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.
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.
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.
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.
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.
