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So how is the medical malpractice situation in your country? How should we solve it?

Discussion in 'Off-Topic' started by Xanikk999, Nov 3, 2006.

  1. Xanikk999

    Xanikk999 History junkie

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    You know.. Doctors make mistakes in prescriptions. Surgeons leave things inside the body. Or someone accidently gives someone the wrong blood type during a transfusion.

    Right now its very expensive and hard to become a doctor. You have to pay a ton of money in medical malpractice insurance and even then you can still be sued sometimes.

    Sometimes these are honest mistakes or accidents and i beileve the doctor should not be held responsible. Because it doesnt matter how much training a doctor has there will still be human error.

    So what should we do? Maybe robotic surgeons would be an answer.
     
  2. JollyRoger

    JollyRoger Slippin' Jimmy Supporter

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    Doctor's make a ton of money, so they can afford the insurance. If an accident happens, there was likely some reason - aka - negligence, so the patient should have legal recourse. Without the threat of recourse, more "accidents" would happen.
     
  3. AL_DA_GREAT

    AL_DA_GREAT amour absinthe révolution

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    Not much. Should teachers be sued if they said some thing wrong. Taxi cab drivers if they make a wrong turn. We are humans. We make misstakes. If they are made on purpose then of course we should destroy the fellow.
     
  4. Xanikk999

    Xanikk999 History junkie

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    But not all doctors make a ton of money. What about the ones who are new to the field?

    10 years of schooling isnt the same as first hand experience.
     
  5. JollyRoger

    JollyRoger Slippin' Jimmy Supporter

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    A new doctor should either be working under the direction of a more experienced doctor or willing to assume the risks that come with practicing without supervision. Most doctors that don't make a ton of money are either the ones who should not be practicing in the first place or those that are using their skills for the greater good and working in organizations willing to cover their malpractice insurance.
     
  6. Sidhe

    Sidhe Deity

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    Robots wouldn't work there'd be a great deal of suing the programmers when the robots failed to perform adequately.

    I think personally the situation has gotten out of hand, I'm not denying that Dr's should be sued for negligence or bad mistakes, there should be accountability, but the sheer breadth of malpractice suits is a real drain on the health services ability to perform.
     
  7. wolfigor

    wolfigor Emperor

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    Maybe not sued, but there should be accountability: incompetence should be punished.
    In a private environment there is a clear contract betwen the school and the (parents) of the students.
    Lets imagine a private school that teach sub-par (e.g. lower levels than what stated in their plan): shouldn't the students or their parents sue for not respecting the contract?


    A wrong turn may add a lot of time to your travel, that and the end you have to pay.
    Maybe you are in a hurry for a business meeting and the extra delay (due to the driver's mistake) may cost you dearly...

    I've been in this situation in Paris.
    I was supposed to attend a business meeting and took a cab out of CGD.
    The taxi driver completely took the wrong way, and the mistake meant that I arrived 40 minutes after the start of the meeting.
    I was furious.
    The taxi meter said 100, the taxi driver offered me to pay 80, I said 0.
    At the end we settle for 50... the point is that the driver's mistake may have had a huge cost for me (loosing the deal) and it took away a lot of my time (time is money).
     
  8. warpus

    warpus In pork I trust

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    From what I heard malpractice fraud is a huge problem in the U.S.

    My solution: If you sue a doctor for malpractice and you lose - you have to pay his/her legal bills.
     
  9. Cutlass

    Cutlass The Man Who Wasn't There.

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    It's really not. Malpractice is 2% of health care costs. And the only way to lower that would be to shift the burden to injured patients.
     
  10. Mathilda

    Mathilda Queen

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    I doubt that.
    I think the fear of malpractice suits is one of the reasons for over testing.
    Everyone suffering a headache needs to get a cat scan "just in case".
    "Let's run all the tests, just to be sure", must account for quite a sum as well.

    Of course the fact that they can make money doing the tests is another factor.
     
  11. Cutlass

    Cutlass The Man Who Wasn't There.

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  12. jtb1127

    jtb1127 Deity

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    It doesn't seem to happen very much. I have never experienced it and I don't know anyone who has.
     
  13. Neonanocyborgasm

    Neonanocyborgasm Deity

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    Ironically, the medical malpractice model in the United States doesn't actually prevent malpractice, and instead creates a perverse incentive whereby more malpractice occurs. A malpractice suit only occurs when a patient, or their representative, makes a complaint. The overwhelming majority of patients are not medically trained, and so have no idea if they are victims of medical mismanagement, and so the overwhelming majority of actual medical mismanagement will never be discovered. Even when a legitimate suit is brought, and the doctor loses (a rarity, btw), it still has no impact on the doctor. He only suffers a monetary loss and gets to continue practicing the same negligent way he always has. The only agency capable of actually disciplining him, the state board, often never even hears about it, as patients have no incentive to complain to the state board (it won't give them money). Many state boards are also rather toothless and rarely discipline any doctor unless under great pressure.

    Studies have shown that patients tend to sue not when they believe they have been wronged, but when they're angry. They may get angry for all sorts of reasons, but rarely is it because of medical mismanagement. Usually it's because they feel they are not properly informed. Law firms that specialize in malpractice have gotten the word out through training videos and seminars, to doctors, that all you must do to prevent malpractice is keep the patient and their families happy. I myself have had to watch these training videos. The same is also true of the same malpractice courts. The judge and jury are not medically trained, and juries are infamous for rendering emotional verdicts not based on actual evidence. Lawyers would claim that ignorant juries are for the best. Being ignorant, they are less likely to be biased. I would argue they are also more likely to be fooled by the attorneys.

    In my own career, what I've witnessed is that patients prefer a doctor with a pleasant bedside manner to a skillful one. They will return to the same fool repeatedly, even while they are being mismanaged, and will never sue that guy, even unto death.

    You have no idea what you're talking about. By the time a new doctor begins independent practice, he's already completed several years of supervision. This is not like law where you come out of the bar exam ready to practice immediately. I spent 5 years in supervisory training before I began practicing independently.

    And doctors don't make a ton of money. Those days are long over. New primary care physicians rarely break the $100k barrier, especially in more populated areas like LA or NY. That may sound like a lot, but it isn't when you have educational loans that are several times that number, and are rising in compound interest.

    See above as to why medical malpractice courts actually increase malpractice. The public views medicine in a business model where "the customer is always right" so if they feel wronged, they demand compensation. The physician just has to keep the "customer" satisfied, even if he's actually robbing him blind. Actual mismanagement, meanwhile, can continue. If you want to actually prevent medical mishaps, let the state boards handle complaints and the courts dispense compensation. At least the state boards are staffed by actual physicians who can't be fooled by sweet talk and parlor tricks. Or have specialized courts, like divorce courts, with judges trained to understand the nuances of medical practice. (Some have advocated this.)

    This is why tort "reform" has had little impact on the cost of malpractice. It simply reduces the compensation. The system remains the same.

    While malpractice avoidance doesn't cost so much money (according to most analyses), it does cost time. Every time a patient has a complaint, doctors feel as if they have to be overly thorough in their investigation, and will order all manner of unnecessary tests, even after a diagnosis is readily explained. They do this so that the patient feels like "something" was done (remember: pleasing the customer). All these unnecessary procedures accumulate into a lot of waste and inefficiency that logjams the medical system.

    Despite what many believe, there is little accountability in the US medical system.
     
  14. warpus

    warpus In pork I trust

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    But it's 2% of your costs.. that's like.. 4% in Canadian math!

    But yeah, smaller than I thought
     
  15. Cutlass

    Cutlass The Man Who Wasn't There.

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    Compared to something like 18% for administrative costs. It's not where the savings are to be found in the health care system. Though it is easy to make an argument that the structure of the medical malpractice system needs reform. But that reform should not be about tort reform, but rather process reform.
     
  16. Godwynn

    Godwynn March to the Sea

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    Kill the relatives of the deceased patient as well.
     
  17. JollyRoger

    JollyRoger Slippin' Jimmy Supporter

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    Unless such sweet talk and parlor tricks are coming from a fellow physician.
     
  18. Mathilda

    Mathilda Queen

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    Things are fascinating when they are counter-intuitive.
    I read the link and didn't find it backing up your first claim though.

    Here's the paragraph on what they called defensive medicine:
    Spoiler :

    Effects on Defensive Medicine

    Proponents of limiting malpractice liability have argued that much greater savings in health care costs would be possible through reductions in the practice of defensive medicine. However, some so-called defensive medicine may be motivated less by liability concerns than by the income it generates for physicians or by the positive (albeit small) benefits to patients. On the basis of existing studies and its own research, CBO believes that savings from reducing defensive medicine would be very small.

    A comprehensive study using 1984 data from the state of New York did not find a strong relationship between the threat of litigation and medical costs, even though physicians reported that their practices had been affected by the threat of lawsuits.(14) More recently, some researchers observed reductions in health care spending correlated with changes in tort law, but their studies were based on a narrow part of the population and considered spending for only a few ailments. One study analyzed the impact of tort limits on Medicare hospital spending for patients who had been hospitalized for acute myocardial infarction or ischemic heart disease; it observed a significant decline in spending in states that had enacted certain tort restrictions.(15) Other research examined the effect of tort limits on the proportion of births by cesarean section. It also found savings in states with tort limits, though of a much smaller magnitude.(16)

    However, when CBO applied the methods used in the study of Medicare patients hospitalized for two types of heart disease to a broader set of ailments, it found no evidence that restrictions on tort liability reduce medical spending. Moreover, using a different set of data, CBO found no statistically significant difference in per capita health care spending between states with and without limits on malpractice torts. Still, the question of whether such limits reduce spending remains open, and CBO continues to explore it using other research methods.

    Not really conclusive so I'm not totally convinced yet.
    This defensive medicine seems to be in the culture, and comparisons are between times when you can get awarded silly money and when there are some restrictions put on the amounts.
    Nano speaks of the same culture, with obviously a lot more knowledge than I, when he says "keep the patient happy". Part of that is running all the tests every time even when not necessary because it makes the patient feel like they are being taken seriously and the doctor really cares about them.
     
  19. Neonanocyborgasm

    Neonanocyborgasm Deity

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    Unless the tribunal consists of his best friends, no amount of doublespeak and misdirection will have that affect. Unlike patients who are wholly ignorant of medicine, other physicians do not suffer this handicap, and will demand specific statements of fact and detail. That's how physicians speak to each other about patients. You really have no idea what an unscrupulous physician will say to patients that make them feel as if they are being properly cared for, even while they are being poisoned. These guys are like politicians. They give grand presentations with much fanfare, all behind a veneer of charm that often hides their ineptitude. The patients don't know better. The doctor is so nice, how can anything be wrong?

    I have been particular witness to such events when I've run into patients whose physicians failed to treat them properly in a timely manner, causing their death by the time I arrived on scene. The initial response is anger and outrage from the families at such unexpected events directed usually to everyone who happens to be in the room at the time (invariably me). But then, as soon as the same physician arrives and talks to them, they are suddenly all smiles and couldn't be happier. That's how effective these guys are, and they aren't so uncommon.

    I've said it before, but I'll repeat myself. The lay public hasn't got half a clue what medicine is, and swallow whatever they're told, and never know what proper medical care is and isn't.
     
  20. timtofly

    timtofly One Day

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    Sounds like just another "peer review" of any scientific field.:sad:
     

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