texas malpractice laws

[zurned]

http://www.emra.org/content.aspx?id=583

In 2003, Texas enacted laws to set a $250,000 cap on non-economic damages (pain and suffering, loss of consortium, mental anguish).[4-5] As a part of medical liability reform in Texas, in order to find a physician providing emergency medical services guilty of negligence, the claimant must show that the doctor acted with willful and wanton negligence. [6] Willful and wanton negligence is defined as gross negligence.[7] This is extremely difficult to prove and is one of the primary reasons for the decrease in medical liability cases against emergency medicine physicians in Texas.


Would love to hear opinions on this, especially attendings who have practiced in Texas.

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[deleted109597]

Uh, opinions of what?

It's a great law.

 

[Birdstrike]

.

 

[xaelia]

I love practicing in Texas.

In the 1.5 years I've been here, I've never given a single thought to performing a test I didn't think was indicated just to protect myself lawsuit from a bad outcome.

I do a CTPA like once a month. I let 70+ year olds with syncope go home. Decisions are shared between me and the patient, not me and my nagging need for risk mitigation.

 

[keeping-it-real]

for those of you in texas...are there any decent per diem or locums jobs?

 

[EMDoc0411]

for those of you in texas...are there any decent per diem or locums jobs?

I was called about a month ago regarding a job that would have paid me $300 per hour if I was willing to do 4+ shifts per month. I could only be available for two, so had to pass.

 

[EM_Rebuilder]

Texas Attending here for about 18 months now; originally from Texas, looked elsewhere after residency but pay and malpractice climate certainly helped drive us back...

I certainly believe in best practice, and evidenced based medicine.. but ultimately, I practice the dogma of 'doing whats best for the patient'. The Texas law sometimes hinders that... We all have that chest pain thats 'probably nothing', but it just hits you funny. Sure I can send it home and if I missed the MI... big deal. At least its not a 'big deal' for my checking account, but it actually is a big deal for that patient. I occasionally run into roadblocks on admission because of the Tort Reform so when a case isnt absoluate or straightforward, I hear reluctance to admit.

Not a huge deal, but its one of the very very very few negative sides of Tort Reform. Its easy to 'not care' anymore when its less likely to affect your lifestyle (money)...

I'd still MUCH rater be in this climate than the flipside. I rarely if ever practice 'defensive medicine' and esentially never 'worry' that a case might go to suit. In my practice, nobody has actually be to trial in 10+ years.... And I am at a level 1 trauma center, tertiary care center...

 

[RustedFox]

Anyone have a good resource to "look up" the basics/caps/etc of medmal in a certain state... say... Florida ?

 

[docB]

Texas Attending here for about 18 months now; originally from Texas, looked elsewhere after residency but pay and malpractice climate certainly helped drive us back...

I certainly believe in best practice, and evidenced based medicine.. but ultimately, I practice the dogma of 'doing whats best for the patient'. The Texas law sometimes hinders that... We all have that chest pain thats 'probably nothing', but it just hits you funny. Sure I can send it home and if I missed the MI... big deal. At least its not a 'big deal' for my checking account, but it actually is a big deal for that patient. I occasionally run into roadblocks on admission because of the Tort Reform so when a case isnt absoluate or straightforward, I hear reluctance to admit.

Not a huge deal, but its one of the very very very few negative sides of Tort Reform. Its easy to 'not care' anymore when its less likely to affect your lifestyle (money)...

I'd still MUCH rater be in this climate than the flipside. I rarely if ever practice 'defensive medicine' and esentially never 'worry' that a case might go to suit. In my practice, nobody has actually be to trial in 10+ years.... And I am at a level 1 trauma center, tertiary care center...

I hear what you're saying but there is another way to look at this. We so overwork CP and waste money and time and resources and work up people who are so low risk that they are more likely to have a false positive that we are really doing more harm than good. If we could dial this back and do it more appropriately we would benefit society although we would miss some MIs and hurt those individuals. Think of it like vaccines. A few patients suffer bad adverse reactions but the community benefits overwhelmingly.

 

[John146]

I hear what you're saying but there is another way to look at this. We so overwork CP and waste money and time and resources and work up people who are so low risk that they are more likely to have a false positive that we are really doing more harm than good. If we could dial this back and do it more appropriately we would benefit society although we would miss some MIs and hurt those individuals. Think of it like vaccines. A few patients suffer bad adverse reactions but the community benefits overwhelmingly.

Agree. Don't mean to derail but there was an excellent discussion on EMRAP recently about the low-risk CP patient. We work up CP in the low-risk patient WAY too aggressively, which results in numerous false positive stress tests and unnecessary PCI. PCI is by no means benign and does not improve mortality in this scenario. (Unfortunately the AHA guidelines are still behind EBM and recommend a stress test within 72 hours. This will likely change in the near future.)

 

[xaelia]

David Newman's SMART EM podcast on stress testing:
http://www.smartem.org/podcasts/stress-testing-moment-clarity

If you have three hours of your life to devote to hearing about every stress testing article, ever.

 

[EvoDevo]

David Newman's SMART EM podcast on stress testing:
http://www.smartem.org/podcasts/stress-testing-moment-clarity

If you have three hours of your life to devote to hearing about every stress testing article, ever.

But oh so informative