If there was a glimmer of hope for military medicine, THIS killed it

[AvoidMilitaryMedicine]

New measure would allow troops to sue for military malpractice mistakes

Rep. Jackie Speier wants to overturn the Feres Doctrine, which bars such lawsuits against the Defense Department.

www.militarytimes.com

Soon it will be open season on military doctors as we will be held liable for adverse outcomes for practically anything and everything despite having little to NO control of our practice.

Forced to practice in austere environments with little/no support? Deal with it.
Forced to be a GMO/DMO for years with no mentorship and/or constantly being asked to practice outside your scope of practice? Deal with it.
Forced to supervise (under your license) hordes of minimally-moderately competent mid-levels without the needed time/resources to do so? Deal with it.
Forced to pick up right where you left off after being deployed for 12 months and seeing few (if any) patients in your specialty? Deal with it.

Queue up the disgruntled disability seekers, ambulance chasers and outright malingerers. With free legal counsel, there will be no cost to potential plaintiffs to pan-sue everyone until he/she gets what she wants. This will further de-incentivize an already overwhelmed and undermanned medical force from doing their jobs as the liability will now be enormous -- especially for surgeons. An important note, if the DoD is sued, it is entirely up to them on what they do and who they hire -- if they settle (as they often do), your name still goes in the NPDB. With the latest DHA measures already crippling recruitment, training and retention, I didn't think it could get worse... but this did it.

Prospective HPSP/USUHS students, think long AND hard before you sign the dotted line.

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Members don't see this ad.

 

[HighPriest]

The biggest issue will be NPDB reporting for settlements. I can see a scenario wherein you get out, try to find a job, and you have a grocery list of settlements for minor BS that the government settled in your name.
The question will be whether or not you'll see a lot of suits. I'm a pessimist, to be sure, but I think you'll see them. It may just be a wave, but the guys caught in that wave will get screwed. I wouldn't trust the DoD or DHA to fight harder to prevent this problem. In fact, it may be an even bigger issue, since the two entities are separated. You'll sue the DHA because the problem happened at their hospital and the DoD because they own the doc, and the DoD see's you as an asset, not a professional. So there's maintenance costs, and this is just one.
Only way this doesn't blow up in their faces is if soldiers just don't sue. I don't see that happening. A lot of guys assume they're getting substandard care in the military. It often isn't true, but it's a general sentiment that I see a lot - especially now that I'm out. I can't tell you how many people tell me they're so happy to not have to see a military doc....I don't have the heart to break the news to them....

 

[Gastrapathy]

Meh. This comes up every couple years and never makes it to the President's desk. There's tons of BS to worry about but Feres isn't going anywhere and isn't all that important anyway.

 

[HighPriest]

Meh. This comes up every couple years and never makes it to the President's desk. There's tons of BS to worry about but Feres isn't going anywhere and isn't all that important anyway.

Probably true.

 

[militaryPHYS]

Agree with @Gastrapathy.

But I really appreciate the click-bait title. It’s like we are a primetime news media outlet now.

 

[backrow]

Agree with @Gastrapathy.

But I really appreciate the click-bait title. It’s like we are a primetime news media outlet now.

A “like” of his post probably would have been sufficient then, and received better than another typical “anything that is negative deserves an immediate and harsh response” response.

It does provide some entertainment at times though (see Tricare thread).

 

[militaryPHYS]

Forgive my sarcasm.

If we have points we need to get across we should be stating them clearly without taking it over the top in our title just to get people to click it.

 

[DrMetal]

Just hypothetically, if they did overturn the FD, who/how would pay for our individual malpractice insurance?

 

[pgg]

New measure would allow troops to sue for military malpractice mistakes

Rep. Jackie Speier wants to overturn the Feres Doctrine, which bars such lawsuits against the Defense Department.

www.militarytimes.com

Soon it will be open season on military doctors as we will be held liable for adverse outcomes for practically anything and everything despite having little to NO control of our practice.

This is a little hysterical...

Easily 95% of my patients (indeed all patients served in CONUS) are dependents or retirees and Feres Doctrine has never applied. For care in deployed settings, FD isn't going anywhere.

I know that you know all of this, so I can only conclude that you're being deliberately disingenuous here.

 

[HighPriest]

I agree it's hysterical and will probably not amount to much, but:

95% of your patients are retirees or dependents? That was definitely never true for me. Maybe 50-50, but I'm shooting from the hip, and I don't have any resource in front of me for reference. Definitely not 95%.

A lot of it would depend upon who we're talking about. A military radiation oncologist probably sees mostly retirees. A GMO would see mostly AD. Some people would, theoretically, be at greater risk. As I said (and again, I'm talking hypothetical) I think you'd see an initial wave of suits as people realized that collar was now gone, and then it would settle down to very infrequent. A lot of those suits would be utterly nonsensical, but you only need one settled to have a record. It would suck to be caught in it. Hypothetically.

 

[colbgw02]

Just hypothetically, if they did overturn the FD, who/how would pay for our individual malpractice insurance?

I would assume the same way that most giant healthcare organizations provide coverage, be self-insured, in this case via the U.S. Treasury. That's how it works for big academic centers, the VA, civilian DoD docs, etc.

 

[Gastrapathy]

Just hypothetically, if they did overturn the FD, who/how would pay for our individual malpractice insurance?

The same people who pay for it now. The taxpayers.

My practice was about 20% AD and that was the lowest risk part. Feres or no Feres never changed how I practiced. The main upside of Feres is to avoid the nuisance lawsuit related to fitness for duty recommendations.

 

[pgg]

I might have been closer to 70/30 non-AD/AD when I was at a small hospital on a military base. But the VAST majority of surgical cases and inpatients at the big 3 Navy MTFs are not active duty. The highest % of AD is probably ortho but even there most aren't.

As a GMO I saw nearly 100% AD of course.

Anyway. The malpractice insurance benefit of being on AD is real, and it's not going to change, Feres Doctrine or no Feres Doctrine. We'll always be covered by the federal tort claims act (or some kind of successor law) and we'll always have an army of government lawyers who aggressively and vigorously contest every claim. The process for getting into the national database after a loss heavily favors us. This is also unlikely to change.

In truth, Feres Doctrine shouldn't apply to AD receiving care in CONUS. Fixing that is ethical and necessary.

 

[d2305]

When I worked in FM, all of my patients were dependents or retirees.

 

[epidural man]

“There are few incentives better than the threat of legal action to push an organization to change its behavior. This would lead to better quality care for our service members and higher levels of readiness.”

Wow. Just wow....

It's amazing to me to think about how much defensive medicine has hurt patients. Only someone looking for a paycheck would make such a ridiculous claim.

 

[Oo Cipher oO]

Corpsman, such as those working in FMF billets, work under their supervising medical officers license, correct? Would you feel comfortable allowing a corpsman to see and treat active duty patients as they currently due with the risk of their blunder may become a lawsuit that can affect your future employment? I don’t know that I would.

 

[d2305]

I remember when military physicians were unlicensed circa 1990.

 

[backrow]

I remember when military physicians were unlicensed circa 1990.

That was merely an administrative issue with poor optics for the vast, vast majority. This is a bit of a different beast.

 

[Monty Python]

What about the Independent Duty Corpsman on the physician-less ballistic missile submarine, performing strategic deterrence patrol for many many weeks submerged, potentially engaged in comm silence at times for tactical reasons? Under whose license does the IDC work? Or does the "Independent" truly mean no physician in the chain? Is the person at BUMED who signed Navy-wide IDC protocols liable?

 

[d2305]

When I was out there, there was a squadron medical officer somewhere. I wasn't on a sub and could always send a message. It was nice to have a carrier nearby who could send a medivac helo. They gave us clindo to keep an appy at bay until he could see a surgeon. I was lucky as when I actually had an advanced appy, there actually was a carrier near.

 

[Matthew9Thirtyfive]

What about the Independent Duty Corpsman on the physician-less ballistic missile submarine, performing strategic deterrence patrol for many many weeks submerged, potentially engaged in comm silence at times for tactical reasons? Under whose license does the IDC work? Or does the "Independent" truly mean no physician in the chain? Is the person at BUMED who signed Navy-wide IDC protocols liable?

In our destroyer squadron, our IDC worked under the squadron doc’s license.