screening panel, proceeds to court and loses at trial, the victim must pay the doctors attorneys fees and costs. Recent examples include awards against victims in excess of $100,000.
Nevada has over 4,000 doctors, 16,000 Registered Nurses, and more than 2,000 Licensed Practical Nurses. Every day, thousands of procedures (e.g., surgery, blood transfusions, medication administration, diagnoses) are performed in Nevada. In 2001, 219 claims were filed at the screening panel, 181 of which were filed in Clark County.
Finally, let's put this all into perspective:
The St. Paul insurance company paid out about $19.6 million in Nevada malpractice claims in the same year that it lost over $108 Million related to Enron: http://www.ntla.org/medmal/Exhibita.pdf
Last time I checked, St. Paul hasn't stopped insuring other businesses or pushed for caps on claims made by fraudulent businesses like Enron whose entire business plan was the corporate equivalent of supposed ambulance-chasing malpractice victims. That wouldn't go over too well in the boardroom; it's a heckuva lot easier to conjure up some smoke-and-mirror "crisis" targeted against individual claimants who have neither the corporate nor financial wherewithal to mount a unified front to defeat such nonsense.
Re:Difficult? (Score:3, Informative)
Socialized Medicine (Score:1, Informative)
As far as the ability to sue, doctors aren't judged by by a jury of peers. Trying to explain complicated biological concepts to a jury that has been hand picked for ignorance by the plantiff's lawyer makes a fair trial unlikely. That's why everyone is moving out of south texas. The jury is of the patient's peers, not the doctors. No one cares about guilt, innocence or jusitice. They just care about the pay out from the insurance company.
As an aside, I'm quitting medicine, and no, i've never been sued. But between no reimbursement for my services, ridiculous risk of malpractice suits and the generally absurb expectations of patients, I've given up.
Re:even better.... (Score:5, Informative)
Tell me about it. I'm in a program with a certified nurse-midwife as my primary care provider. After 23 weeks of pregnancy, I haven't seen a "doctor" at all (which I'm fine with). However, I've already paid a deposit on my expected co-pay for the *doctor's* delivery charges... which I won't owe them until sometime in late June or early July.
Granted, they are charging me in advance because apparently the routine visits throughout the pregnancy are all packaged in with the delivery according to my insurance company, so they get *no* payment until the baby is delivered... and have some difficulty collecting if I up and deliver somewhere else. But no one has ever been able to explain to me why I'm paying for a doctor's services in a program where I don't actually see one.
Re:even better.... (Score:2, Informative)
1. If you had a pay all this money, why didn't you go to trial and prove your case?
Becuase its not up to the doctor on whether the case goes to trial. That decision is made by his malpratice insurance.
2. If they answer, "my insurance company made me settle," then ask them why they rolled over on their principles because some faceless insurance company told them to.
Again, they dont have a choice in the matter. There insurance company most likely decides this.
Have insurance premiums gone down? Probably not. But what does go down in price? Whats happened is in locations where tort reform has happened, annual premium increses have dropped from double or even triple digit percentage increases down to the single digits.
Malpractice insurers may be greedy. Health insueres may be greedier. But lawyers are the greediest son of a bitches there are.
Off topic and anecdotal. You have been warned. (Score:2, Informative)
Sure, the water in the espresso machine is scalding, and the espresso dripping from it is pretty hot too. But in the little cup that catches it, it cools very quickly. This is why the milk must be added to it as soon as possible. The end beverage product will vary from 160 to 180ish, with somewhere around 175 being a nice ideal. When you are making 5 drinks in a little under two minutes, for an hour and a half straight, this is hard to achieve in practice. Other complications involve children's beverages, which are served at much lower heat (usu. 140 max) and beverages served at higher heat, such as hot apple cider and americanos.
An americano is what you get when you add 190 degree water to espresso. It is the Italian approximation of American coffee.
As I have been employed at a McDonald's franchise after the disputed, I will simply say that if they lowered the hold temperature of the coffee then it was a damn good thing they did so, as it was at least 185 degrees at "my" store in CA. The water used to make the coffee was abominably hot. We had to use it to make hot tea for people. The teabags come in a paper wrapper with golden arches on them, so I was never tempted to try the tea. The water itself was comfortably above boiling. It burnt me worse than the fry oil ever did.
Coffee has a higher boiling point than plain old water, which means that you may not necessarily be aware that what you think is hot coffee is actually a nuclear furnace in an insulated bunker.
I will go far as to say that I believe that if the woman in question was burnt as badly as she claims and McDonald's would not cover her hospital bills and she sued McD for the purposes of paying her medical expenses, then her lawsuit was not frivolous, given my bias that nobody should be peddling a substance capable of that level of tissue damage for the specific purpose of ingestion into one's vulnerable oral orifice.
Twist Tricks,
Arek Rashan
Re:The Good Samaritan Laws (Score:1, Informative)
It wasn't so much that Samaritans weren't good... more that there was a huge amount of animosity between the Samaritans and the Judeans. So you wouldn't expect a Samaritan to spend a lot of time and money helping a Judean stranger.
Re:even better.... (Score:5, Informative)
Good Samaritan Laws (enacted in every state in the USA) protect people who perform CPR and emergency care from lawsuits over injuries sustained during the care.
So if you are CPR-certified, and crack a heart attack victim's ribs after they consent* for you to perform CPR on them, they can't sue you for the cracked ribs.
Good Samaritan laws do not obligate anybody to help somebody in an emergency. Not helping somebody in an emergency is perfectly legal.
Btw, I am a law student, and CPR-certified.
*: You can obtain regular consent or implied consent. Implied consent is when a person is unable to consent (usually due to being unconcious) but a reasonable person would likely consent. Handy if somebody is choking on food but won't consent to the heimlich, because as soon as they pass out, you can perform rescue breathing/unconcious choking care on them.
RTFA (Score:4, Informative)
[OT] Samaritans (Score:5, Informative)
As an AC mentioned, I don't think they were a horrible people, but there was a lot of mutual animosity between them and the Jews. There had been a recent incident involving defacing a temple, and so Jews were actually praying that Samaritans would not get eternal life. You can read the parable itself at Luke 10:30 [carm.org] and a good analysis here [cfchome.org]. It mentions why the priest and Levite were reluctant to help, and why the Samaritan would be as well. Yet of course the despised Samaritan does what the others would not.
I'm an atheist, but I like this parable. And it seems that most people neither understand the historical details nor understand that they can be the good Samaritan in their daily lives.
Re:The Good Samaritan Laws (Score:3, Informative)
If it's a doctor however and they are trained for something, they are still liable for malpractice.
Re:Difficult? (Score:3, Informative)
Alan Hicks wrote: I can legally buy my own general purpose antibiotics and knock out most anything.
Idarubicin replied: Most common ailments from which people suffer (most coughs and colds, the flu) are viral infections. Antibiotics don't have any effect on them whatsoever. [...] through the regular use of antibiotics, you encourage the evolution of bacterial strains resistant to common broad-spectrum antibiotics. That doesn't just screw you, by the way...it affects the rest of us too.
Idarubicin is very much right. As someone who is quite allergic to at least one antibiotic, I hate people who abuse antibiotics by (1) taking them when they are unnecessary and (2) failing to finish their courses of antibiotics. (You do not stop taking the pills when you feel better! You take them all!) By failing to use antibiotics properly, you encourage resistant strains. Thus, we have to switch to different antibiotics, and that idea scares me. There aren't that many good ones to choose from, and who knows if any of the other ones are also dangerous to me. I'd rather just stick with the one I've repeatedly taken without problems, but people like Alan Hicks might make that impossible.
They're already limiting antibiotic use for ear infections [cnn.com], which are bacterial infections. They likely will have to start limiting them more for other types of infections as well. Though the article doesn't say so, I believe this is largely because antibiotics are abused by people like you, Alan Hicks.
How to take antibiotics properly: Go to the doctor when you think you need them. Tell him your symptoms. If he thinks you need antibiotics, question it anyway. Make sure his diagnosis makes sense, and make sure it is for a bacterial infection. When he gives you a course of antibiotics, take every one at the proper time. If you only feel better near the very end of the course, ask about extending the course to completely knock out the infection.
Re:Funny how stats don't back up doctors arguments (Score:3, Informative)
What I find amazing is the fact that NONE of the statistics support any of these positions. According to two recent studies - one by the AMA and the other by the Harvard Public Policy school (?, I believe the Harvard Medical Practice Study) - both found that:
- malpractice, at least as defined by negligence, is fairly common
do you have the definition of negligence handy? the abstracts of the studies you cite do not define it. they also dont define their definition of negligence for the purposes of the study. (i'm sure the study does, but i dont have accounts on those websites, so i cannot read anything but the abstract)
from the abstracts, though, it appears that about 1% of medical events result in adverse events resulting from negligence.
that doesnt really seem that common to me.
- of those with valid claims, only about 1% actually bring suit against a doctor
This seems (From the abstracts, at least) to be an incredibly vague point. How are claims determined to be valid if they are not filed? Were suits not filed because settlements were reached? Were they technically valid, but so insignificant it wasnt important to the patient? I'm not sure that there is any meaning in this statistic.
- of those who bring suit, only 1% are successful
i didnt find this statistic in the abstracts. Do you have a more specific place i should look to find this data?
i did find the statement that most malpractice claims were for adverse effects not resulting from negligence. this seems to imply that the majority of malpractice claims are for actions that do not constitute malpractice. (of 51 claims filed in the study, only 8 were for actions that constituted malpractice). i'm not sure if that is an accurate inference to make, though, because the information in the abstracts is vague. (that's not a condemnation, it's an abstract, after all)
This means that 1/100 of a percent of incidents of malpractice actually result in an award.
i'm not sure that's a fair assumption. 1/100 of a percent of malpractice cases that were deemed valid resulted in a lawsuit that was successful. Does this take into account settlements? Is there a difference between the definition of actionable malpractice in law and actionable malpractice in the study?
I would also be interested in knowing how many malpractice claims for actions that were not negligent were successful.
Then you have the fact that the review committees in every case are made up of doctors and professionals,
the studies you have cited were all compiled and presented by doctors, weren't they? it seems to me that doctors are exactly who you want evaluating claims of medical malpractice.
Do you happen to have a link for the NY study about 10 doctors being responsible for nearly 50% of the cases? I didnt see that in the abstracts in your other post.
Why were they practicing? Because the medical review boards hed declined to suspend their licenses for the incidents. These are people like the guy who operated on the wrong side of his patients skull, the guy who carved his initials into his patients abdomens etc.
in the case of the guy who carved his initials, his license was revoked. It took 5 months to revoke his license, but it was revoked. I didnt see the guy operating on the wrong side of his patient's skull story.
Re:The Good Samaritan Laws (Score:1, Informative)
Anyways, my point is, one of the things I learned, at least the ways the laws in Indiana work is that Good Samaratin laws do NOT apply to anybody considered a 'medical professional' So, as an EMT, if I stopped to help, I COULD be sued under malpractice laws, because if I did something wrong, it was expected that I should have known better becuase I was a trained professional. Theoretically, it's still a dicey situation for me even though my license is expired, because I have had the training in the past.
Re:even better.... (Score:5, Informative)
As I understand it, the crisis started when a doctor who had only (insert amount here, I don't remember how much. Try about 3 million) coverage. He lost a malpratice suit. The jury awarded (I think hundreds of millions) in dammages. The insurance company paid the policy limit. The court objected and forced the insurer to pay way beyond the coverage plan. (I think it was a defective baby case). Due to this opening of the cap on insurance policies, insurers found they were charging rates for a (one or two) million policy, but had the liability of (a good part of a billion) in coverage. Needless to say they started to charge for (maybe 500) million policies instead of one or two because the court re-wrote the doctors policies. With a policy limit removed by the courts, we have the spiral of hit the deep pockets with lawsuits and charging for the big policies that the courts mandated. The mistake happened when a multi hundred million award was forced out of a several million policy. That broke the insurance system.
Any history buff want to help me fill in the blanks? Anybody want to prove me wrong?
Re:The Other Side (Score:2, Informative)
Actually I believe that in Tort cases, as with any civil case there doesn't need to be a clear preponderance of the evidence, the jury just needs to be beyond a shadow of a doubt sure.
Re:RTFA (Score:1, Informative)
Now, isn't that interesting? They're using the nation's 75 largest counties to generate statistics for the entire nation.
Of course, small counties couldn't *possibly* have different tort statistics than the large counties, could they?
And neither do I suppose it is going to make much difference if all the nation's large counties just so happen to lie in the western United States...
Re:The Other Side (Score:2, Informative)
Too many suits is a problem (Score:1, Informative)
I'm not certain of the purpose of the database of plantiffs. Its best use appears to highlight how useless such databases are. Everyone seems fine that there is a database on physicians who are sued, eventhough the physician may have won every case in the database. A doctor in a high risk specialty my be sued frequently due to bad outcomes eventhough they do everything correctly. Either database (physician or plantiff) is probably equally meaningless.
Re:The Good Samaritan Laws (Score:2, Informative)
IIRC, "Good samaritan" laws don't apply to anyone who tries to help--just people who know what they're doing, as long as they do it right.
They're exactly designed to allow doctors, EMTs, and Nurses to stop by an accident and help, without worrying about being sued so long as they follow proper emergency procedure.
But, in any case--if a doctor or anyone else is uncertain about it, they should talk to a lawyer in their area for an answer.
Re:Too many suits is a problem (Score:3, Informative)
If physicians were better at doing their jobs, fewer of them would be sued. I hear of too many cases of incompetents who will not listen to patients, have their mindset on what they think is wrong rather than on treating the patient's illness, and presuming the patient has no idea what they are talking about AND is not worth listening to.
There is one good reason: a doctor who doesn't make negligent errors amounting to incompetence and is open with their patients is not going to get sued. A lawyer who is not getting anything from the patient is not going to spend a fortune out of his own pocket to gather evidence and try a case that doesn't have a reasonable chance that they could win.
You have it backward, it would mean that 20% of the time doctors were wrong. The plaintiff is the person suing, not the doctor.
It is extremely hard to sue a doctor and win, first because doctors tend to maintain a "code of silence" where doctors simply will not go into court and report on another doctor's incompetence, (1) because they don't want to lose (lucrative) referrals from other doctors and (2) because their own insurance carrier might raise their rates or cancel them in retaliation. If a lawyer cannot find an expert witness - which would have to be another doctor - to show incompetence he can't possibly sue and win. (Unless it's "res ipso loquitor" ("the thing speaks for itself") class incompetence, i.e. x-ray before operation shows area where operation is being performed, x-ray after shows same area plus a clamp that wasn't there before and isn't supposed to be there.)
Second, the standard contituting "malpractice" is more than error, more than even mistake, more than negligence, but almost incompetence. If this class of standard were used in automobile accidents, the only time your insurance company would have to pay anything is if you were not only negligent in hitting someone but were drunk at the time.
If a doctor makes a mistake in diagnosis, but it's reasonable given the circumstances, that is not malpractice even if the patient is injured or killed as a result, and even though it's a result of an error on the part of the doctor.
If I drive a vehicle I'm not familiar with and in making a turn in a parking lot, I nick another car, that's negligence and I'm liable. In the same circumstances of a doctor trying a new procedure and making a mistake, even if it kills the patient that is most likely less than the threshhold necessary to collect for malpractice.
Maybe some of it has to go to lawyers if it's the only way to get healthcare that isn't the result of negligent incompetence.
That database is not available to the general public. It's primarily for the licensing authorities, malpractice insurers, possibly for some hospitals, but no access under any circumstances for you and me as patients at all.
A lawyer who is working on a contingency fee is not going
As somebody who does this (Score:3, Informative)
Disclaimer: I'm an ER doc, and I've got about every certification you can shake a stick at... BLS, ACLS, ATLS, Pediatric ALS, etc, etc... in addition to experience rendering care under fire as a tactical medic. I'm comfortable rendering care in the field, partially from my training, but also because EMS direction is part and parcel of EM practice. I also carry my jump bag in my vehicle, so I've got advanced airway management, hemorrhage control, monitoring capability... all in a backpack.
I stop at traffic accidents if they happen right in front of me, or if there is no EMS on scene. However, I would not expect a radiologist to stop (in fact, I'd almost hope he wouldn't... he'd probably just be in the way). If somebody is really FUBAR'd and needs me to stay with them, I stay until they're in qualified hands (that may mean a ride to the hospital)... otherwise, I immediately hand off to the medics and leave.
Having a medical license doesn't mean you're qualified to offer care in the field. For my own part, if I was laying bleeding in the road somewhere, I'd rather have a paramedic (or maybe a surgeon) than some of my colleagues. I don't mean that as an insult to other doctors... but care in austere environments is very different from the office... it's simply not within the scope of most physicians' practice or experience.
Re:The Other Side (Score:3, Informative)
Nope. There are only time limits for adults. There is no such limit for malpractice where a minor is involved. Exact details vary from state to state.
Since the article itself refers to Texas, let's look at their laws. There, you have two years to bring an action. If it's a course of treatment, rather than a specific incident, you have two years from the date of the last treatment. If, however, this period begins before the claimant is 18, an action may be brought at any time until the claimant's 20th birthday.
Now, a pediatrician or other provider working with kids has a decent amount of exposure. But a OB has a full twenty years until they're certain they aren't going to be sued for a perceived negligence on their part.
My sister is an OB nurse. She sees plenty of people who don't bother with proper pre-natal care. They drink and smoke (cigarettes and otherwise) throughout their pregnancy. When the kid pops out with a problem, there's lawyers all over daytime television who are willing to take the doctor to court, because it's obviously their fault.