Special Liability Laws for EM

[docB]

I was talking to one of the senior partners in my group and he said that he thinks that the ER should be preferentially shielded from liability. He's been doing this since before EM existed so he's to be taken seriously.

His argument is that the ER is the intersection of all of medicine and an amplifier for every problem in the system. I'm not saying other specialties don't have their problems to put up with and that they're not busy. But, ERs are special. Where else is a unit and the docs routinely asked to run multiple simulteneous codes? Who else deals with MCIs (multi casualty incidents)? Who else is expected to be the front line for the hospital for haz-mat, bio weapons, epidemics and other extreme circumstances? Who else is mandated to deal with everyone who walks or rides in, the homless, the nursing home pts, drunks, druggies?

Given all this wouldn't it be a good idea to limit the liability faced by ER docs? High liability is making the field less attractive and defensive medicine is slowing us down. We could see more people cheaper with some protection. Wouldn't that be good for a society that has come to rely on the ERs for so much of its medical care?

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[turtle md]

Sounds good to me. Where do I sign up?

 

[RichL025]

Unfortunatly, it will take a long time (or never) to happen.

Liability laws aren't crafted in response to a sober and realistic assesment of the conditions in a crowded ER - politicians just don't work that way

The only way it would change is if there was a shortage of doctors willing to work in an ER - just like the malpractice "crisis" in some states with OBs and neurosurgeons - the state legislature steps in to try and put a band-aid on the problem after they realize they have no doctors.

And with the growth of interest in EM as a specialty, I don't forsee a shortage of physicians willing to work in ERs.

 

[southerndoc]

Georgia's new malpractice law limits liability of emergency physicians.

 

[DrQuinn]

FL has a cap for EPs. A "non piercable cap," actually. There's also a general cap but that is a "soft cap" for all other docs.

Q

 

[MS05']

FL has a cap for EPs. A "non piercable cap," actually. There's also a general cap but that is a "soft cap" for all other docs.

Q

They also have that 3 strikes and your out (lose your license) rule too though...

 

[docB]

This raises an interesting question: Which is worse? No cap or three strikes.

 

[MS05']

This raises an interesting question: Which is worse? No cap or three strikes.

It's pretty sad that it comes down to picking between the above two options...definitely why I went into medicine, to pick the lesser of two evils

 

[docB]

It's pretty sad that it comes down to picking between the above two options...definitely why I went into medicine, to pick the lesser of two evils

It's worse than that. The reality is that we may not get to choose between them but have to accept both.

 

[GeneralVeers]

They also have that 3 strikes and your out (lose your license) rule too though...

All the attendings I've talked to call this the "two strikes and you leave the state law".

It makes me never ever want to practice in Florida. Considering the amount of old people who are moving down there, and the projected increases in population, they are going to have a horrendous shortage of doctors if this law remains in effect.

 

[aphistis]

All the attendings I've talked to call this the "two strikes and you leave the state law".

It makes me never ever want to practice in Florida. Considering the amount of old people who are moving down there, and the projected increases in population, they are going to have a horrendous shortage of doctors if this law remains in effect.

Let 'em find out the hard way. When the 2010 census reports a 5% per annum death rate thanks to a complete vacuum of medical care, all those hard-working civic-minded lawyers & politicians (do I repeat myself?) will have no one to thank but themselves.

 

[anonymousEM]

When the FL College of EM went to lobby this year at the state capitol several residents were in attendence from the different residency programs in FL and these were the topics that were discussed. We had audience with the Lt. Governor and she asked everyone to introduce themselves and made a comment that the way to get and keep more doctors in FL is to have more residencies in FL. Then she asked who planned to stay in FL after training--ONLY ONE PERSON RAISED HIS HAND. She was shocked to see the residents' opinions of the new legislation. Hopefully if the 3 strikes sticks it will be with a well defined description of what constitutes a strike with the state medical board presiding and not "left to be decided by the local courts"

 

[WilcoWorld]

Does ACEP or SAEM have lobbyists? Personal injury & malpractice lawyers sure as heck do.
For most of its existence the field of medicine has enjoyed a special place in society. It was viewed almost as a gift given from the physician to the patient, and, as such physicians were under much less scrutiny. There are still many docs who feel that they should enjoy a privileged position in society. Thus it is many doctors’ opinion that the politicians should take care of this problem or they'll loose the wonderful gift of health care that we currently bestow upon them. However, we are no longer seen as knights in white cotton by most. We must take action against malpractice ourselves if we are to prevent the current trajectory from reaching it's disastrous conclusion.
In my opinion we need to:
1) Educate our friends & patients about the situation so that they too can pressure legislators to take proper actions.
2) Use our organizations to fund lobbyists so that it's not just the attorneys being represented by the legislative branch.
3) Educate ourselves about these laws & policies so that we may a) abide by them and b) become more keenlyaware of their deficiencies in need of repair.

 

[NurseyK]

Hey...as we speak of med mal...

does anyone know where I can find out avg premium quotes for different specialties (obviously I'm most interested in EM)? Unless someone knows about what the cost for med mal insurance is per year for EM?

Thanks....

Kat

 

[MS05']

Does ACEP or SAEM have lobbyists? Personal injury & malpractice lawyers sure as heck do.
QUOTE]


I can't remember where I heard it, maybe it was a mailing from ACEP or from the AMA, I think it was the AMA now that I think about it, but it was a statement comparing how much physician groups spend verse how much lawyers spend on political campaigns. By "political" I mean contributions to their cause, not supporting a specific candidate for office. I can't remember the exact numbers, but the difference was astronomical, AT LEAST 10:1 in favor of the lawyers!!!


This begs the questions, do we as physicians need to advertise more? I know, it sounds like a ridiculous idea, but think about....when was the last time you heard a lawyer commercial on TV or on the radio supporting their cause or promoting themselves? Probably within the last 30 seconds and at the rate they advertise the next one will be coming on in the next minute or two. When was the last time you heard a similar commercial from a physician group stating our cause and how, particularly in Florida, physicians are being driven out of practice?!!?!?

My guess is never or very seldom. To be honest, this is a war between us and attorney groups for public trust........

 

[GeneralVeers]

Of course ACEP and SAEM have lawyers, as does the AMA. The problem is that lawyers make their living being lawyers, hence they have all the time and energy to devote to screwing over healthcare providers.

Doctors have to spend actual time with patients, so only have limited time and money to spend defending their interests.

Net result is that laywers will win most of the time.

I have noticed that no time in medical school is given to liability issues, and encouraging young doctors to get involved politically.

 

[docB]

Of course ACEP and SAEM have lawyers, as does the AMA. The problem is that lawyers make their living being lawyers, hence they have all the time and energy to devote to screwing over healthcare providers.

Doctors have to spend actual time with patients, so only have limited time and money to spend defending their interests.

Net result is that laywers will win most of the time.

I have noticed that no time in medical school is given to liability issues, and encouraging young doctors to get involved politically.

I think he was talking about lobbyists, not lawyers. I actually don’t think that SAEM has lobbyists as that’s not their thing. ACEP does. That brings up the question of whether it’s better to ally with all other specialties and fight for general reform like caps or if we should break off and fight for special considerations for ERs. As much as I’d like to see special protection for EM I think that we’d be too weak to have a national impact and are probably better off staying united with everyone else.

 

[EMRaiden]

I was talking to one of the senior partners in my group and he said that he thinks that the ER should be preferentially shielded from liability.

South Carolina just passed a Med-Mal law and one of the provisions is that Emergency, Surgical and OB/GYN cases involving TRUE emergencies (not sure how that is defined) must show gross negligence not simple malpractice.

As an aside SC has a very favorable malpractice climate, especially with our new law- cap on damages, joint and several liability, etc- and relatively low insurance rates.

 

[Jeff698]

South Carolina just passed a Med-Mal law and one of the provisions is that Emergency, Surgical and OB/GYN cases involving TRUE emergencies (not sure how that is defined) must show gross negligence not simple malpractice.

I'm pretty sure our recent MedMal reform law in Texas also included this definition. It also included caps on P&S claims, something that was backed up by a state constitutional ammendment approved by the voters so that it can't be overturned in the courts like it had been in the past.

Take care,
Jeff

 

[carrigallen]

The AMA opposed special liability laws because they see them as a "divide and conquer" tactic. Select groups are appeased, but the overall problem is not addressed.

 

[docB]

Can anyone think of any other area of medicine that has been hit with an unfunded mandate like EMTALA? I understand the problem of divide and conquer but I think that the insane pressure put on ERs with both EMTALA and med mal has made a bad situation untenable.

 

[bemused]

Can anyone think of any other area of medicine that has been hit with an unfunded mandate like EMTALA? I understand the problem of divide and conquer but I think that the insane pressure put on ERs with both EMTALA and med mal has made a bad situation untenable.

This crap makes forensics look more and more attractive. Dead patients bring no law suits.


{Just gotta be sure you know the dead ones from the live ones }