Straightforward advice on reducing malpractice claims

The American Medical Association issued a report on malpractice claims .

The report found that over the course of a career, most physicians will have been sued at least once.  Given how many patients a doctor sees over a career, the frequency of malpractice claims is very low.

There are a few straightforward things that doctors and patients can do to reduce the risk of a malpractice suit:

• Doctors should give patients technically sound care.
• Doctors should provide care  in a caring environment. Obtaining  feedback from patients on their perceptions of their care helps in this task.
• Patients should make sure they get copies of any laboratory or pathology work that is done.  That will help assure that nothing falls through the cracks.

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Is there ‘defensive medicine?’

In his blog on patient protection, malpractice attorney Patrick Malone questions the idea of “defensive medicine.” He writes, “if there’s any chance the test may help the patient by revealing a treatable problem, then the test was necessary and doesn’t fall into the category of insurance fraud or defensive medicine.”

This isn’t quite true. Every test also comes with risks. A test might have a chance of revealing a treatable problem, but the risk of the test might exceed the potential benefit. For example, we could get a chest X-ray to look for cancer or a CAT scan of the head to look for brain injury, but the risk of the radiation may well exceed the potential benefit of the test. The right answer in such situations may be to avoid the test. But if a doctor doesn’t order the test, he or she runs the risk of missing the rare treatable problem and being sued.

The right answer to this may lie in a less paternalistic medical system. The doctor ought to educate the patient about the benefits and risk of the test, then let the patient decide if they want to take the risk of the test or the risk of missing the rare problem. Empowering the patient is usually the right answer, whether it comes to health care costs or avoiding malpractice issues.

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What’s to learn from malpractice?

In a July 14 blog, Medical Justice founder and malpractice protection champion Jeffrey Segal, MD, JD, explains why medical malpractice suits don’t help.

“If I touch a hot stove and burn my hand, I learn not to touch a hot stove again. Painful lesson, but lesson learned. How does this make our lives worse? When a person gets burned, whatever the reason, that person will naturally avoid that stimulus in the future. If that person is a doctor, and that stimulus is a frivolous lawsuit, the future behavior will be to avoid that stimulus (the frivolous suit) by ‘protecting themselves’ via defensive medicine.”

Dr. Segal makes a great point about frivolous lawsuits.  The resulting defensive medicine has been reported to cost us up to several billion dollars a year.

But what about the lawsuits that aren’t frivolous? Will patients and doctors learn from the mistakes that resulted in real harm to patients? Malpractice lawyer Patrick Malone offers advice in his blog to help people avoid putting themselves in situations that could result in a needless adverse outcome. Malone points out that step one is for patients to get and read their medical records.

I wonder how many problems would be averted if patients made a point to get, read and keep a file of their medical records. For some reason, it just isn’t a part of our culture. I have to admit, I probably keep a better file of records on the work that has been done on my car than I keep on my own medical care. This culture will change. It has to in order to better assure the quality of our medical care.

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Another View on Malpractice on “Getting Better Health Care”

Earlier I pointed out we had a great interview with a medical malpractice plaintiff’s attorney on the Getting Better Health Care radio program.  To hear a completely different point of view, listen to the interview with Jeff Segal, founder of Medical Justice (http://webtalkradio.net/2010/02/22/getting-better-health-care-–-protecting-doctors-and-patients-from-medical-malpractice/). 

I’m always struck by how different people can perceive one issue so totally differently depending on their experiences and relationship to the issue.

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Visit with a Malpractice Attorney on “Getting Better Health Care”

I had a great interview with Tom Comerford (http://www.comerfordbritt.com/Bio/WComerford.asp) on “Getting Better Health Care.” Tom is a medical malpractice plaintiff’s attorney. We heard his thoughts on myths surrounding medical malpractice and his take on the importance of medical malpractice issues in health care reform. To download the podcast, click here: http://webtalkradio.net/2010/02/15/getting-better-health-care-%E2%80%93-the-physician%E2%80%99s-perspective-on-health-care-reform-2/.  Bottom line: Tom doesn’t see medical malpractice as the underlying problem facing our health care system, and he doesn’t think that tort reform is the answer.  We’ll get a contrasting opinion in another episode of the program.

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