Articles Posted in General Medical Negligence

For over a decade, proponents of tort reform have argued medical malpractice reform is needed to reduce spiraling healthcare costs. If these reforms were implemented, tort reformers promised reduced healthcare costs. Opponents of tort reform argued medical malpractice reforms would have no significant impact on healthcare costs, as medical malpractice lawsuits account for less than 1% healthcare costs. So, who was correct?

According to recent figures, the total number of medical malpractice payouts on behalf of doctor fell to its lowest level in a decade–down 28% since 2003. In addition, the total value of medical malpractice payouts is also significantly down. However, the nation’s healthcare expenses did not followed suit. Instead, healthcare costs have risen a startling 58% in the last decade. This confirms that medical malpractice costs have no appreciable impact on healthcare costs. Indeed, if medical malpractice costs were a major driver behind soaring healthcare costs, the substantial reduction in medical malpractice payouts over the last decade should have significantly lower healthcare costs.

In 2012, the total number of medical malpractice payouts was 9,379 compared to 16,565 in 2001. In 2012, the total value of medical malpractice payouts was $3.14 billion versus $4.41 billion in 2003. Despite these significant reductions in medical malpractice payouts, healthcare costs over doubled in the last decade.

Doctors who work in high-risk specialties, like surgeons, are practically guaranteed to face a medical malpractice claim during their careers, according to a 2011 study by the New England Journal of Medicine. The study, which analyzed malpractice claims from a large liability insurer over a period of 14 years ending in 2005, found that 99% of doctors in high-risk specialties, like neurosurgeons, thoracic-cardiovascular surgeons, and general surgeons, were likely to face a claim by age 65. In contrast, only 75% of physicians in low-risk specialties could expect a claim during their career.

Annually, only 7.4 % of doctors across all specialties faced a malpractice claim, according to the study, but within that percentage there was a significant variation between specialties. Neurosurgeons were most likely to face a claim at 19.1%, with thoracic-cardiovascular surgeons and general surgeons close behind, at 18.9% and 15.3%, respectively. Less likely to face a claim were lower-risk specialties like family medicine (5.2%), pediatrics (3.1%) and psychiatry (2.6%). Additionally the study found that within the percentage of doctors facing claims annually, only 1.6% of the claims were compensated.

In regards to payment of claims, the study discovered that there was no correlation between the specialties with the highest number of claims and the highest average payment. For example, although neurosurgeons faced the highest number of claims in a year, their average payment was calculated at $344,811, as opposed to the average payment for a claim against a pediatrician, calculated at $520,924. Additionally, payments exceeding $1 million, defined in the study as outliers and accounting for less than 1% of all payments, were mostly attributed to lower-risk specialties including obstetrics/gynecology, pathology, and pediatrics.

When a patient goes to a doctor or hospital, he or she puts their health and well-being in someone else’s hands and expects the best care possible. While this is the case in most situations, unfortunately doctors and healthcare providers can and do make mistakes–this is known as medical malpractice. When these mistakes have devastating or even tragic consequences, patients and family members may feel the need to hold health professionals responsible for their negligence and file a medical malpractice lawsuit. While patients need to have some form of recourse for conduct that falls below the standard of care, the amount of time health professionals spend dealing with medical malpractice lawsuits can affect patients and doctors across the entire industry.

A recent study of the malpractice claims records of more than 40,000 doctors, published in Health Affairs, found that most claims took nearly two full years from the beginning of the lawsuit and nearly four years from the actual event to come to resolution. If a case resulted in payment to a plaintiff or involved more serious patient injuries, the suit often took even longer to resolve. The study also examined how much of a doctor’s career is spent on open claims. The findings showed that an average open claim takes four years of a doctor’s time as he or she works through the lawsuit, with certain specialists, like neurosurgeons, devoting even more of their professional lives to legal issues.

Drawn-out legal battles can have adverse effects on patients as well. A medical malpractice case that successfully creates change in a doctor’s actions, a facility’s philosophy or even throughout the industry can benefit many patients. But if the lawsuit is tied up in court, these improvements are delayed as well. Studies also show that patients would prefer that physicians acknowledge medical errors and apologize for the mistake early in the legal process rather than deal with a lengthy claim that could delay compensation.

Many of us have seen a handwritten prescription by a doctor and wondered how anyone can read the writing. In most instances, the pharmacist is able to decipher the writing or they will call the doctor’s office for clarification. However, poor penmanship by doctors can lead to medical malpractice, including medication errors. In fact, there have been many medical malpractice lawsuits where a patient died as a result of a medication error from a doctor’s poor penmanship.

A well-known example of how a doctor’s poor handwriting can lead to tragedy occurred in Texas over a decade ago. Because of a doctor’s poor penmanship, a pharmacist filled Pendil (a blood pressure medication) rather than Isordil (a medication for heart pain). As a result, a Texas wife lost her husband when he ingested the wrong medication, suffered a heart attack, and died. After she filed a medical malpractice suit, the jury determined the doctor’s poor penmanship caused the medication error which, ultimately, lead to her husband’s death. Thus, the jury’s sole basis for finding the doctor negligent was his poor handwriting.

Poor penmanship by doctors is an unfortunate problem that has not gone unnoticed by the medical community. Indeed, the American Medical Association (AMA) has warned doctors about their penmanship and urged them to improve this skill. Over the last decades, there have been multiple AMA policies urging doctors to improve their handwriting. These policies have also advised doctors to also include the “purpose” of the prescription “to avoid confusion on the part of either the pharmacist or patients.” At Cedars Sinai in Los Angeles, doctors are encouraged to take handwriting courses to improve their penmanship. At Indiana University, the medical school finds penmanship so important they include penmanship training as part of their curriculum medical students.

As with any cancer diagnosis, patients who are told they have breast cancer are frightened and need information. The best person to provide this information is their doctor. The patient’s doctor must educate the patient about their condition and available treatment options including surgery. After all, informed consent must be more than signature on a consent form the day of surgery. However, according to a recent study published in the Journal of the American College of Surgeons, half of early-stage breast cancer survivors lacked basic information about their disease and treatment options. As a result, the study concluded many doctors fail to provide their breast cancer patients valuable information necessary for them to make an informed decision about their treatment options. As a medical malpractice lawyer, I have handled my share of informed consent cases. However, I was even surprised by the results of this study showing that many doctors, perhaps close to half, fail to provide their patients critical information they need to make an informed decision about their breast cancer treatment options.

Lead by lead researcher, Dr. Clara N. Lee of the University of North Carolina School of Medicine, Chapel Hill, the retrospective study evaluated the decision making process of early stage breast cancer patients regarding surgical treatment. Surveys were mailed out to adult women with a history of early-stage invasive breast cancer treated at one of four academic medical centers: The Dana-Farber Cancer Institute, Boston; Massachusetts General Hospital, Boston; University of California, San Francisco; and University of North Carolina, Chapel Hill. Based on answers to basic questions about their disease and treatment options, patients answered only half their questions right (52%), demonstrating these patients had a large knowledge gap regarding their disease and treatment choices.

Because study data was collected an average of 2 ½ years after the patient’s surgical procedure, researchers recognized that some patients are likely to forget some information over time. However, the information that was forgotten was simply too basic, according to researchers, to be simply forgotten. For example, only half of breast cancer survivors from the study knew the survival rate was the same for breast-conservation therapy and mastectomy. Likewise, breast cancer survivors who underwent a partial mastectomy routinely did not know the local recurrence rates (compared to women who had a mastectomy).