As a doctor Would you treat John Edwards and his Family

[Droopy Snoopy]

this actually made me feel ill reading it. this man is scum.

I agree, but take the article with a grain of salt. The Washington Times is the print version of Fox News.

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[turkleton]

Unbelievable. My distaste for politicians has been growing steadily over the past couple years and its articles like this which really sometimes makes you wonder if there is one decent person in Washington- Republican, Democrat, Communist or otherwise. How the hell can a man who contributed to derailing the insurance framework of a state get on tv and pretend to be the advocate of the very people he just screwed over.

 

[OncoCaP]

Unbelievable. My distaste for politicians has been growing steadily over the past couple years and its articles like this which really sometimes makes you wonder if there is one decent person in Washington- Republican, Democrat, Communist or otherwise. How the hell can a man who contributed to derailing the insurance framework of a state get on tv and pretend to be the advocate of the very people he just screwed over.

There are plenty of decent people out there. However, just because you are decent doesn't mean that you are not going to get smeared with the political equivalent of feces at every opportunity. You won't know who is decent or who isn't from reading the media ... that's for sure. People will make stuff up about decent people in large quantities if necessary. In politics everything short of murder is par for the course, so it's like ultimate fighting ... you must be very tough to want to play in that sandbox / dungeon. Getting smeared by false information is all part of being in politics (much like punching and getting punched are part of boxing). I wouldn't take various accusations too seriously because it's really hard to know what the real story is. Lord knows that as average citizens we barely have a clue about who we can trust and who we can't.

Compared to people I have met over the past 15 years or so in the business world, Edwards strikes me as considerably above average ethically. He comes across as a compassionate person who really cares about helping people. A less ethical person would have paid off the juries or perhaps cheated his clients out of at least a little bit of their money (something that I would consider common and perhaps "average" on the scale of ethical of what I have observed personally -- not really acceptable for me, but I'm not the person making the rules of ethics). When it comes to money, many people have few scrupples. A less compassionate person than Edwards would not have gone into politics himself and given up a much more high-paying career as a trial lawyer. I suppose it is possible that he has a thirst for power and fame, but he was already pretty powerful and famous as a trial lawyer. He would be more famous and powerful if he was richer than Bill Gates. On the other hand, he wants to be President of the U.S.A., which, from what I have read, requires an XXL-sized ego to even attempt.

The more typical unethical person would simply have paid off politicians (made large donations) rather than exposing him/herself. As far as I know, he made all his money by following the rules and winning contests by working with the legal system the way it is designed. As far as I know, there are still plenty of OB/GYNs and neurosurgeons in NC. If we don't like the legal system, we can always change it assuming that most politically powerful (wealthy & politically connected) Americans agree with the changes we want. The reality is that the "players" in the U.S. like the legal system in the U.S. the way that it is because it favors them. If you don't like it, work on convincing the people who can change it. No sense in beating up on one of the more ethical politicians / trial lawyers out there ... then again, there is no way of knowing who is ethical and who isn't because the information we get about politicians is not very reliable in my opinion.

 

[QuikClot]

Sadly, the process of redress through a tort action is flawed in many ways. It's unpredicable, judgements may be emotional, evidence unscientific. It's kind of like SDN.

What if we were to look at malpractice rationally and not be anecedote? What's the average malpractice premium? What is awarded in claims compared to medical spending? (In 2003, it was .251%. .251%.) Are these awards rising dramatically from year to year? (No.) How does the cost of insurance compare with a physician's salary? (On average, it's less than 10%.)

Businesses and individuals often have to pay a lot in insurance -- check out the rates for workmen's comp. In a limited number of areas, for a limited range of specialities, malpractice insurance premiums can be disproportionally high. For most doctors they aren't. If Ob/Gyn doctors in rural areas are hit with high premiums, then it makes more sense to subsidize their premiums, not cap all awards or villify the whole idea of holding doctors accountable for their mistakes.

Because, not to belabor the obvious, doctors screw up. They work drunk. They work high. They fail to perform up to the standard of care. They fail to stay current. They overwork themselves and make stupid mistakes while exhausted. They ignore evidence that the situation isn't what they thought it was. Innocent people get hurt, and their only recourse is to sue.

There are better systems one can imagine for addressing mistakes -- definitely. This is the system we have, and malpractice lawyers are a necessary part of it. I'm not hearing any creative ideas about how to make it better, just a lot of how horrible it is to sue doctors and ruin their careers, which is apparently just a hair above making your living as a matchmaker for pedophiles. Not feeling it, sorry.

Let me suggest an exercise for those of you who work in heathcare or are in clinical rotation. Find out the last ten things that changed in your practice enviroment to make patients safer. Electronic prescriptions, new protocols, change of equipment, whatever you think made a postive difference. Then find out how many of those things changed either as the result of a lawsuit or management's fear of one. There's more to torts than the vanishingly rare million-dollar lawyers' fee. It's also about ordinary people having recourse to the law, and the powerful having to face up to their mistakes and think about how to avoid them in the future.

 

[da8s0859q]

Unbelievable. My distaste for politicians has been growing steadily over the past couple years and its articles like this which really sometimes makes you wonder if there is one decent person in Washington- Republican, Democrat, Communist or otherwise. How the hell can a man who contributed to derailing the insurance framework of a state get on tv and pretend to be the advocate of the very people he just screwed over.

Jerkoffs in every career, but yeah, politics is kinda notorious for that.

But as to your question, it's because he's a politician.

 

[dutchman]

Sadly, the process of redress through a tort action is flawed in many ways. It's unpredicable, judgements may be emotional, evidence unscientific. It's kind of like SDN.

What if we were to look at malpractice rationally and not be anecedote? What's the average malpractice premium? What is awarded in claims compared to medical spending? (In 2003, it was .251%. .251%.) Are these awards rising dramatically from year to year? (No.) How does the cost of insurance compare with a physician's salary? (On average, it's less than 10%.)

Businesses and individuals often have to pay a lot in insurance -- check out the rates for workmen's comp. In a limited number of areas, for a limited range of specialities, malpractice insurance premiums can be disproportionally high. For most doctors they aren't. If Ob/Gyn doctors in rural areas are hit with high premiums, then it makes more sense to subsidize their premiums, not cap all awards or villify the whole idea of holding doctors accountable for their mistakes.

Because, not to belabor the obvious, doctors screw up. They work drunk. They work high. They fail to perform up to the standard of care. They fail to stay current. They overwork themselves and make stupid mistakes while exhausted. They ignore evidence that the situation isn't what they thought it was. Innocent people get hurt, and their only recourse is to sue.

There are better systems one can imagine for addressing mistakes -- definitely. This is the system we have, and malpractice lawyers are a necessary part of it. I'm not hearing any creative ideas about how to make it better, just a lot of how horrible it is to sue doctors and ruin their careers, which is apparently just a hair above making your living as a matchmaker for pedophiles. Not feeling it, sorry.

Let me suggest an exercise for those of you who work in heathcare or are in clinical rotation. Find out the last ten things that changed in your practice enviroment to make patients safer. Electronic prescriptions, new protocols, change of equipment, whatever you think made a postive difference. Then find out how many of those things changed either as the result of a lawsuit or management's fear of one. There's more to torts than the vanishingly rare million-dollar lawyers' fee. It's also about ordinary people having recourse to the law, and the powerful having to face up to their mistakes and think about how to avoid them in the future.

This is what I fear the most about medicine. In the face of confusion, physicians will resort to self blame, because they lack the balls to stand up against what is wrong. FRIVOLOUS LAWSUITS are exactly what they are-> FRIVOLOUS, and they account for ~46% of lawsuits filed today. Is it really the hard working/dedicated physician's fault that someone wants to make a buck out of every bad outcome in medicine today? No one is suggesting that we prevent legitimate victims from legal recourse, but I am not buying this "doctors are the reason people file frivolous lawsuits argument". If you have in fact done your research right, you will know that it is not the average payout that is forcing premiums higher(especially for OB/GYNs) but the share volume of litigation(46% of which should never had made it to court).

It is also funny that you somehow decided to refer to doctors(the most powerless professionals on the face of the earth) as powerfull.

 

[QuikClot]

The average salary of physicians puts them in the top decile of earners, and they consistantly rank near the top of the most respected professionals. They, and their employers, who also get sued, are indeed powerful. But many of your posts have this theme of physicians as persecuted victims, which is not how any of the physicians I know feel about themselves.

It's ironic, given that you're so scared and insecure, that you accuse other people of lacking courage, as if the only reason one would disagree with you is because they are afraid. Whining and complaining, arguing and villifying others, demanding everything and admiting to no responsibility -- these things do not require any bravery.

The idea that 46% of lawsuits are frivolous is striking (how was that statistic collected, I wonder -- did the plantiff check the "frivolous lawsuit" box on the paperwork?) but it's unsourced, and I happen to know that 83% of the statistics used on SDN are made up on the spot.

 

[dutchman]

The average salary of physicians puts them in the top decile of earners, and they consistantly rank near the top of the most respected professionals. They, and their employers, who also get sued, are indeed powerful. But many of your posts have this theme of physicians as persecuted victims, which is not how any of the physicians I know feel about themselves.

It's ironic, given that you're so scared and insecure, that you accuse other people of lacking courage, as if the only reason one would disagree with you is because they are afraid. Whining and complaining, arguing and villifying others, demanding everything and admiting to no responsibility -- these things do not require any bravery.

The idea that 46% of lawsuits are frivolous is striking (how was that statistic collected, I wonder -- did the plantiff check the "frivolous lawsuit" box on the paperwork?) but it's unsourced, and I happen to know that 83% of the statistics used on SDN are made up on the spot.

I don't have enough time to dig for the latest data that says it is now at 46%, but here is one.

http://www.ama-assn.org/ama/pub/category/16265.html

"Today's study is proof positive that meritless medical liability lawsuits are clogging the courts, with 40 percent of lawsuits filed with either no verifiable medical injuries or errors. The costs of these meritless lawsuits are borne by patients who have decreased access to care as physicians are forced to spend significant time and money defending against meritless lawsuits"

FYI, fighting for yourself requires bravery. However, seeing as you are in the business of projecting yourself as more sophisticated than the average SDN member, I can see how normal logical stuff like "lets cut down on meritless lawsuits" will be too ordinary for you to relate to.

 

[QuikClot]

The link doesn't provide the study. No methods, no demographic data, no results, no p-values. Honestly, where's the beef? The claim of a party with an obvious axe to grind -- would you treat patients based on that kind of evidence?

FYI, fighting for yourself requires bravery.

You are whining, not fighting, but that isn't the biggest problem with your claim. Attacking other people is the easiest thing in the world. Inciting other people to dislike other people, especially if you can appeal to a financial interest, is almost as easy. So that's a silly assertion. You also conflate "fighting for yourself" with "fighting for [your idea of] what gets physicians the best deal." And that's wrong on two levels. First, blindly supporting what the herd wants is cowardly, not courageous. Second, fighting for one's own beliefs may be courageous, but fighting for one's interests is not. Selfishness is neither cowardly nor courageous, it's just selfish. And selfishness may have its place, but it is far from being a virtue in and of itself.

However, seeing as you are in the business of projecting yourself as more sophisticated than the average SDN member, I can see how normal logical stuff like "lets cut down on meritless lawsuits" will be too ordinary for you to relate to.

So you now want to attack me, which I suppose you will also chose to regard as courageous. Sorry, you haven't shown how whining about how terrible lawyers are cuts down on "meritless lawsuits." You haven't supported your claim that 46%, now 40% of lawsuits are frivolous. And you certainly haven't convinced anyone that pissing and moaning about lawyers in an anonymous internet forum is an act of courage. Plu-lease.

 

[Stolenspatulas]

 

[dutchman]

The link doesn't provide the study. No methods, no demographic data, no results, no p-values. Honestly, where's the beef? The claim of a party with an obvious axe to grind -- would you treat patients based on that kind of evidence?



You are whining, not fighting, but that isn't the biggest problem with your claim. Attacking other people is the easiest thing in the world. Inciting other people to dislike other people, especially if you can appeal to a financial interest, is almost as easy. So that's a silly assertion. You also conflate "fighting for yourself" with "fighting for [your idea of] what gets physicians the best deal." And that's wrong on two levels. First, blindly supporting what the herd wants is cowardly, not courageous. Second, fighting for one's own beliefs may be courageous, but fighting for one's interests is not. Selfishness is neither cowardly nor courageous, it's just selfish. And selfishness may have its place, but it is far from being a virtue in and of itself.



So you now want to attack me, which I suppose you will also chose to regard as courageous. Sorry, you haven't shown how whining about how terrible lawyers are cuts down on "meritless lawsuits." You haven't supported your claim that 46%, now 40% of lawsuits are frivolous. And you certainly haven't convinced anyone that pissing and moaning about lawyers in an anonymous internet forum is an act of courage. Plu-lease.

To the extent that you need p-values to confirm the validity of a widely accepted Harvard study, I am going to discontinue this argument.

 

[shivasHeroLike]

nope, i would refer him to someone else.

 

[QuikClot]

Yeah, you do that. Your study which you are referencing third-hand without having read it yourself is really a crushing rhetorical blow. And who actually looks at the data themselves, when someone has attached a fancy name to their assertion.

The study is here: http://www.hsph.harvard.edu/faculty/articles/litigation.pdf. Let's take a look at the study and what you claim it says: that 40% of lawsuits alleging medical malpractice are frivolous. "Frivolous" is a legal term and is grounds for dismissal; none of the lawsuits studied were found to be frivolous in that sense. According to Wikipedia:

"The more common or colloquial use of the term "frivolous" in political discourse refers to lawsuits that are based on a theory that seems absurd, or where the claim results in damages that greatly exceed what one would expect from reading a brief summary of the case. Awards for medical malpractice are sometimes derided as frivolous (in this sense of meaning "excessive")."

But the study does not look at the size of awards relative to the harm, either. So, again, no frivolous claims in the common or the legal meanings of the word. So what did you mean? You were quoting "Cecil Wilson, M.D.," who claimed that "Today's study is proof positive that meritless medical liability lawsuits are clogging the courts, with 40 percent of lawsuits filed with either no verifiable medical injuries or errors."

What the study found was that in 3% of the cases, physician review found no injury, and in 37% of the cases, the physicians felt that the injury, while real, was not the result of a medical error for which the physician was responsible. This does not mean that the lawsuits were frivolous in any sense of the word. Whether a medical error caused an outcome is exactly what is in dispute in a lawsuit. It is to be expected that in some case the facts would be with the plantiff, and in others they would be with the defendant. Your and Cecil's interpretation of these findings is flat-out wrong. Here's what the study itself said:

Our findings point toward two general con-
clusions. One is that portraits of a malpractice
system that is stricken with frivolous litigation are
overblown. Although one third of the claims we
examined did not involve errors, most of these
went unpaid. The costs of defending against them
were not trivial. Nevertheless, eliminating the
claims that did not involve errors would have de-
creased the direct system costs by no more than
13 percent (excluding close calls) to 16 percent
(including close calls). In other words, disputing
and paying for errors account for the lion's share
of malpractice costs. A second conclusion is that
the malpractice system performs reasonably well
in its function of separating claims without merit
from those with merit and compensating the lat-
ter.

And that, my friend, is why you should read the study yourself. Game, set, and match. 'Gnight.

 

[Stolenspatulas]

From wikipedia:

In 1985, Edwards obtained a $5.75 million settlement in a cerebral palsy case for medical malpractice during childbirth, representing Jennifer Campbell, a five-year-old cerebral palsy patient. This established the North Carolina precedent of physician and hospital liability for failing to determine if the patient understood risks of a particular procedure.[6] During the trial, it has been argued that Edwards relied more on his verbal skills as a trial lawyer than on actual science. While delivering his summary, Edwards said that "I have to tell you right now – I didn't plan to talk about this – right now I feel her [Jennifer], I feel her presence...[Jennifer's] inside me and she's talking to you."[7]

What a douchebag. I hate him.

 

[dilated]

Compared to people I have met over the past 15 years or so in the business world, Edwards strikes me as considerably above average ethically. He comes across as a compassionate person who really cares about helping people. A less ethical person would have paid off the juries or perhaps cheated his clients out of at least a little bit of their money (something that I would consider common and perhaps "average" on the scale of ethical of what I have observed personally -- not really acceptable for me, but I'm not the person making the rules of ethics).

WTF? Did you seriously just argue that John Edwards is ABOVE AVERAGE ethically because he didn't BRIBE JURIES? Bribing juries is a felony and if John Edwards did it he would currently be disbarred and in pound-me-in-the-ass federal prison. Instead he just admitted to manipulating the flawed jury selection system, let's have a parade for him. The fact that he observes legal niceties while having little or no regard for the spirit of the law and the people he hurts in order to buy himself a slightly larger $20 million mansion while moaning about "Two Americas" makes him about as ethical as pond scum.

 

[OncoCaP]

WTF? Did you seriously just argue that John Edwards is ABOVE AVERAGE ethically because he didn't BRIBE JURIES? Bribing juries is a felony and if John Edwards did it he would currently be disbarred and in pound-me-in-the-ass federal prison. Instead he just admitted to manipulating the flawed jury selection system, let's have a parade for him. The fact that he observes legal niceties while having little or no regard for the spirit of the law and the people he hurts in order to buy himself a slightly larger $20 million mansion while moaning about "Two Americas" makes him about as ethical as pond scum.

Well, it depends on what you consider "average" of course. I was just speaking of my experience. I have found that the threshold for an average person to commit a crime that will most likely go undetected is relatively low. Just because jury tampering is a terrible crime doesn't mean that it would always be easy to detect. The most common way for jury tampering to be detected is for the juror to report it. If a juror was unethical, it might be hard to detect such a crime. I'm not an expert on these things, and I'm just giving my amateur opinion on this.

Maybe you have had a more positive experience with the general public (which would be a good thing in my opinion). In my experience, an average person will steal candy or a coke from a vending machine if it is left unlocked (commit a crime for as little as $0.50). Put $5.75 million on the block, and, yeah, the average person will do pretty much anything to get the cash, including a felony if they think they might get away with it. Sorry if I'm so negative; it's just my own personal observation. I'm not suggesting that everyone is this way, just most people.

I personally have found that the average person will use money, gifts, freebies, trips, speaking fees, stock, sex, lies, etc., to influence a decision maker waving $5.75 million because I have personally observed countless people do such things for much less money. It sounds like John Edwards' worst offense was using science that is highly questionable and convincing a jury with an emotional appeal -- well, it's his job to convince a jury. If he's incompetent when it comes to science, he wouldn't be unethical because of that. Lawyers don't need to be great scientists; it's not part of their job. We don't know if he believes the junk science or not. For all I know, he really believed the physician should have done the C-section right away, and he has the right & job to tell the jury that.

Here are few reports of jury tampering and well as just plain bribery (non-jury). Note that the amounts are much smaller than any of John Edwards' famous wins.
http://www.msnbc.msn.com/id/17389974/
http://query.nytimes.com/gst/fullpage.html?res=9C0DE6D61F30F930A1575BC0A960958260
http://www.washingtonpost.com/wp-dyn/content/article/2006/06/29/AR2006062901912_pf.html
http://select.nytimes.com/gst/abstr...anizations/F/Federal Bureau of Investigation
http://select.nytimes.com/gst/abstr...anizations/F/Federal Bureau of Investigation
http://select.nytimes.com/gst/abstr...anizations/F/Federal Bureau of Investigation

Again, if I'm way off base when I think that the average person would say yes to an indecent proposal for about $6 million dollars or commit a felony, that would be a good thing. In my opinion John Edwards did far less in terms of unethical behavior than what the average person would do, but I hope you are right that John Edwards is way below average ethically ... that we live in a nation of highly ethical people so that John Edwards really sticks out on the low end.

I'm also not suggesting that I like the fact that John Edwards used an emotional appeal to convince a jury on a matter that is closely connected to a scientific question of what happens to a baby in certain deliveries. The fact that he uses such emotional techniques doesn't mean that he is unethical, however. Also, getting very rich as a trial lawyer also doesn't seem unethical either. Maybe I've missed something, but I haven't read anything so far where he committed an ethical violation (which I agree would cost him is license or more if found true). With our current system suing physicians is not unethical if the lawyer thinks the physician committed an error that led to an injury. I do wish we had a better system where cases where reviewed for merit (such as whether the particular claim is consistent with reliable science) before they were allowed to proceed. The fact that we don't have such as system isn't John Edwards' fault.

From what I can tell about the significance of Mrs. Edwards' cancer is that it raises questions about whether John Edwards will be able to go on in his Presidential bid in terms of raising cash and convincing donors that he is still a viable candidate in the middle of his family crisis. The question about whether she will get treatment because he is a trial lawyer seems to be a non-issue. Trial lawyers do get a bad rap, but I'm not sure it is deserved compared to other professions that also have bad actors.

 

[Haemulon]

Edwards' malpractice suits leave bitter taste


By Charles Hurt
THE WASHINGTON TIMES

The American Medical Association lists North Carolina's current health care situation as a "crisis" and blames it on medical-malpractice lawsuits such as the ones that made Democratic vice-presidential candidate Sen. John Edwards a millionaire many times over.
One of the most successful personal-injury lawyers in North Carolina history, Mr. Edwards won dozens of lawsuits against doctors and hospitals across the state that he now represents in the Senate. He won more than 50 cases with verdicts or settlements of $1 million or more, according to North Carolina Lawyers Weekly, and 31 of those were medical-malpractice suits.

During his 20 years of suing doctors and hospitals, he pioneered the art of blaming psychiatrists for patients who commit suicide and blaming doctors for delivering babies with cerebral palsy, according to doctors, fellow lawyers and legal observers who followed Mr. Edwards' career in North Carolina.
"The John Edwards we know crushed [obstetrics, gynecology] and neurosurgery in North Carolina," said Dr. Craig VanDerVeer, a Charlotte neurosurgeon. "As a result, thousands of patients lost their health care."
"And all of this for the little people?" he asked, a reference to Mr. Edwards' argument that he represented regular people against mighty foes such as prosperous doctors and big insurance companies. "How many little people do you know who will supply you with $60 million in legal fees over a couple of years?"
Through a spokeswoman, Mr. Edwards declined to comment beyond e-mailing his and John Kerry's "real plan for medical-malpractice reform."
The plan calls for one measure that Mr. Edwards previously had said is meaningless and does not impose caps on verdicts for economic damages or limits on attorneys' fees.
One of his most noted victories was a $23 million settlement he got from a 1995 case — his last before joining the Senate — in which he sued the doctor, gynecological clinic, anesthesiologist and hospital involved in the birth of Bailey Griffin, who had cerebral palsy and other medical problems.
Linking complications during childbirth to cerebral palsy became a specialty for Mr. Edwards. In the courtroom, he was known to dramatize the events at birth by speaking to jurors as if he were the unborn baby, begging for help, begging to be let out of the womb.
"He was very good at it," said Dr. John Schmitt, an obstetrician and gynecologist who used to practice in Mr. Edwards' hometown of Raleigh. "But the science behind a lot of his arguments was flawed."
In 2003, the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists published a joint study that cast serious doubt on whether events at childbirth cause cerebral palsy. The "vast majority" of cerebral palsy cases originate long before childbirth, according to the study.
"Now, he would have a much harder time proving a lot of his cases," said Dr. Schmitt, who now practices at the University of Virginia Health System.
Another profitable area of litigation for Mr. Edwards was lawsuits against psychiatrists whose patients committed suicide.
In 1991, he won $2.2 million for the estate of a woman who hanged herself in a hospital after being removed from suicide watch. It was the first successful medical-malpractice case in Mr. Edwards' home of Wake County.
During jury selection, Mr. Edwards asked potential jurors whether they could hold a doctor responsible for the suicide of their patients.
"I got a lot of speeches from potential jurors who said they did not understand how that doctor could be responsible," Mr. Edwards recalled in an interview shortly after the trial. Those persons were excluded from the jury.
In the end, Mr. Edwards scored $1.5 million for "wrongful death" and $175,000 in "emotional distress" for the woman's children.
"One thing I was grappling with was how to explain to the jury the difference between loss of companionship and society — the things under the wrongful-death statute — and emotional pain and suffering, which superficially sound like the same thing," he said at the time. "What we did was to tell them the wrongful-death damages are for the loss of all the things that a mother does for the child. But the emotional pain and suffering damages represent the grieving. The pain is something you feel over the death of your mother."
In 1995, as Mr. Edwards neared the pinnacle of his success, Lawyers Weekly reported on the state's 50 biggest settlements of the year.
"Like last year, the medical malpractice category leads the new list, accounting for 16 cases — or 32 percent — three points better than last year," the magazine reported. "By and large, that upward trend had held since 1992, when only four [medical malpractice] cases made the survey."
Mr. Edwards was singled out.
"Another reason for this year's [medical malpractice] jump was a strong showing by the Raleigh firm of Edwards & Kirby," it reported. "Partner John Edwards was lead counsel in eight of the 16 medical malpractice cases in the top 50."
Later in that article, Mr. Edwards was interviewed about the $5 million he won from doctors who delivered Ethan L. Bedrick, who had cerebral palsy. Mr. Edwards credited the jury focus groups that he routinely used to help prepare his arguments.
"They gave me several bits and pieces of information to use when addressing the jury," Mr. Edwards was quoted saying. "You can use them to decide whether to get involved in a case or whether to accept a settlement offer, but our primary use is trial presentation."
The article went on to observe: "Focus groups can be put together for as little as $300, according to Edwards — a small investment compared to the $5 million won in Bedrick."
It is not clear just how much Mr. Edwards made as a lawyer, but estimates based on a review of his lawsuit settlements and Senate records place his fortune at about $38 million.
Like many Democrats, Mr. Edwards has benefited from the generosity of fellow trial lawyers, who have given millions of dollars to Mr. Edwards' political campaigns and other political endeavors.
Part of the platform that Mr. Edwards is running on includes medical-malpractice reform. The Democrats' plan would go after insurance companies that increase doctors' premiums and ban lawyers and plaintiffs for 10 years if they file three frivolous lawsuits.
One tenet of their plan would "require that individuals making medical-malpractice claims first go before a qualified medical specialist to make sure a reasonable grievance exists."
However, Mr. Edwards said in a 1995 interview that such pre-screening is unnecessary.
"Pre-screening as a concept is very good, but it's already done by every experienced malpractice lawyer," he told North Carolina Lawyers Weekly.
As a result of these and other cases, insurance rates for doctors have skyrocketed — putting some out of business and driving others away, especially from rural areas. And doctors who have lost cases to Mr. Edwards have been bankrupted.
Patients, meanwhile, are left with rising health care costs and fewer — if any — doctors in their area. It is increasingly a nationwide problem, physicians say.
Dr. VanDerVeer, the Charlotte neurosurgeon, recalled one recent night on duty when two patients arrived in an emergency room in Myrtle Beach, S.C., where the area's last neurosurgeons quit earlier this year.
"No one in Myrtle Beach would accept responsibility for these patients," he said. And because it was raining, the helicopters were grounded, so the patients were loaded into ambulances and driven the four hours to Charlotte.
Upon arrival, one patient had died, and the other learned that she merely had a minor concussion — and a $6,000 bill for the ambulance ride.
"That's just one little slice of life here," Dr. VanDerVeer said. "It's a direct result of the medical-malpractice situation that John Edwards fomented."
Dr. Schmitt had spent 20 years delivering babies in Raleigh. Though he had no claims against him, his insurance tripled in one year. With no assurances that his rates would ever drop, or just stop rising, he left town.
For Mr. Edwards' part, he doesn't necessarily begrudge the doctors he sues.
In the book he wrote while campaigning for president, "Four Trials," Mr. Edwards referred to the doctors who he'd won millions from in two cases.
"In the E.G. Sawyer case and the Jennifer Campbell case, the defendants were not malevolent but were caring and competent doctors who worked in good hospitals and yet made grievous mistakes," he wrote. "They had erred in their judgment, but no one could despise them."
Doctors, however, take it all a bit more personally.
"We are currently being sued out of existence," Dr. VanDerVeer said. "People have to choose whether they want these lawyers to make gazillions of dollars in pain and suffering awards or whether they want health care."

Wow. Thanks for posting this. The article makes a compelling case.

 

[Stolenspatulas]

Well, it depends on what you consider "average" of course. I was just speaking of my experience. I have found that the threshold for an average person to commit a crime that will most likely go undetected is relatively low. Just because jury tampering is a terrible crime doesn't mean that it would always be easy to detect. The most common way for jury tampering to be detected is for the juror to report it. If a juror was unethical, it might be hard to detect such a crime. I'm not an expert on these things, and I'm just giving my amateur opinion on this.

Maybe you have had a more positive experience with the general public (which would be a good thing in my opinion). In my experience, an average person will steal candy or a coke from a vending machine if it is left unlocked (commit a crime for as little as $0.50). Put $5.75 million on the block, and, yeah, the average person will do pretty much anything to get the cash, including a felony if they think they might get away with it. Sorry if I'm so negative; it's just my own personal observation. I'm not suggesting that everyone is this way, just most people.

I personally have found that the average person will use money, gifts, freebies, trips, speaking fees, stock, sex, lies, etc., to influence a decision maker waving $5.75 million because I have personally observed countless people do such things for much less money. It sounds like John Edwards' worst offense was using science that is highly questionable and convincing a jury with an emotional appeal -- well, it's his job to convince a jury. If he's incompetent when it comes to science, he wouldn't be unethical because of that. Lawyers don't need to be great scientists; it's not part of their job. We don't know if he believes the junk science or not. For all I know, he really believed the physician should have done the C-section right away, and he has the right & job to tell the jury that.

Here are few reports of jury tampering and well as just plain bribery (non-jury). Note that the amounts are much smaller than any of John Edwards' famous wins.
http://www.msnbc.msn.com/id/17389974/
http://query.nytimes.com/gst/fullpage.html?res=9C0DE6D61F30F930A1575BC0A960958260
http://www.washingtonpost.com/wp-dyn/content/article/2006/06/29/AR2006062901912_pf.html
http://select.nytimes.com/gst/abstr...anizations/F/Federal Bureau of Investigation
http://select.nytimes.com/gst/abstr...anizations/F/Federal Bureau of Investigation
http://select.nytimes.com/gst/abstr...anizations/F/Federal Bureau of Investigation

Again, if I'm way off base when I think that the average person would say yes to an indecent proposal for about $6 million dollars or commit a felony, that would be a good thing. In my opinion John Edwards did far less in terms of unethical behavior than what the average person would do, but I hope you are right that John Edwards is way below average ethically ... that we live in a nation of highly ethical people so that John Edwards really sticks out on the low end.

I'm also not suggesting that I like the fact that John Edwards used an emotional appeal to convince a jury on a matter that is closely connected to a scientific question of what happens to a baby in certain deliveries. The fact that he uses such emotional techniques doesn't mean that he is unethical, however. Also, getting very rich as a trial lawyer also doesn't seem unethical either. Maybe I've missed something, but I haven't read anything so far where he committed an ethical violation (which I agree would cost him is license or more if found true). With our current system suing physicians is not unethical if the lawyer thinks the physician committed an error that led to an injury. I do wish we had a better system where cases where reviewed for merit (such as whether the particular claim is consistent with reliable science) before they were allowed to proceed. The fact that we don't have such as system isn't John Edwards' fault.

From what I can tell about the significance of Mrs. Edwards' cancer is that it raises questions about whether John Edwards will be able to go on in his Presidential bid in terms of raising cash and convincing donors that he is still a viable candidate in the middle of his family crisis. The question about whether she will get treatment because he is a trial lawyer seems to be a non-issue. Trial lawyers do get a bad rap, but I'm not sure it is deserved compared to other professions that also have bad actors.

The ethically-average person (or trial lawyer, for our case) would not bribe a jury or commit similar crimes NOT b/c of the ethics but b/c of the risks of getting caught. Stealing a soda from an unlocked vending machine is one thing, but what you're proposing is a totally different ballpark. still it happens, and john edwards wouldnt be running for president if he had committed such acts (b/c they of course would surface and ruin him).

IMO, if he wants to be president, he should have a stronger moral/ethical character than most Americans. He should stand out as someone who would not abuse power, not manipulate the truth just to win, etc.... if we don't elect someone like that... we get Bush. Too bad there's no way around his past... i wonder how many people think about his past when it comes to voting time.

You are definitely right in stating that his wife will get treatment pretty easily. Most doctors would be willing to treat her even if they hate what he has done (which is likely). That doesn't mean we can't give him lip and let him realize how he has devastated so many lives. I wonder how many times he has seen the irony in all of this.

Honestly, I can't trust that smile. He's so manipulative. You have to be in order to win such ridiculous lawsuits ("Hear me out America.... close your eyes and listen.... i can hear, unspoken Baby Jennifer....she wishes for for....").

 

[mjl1717]

Wow!! Ive been enlightned by these recent posts. Didnt realize the Edwards camp was so rough on doctors! But as Fightfire said sometimes poetic justice plays a BIG role..[the crazy part is I thought Edwards was a nice guy and even thought about voting for him; going to Africa, smiling, picking up babies, etc.. Great post.

 

[sirus_virus]

The bottom line is that our justice system should protect everyone equally. Right now, the laws are tilted against doctors. The doctors getting hit with meritless lawsuits don't deserve it any more than the victims of legitimate malpractice deserve to be abandoned. The lottery civil justice system is getting ridiculous.

On a side note, who are all these members of the Film Actors Guild showing up on this thread, expressing their support for litigation against doctors, even when they are well on their way to recieving theirs? I don't know about you guys, but after reading this thread, I see an oppurtunity here. If I ever get tired of this whole medicine gig, I might look into joining forces with medmal lawyers and beating the crap out of physicians myself. Hell, from what I see, there is a lot of money in that stuff. I like money, lawyers love litigation, the public wants to sue, and some doctors like getting sued. We could all get together and do the damn thing.

 

[HailMary]

The correct analogy would be to a lawyer that defends someone accused of murder. That is what Edwards' position was when he practiced. People chose to sue, and they get representation. Some 70,000 people die by medical error every year, and many more than that have signifigant morbidity. Yet the assumption seems to be that malpractice is evil because some doctors may not have done anything wrong -- that's not sensible. It's like saying that, because of those medical errors, doctors are money-hungry villians who don't care if their patients live or die.

I'm sure if one enjoys getting their hate on, it's fun to imagine a malpratice attorney needing your help and slamming the door in their face. Perhaps later, you folks can fantisize about letting the girl who wouldn't date you in high school die of cancer. Realistically, one competent doctor is much the same as another. On the other hand, if you are accused of something that may ruin you -- gross malpractice, perhaps -- there is a big difference between the best lawyer in the country and the middle of the pack. And suppose you were to call the best lawyer in town and he were to say "Aren't you that doctor who is always villifying and abusing trial lawyers? Nu-uh." Now that would be poetic justice.

Excellent post!

 

[OncoCaP]

The ethically-average person (or trial lawyer, for our case) would not bribe a jury or commit similar crimes NOT b/c of the ethics but b/c of the risks of getting caught. Stealing a soda from an unlocked vending machine is one thing, but what you're proposing is a totally different ballpark. still it happens, and john edwards wouldnt be running for president if he had committed such acts (b/c they of course would surface and ruin him).

IMO, if he wants to be president, he should have a stronger moral/ethical character than most Americans. He should stand out as someone who would not abuse power, not manipulate the truth just to win, etc.... if we don't elect someone like that... we get Bush. Too bad there's no way around his past... i wonder how many people think about his past when it comes to voting time.

You are definitely right in stating that his wife will get treatment pretty easily. Most doctors would be willing to treat her even if they hate what he has done (which is likely). That doesn't mean we can't give him lip and let him realize how he has devastated so many lives. I wonder how many times he has seen the irony in all of this.

Honestly, I can't trust that smile. He's so manipulative. You have to be in order to win such ridiculous lawsuits ("Hear me out America.... close your eyes and listen.... i can hear, unspoken Baby Jennifer....she wishes for for....").

Criticism of Edwards is certainly appropriate. We need to check his background just like the background of every other Presidential candidate by asking some tough questions. I'm just trying to sort through the basis of the criticism. Is it just because Edwards became wealthy by suing physicians that makes him unethical? I don't agree with the basis of Edwards' arguments in his high-profile cases, but the juries did ... and their opinion is what counts in our system.

When it comest to "average," I was considering the ethics of the public at large as opposed to trial lawyers, who I would consider a large cut about the public ethically (in terms of not breaking the law, cheating their clients, etc.). If you just take trial lawyers, I would say they are highly ethical, so maybe is just average in that case (I don't believe the stereotype). Are they aggressive? Yes. Are they willing to use every ethical and legal means at their disposal to win cases? Yes. I have known a number of lawyers (although no trial lawyers), and they have been strong advocates for their clients, which in a sense would be unethical because they are not considering whether their client's opponent (a physician, for example) is actually right. An ethical lawyer in the sense that people seem to be suggesting here would listen to both sides of the case and then only represent the case they thought was stronger (and give physicians a few extra points in the consideration). We have an adversarial system, which is not my preference, but that is the system we have.

To say Edwards is unethical because he successfully sued physicians doesn't make sense to me. It would be like saying that physicians are unethical because they refused to provide a non-emergency treatment to a patient who was unable to pay them (and patient became disabled, for example). It seems a bit judgmental to critique someone for working within the system. I would be like attacking a football player because he tackled someone who then got injured. If you don't want to get hurt, don't play football. If you don't want to get sued as a physician, don't treat patients who can sue you. When I get sued as a physician and I did not do anything wrong, I'm not going to take it personally. I'll just consider it a tax, like a tax we pay on our income. Will I do my best to support tort reform? Yes. I don't like our legal system, but, again, there are powerful people who want to keep it that way and it is difficult to improve it.

Maybe it would be more ethical for lawyers to listen to both sides of a case before taking a client or for physicians to treat patients without consideration for the patient's ability to pay. Maybe lawyers and physicians like that should be the ones running for President, but these are not the people that people want for President. People want a President who can make their lives as good as possible by advocating for them ... lowering taxes or increasing benefits, etc. In a sense, a strong advocate for the (powerful & well-connected) public's self-interest is exactly what Americans want and get. I realize that there are more qualified people for the job of President who either don't have the money, don't want to put their family through the ordeal, or simply don't have a strong political party backing them. Again, I don't see how this is Edwards' fault.

 

[Stolenspatulas]

To say Edwards is unethical because he successfully sued physicians doesn't make sense to me.

Its the way he did it. Channeling the life-force of baby Jennifer? Come on. Its not illegal, but I believe that is unethical and manipulative. He is stopping at nothing to win the case for his client, which I do agree is of course his job and an element of the system.

Also the repercussions of his actions have been very much devastating to health care in NC especially. He was always just looking at the $$$$, and not the people. Bad quality for a president I'd say.

 

[OncoCaP]

Its the way he did it. Channeling the life-force of baby Jennifer? Come on. Its not illegal, but I believe that is unethical and manipulative. He is stopping at nothing to win the case for his client, which I do agree is of course his job and an element of the system.

Also the repercussions of his actions have been very much devastating to health care in NC especially. He was always just looking at the $$$$, and not the people. Bad quality for a president I'd say.

I can't see myself voting for Edwards either (or Hillary for that matter). I'm a Republican, so the chances of me voting for a Democrat are basically zero. If he is ethical or not, I'm very unlikely to vote for him unless maybe it comes down to him on the Democratic side and Louis Farrakhan wins the Republican nomination, for example.

Before I went into the working world, I was very idealistic. I thought that no one should ever lie, do something just for the money, etc. Then I realized I was surrounded by people did these things regularly in the business world. I dare say it was average and typical for people around me to say something that was misleading in order to win a $6 million contract. I'm ashamed to say that I have even said things that were completely untrue in order to win a contract (on more than one occasion). I felt very bad about that and made more of an effort to be honest and ethical, even when it was to my disadvantage and reduced my company's profits. For example, I angered some of my business partners by not taking advantage of a client who we had over a barrel, thereby reducing our profit. You take a lot of heat when you leave money on the table because you want to be fair; I can see why a lot of people would not want to do that, even if I don't agree with people who are not honest or ethical.

Am I impressed by Edwards' background as a trial lawyer: no. The fact that he made those junk science claims in his trials suggests he would do similar things as a President (only present the facts that support what he thinks should be done or be unable to comprehend what is true). However, people do make mistakes and lie. As someone who has lied for the money before (and regretted it and made changes), I'm not really in a position to look down on him.

Now when it comes to treating trial lawyers and their families, I would do it. I would also treat drug dealers, prostitutes, murders, etc. I'm not agreeing with what they do, but I am providing a service to them anyway. I would be extra careful to make sure I was not taking any extra chances with respect to getting sued. If I did not feel comfortable (prognosis was bad and family was expecting a great outcome anyway), I might even consult with an attorney on the specifics and ask him what I can do to protect myself.

 

[Haemulon]

I can't see myself voting for Edwards either (or Hillary for that matter). I'm a Republican, so the chances of me voting for a Democrat are basically zero. If he is ethical or not, I'm very unlikely to vote for him unless maybe it comes down to him on the Democratic side and Louis Farrakhan wins the Republican nomination, for example.

Before I went into the working world, I was very idealistic. I thought that no one should ever lie, do something just for the money, etc. Then I realized I was surrounded by people did these things regularly in the business world. I dare say it was average and typical for people around me to say something that was misleading in order to win a $6 million contract. I'm ashamed to say that I have even said things that were completely untrue in order to win a contract (on more than one occasion). I felt very bad about that and made more of an effort to be honest and ethical, even when it was to my disadvantage and reduced my company's profits. For example, I angered some of my business partners by not taking advantage of a client who we had over a barrel, thereby reducing our profit. You take a lot of heat when you leave money on the table because you want to be fair; I can see why a lot of people would not want to do that, even if I don't agree with people who are not honest or ethical.

Am I impressed by Edwards' background as a trial lawyer: no. The fact that he made those junk science claims in his trials suggests he would do similar things as a President (only present the facts that support what he thinks should be done or be unable to comprehend what is true). However, people do make mistakes and lie. As someone who has lied for the money before (and regretted it and made changes), I'm not really in a position to look down on him.

Now when it comes to treating trial lawyers and their families, I would do it. I would also treat drug dealers, prostitutes, murders, etc. I'm not agreeing with what they do, but I am providing a service to them anyway. I would be extra careful to make sure I was not taking any extra chances with respect to getting sued. If I did not feel comfortable (prognosis was bad and family was expecting a great outcome anyway), I might even consult with an attorney on the specifics and ask him what I can do to protect myself.

Hmmmmm. It sure would be horrible to have a President like that!
Uh .... wait ...

 

[OncoCaP]

Hmmmmm. It sure would be horrible to have a President like that!
Uh .... wait ...

Yes, and the previous President (before the current one) always told the truth and was never misleading either. John Edwards would be out of his out of his league ethically as President.

It seems to me that the public's self-interest (what can this President do for me: lower taxes, get us out of Iraq, increase benefits, provide healthcare, etc.) outweighs their desire to have someone who always says the whole truth in a way that is never misleading.

 

[dilated]

An ethical lawyer in the sense that people seem to be suggesting here would listen to both sides of the case and then only represent the case they thought was stronger (and give physicians a few extra points in the consideration).

Well... partially, yes. The lawyers have been (amazingly) successful in convincing the public that somehow standard ethics do not apply to their professional activities (I did bad things... because I was obliged to do bad things for my client!), but that doesn't make it any more true. If it became the law for physicians to euthanize disabled people tomorrow, the fact that it was perfectly legal and within their professional scope of duty would not change the fact that it is wrong. "I was just following the law" went out of style as a justification for doing immoral things about 61 years ago. John Edwards obligation not to lie or purposefully do things he knows are wrong is exactly the same as yours or mine. Does he have to do that? Obviously not, but I would certainly work against a candidate I felt essentially had no regard for moral behavior.

 

[psipsina]

Yes, and the previous President (before the current one) always told the truth and was never misleading either. John Edwards would be out of his out of his league ethically as President.

It seems to me that the public's self-interest (what can this President do for me: lower taxes, get us out of Iraq, increase benefits, provide healthcare, etc.) outweighs their desire to have someone who always says the whole truth in a way that is never misleading.

I think the revulsion that many of us feel towards John Edwards is because its difficult to trust someone who could destroy physicians who had not been negligent in their care to reform the healthcare system. It seems that its easier for politicians to focus on physicians as the problem instead of all the things that are really the issues but would be reformed because of large pharm and insurance lobbies. Someone like Edwards who obviously doesn't have any problem laying blame in the laps of non-negligent physicians seems more likely to go the easy route ala connecticut and decide that physician's income is the root of the health care crisis than others who haven't shown any obvious anti-physician behavioral patterns up to now. I don't think having the next president, who will likely be faced with dealing with the healthcare crisis, being anti-physician instead of anti big pharma/insurance is best for the public's interests in this matter. On many other issues Edwards and I line up, but this is a huge issue that I just don't trust him to actually fix.

Just for the record, I am in no way opposed to negligent physicians being held accountable for their actions. I am opposed to trial lawyers who have clients that have faced tragedy and need money and are willing to attack non-negligent physicians to help them pay their bills. Physicians are human beings, we are fine tuned diagnosing machines but we will make mistakes. The fact that we put ourselves through 11+ years of post high school training and work crazy hours is usually indicative of a person who has the best intentions for their patients, and its ridiculous that human error or simply being in the wrong place at the wrong time can result in that well intentioned highly educated person being destroyed by the likes of John Edwards. I really feel for his clients who have no one but lifes circumstances to blame and need money to pay medical bills, but that doesn't give them the right to destroy those who did their best to help them to pay those bills or to make life seem more just because they have someone other than god or karma to blame.

 

[OncoCaP]

Well... partially, yes. The lawyers have been (amazingly) successful in convincing the public that somehow standard ethics do not apply to their professional activities (I did bad things... because I was obliged to do bad things for my client!), but that doesn't make it any more true. If it became the law for physicians to euthanize disabled people tomorrow, the fact that it was perfectly legal and within their professional scope of duty would not change the fact that it is wrong. "I was just following the law" went out of style as a justification for doing immoral things about 61 years ago. John Edwards obligation not to lie or purposefully do things he knows are wrong is exactly the same as yours or mine. Does he have to do that? Obviously not, but I would certainly work against a candidate I felt essentially had no regard for moral behavior.

So who do you want for President (or who at least is ethical, in your opinion)?

I think the revulsion that many of us feel towards John Edwards is because its difficult to trust someone who could destroy physicians who had not been negligent in their care to reform the healthcare system.

I'm not sure I trust him to be completely fair and honest either. However, I can't think of any Presidential candidate that I completely trust to reform healthcare or anything else. The best we can do is pick the one most likely to be successful in accomplishing what we want and slap them on the wrist when they do something wrong (hold them accountable as much as possible). I always prefer working with people who are extremely honest and trustworthy. However, I'll work with people who are not trustworthy because I don't want to retreat to the mountains or desert and become a hermit living off the land.

It seems that its easier for politicians to focus on physicians as the problem instead of all the things that are really the issues but would be reformed because of large pharm and insurance lobbies.

Edwards has said some things that suggest his support for physicians (see previous message above). Now, how much he is actually able to do for physicians if he were to become President, I'm not really sure; I would suspect much less than we would want. So do you think Hillary or McCain would do more to protect physicians as part of healthcare reform?

I really feel for his clients who have no one but lifes circumstances to blame and need money to pay medical bills, but that doesn't give them the right to destroy those who did their best to help them to pay those bills or to make life seem more just because they have someone other than god or karma to blame.

We need to improve the system, no doubt. Many physicians groups and legislators are working hard to accomplish this. It's a adversarial process to make the improvements and progress is slow.

 

[Droopy Snoopy]

So who do you want for President (or who at least is ethical, in your opinion)?

A war hero who stands up to five and a half years of torture in the Hanoi Hilton. It's probably a good indication he won't roll over for anybody handing out a campaign contribution and a free lunch.

 

[PediBoneDoc]

the question of would you treat someone if they were likely to sue? this person being jon edwards. this is really an ethical question as we all know. it is like the question i was give in a medical school interview, "would you treat an AIDS patient?"

i practice next to the malpractice capital of the united states. we are acutely aware of the risks of law suits. so, we practice accordingly with every patient.

you will encounter number of issues like this one in practice.

treating the drunk drive who just killed the family in the next trauma bay. treating the shooter and the victim. treating any lawyer. treating a family friend. child abuse victim and family members (something i see too much of)

for the most part, i treat everyone the same. we i have a nauseous feeling in my stomach about a patient or patients family member, i focus on the medical problem. "just the facts"

so would i treat mr. edwards and family. if they came to my office, i guess i would. i would just get some Maalox and take care of the patient.

 

[DarksideAllstar]

To the extent that you need p-values to confirm the validity of a widely accepted Harvard study, I am going to discontinue this argument.

Of all the dumb@ss things I've read on this thread, this takes the cake. Just because its "widely-accepted" doesn't make it valid. You'll find a lot of people (including those that are part of the "widely-accepted" community) don't scrutinize the literature the way that they are supposed to. And just because it has the name Harvard attached to it doesn't make it valid.

And to answer the OP's question, yeah, I'd read his (or his wife's) biopsy slides.

 

[emtji]

i wouldn't treat him. karma bits you in the rear sometimes.

 

[Dr. C. Troy]

Well, we already have an article from the absolutely insane Sun Myung Moon's (he thinks he's the second coming of Jesus, as evidenced by the following quote, "[I am] humanity's Savior, Messiah, Returning Lord and True Parent.") Washington Times, so I thought I would feed some far more relevant data/discussion pieces into this discussion than the griping of a few lone neurologists who are too afraid to do their jobs that they'd rather let a patient die:

And the far more reputible NYT (yes, I say that with a straight face):

Study Says Malpractice Payouts Aren't Rising

Article Tools Sponsored By
By JENNY ANDERSON
Published: July 7, 2005

When Mike Kreidler was an optometrist in Olympia, Wash., he railed against trial lawyers. He believed that aggressive trial lawyers were the reason he faced rising insurance premiums.

Dr. Kreidler, now in his second term as Washington State's insurance commissioner, has changed his mind. He has decided that the problem is not the lawyers - although they have contributed - but also the insurance companies.

"I came full circle," he said. "I started out with a strong bias against trial lawyers and lawsuits, and now I see the trade-off and I have both sides, the trial lawyers and the insurance companies, mad at me."

The high price of medical malpractice insurance is a notoriously nebulous and highly politicized subject. Insurers and doctors contend that the insurance is more expensive because of a surge in jury awards and settlements. Consumer advocates and their political allies assert that insurers have raised rates because they can, arguing that insurers' claims have slowed significantly while premiums have shot up.

A study to be released today by the Center for Justice and Democracy, a consumer advocacy group in New York, may add fuel to that debate. The study, compiled from regulatory filings by insurers to state regulators, finds that net claims for medical malpractice paid by 15 leading insurance companies have remained flat over the last five years, while net premiums have surged 120 percent.

From 2000 to 2004, the increase in premiums collected by the leading 15 medical malpractice insurance companies was 21 times the increase in the claims they paid, according to the study. (The net totals in the study are calculated after accounting for reinsurance.)

Of the 15 companies examined, 9 are mutual insurers owned by their policyholders, 3 have publicly traded stock but are part of larger conglomerates and 3 are publicly traded and focus primarily on medical malpractice. The stock prices of those three companies have each risen more than 100 percent since May 2002.

"In recent years, medical malpractice hasn't been unprofitable but it's been phenomenally profitable," said Jay Angoff, the former state insurance commissioner of Missouri and a consultant on the study.

Insurance industry officials not only disagree with Mr. Angoff and the study, they discredit the methodology. They say that it is unfair to compare the premiums that insurance companies charge with claims paid, because it often takes 8 to 10 years for the claims to materialize, so companies have to set aside extra reserves.

"It's a meaningless comparison that no respectable actuary would consider," said Lawrence Smarr, president of the Physicians Insurers Association of America, the trade group representing physician-owned insurance companies.

Industry officials instead look at incurred losses, which include what insurance companies pay in claims as well as what they set aside for reserves to pay for future claims. The study, for its part, emphasizes that incurred losses are not payments the insurer has made but rather are estimates of claims.

The reason malpractice insurance premiums are on the rise, Mr. Smarr says, is claim costs have risen as juries have awarded higher awards to plaintiffs, and insurance companies have used those claims as the justification for settling more cases.

"The real problem is claim severity," he said. "It means that juries are awarding higher amounts and jury verdicts drive the potential cost of the claim so that makes settlements rise."

According to the association's data, collected on a voluntary basis by its membership, 70 percent of malpractice cases closed in 2003 were dismissed, 24 percent were settled, 5 percent were tried and found in favor of the defendant and 0.8 percent were settled in favor of the plaintiff.

But it is that 0.8 percent that drives the costs, according to advocates for a national limit on what juries can award in medical malpractice cases. The uncertainty and the emotional circumstances of claims drives more settlements, regardless of the merit of the cases.

"We have a proven record of the fact that the premiums will come down when you get strong liability reform - that's why we're pushing caps on noneconomic damages," said Edward Hill, the president of the American Medical Association.

Insurance companies set rates, collect premiums and then estimate how much they will need to pay in claims. While they wait to pay those claims, they invest the money. A variety of reasons, including poor investment performance and rising reinsurance costs have contributed to rising costs.

Insurers look at incurred losses, which include money set aside for future reserves, as well as ratios that include the administrative and legal cost of underwriting new business. The most commonly cited profitability measure is the ratio of all the costs of doing business - underwriting, legal and administrative - to the premiums earned.

Mr. Angoff contests the use of the combined ratio, which is based on "overwhelming estimates." He also examined the incurred-loss ratio for the leading 15 insurers and found that it fell by almost 25 percent from 2000 to 2004 to 51.4 percent, meaning that the companies took in almost twice as much in premiums during that time as they paid out in claims.

"The argument that they have to raise rates because their incurred losses are going up, I don't buy it," Mr. Angoff said, "because incurred losses are estimates and the estimate of future losses can only rationally be built on their paid losses."

The numbers in the study, said the Connecticut attorney general, Richard Blumenthal, "cast a completely different picture than the public or many public officials have assumed."

"They have the potential to alter the debate fundamentally from seeming to cast the rapacious personal injury lawyers as the complete culprits and the insurers as innocent bystanders with doctors as victims to the insurers as equally responsible, if not more so," Mr. Blumenthal said.

Dr. Kreidler of Washington State is also not convinced that runaway juries are the sole cause for large rate increases. "Focusing exclusively on capping noneconomic damages will have a marginal effect on premiums and it will not have a pronounced dramatic impact," he said. "I think we should be doing something to make the tort system cheaper and making medicine safer."

Some insurance executives agree. "Malpractice insurance has changed how medicine is practiced," said William R. Berkley, chairman and chief executive of the W. R. Berkley Corporation, which underwrites particularly risky malpractice areas. "Part of it is good for patients; doctors are more careful. The problem is the cost."

Personally, I've always felt that it's easy to blame the high premiums on the lawsuits, as it's so highly publicized. But, like just about everything in politics, it's not so cut and dry. If you want to blame someone, blame the insurance companies which definitely our not on doctors' sides, despite their success in uniting doctors with them through the demonification of a "common enemy" -- the malpractice attorney. That said, I don't particularly like John Edwards, but feel that wishing death upon him and his family is nothing short of absurd, and simply innappropriate and ultimately unproductive for those of us in the medical field. Doctors' lack of business sense allowed the HMOs and insurances to come in and essentially screw them over. And now, it's just continuing to perpetuate itself as physicians would rather rally behind a stupid, convenient scapegoat propped up by these companies instead of band together and wage a tough fight against the real foe.

 

[dutchman]

Personally, I've always felt that it's easy to blame the high premiums on the lawsuits, as it's so highly publicized. But, like just about everything in politics, it's not so cut and dry. If you want to blame someone, blame the insurance companies which definitely our not on doctors' sides, despite their success in uniting doctors with them through the demonification of a "common enemy" -- the malpractice attorney.

It is not the payouts that is pushing the premiums up, but the volume of lawsuits. Even when a doctor wins a lawsuit, money is spent defending that case. Same thing with cases thrown out.

 

[acute2]

http://www.cnn.com/2007/POLITICS/03/22/edwards.2008/index.html
Apparently, it seems like John Edwards wife's cancer is acting up. My question to you guys is: Knowing that this guy pretty much made a living off of suing the hell out of doctors(even in cases that we now know were meritless), would you treat him or his family in a non-emergency situation?

If I were a physician, I will still attend to him or whoever who comes to me for medical help, regardless if he is John Edward or the wife, but with reservations of course if I think the treatment is out of my field already, or I am not allowed by law to perform such procedure, or I do not have access to the instruments, facilities, or modalities of a particular treatment or management. If that is the case, I will refer the patient to another physician who can best manage the medical condition.

In relation to the hypothetical scenario with a patient who is known for making "a living off of suing the hell out of doctors(even in cases that we now know were meritless)..." I will still attend to him with the diligence required to any standard of care that is expected in any doctor-patient relationship. My fear is, he might sue me for not attending to him

 

[Dr. C. Troy]

It is not the payouts that is pushing the premiums up, but the volume of lawsuits. Even when a doctor wins a lawsuit, money is spent defending that case. Same thing with cases thrown out.

I agree that it would be nice to reduce the volume, and that this is a productive area of discussion. Even if you did nothing wrong, having a frivolous lawsuit loom over your head when something terrible obviously happened is only going to make you feel worse and make it harder for you to do your job while the suit plays itself out, so it would be universally beneficial to prevent this from happening.

But unfortunately, due to the way the American legal system is set up, it seems as if you can either deal with a large volume of "frivolous" lawsuits, or set it up such that people with legitimate lawsuits are ignored also, though a lawyer would definitely have a better understanding on this matter than me. And in the end, people are probably going to want to make sure that nobody is wronged and then ignored, and would rather keep the volume than deny a few legit cases. Part of the problem is certain people's inability to accept the fact that bad things will happen, and that no one is at fault -- and obviously the lawyers that want to convince the public that someone is always at fault. However, I feel that they are a very small part of the problem, and the actions of a few lousy lawyers are used to represent the larger legal community, which, like every profession, has members more concerned with personal gain than with ethical decision-making and the so-called "greater good".

 

[Tired]

In relation to the hypothetical scenario with a patient who is known for making "a living off of suing the hell out of doctors(even in cases that we now know were meritless)..." I will still attend to him with the diligence required to any standard of care that is expected in any doctor-patient relationship. My fear is, he might sue me for not attending to him

Outside of an emergent situation, you cannot really be sued by a patient until you establish a physician-patient relationship with them. They can try if they want, but in order to be sued for malpractice, you have to first agree to treat them.

Also, check out the AMA Code of Ethics. Physicians have the the right to refuse to treat any patient for any reason, as long as they do not have an established relationship with that patient. You can turn down referrals because a patient has a history of filing lawsuits, because they don't have good insurance, or because you don't like their nail polish. In addition, you are free to terminate a patient from your service as long as give them ample notice and opportunity to find a new physician, and make appropriate provisions for their medical records to be transferred.

Don't be cowed by the B.S. most of your faculty throws your way; you have no obligation to "take all comers", unless you choose to set up that kind of practice. I mean hell, we're not nursing (check out their Code, which goes completely the other way). You are in charge, you choose who you treat.

 

[acute2]

Tired,
thanks for the info

 

[78222]

I wouldn't add him as a new patient, but I would treat him in an emergency situation - as I would anyone else regardless of the extent of my burning hatred for them.

 

[nobrainer]

..... When I get sued as a physician and I did not do anything wrong, I'm not going to take it personally. I'll just consider it a tax, like a tax we pay on our income.

Total BS.

 

[dutchman]

Total BS.

I did'nt know anyone else noticed the strangeness of that remark. If you get sued while you did nothing wrong, and loose bigtime, how would you explain to your family that the bankruptcy you are about to file should be looked at as a "tax" worth paying? I know some people are more than happy to sacrifice themselves for medicine, but at least think about your family for goodness sake.

 

[OncoCaP]

I did'nt know anyone else noticed the strangeness of that remark. If you get sued while you did nothing wrong, and loose bigtime, how would you explain to your family that the bankruptcy you are about to file should be looked at as a "tax" worth paying? I know some people are more than happy to sacrifice themselves for medicine, but at least think about your family for goodness sake.

Physicians get sued all the time for something they didn't do improperly. This entire thread gives ample examples of how John Edwards sued physicians who didn't do anything wrong as far as science goes ... and John Edwards is one of thousands of lawyers who have done this (and there are thousands more still doing this). Edwards convinced a jury that the physicians did do something wrong and a jury of untrained men and women is going to evaluate whether that physician did his job ... what do you think the odds are of them getting the right decision? Not so great ... maybe 50/50 best case. Most cases are settled out of court because few want to take a chance on what a jury will decide. I don't like the current state of affairs in medical malpractice but I don't make it a habit to stress over something I cannot control. In addition, I don't plan to go into OB/GYN, so that cuts my chances of getting sued by quite a bit.

I have heard of and read about physicians getting sued for no reason other than a bad outcome (like an excellent ortho who is the dad of one of my former classmates for example) that was no fault of the physician, losing the case, then then moping for the rest of their career ... basically being broken people ... wishing they could get out of medicine. My classmate's dad was a broken man after the experience. He never enjoyed medicine ever again after he lost that lawsuit. It was a blow to his ego that he could never let go. Seems like a waste to me.

There are many things in life we cannot control. I have no control over someone suing me if I did nothing wrong and I was careful to take all reasonable steps to prevent a lawsuit (and got malpractice insurance as well). I could get killed by a drunk driver on the way home from the clinic, but I'm not going to stop driving for fear of getting killed. If I get sued, I'll put in a reasonable effort to defend myself, but I'm not going to obsess about it or hang my head if I lose a lawsuit.

My family loves me whether I have money or not, so there is really nothing much to explain to them. Yeah, sure it would be disappointing to have to give up medicine (say I lost my license for something I didn't do wrong as well). I expect that bad things will happen to me in life despite my best efforts, and when they do, if I'm still alive, I'll pick myself off the floor and move on. It's part of my life philosophy, but I can understand that there are people who want to fight a lawsuit for years through appeal after appeal with every ounce of effort in their body. I would rather practice medicine as much as possible than spend my time in a courtroom.

 

[beetlerum]

I did'nt know anyone else noticed the strangeness of that remark. If you get sued while you did nothing wrong, and loose bigtime, how would you explain to your family that the bankruptcy you are about to file should be looked at as a "tax" worth paying? I know some people are more than happy to sacrifice themselves for medicine, but at least think about your family for goodness sake.

That's why you carry insurance.

 

[Dr__Robert]

As a (hopefully) future physician I would not want to treat him... however as a Christian I would feel that I have to. For Jesus said "Love your enemies," -- perhaps the hardest of the beatitudes. John Edwards is in every way my enemy, he is (represents) everything that is wrong with our world. He's a materialistic, power-hungry, hippocrite. Nonetheless, I would feel inclined to show him the love that he has never shown his fellow men.
"Even the pagans love those who love them."

 

[RokChalkJayhawk]

Yes I would, even if he sued me before. If I made a mistake I made a mistake.

 

[JohnnyOU]

Edwards can bl*w me.
I don't trust any politicians either. Rep/Dem whatever.
Laziest bunch of fakers and freeloaders on the planet.

And no...I wouldn't treat him or his old lady.

 

[Towelie]

I'm surprised that anyone is answering "no" to the above question. As disgusting as Edwards may or may not be, I would imagine that at some point you will have to treat far more objectionable patients.

 

[QuakerPreMed]

Of course I would. But then I'd even vote for him.

Thank you. After reading some of the speciality forums and rants against national health care I thought I was the only liberal doctor of the 21st century.

 

[Rattailed Jimmy]

No, I absolutely would not treat him or any member of his family except under emergency circumstances. That said, one could make a reasonable argument about the "humanity" of "treating" someone with widely metastatic breast cancer.