Malpractice Methodology

[groovedaddy]

The health care legislation that Congress enacted earlier this year, contrary to much of today’s overheated rhetoric, does many things right. But it does almost nothing to reform medical malpractice laws. Lawmakers missed an important opportunity to shield from malpractice liability any doctors who followed evidence-based guidelines in treating their patients.

As President Obama noted in his speech to the American Medical Association in June 2009, too many doctors order unnecessary tests and treatments only because they believe it will protect them from a lawsuit. Instead, he said, “We need to explore a range of ideas about how to put patient safety first, let doctors focus on practicing medicine and encourage broader use of evidence-based guidelines.”

Why does this matter? Right now, health care is more evidence-free than you might think. And even where evidence-based clinical guidelines exist, research suggests that doctors follow them only about half of the time. One estimate suggests that it takes 17 years on average to incorporate new research findings into widespread practice. As a result, any clinical guidelines that exist often have limited impact.

How might we encourage doctors to adopt new evidence more quickly? Malpractice reform could help — possibly a lot.

http://www.nytimes.com/2010/10/21/opinion/21orszag.html?th&emc=th

[Scuba]

1. Groovedaddy takes on a little-understood issue. The Republican mantra...

...is "tort reform" which is a subtle way of saying "let's limit damage awards to those who have been harmed. After all, wealthy physicians support us".

On the patients's side are those trying to improve care while reducing costs, ergo "clinical guidelines". Widely criticized as "cookbook medicine trying to take away physician decision-making" clinical guidelines are none the less making inroads.

If you want to see "cookbook medicine" take a look at any practice and you may see a physician diagnosing and treating patients just as she/he has done for years. My favorite example is a local physician who specializes in treating Lime's Disease. Accordingly, virtually every patient seen by this doctor is diagnosed with Lime's Disease.

There is so much new information published that a physician would have to read more than 24 hours a day to keep up. Not going to happen. What can happen is that physicians use "check lists" just as airline pilots do, to ensure that all appropriate tests are being conducted, and unnecessary (read: costly) tests are not.

Better information systems to provide quick access to the guidelines are needed - and to provide access to results from tests already performed so that another, unnecessary test, isn't ordered.

Remember: the most expensive piece of equipment in a hospital is a physician's pen.

[Baalath]

2. I don't think that limiting awards helps the drs as much as

it hurts the attorneys and helps the insurance carriers. Perhaps it hurts the self employed physicians when it isn't limited, but they aren't the ones effecting policy at a congressional level. Employed physicians are shielded in a large part from malpractice costs.

I just lost my job because a self employed physician sold his practice and went to work for a hospital.

[Scuba]

3. First, sorry about you losing your job. Good luck to you and your family...

... limiting compensation help some physicians - the incompetent ones. Otherwise it just helps insurance companies and hurts attorneys and those injured by malpractice.

Limiting damages to those injured does nothing to improve health care, in fact it arguable makes it worse.

One again, the Republicans see this issue only in terms of how to keep money in the hands of the wealthy.