malpractice rates high?

[jayman]

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I've been hearing how EM malpractice rates are pretty darn high...besides neurosurg, ob, and ortho.

Why so high? It would seem to me that because of the nature of the ER, most patients would be happy just to have someone available to help them...how can anyone think that an ER doc would intentionally or carelessly screw a patient over in a critical situation where outcomes are variable to begin with? And how would anyone in a court of law even try to make such a claim?

Maybe I'm just not understanding exactly on what grounds you can sue a doc for "malpractice"...but intrinsically it seems that ER docs shouldn't have such high rates. I mean, even if mistakes are made in a critical situation, members of the legal community/patients have to realize that the ER isn't a nice, calm office where a patient's particulars can be pondered over before arriving at a plan-of-action...don't they see this?!?!?!?!? <sigh>

any insights would be appreciated.

 

[The White Coat Investor]

Yes malpractice rates are high. There is no tolerance in juries for missed MIs. Nor is there a tolerance for missed fractures. Couple all that with a stressful, overcrowded work environment without a long-term doctor-patient relationship and you have a recipe for a medicolegal disaster.

Just remember lawsuits are about money. That's it. Its a cost of doing business. Everybody gets sued. Its not about what kind of a doctor you are nor what kind of a person you are.

To sue for malpractice all you need is a lawyer. To successfully sue for malpractice you need:
1) The doc to make a mistake
2) Something bad to come from it.
3) The patient to notice that something bad has come from the doctor's mistake.
4) A poor-enough doctor-patient relationship that the patient is willing to trash it by sueing the doctor.

 

[emdoc21]

EM physicans have one of the highest medmal rates for several reasons:

1) We see many more patients than most docs.
2) We see many more SICK patients than most docs.
3) We have no prior doctor-patient relationship, so the patients couldn't care less about suing someone they don't know.
4) We work in a chaotic environment, with limited information, frequent interruptions, and may have several critical patients at one time...things get missed
5) Trauma patients, drug/alcohol abusers, and the indigent are more likely to sue than other patients
6) We're another name on the chart for the lawyer to sue when patient X has a fatal PE on hospital day 7
7) There are many hired guns (expert witnesses) within EM and in other fields who tell the jury that what we did was not EM standard of care, when it actually is.

Jayman, you are making a mistake in assuming that a jury will have empathy or understanding for an emergency physician. There is no room for justice in a medmal trial. Overall, there is a much stronger relationship between the award and the severity of the bad outcome, rather than the contribution of the bad outcome to negligence. In the end, it's all about money...we have it, and the plaintiffs and lawyers want it.

Tht being said, most EM docs can earn between $150-$250,000, AFTER malpractice expenses.

 

[DrQuinn]

Agreed with above posters.

In the ED you are working in a fishbowl... everyone looks in on you, but you're by yourself making out with the SCUBA diver. You're the first to see the patient, and if someone screws up behind you on an admission, and their family decides to sue that doctor, often times you will be subpoenaed as well. Much like in the criminal defense arena, you'll book them for any charge you can get... but by the time the trial is going on, you're really focusing on only a few.

EM is most definately a high risk surgery... but you just have to be dogmatic about how you approach patients. You WILL be sued. But can you justify your patient care? That's all that matters. If you are not dogmatic about your approach to each patient, you will more often than not let a few slip between the cracks and get bit on the butt more often.

*my use of dogmatic stems from a great ED attending I once had. Its all about dogma!*

Q, DO