Why I hate lawyers...

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Gleevec said:
Oh, I just meant if your town had to choose between a malpractice lawyer and a doctor, it would almost assuredly choose the doctor. And then I jokingly meant Im glad were going to be doctors.

Yeesh, like 95% of my post was correct grammar and one wierd sentence takes over this thread. Its not like I spend much time or proofread these things. 😉

No harm, it's all me - my slowness gets in the way sometimes - thanks for the clarification. 😀

Ken - I think what gives people such a bad taste for lawyers is not the fact that there are a lot of hardworking lawyers who are, according to you, honest and in it for the client's benefit. The problem is that if you watch daytime TV, you get a new ad every five minutes directed at people who are looking for "compensation for YOUR injuries". I've even seen commercials directed at specific disorders ("Have YOU suffered a birth defect in the last ten years?"). No matter how many crappy doctors there are who are in it for the cash, they will always look better from the outside because they don't shove it in everyone's face that they're looking for the newest quick buck they can find. They take patients as they come and let the money come through on it's own. And it's not even like it's just a few greedy lawyers doing this - I see hundreds of these a year, all are from different attorneys, and I don't even watch TV that much. Do a search for "medical malpractice lawyer shopping" on google and you get over 100,000 hits. It just LOOKS sleazy, and you sure get the impression that they'll take any case they can get and stretch it if they have to.

The best was when I was reading some of the articles that have been posted here from some of the online news sources. As you finish some of these articles, notice that the paid advertisements at the bottom of each page (the ones that are inserted based on the content of the article) are all for MedMal lawyers. Even in articles about how MedMal is destroying the medical field, they get their advertisements in. :laugh: :laugh: :laugh:
 
Wow, what an interesting discussion.

Ken, there is no winning here for you. While we students may disagree on many things, there are two we are agreed on and that is, first, lawyers are a threat to us and what we do. They make our life long dream less than what it is. We are too busy looking over our shoulder and covering our butt to focus on doing our job. Second, no formal education can rival that of a physician.

One of my best friends is a lawyer who specializes in medmal defense. He and his coworkers often say what jerks docs are in depos, etc. Of course they're jerks, they just blocked four hours of seeing patients to sit in a little room answering stupid questions. A doc friend of mine said that a lawyer should be able to ask all pertinent questions in a deposition in less than fifteen minutes. So, he adjusted his deposition pay scale so that the first fifteen minutes is free, the second fifteen minutes is $100, the third fifteen $200, the fourth $400... etc. Good theory but never worked. The lawyers never could get their poop in a group to get him out of there in less than two hours.

Good luck in med school, Ken. I wish you all the best.
 
I read a book a couple of months ago written by a Harvard Surgery resident who also got his Master's in public health or something like that. I don't remember the name of the book offhand, but in it he spent an entire chapter discussing the findings of an epidmiological study done at Harvard on why and which doctors are being sued. The Harvard group's study determined that while "bad" doctors are sued a lot, so are supposed "good" ones. The point of their findings was that it did not matter the training or supposed skill of the doctors being sued, in more than 90% of the 4,000 or something cases they studied, it was pure human error. Yes, "bad" doctors do make more mistakes, and yes they should be punished, but another question was raised in the book. What should the punishment be?

The study followed almost half of the doctors who had been sued, and the rate of their error did not change. If you are a good doctor, then you will be a good doctor who has been sued, which is a stain on your reputation. If you are a bad doctor who is sued repeatedly, then something should be done to stop this doctor from practicing. Their finding was surprising to them, but also should have been expected. If you are a CT or neurosurgeon, for example, working on your 9th hour of an intricate case, how will losing a 300,000 dollar settlement two years ago keep you from being exhausted and making a mistake? No amount of money can keep us imperfect humans from making a, hopefully, rare mistake.

The point they were trying to make is the amount of money paid out by the doctor or insurance company had no bearing on future cases. The Harvard group argued instead that another form of punishment needs to be utilized. I don't remember offhand their suggestions, but it makes sense. I'll find that book tonight, and post it's name tomorrow or something. It was excellent reading and very introspective on the profession as a whole. (Medicine, not law, thank God)
 
Ugh, I don't know if it is such a good idea putting in my opinion, but I imagine that I am the only person reading this thread that has taken the bar exam (in two states) as well as the USMLE (steps 1 and 2). It is very difficult to compare the examinations because they are so different. As was previously mentioned, the bar exam consists mainly of a day of multiple choice questions and a day of essays. The MCQ are nasty. They require careful reading to the facts and application of you legal knowlege base. They test the true minutia of the law. In my opinion, the questions are more intellectually rigorous on the the bar exam than the USMLE. The essay section of the bar exam is testing your ability to apply the law to a factual scenario, analyze it and produce a well reasoned argument. This is the essential skill of a good attorney. Of course, as with any essay test good writing skills and the ability to BS can make up for a certain lack of knowlege.

All this being said, it is difficult to say which test is "difficult" because you don't get your scores back on the bar exam. Pass rates are difficult to compare because there are no (generally) foreign trained students taking the bar exam and since there are many more law graduates, the academic ability of those taking the test has a broader distribution. I would much rather take step 2 again the the MCQ portion of the bar and would probably say the same for step 1.

Ed
 
Ken, Man you sure think you are hot ****. I only mention her schooling because it gives a basis for comparison to people from lower tiered schools who make up the medmal attorneys. You claimed that it is easy to publish a paper. Please let me know where you have been published. I could get into a pissing match with you about all your rude comments but Ill keep this as short and sweet as possible.

1) Where did you publish an article?
2)
Let me clear up some facts. Roughly 1/3 of all suits against doctors win an award and the awards average around 8-900K. You say that these awards arent enough and that doctors should be punished more severely? Maybe you need to wake up and smell the coffee. Do you think one mistake should ruin a persons whole career?

Ill admit it came from an article in a class I took it was from the www.memag.com website. I cant find it now and sadly I dont have time to locate the article.

I refer you back to the factfinders - the jury.
3. Hey Ill take a jury of my peers anyday (laugh at you) Ill take 12 doctors in any med mal case. Sadly, in these cases "peers" are people who are very poor and look at this like a chance to help someone else win the lottery. Although I am sure you already knew this. I could bash you here but like i said Ill keep it straightforward)

I like the idea of a loser pays system. However, your economics needs a little remediation. If a lawyer has less than a 100% chance of winning, he will have to charge more than a base fee to make up for his time and expenses that are spent on cases that either don't pan out and even get filed, or cases that are lost. There certainly are a few, loud, obnoxious shyster lawyers that will screw over clients and do little work, but they are so much more the exception than the norm.
4. My economics dont need any help if a lawyer were really picked the good cases he should win oh lets say 50% of the time. So that cuts his total hourly rate to $125 / hr of EACH case won. Now if they work "80-100" hours a week like you claim (I dont believe it one bit) then working the low end of the scale which is 80 hours per week would allow them to work 4000 hours per year (with 2 weeks vacation) that would allow them to earn a whopping $500,000 per year. I think that is a handsome reward for a measly 3 years of education.

Umm, although your wife, a graduate of the number 6 law school in this whole gosh darn country, may be working at some 40 hour a week government job, or maybe she gives the partners a few "extras" to avoid spending too much time at work, many lawyers work 80-100 hours per week. Or maybe I should say successful lawyers. I have seen a lot of BS in this thread, you are right, and maybe it's coming from the keyboard of someone who isn't speaking from first hand experience, but rather 2nd hand knowledge and predjudices. With all of your vehement dribble, I'm surprised your wife actually puts up with you, or for that matter how you put up with a sleazy, cheating woman that "screws people over".

5. Ahh the personal attacks I love it. Doesnt that usually result from someone who doesnt have a real point to make? Actually just for facts sake ill say she works in a big firm in Chicago works her ass off and as far as I know doesnt cheat on me. She actually is one of the top billing attorneys at her firm and defends doctors from scum attorneys. It pains me that you are completely off base. In addition, you claim my knowledge is second hand but I dont think you are a practicing attorney either unless I missed something. So you dont really have an idea about what you are talking about do you?

More baseless rantings represented as fact. Do you have any data on this? I haven't called one person on here stupid, but was merely presenting the opposite side, and get attacked by untruths and ridiculous rantings from someone who has barely finished 2 years of medical school at Finch? I don't even know why I'm bothering to respond to the incoherent rantings of an idiot.

6. Actually this is simple math. As it is easier to get into Law school and there are more lawyers it reasons that the average doctor is smarter than the average lawyer. I can provide mathematical explanations if necessary!! ROFLMAO
 
More Fuel to the Fire. I personally think these stats are insane but....

News of the Day ... in Perspective
4/13/2004
Malpractice awards reach record high.

The average medical malpractice verdict in 2002? What would you guess?

$6.2 million. That's right, the average verdict was an astronomical $6.2 million. That means many were far higher. Any trial lawyer who argued his case before a jury that returned a verdict in his favor could expect to win, on average, $6.2 million in 2002. The average is probably even higher now.

These verdict data were just released by the annual Personal Injury Evaluation Handbook, published by Jury Verdict Research, of Horsham Pa. It compiles a nationwide database of 213,000 verdicts.

Many doctors are told that they can expect to win most malpractice verdicts. True, but not by much. In 2002, plaintiffs won 42% of malpractice cases. That is up from 40% in 2001, 37% in 2000 and 35% in 1999. The trend is obvious.

The increase in the average award has also been up, up, and up. The average verdict award was $3.3 million in 2000, and $3.9 million in 2001, before skyrocketing in 2002.

On April 13th, the U.S. Senate once again defeated tort reform legislation.

http://www.aapsonline.org/nod/newsofday61.htm

For the lawyers who need a link.

http://www.amsa.org/hp/medmalfacts.cfm

Just the major points!! If you want the full thing click away... 👍

States with caps of $350,000 or less had premium increases of only 12%, while states without caps had increases on average of 44%

The median award in 2000 was $1,000,000 according to JVR
Just to remain fair .. Ill post the other 2 bits of info
The median award in 2001 was $135,941 according to the DHHS
The average award in 2000 was $42,607 according to the CFA

Obviously it is really hard to find the true answer as it looks like everyone is full of BS. There is a huge gap here so who knows? Either way we can agree that MedMal lawyers are SCUM!!! They are trying to ruin our noble and honorable profession. 😡
 
Comments on the frivilous nature of these suits.... from the above article

Only 29.4% of cases from 1985 to 1999 were settled in favor of the plaintiff
Only 6.7% of cases received verdicts in court
Only 19.1% of court cases ruled in favor of the plaintiff

hmm so using my considerable math skills 70.6% of these cases recieved not a single penny... I think the term frivilous is appropriate!
 
That's why the term "legal lottery" is so appropriate. You have a relatively slim chance of winning. But when you do, WOOOOOO!!! Party at my house! "We're in the money! We're in the money!"
 
EctopicFetus said:
Comments on the frivilous nature of these suits.... from the above article



hmm so using my considerable math skills 70.6% of these cases recieved not a single penny... I think the term frivilous is appropriate!


But, the lawyers made out.
 
Well as some lawyers (who have no cred according to our buddy in TX) when lawsuits happen (except medmal) often no one wins but the attorneys (due to their exorbitant fees). Of course in the med mal arena the lawyers and those who may or may not have been injured by MDs sure got a lot out of it. Pain and suffering... Puhleez.. 1 million? Come on!
 
flighterdoc said:
But, the lawyers made out.

EctopicFetus said:
Well as some lawyers (who have no cred according to our buddy in TX) when lawsuits happen (except medmal) often no one wins but the attorneys (due to their exorbitant fees). Of course in the med mal arena the lawyers and those who may or may not have been injured by MDs sure got a lot out of it. Pain and suffering... Puhleez.. 1 million? Come on!

I still think you people are having trouble grasping the concept of a contigency fee agreement employed in med mal suits. The plaintiff's lawyers do not collect any fees unless they actually WIN or SETTLE. It is a high risk-reward roulette game they are playing.

Yes, the defense lawyers get paid either way, by the hour. But it isn't exactly as if they are in cahoots with the plaintiffs bar, encouraging them to drum up lawsuits.
 
samurai_lincoln said:
Yes, the defense lawyers get paid either way, by the hour. But it isn't exactly as if they are in cahoots with the plaintiffs bar, encouraging them to drum up lawsuits.

Maybe not, but lets be honest. defense lawyers love it when their clients get sued. They have zero incentive to protect them from suits.
 
Hmmm. I found something in the article that caught my eye, and I thought someone else would bring it up...

Miller, who says he has not been sued for malpractice, says he pays $84,151 a year for malpractice insurance. He says that after he paid business costs and taxes last year, his take-home pay was $64,000.

This guy is a neurosurgeon. ALL published figues say the median salary for n-surg is 300+ k per annum (it's seldom clear if this is before insurance or not, but the conventional wisdom is that it is). If he has $148,000 before malpractice and after business costs and taxes (but business costs are tax deductible, as is insurance I believe), this means he's paying over 150k/year in "business costs".

Either there's something fishy here, or this guy is a total business knucklehead and needs to hire a good office manager post haste.
 
Iatrogenic said:
I love that! Brilliant idea!

Did you also know that there are more lawyers in Manhattan alone than in the entire country of Japan?

Did anyone see the Simpsons episode where the family needed a lawyer and all of a sudden their car was surrounded by lawyers looking for work? I think they said something like there are 10 lawyers for every 1 person in the USA. I don't remember the episode exactly, but it was something along those lines. I love the Simpsons and how the jokes are always so relevant.

The problem is that there are way too many lawyers in this country. Lawyers are necessary because they keep businesses and the such honest, but when there are so many of them they are more willing to take up ridiculous cases to make a quick buck. Maybe the solution is to limit the amount of lawyers that can practice. The amount of doctors in the US is pretty tightly controlled, maybe a similar system is needed for lawyers. I'm sure we could get along fine with half of the law schools that are in this country.
 
This guy is a neurosurgeon. ALL published figues say the median salary for n-surg is 300+ k per annum (it's seldom clear if this is before insurance or not, but the conventional wisdom is that it is). If he has $148,000 before malpractice and after business costs and taxes (but business costs are tax deductible, as is insurance I believe), this means he's paying over 150k/year in "business costs".

Either there's something fishy here, or this guy is a total business knucklehead and needs to hire a good office manager post haste.[/QUOTE]


150K in business expenses in nothing. A staff of one nurse and two office people would push 100k in salary expenses. Now add in medical insurance, the employer part of the payroll taxes (employees only pay half), rent or commercial property mortage and you are already over 150K.

But keep in mind that there are many ways for a physician to get passive income from their business if it is set up correctly and if they own their own building and the passive income is not noted in their "salary" and is also taxed less than a salary. It is better to be than appear to be. Take physician reported incomes with a grain of salt.
 
Forensic Path, as far as limiting the # of lawyers.. Please see my previous post espousing the same thing. BTW I think it is interesting Ken37 hasnt been back..
 
flighterdoc said:
The reason there are so many essay questions is because there aren't any answers - just opinions.

That's ******ed. There are right and wrong answers. That's why people often fail. In Ohio the bar exam consists of one full day of the so-called "multi-state" bar exam, which is all multiple choice questions. The other day and a half (2.5 days total) consists of essay questions graded on a 1-7 scale depending on whether you "saw" all the issues and addressed that correctly.

I have NO IDEA whether one is harder than the other. I'll know in a few years, I guess. I would trust Ed Madison on this issue.

Judd
 
EctopicFetus said:
Ken37, you are obviously a complete an utter *****.My wife went to University of Chicago (the #6 law school in the country). Tell me if you agree with this: the lawyers that go after the doctors are the lowest on the totem pole. They are usually the ones that go to the crappiest law schools and if they dont they graduate at the bottom of their classes. While I agree there are a few of these guys who probably have half of a brain you would be the biggest putz in the world if you didnt realize that these guys are pure scum. I would love it if they limited the number of lawyers in this country much in the same way they do doctors. While I am sure you were the stud of some 4th tier school your inability to attend a better law school shows enough about your mental capacity. Becoming a lawyer is a complete joke. Three years of school and lets be honest the third yr is a complete joke. So in essence your bar exam covers 2 full years of education. When people are taking step 3 they are being tested on over 5 years of material. In addition, to your point about a Podunk state, I am currently in Illinois and will be getting out of dodge ASAP to go back to somewhere warmer. That being said passing the bar here isnt all that easy. I will also say that her classmates had no problem passing Cali or NY (reputedly the 2 toughest). Just out of curiousity why dont you fill us in on what publications you are published in? Yeah thought so.. those journals... uh uh disappeared?

What makes me laugh is people like you who think they have an iota of an idea of what we go through. Medical students study harder and get this... are smarter on average than attorneys (I can explain if you wish).


Are you kidding me? You must be either fresh out of undergrad or have been kidnapped by Trial Attorney Aliens.. How is it that they should work together when they represent different sides of fence and trial attorneys make their living chasing medical errors (which in some cases arent errors but rather bad outcomes).

Do all current and future MDs a favor, dont go to med school it will be too easy for our high priced attorneys to make you look like the ***** you are when you come chasing after us.

I am saddened that people would respond to this.

Judd
 
Judd, he started with me. I have no problems with attys except the ambulance chasers. There are too many of them and they all think their you know what doesnt stink.
 
samurai_lincoln said:
I still think you people are having trouble grasping the concept of a contigency fee agreement employed in med mal suits. The plaintiff's lawyers do not collect any fees unless they actually WIN or SETTLE. It is a high risk-reward roulette game they are playing.

Yes, the defense lawyers get paid either way, by the hour. But it isn't exactly as if they are in cahoots with the plaintiffs bar, encouraging them to drum up lawsuits.

I was going to say this. I'm glad you did. This is the second time in as many threads that Flighterdoc has failed to grasp this concept.

judd
 
Finn said:
This guy is a neurosurgeon. ALL published figues say the median salary for n-surg is 300+ k per annum (it's seldom clear if this is before insurance or not, but the conventional wisdom is that it is). If he has $148,000 before malpractice and after business costs and taxes (but business costs are tax deductible, as is insurance I believe), this means he's paying over 150k/year in "business costs".

Either there's something fishy here, or this guy is a total business knucklehead and needs to hire a good office manager post haste.


150K in business expenses in nothing. A staff of one nurse and two office people would push 100k in salary expenses. Now add in medical insurance, the employer part of the payroll taxes (employees only pay half), rent or commercial property mortage and you are already over 150K.

But keep in mind that there are many ways for a physician to get passive income from their business if it is set up correctly and if they own their own building and the passive income is not noted in their "salary" and is also taxed less than a salary. It is better to be than appear to be. Take physician reported incomes with a grain of salt.[/QUOTE]

yes, but most published income figures are AFTER expenses, but BEFORE taxes. I read that article a few days ago (somebody published it here) and I agree that something was "fishy" about it. That guy played a bit fast and loose with the numbers.

Judd
 
EctopicFetus said:
Judd, he started with me. I have no problems with attys except the ambulance chasers. There are too many of them and they all think their you know what doesnt stink.

Perhaps you are right - but you went after his intelligence based on the school he went to. Not kewl.

Judd
 
Judd, Texas is just fine. All i said is it wasnt great. Hell im not going to a great law school? BTW im sure you noticed his unwarranted attack on my wife saying she cheats on me etc. But I guess I should not care about that? I dont take his comments seriously cause each of us has enough anonymity that we can say what we want without real consequences. Makes us all a little braver than we should be. Either way he seems to have fallen off the face of the earth cause he doesnt want to acknowledge the truth.
 
I'd just like to say, having read this thread in its entirety, that the amount of sophistry and selective reasoning that Samurai Lincoln and Juddman have employed borders on farcical. It's obvious that each of them are either lawyers or have studied to be one, just from their general manner of discourse and diction.


And, just so you know, even IF neurosurgeons still made $400K after all expenses and taxes, who in the hell are you to say (or at least insinuate) that they shouldn't, or that their income somehow mitigates the concerns they have and their legitimate criticism of our tort system? If they don't deserve to make that money, who does then? 2-year MBA grads? 3-year law school grads? Airheaded CEO's? A neurosurgeon endures a total of 9+ years of academic and clinical post-graduate schooling, including a grueling residency (like all physicians) and a barrage of rigorous testing and evaluations spread out over the course of several years. What else is comparable in this regard? Certainly, if a lawyer (which, to my mind, is a glorified Master's degree, no matter how arduous those 3 years are) "deserves" to make $500K, then a doctor of ANY sort does, nevermind neurosurgeons. Just my general opinion.


What's sad is that becoming a doctor is probably the last noble and decent occupation that one could pursue in this nation and still be reasonably assured of economic comfort, yet our financial rewards are largely being chiseled away at due to the greed and myopia of others. To be certain, I decided to venture down the path of medicine for three major reasons: first, the only thing I've ever known about my path in life was that I fervently desired to help people and affect some measure of good in the world; secondly, I desired to do something commensurate with my abilities; third, I wanted to be economically comfortable for my future family's sake (not my own sake- were I fated to live a solitary life, I would have no desire for anything beyond $80K per annum). Now, those three reasons are of roughly equal significance, but due to some of my other priorities (such as supporting a family), the monetary aspect takes slight precedence. I cannot see investing 7-10 years into this journey and coming out making $90K (particularly not with $150K in debt). I could just go get my MBA for that matter, or, better yet, become a lawyer. 😛


The point of my seemingly tangential ramblings is that doctors should ALWAYS be among the most well-compensated members of society due to the specialization of their knowledge, the length and difficulty of their schooling, and their dedication to what is by all accounts a noble profession (desire for adequate compensation does not make it any less noble, btw). Anything which cuts into that bottom line to the point where you have doctors fleeing certain states or leaving the field of medicine altogether needs to be examined at the very least.


I ask juddman this: if all of these cases are so meritorious, and the frequency of these medical errors so high, how do other nations deal with it? I can almost guarantee you that places like Britian or Switzerland or Australia do not have anywhere NEAR the amount of A) lawyers or B) malpractice suits that the US has. Coincidence? I think not. 😀 I mean, we don't hear horror stories of deformed babies or public outcry over medical malfeasance from these other nations, so obviously whatever avenues of redress they have available are functioning optimally, without having the deleterious effect on the health professions that our litigious society has here.


I read an interesting fact in Time magazine in the late 90's; it said that there were currently more people enrolled in law school than had existed lawyers since the beginning of the century. In other words, the amount of practicing lawyers from 1900-1997 was eclipsed by the number of law students in institutions around the nation. That simply boggles the mind. What people fail to realize is this: lawyers are one of the few professions who (have to) create their own market in order to compensate for the glut of attorneys currently saturating our society. If we are to assume that the number of instances of wrongful conduct, in all spheres, which warrants legal action remains relatively constant throughout the years (and I see no reason why this would not be a reasonable assumption, within limits), then obviously lawyers must somehow manufacture work for themselves. And our present situation vis-a-vis the medical field is just one manifestation of that-- and those manifestations are ubiquitous, from medmal, to divorce cases, to litigation brought against corporations (whom I have no love for, btw, being the only form of life below lawyers on my food chain 😉). These are symptoms of the same overarching problem.


It's just amusing how all these other nations manage to stay calamity-free without the surfeit of lawyers and malpractice suits which we in the States are subjected to. I think it's repugnant, and anyone who even REMOTELY defends the status quo as regards these issues is either a tool or has a vested interest. Yeah, you could say the same about the majority of the posters on this board, given their chosen profession, but I submit that if both attorneys are physicians were required to draft their own proposals for how malpractice litigation in this country should be handled, and these plans were then subject to a referendum by the genral populace, then the lawyers would lose. Badly.

Of course, this is only if the lawyers would be prohibited from utilizing excessive "legalese" in their wording (and actually had to be transparent in their reasoning for a change), and if they were not allowed to include a bullet-point that said, "AND YOU TOO CAN BE RICH IF YOU VOTE TRIAL LAWYERS!" 😀 Because believe it or not, doctors are not looking for an end to all malpractice settlements, or the ability to bring legitimate claims to court-- they're just looking for some common-sense to be brought to bear on these issues, which is something that has been sorely lacking for the past decade or so.


Personally, I think that if the situation ever got to that point, all the physicians in the nation, from every specialty, should just stage a walk-out. Surely they have enough saved to live for a week-- and, believe me, that's all it would take for sensible legislation to get passed if this occurred. People talk about "importing foreign docs/med students"....yeah, ok. If you believe that any other nation would allow our country to steal their entire health services workforce.


Or maybe the US would just "liberate" another nation of their thousands of doctors-- we seem to be fond of that. 😉 😛
 
Cant say I agree with it all.. But VERY WELL SAID!!! 👍
 
COMMENTARY
There Is No 'Right to Sue'
By PHILIP K. HOWARD

American justice has created a crisis in American health care. Methodist Hospital in Philadelphia, for example, closed its maternity ward on July 1, unable to afford an exponential rise in malpractice rates. The last medical trauma center in Las Vegas closed its doors earlier this month, reopening on a temporary basis only with special legislative protection. Doctors are bailing out of high-risk specialties. One in 10 obstetrician/gynecologists say they will no longer deliver babies, confronted with malpractice rates that have risen to over $200,000 a year in some states.

President Bush last week called for federal legislation to limit damages in malpractice cases to actual costs and lost income. Modeled on a California law that has kept down malpractice rates, Mr. Bush's plan would cap "pain and suffering" and other non-economic claims to $250,000. With critical medical services disappearing around the country, the case for reform would seem obvious, indeed a matter of life and death.

Stun Gun

But Senate Majority Leader Tom Daschle has scoffed at President Bush's proposal, citing the "rights of patients." The top funders of the Democratic Party, the trial lawyers, have used this argument successfully for years. Like a stun gun, it stops cold every effort at health-care liability reform: Why should Congress restrict any injured American's "right to sue"?
What exactly is this "right"? Anything important enough to be a right presumably should promote, on balance, our general welfare and freedom. But American justice is causing health care to suffer a kind of nervous breakdown. Malpractice rates are only the tip of the iceberg. Distrust of justice induces doctors to squander billions in unnecessary "defensive" procedures. Many doctors won't communicate with patients by e-mail for fear that a written record might later be used against them.
Health care is not the only casualty of American justice. Reputable companies are reluctant to bid on homeland-security contracts, because they don't want civil liability if a terrorist slips through. The risk of litigation apparently outweighs the risk to our lives. Like lambs led to slaughter, still no one questions the "right to sue." Americans in all walks of life no longer feel free to act on their best judgment. Many teachers and principals, tired of legal threats from zealous parents, now avoid the ordinary disciplinary judgments needed to maintain order in the classroom. We can't even play as we choose: Playgrounds are being stripped of time-honored implements, such as seesaws and swings.

Striving to be fair to every victim, we've undermined not only our common good, but everyone's freedom to use their best judgment. The moral authority of victims is powerful. But the resulting laissez-faire lawsuit culture means that social policy gets made, by default, at the intersection of personal tragedy and personal greed. All of society ends up victimized by the victims.

We lack even the vocabulary to debate what is the right decision, because no one -- not even tort reformers trying to place limits on damage awards -- is willing to confront the so-called "right to sue." The ability of every American to take a claim to a jury, we've been taught, is what justice is all about. This powerful preconception, as it happens, turns justice on its head, which is why health care and other common institutions are on the verge of collapse.

Suing is not a unilateral right of freedom, like free speech or a property right. Those hallowed constitutional rights -- the safeguards of our freedom -- protect us against government power. Suing, by contrast, is a use of government power against another free citizen, coming down to that fateful verdict when the full power of government may compel the defendant to pay millions. Being sued is like being indicted for a crime, except that the penalty is money.

Today in America, however, we let any self-interested person use that power without any significant check. This past week a doorman I know nervously showed me a complaint in which he was sued for $1 million for a minor accident that occurred a year ago in which no one went to the hospital. Letting such a claim hang over his head -- even if he is ultimately victorious -- does not resemble justice, but extortion.

Put yourself in a doctor's shoes. Every patient is a potential plaintiff. Whenever a sick person gets sicker, a lawyer can readily come up with something different that might have been done. The possibility of a claim from virtually anyone -- with the attendant years of litigation under the dark cloud of a ruinous verdict -- would drive most normal people into defensive cocoons. It's driving many doctors out of the medical profession altogether.
The point of law is not to let anyone sue for anything. Law's goal is closer to the opposite: to draw the boundaries of who can sue for what. The Constitution affords the right to a trial by jury "according to the rules of the common law." It is the role of legislatures and judges to make and interpret those rules of law.

Law isn't supposed to be a neutral process. It's supposed to set standards of right and wrong. Justice Oliver Wendell Holmes Jr. once observed that law is a "standard which we hold the parties to know beforehand ... not a matter dependent upon the whim of the particular jury." Today, justice is standardless.

Tool of Freedom

Setting limits on lawsuits is not an infringement of freedom, but a critical tool of freedom. Otherwise one angry person, by legal threats, can bully everyone else. Limiting lawsuits is also a critical tool of social policy. For example, Americans cannot sue utility companies for damage sustained from blackouts, because legislatures long ago prohibited such suits to keep utility bills from skyrocketing. Limiting lawsuits over terrorist attacks is essential to mobilize all resources for our national security.

There is no "right to sue." Letting anyone sue for almost anything is not the rule of law but the opposite, a kind of law a la carte. Donald J. Palmisano, president-elect of the American Medical Association, says President Bush's proposal "will go a long way toward bringing common sense back to our liability system." He's right.

Mr. Howard, a lawyer and author, is chair of Common Good, a bipartisan group dedicated to legal reform.
 
That was an excellent article.


Indeed, this nouveau concept of "the right to sue"-- which is as apt a description as any you're likely to find-- ultimately evolved from the devaluation of personal responsibility in our society-at-large; this tendency, which saw its widespread genesis in the late 80's to the best of my knowledge, was then seized upon by rapacious attorneys of all stripes (medmal, personal injury, divorce etc.) and used to fatten their pockets. I find it amusing that juddman previously had the gall to compare society's loathing of lawyers to the ethnic and racial bias of the past; the argument, I suppose, is that one unsubstantiated belief is no better than another, and if the one has been exposed to the light of reason and critical thought, then the other necessarily has to follow. Here's the hitch, however: people have much more pressing and valid reasons to dislike lawyers than they did blacks. Further, this anti-lawyer sentiment cuts across all social classes and ethnic groups-- when you have that kind of consensus, it's hard to argue that there's not a kernel of truth in there somewhere (and yes, I'm well aware that argumentum ad populum is a logical fallacy, but I am dealing with converging lines of evidence here). But folks like Samurai and Juddman aren't willing to budge in the slightest, feeling critics of lawyers to be benighted halfwits not yet cognizant of the vast good which attorneys do. This is specious nonsense.


To be sure, not all lawyers are "bad", or "greedy", but many-- too many-- are. And what's worse, they are encouraged by our broken system to play to those lesser tendencies in themselves and exploit them for personal gain; believe me, the day somebody proposes "lawyer insurance" is the day that the insurance companies go out of business, because lawyers would never allow that to stand.

A great many attorneys do much good, and their very existence provides a valuable check on governmental, corporate, and institutional excess-- nobody is debating that. They provide a necessary service to society and to people. But the fact of the matter is that they don't know their place; more precisely, they think that everywhere is their place, and have their hands in every cookie jar, always looking to further encroach on our right as people and professionals to be free from needless, excess litigation.


"The sky is not falling", attorneys will say. They're right-- it has already fallen. And with it, any hope of getting out from under the yoke of their unbridled avarice has also been crushed.


Sensible, reasonable people see these things. Just because an intelligent person (and a sophist, to boot; i.e., a lawyer-- see: juddman) may be able to talk their way out of these accusations, and may be able to supposedly "speak to" these claims (which will no doubt be denounced as mere hyperbole backed by little "fact"-- as if I'm going to waste my time doing research on prima facie issues such as this), doesn't mean that they are somehow not valid. Lawyers and those that defend the indefensible status quo in this nation would have you believe that only they hold the keys to logic, that only they have eyes to see the truth. The fact of the matter is that everyone else besides them sees the truth (not being blinded by self-interest), and occasionally you'll have the odd attorney who realizes their place, their proper function, and what level of compensation and entitlement is commensurate with their station. Those attorneys are too few and far in between, however.


But I'm rambling now... 😛
 
CJMPre-Med said:
And, just so you know, even IF neurosurgeons still made $400K after all expenses and taxes, who in the hell are you to say (or at least insinuate) that they shouldn't, or that their income somehow mitigates the concerns they have and their legitimate criticism of our tort system? If they don't deserve to make that money, who does then? 2-year MBA grads? 3-year law school grads? Airheaded CEO's?
How about A-rod's $252 million contract? Or any athlete for that matter? Hollywood Actors/Actresses? No one has a prob with these people making more money than the GNP of entire countries, and frankly neither do I, but god forbid a physician make more than $250,000...better sue the greedy bastards.
 
kinetic said:
Agreed. And more specifically, I would add this:

Not only do they assume they deserve compensation, but they assume that ANY BAD OUTCOME was the fault of someone or something out there. Slipped on a sidewalk? In the past, that was because you weren't being careful. Nowadays, it's the homeowner's fault. And nothing is ever due to just error - like, for some reason nobody can just shrug off stuff any more. If you tap bumpers with someone, they will rarely just drive off. Usually, they roll out of their car, clutching at their necks and writhing in pain, at the same time screaming that they are paralyzed and sexually dysfunctional.

At the same time, these people (the general public, I dare say) expect doctors to be gods: completely infallible. They're not! They're people... they're human... they make mistakes!

Seriously- doctors and healthcare personnel are in a profession that entails dedicating their lives to HELPING people. And (for the most part, I can't speak for all) they're doing the best they can. To milk them for all they're worth because they made a human mistake because they're -- gasp! -- HUMAN is to completely abuse the system.
 
CaptainZero said:
How about A-rod's $252 million contract? Or any athlete for that matter? Hollywood Actors/Actresses? No one has a prob with these people making more money than the GNP of entire countries, and frankly neither do I, but god forbid a physician make more than $250,000...better sue the greedy bastards.

It's all about the priorities of our society. We, as a society, value "big business", and entertainment of all sorts (movies, sports etc.), above noble and laudable ventures such as medicine. At least with athletes, you can't really begrudge them the money (though I find it obscene and philosophically indefensible) because the money is there-- in other words, they are not duping the fans into coming to the games to pay for their exorbitant salaries. The money is there, and nobody is truly being harmed by athletes receiving their compensation. What are the options? Franchise owners adding another few hundred million to their net worth? No thank you. 😀


Much like lawyers, athletes create their own market by dint of their skill in their craft. The better and more entertaining they are, the more people will come to the games and buy sports-related paraphernalia, the greater the influx of money will be for the team, and the more these athletes will be paid. They are not doing what lawyers and corporations do, which is basically extortion on a mass scale: Lawyers in the aforementioned ways, by preying on the mistakes and misfortunes of others, and corporations by their "profit uber alles" mentality, which manifests itself as atrocious labor practices at home and abroad, including mass layoffs (excuse me, "attritions" 🙄 ) and ever-decreasing pensions and benefits, while the CEO's and execs reap record bonuses and salaries in excess of $20M even when their companies post losses.


So, although philosophically I do not agree with anybody making $40M per year, I can much more countenance athletes doing so (through salary + endorsements etc.) than CEO's who play golf and get massages all day or lawyers who take advantage of others in order to buy that second house in the Hamptons. Sure, you can point to rising ticket prices and all, but if it became prohibitively expensive for people to go to the games, they simply wouldn't go. Last I checked, the "right to enjoy sporting events" was quite a ways down below "life, liberty, and the pursuit of happiness". 😉


Minimum salary for doctors (GP, Family, Peds, Internist etc.) should be around $180K in my opinion, and it should work up from there. Neurosurgeons and cardio-thoracic surgeons should be making upwards of $500K per annum. I see no philosophical objections to this. Mind you, I'm not advocating that lawyers or company execs starve or anything-- they should still be permitted to make their money (though not as much as presently). But when you have a doctor who invested 8+ years of his life into his profession and incurred $150K in debt making $85K, as with some pediatricians and GP's, well, something is horribly wrong.


Perhaps doctors and surgeons should operate via contingency fees as well; if they save a man's life, they should be entitled to 30-40% of his eventual earnings, no? 😉 And, just so people know, I have always staunchly advocated just compensation for doctors, even many years before I had any inkling that I would endeavor to become one (which I just realized a couple of years ago). It is an inherently noble and worthy calling, and those who dedicate themselves to the practice of medicine-- whether solely for altruistic reasons or for a confluence of reasons, such as in my own case-- should not be assured of anything less than financial comfort. Not to be "rich", but to be "comfortable". And in my opinion, in this day and age, with costs being what they are (cost of living as well as raising a family etc.), "comfort" sits at around $150K/year. All I've ever wanted, personally, was to be comfortable for the sake of my family; I've never desired wealth for its own sake-- that would be covetous of me. It'd make me...well, a lawyer. 😛


If all med students/practicioners desired was money, then they would've just gotten their MBA or went to law school, no? It certainly would've been much easier than the path they've followed.


In short, the entire value system of our society is horribly warped; unfortunately, I don't see that changing anytime soon.
 
CJMPre-Med,
Words of wisdom, man. Words of wisdom!

gee I wonder what ever happened to all the law advocates on this forum...
 
I'm a democrat but the one bad thing about my party is that they support trial lawyers. Democrats are big time trial lawyer advocates and against tort reform. If there is one good thing about the Bush cabinet is their support of tort reform. John Edwards, a former trial lawyer, is the last person any physician wants as President of the United States.
 
cgt3477 said:
Did you hear that some doctors are refusing to treat lawyers or their families?

here's one of many articles about it:
USA Today article

I think the only way to fix the situation is to start capping lawyer fees and the jury awards. Or we need to change our legal system into a losers-pay court system (which is what is done in many parts of the world).

What upsets me the most are those people that decide to sue not because they have been harmed but they sue because of the possibility that they can make a quick buck. Most people/companies settle a lawsuit because it makes more economical sense than defending themselves. Also some people in this country need to start accepting responsibility for their own actions (like the man suing mcdonalds-no one put a gun to his head to eat there)...

just my 2cents

A losers-pays system would never work because the trial lawyer lobbyists in this country are too strong and would never allow it. There is too much money to be lost if such a system arose here. Placing caps on "pain and sufferring" damages are slowly occurring. But I like the idea of physicians refusing to treat malpractice attorneys and patients in non-emergency cases.

I understand that physicians are now refusing to treat malpractice attorneys and patients who have been involved in many malpractice cases. The question is how do you find out which patients are either malpractice lawyers or people who have sued doctors repeatedly in the past?

Information like this could make someone very wealthy. Someone should create software that has a list of all the medical malpractice attorneys and patients who have been involved with a medical malpractice case in the United States. Then when a patient arrives in an office, you can type the name of the patient and see if a match occurs. If it does, the physician can then decide if he or she wants to treat the person if it's a non-emergency case.
 
CJMPre-Med - you asked in one of your previous posts how other countries have such low malpractice rates; I can tell you how things are in my country.
First of all, there is the general deterrent, that applies to any kind of lawsuit:
If I decide to sue Mr. X for whatever reason, and I lose, I have to pay the expenses that he incurred by having to defend himself (lawyer's fees, time off work, etc); if I do not have the money to pay him back, I go to jale (for an amount of time that will equal his expenses).
The specific deterrent is this: there is a medical organization (in my country's case named The College of the Doctors), and no lawsuit brought against a doctor is seen in court unless given the ok by this College of Doctors. They really helps the frivolous cases.
I could only hope that similar systems would be implemented here in the States. And let's not forget, out of every other job in the US, doctors have the biggest power...all it takes is a one day strike. The way things are going, I think that's where we're heading, and unfortunately it might just happen that the ER docs will also participate in that one day strike...
 
daelroy - so far it is illegal to have such lists, as it is also illegal to have lists with the frequent ER patients who come only to get their fix of Demerol
 
Romed81, thanks for the feedback. All of the measures you've outlined strike me as sensible, and, indeed, many of them mirror my own sentiments as to what would constitute effective reform of the malpractice "industry" in America. One thing I'd like to add, however, is that the "College of Doctors" should have a couple of legal experts (judge etc.) sitting on the board as well, if only to avoid charges of cronyism. But all of those things are sensible imo.

May I ask what country you're from? 🙂
 
romed81 said:
daelroy - so far it is illegal to have such lists, as it is also illegal to have lists with the frequent ER patients who come only to get their fix of Demerol

I can see how compiling a list of patients who frequently sue or use demerol is illegal. But a national directory of medical malpractice attorneys should not be illegal. That's in the yellow pages of every phone book. Software would merely compile that information into one organized list; I don't see how that is illegal.
 
romed81 said:
First of all, there is the general deterrent, that applies to any kind of lawsuit:
If I decide to sue Mr. X for whatever reason, and I lose, I have to pay the expenses that he incurred by having to defend himself (lawyer's fees, time off work, etc); if I do not have the money to pay him back, I go to jale (for an amount of time that will equal his expenses).

How do poor patients who have been injured wrongfully sue their doctor in court? That's quite a decision, no? Win or go to jail. I'm guessing only the wealthy have a legally cognizable and enforceable interest in demanding that their care providers exercise due care.

Judd
 
Sledge2005 said:
A lot of doctors use the tactic of putting everything in their spouse's name. You just have to make sure you REALLY trust your spouse!


Actually in florida it really doesnt matter. Everything is split 50/50 unless stated other wise in a pre-nup; so it really doesnt matter whos name anything is in. And in Florida theres a homestead clause that states your hose cant be touched if ur sued. So the doctors are doing a good thing by placing things that might be attractive to a lawyer in their spouses names.
 
juddson said:
How do poor patients who have been injured wrongfully sue their doctor in court? That's quite a decision, no? Win or go to jail. I'm guessing only the wealthy have a legally cognizable and enforceable interest in demanding that their care providers exercise due care.

Judd

And yet-- amazingly-- their society does not crumble, and we don't hear horror stories of the indigent being victims of malpractice deprived of all recourse. I don't know how they do it, those wily foreigners! 🙄 😛

Wretched attempt at sarcasm aside, I would think that the previously mentioned "College of Doctors" would serve to filter out illegitimate claims, thus avoiding such potentially troubling scenarios as you allude to. In other words, a valid case from a poor plaintiff which goes to trial has a much better chance of being won, having been judged as legitimate by experts in the field.

I see what you're saying, but I still insist that something like that could work, and should be instituted posthaste. If deemed necessary (and it might be, as you raise valid concerns), it could be amended somewhat to account for these realities-- say, by instituting a sliding pay scale should the plaintiff be unable to pay after having been found to have brought a frivolous suit. That is, if a person makes $30K, and the expenses incurred by the doctor or hospital while defending the case were in the amount of $60K, then a cap would be set at 15-20% of the plaintiff's income per year until the sum had been paid (these are arbitrary numbers which would obviously be set only after much debate). But it strikes me as reasonably fair.


Obviously, those with higher incomes would be able to pay a higher % as well, not just a higher absolute amount per year. So if a person earns $75K/year, they would be subject to a penalty of 30-35%, for instance.


I like the gist of the policy, but I see no reason to throw people in jail if they don't have the means to pay (it strikes me as excessive, in the same way that our current medmal system does). Just take a small % for more years, which would still allow that person to not starve.


Sensible reform must be made, and this would be one step in that direction. I wonder if the country he speaks of just doesn't have any poor people, if they don't have any advocacy groups for the indigent, or if they just don't have as many lawyers as we do here in the US. I'd wager it's the latter. 😛 After all, though your concerns would appear to be well-founded, one would think that advocacy groups would be up in arms over such a system, yet I would imagine that this is not the case; this suggests to me that these concerns are dealt with through other avenues-- unless you're making the ludicrous claim that only the US cares about its poor and underprivileged.


The only other argument one could make is that such a system keeps poorer folk from even bringing suit due to the potentially ruinous economic consequences. Though, like I said, I feel that many of those concerns would be allayed by the aforementioned College of Doctors (which should have legal experts on it as well in addition to physicians), as the only claims which ever got to court in the first place would have been deemed to be meritorious by experts.


But who knows; hopefully romed81 can further clarify how his country's system works in such instances (as well as telling us which country it is).


I also find it amusing to even entertain the notion that most lawyers care in the slightest about the underprivileged. For $500/hour, which is the going rate for most top defense and corporate attorneys, it wouldn't seem so. If these medmal lawyers didn't work on contingency fees, but instead on flat rates or hourly rates, we'd see just how far their purported altruism and nobility goes. I'd say that the most preferable system would be a costs + flat-rate system-- at least then, lawyers would actually command a modicum of respectability. So they'd recoup their costs while still commanding a tidy sum for themselves; this would also reign in the tendency to seek these astronomical verdicts, which are nonsense anyway. Lawyers are quick to say that you "cannot quantify the loss of a limb, or paralysis". And, if it can indeed be shown to be due to gross negligence or reasonably foreseeable error, I do not deny that such persons should be entitled to HUGE sums, on the order of multiple millions of dollars. A victim of avoidable paralysis should receive about $5-10M in my opinion (and more if it's ever necessary due to the resultant medical expenses). A McDonald's coffee burn victim with first-degree burns on a normally covered part of her body should not get $3M in any universe.


It's always amusing when lawyers play the "moral high ground" card. What they fail to realize is that, for them, there is no high ground-- they're standing smack-dab in the middle of the terrestrial equivalent of the Marianis Trench. They supposedly care about the poor being able to bring suit, yet show no compunction when bilking them out of 40% of their award. Yeah, they really care about the rights of the underprivileged. 🙄 Just another example of the sort of sophistry that all too many folks can't see through even with bifocals.


When things start affecting the lawyers' bottom line, then you'll see where their true motives lie, though they'll always spin it in the most positive way so as to not come off as the greedy slime many of them are. And, undoubtedly, some will say that doctors are also complaining because it's hurting their bottom-line, and this is true; the difference is that I know of no doctor making $2M/year, while there are probably several dozen attorneys just in NYC making that much and getting fat off of the status quo. A doctor of any sort should not be making $90K-- it's philosophically indefensible (unless you're a radical socialist, but then lawyers would have to make $90K too 😛). But to assert that lawyers' income should take a hit from $1M+ to a more reasonable figure like $3-400K is much more defensible imo.


The thing that gets me the most is that people fail to realize that sophistry is part of an attorney's job; they'll necessarily be better at it than you are, and they WILL be able to use that silver tongue of theirs to make even the most grossly disproportionate punitive measures seem palatable. Don't be conned. I've learned in my life that people can intellectually justify anything; those that are eloquent and intelligent, all the more so. We have people who write legitimate philosophical essays in this country defending bestiality, or the murder of newborn babies (see: Singer, of Harvard); when you read such things, they can actually almost convince one to lend them their support-- they're that powerful and persuasive, if not cogent. Doesn't make it right.


And neither are lawyers right in their desire to maintain the status quo and even further expand their diabolical little empire (the US). As a culture, it's about time we put our foot down; unfortunately, it's not going to happen, as the same trends in government (PAC's, soft money etc.) which have usurped our power and prestige as voters and tax-paying citizens also serve to further consolidate the influence of attorneys. They have this nation by the balls, sadly. So do the corporations. Ridding ourselves of the excesses of both will, I believe, be the great struggle of our generation-- at least if we as a nation ever wish to regain a shred of credibility and sanity.


Anyway, enough of my ranting... 😛 😳
 
so let me begin by saying that maybe I see things from a different perspective due to the fact that I come from another culture; maybe I see things differently because I had to work my butt off in order to pay for all expenses during college without any kind of outside help. However, this is the conclusion to which I arrived at: the money that I make through my sweat is my money only, and I will fight as much as I can to keep it that way. That being said, I want to get to the point that juddson is making about poor patients. I don't know how other feel about this issue, but I have absolutely NO sympathy for poor people in this country. I've learned that if you work hard enough, in the United States you are almost guaranteed a place in the middle class. Take away the college students, and the few exceptions that are bound to occur, and I hope that you'll have the wisdom to see that the above statement, although a generalization does have solid grounds. Throughout my experience in this country, the only thing keeping people out of the middle class has been work. So WHO are the ones who are THE POOR??? Well, I've worked in the ER for about 4 years, and I have seen who the poor are: the drunks, the crackheads, the ****** who have 5+ kids in order to get more money from the government, and so on; I have a feeling that y'all know who the poor are too, it cannot be that everybody else is blind, and I am the only one with my eyes open.
So how do these "poor" people towards whom due to the connotation of the word "poor", I should feel "sympathy, compassion, mercy" get their medical treatment? Well, they get it free of charge; free for them, not so free for me, or anybody else who is paying taxes so that that those alcoholic lazy butts can get food stamps and healthcare.
So let me ask you this juddson...if I own a restaurant, and I run it like a business (by the way, I think that's one of the major problems with this country - it is being run by lawyers, not businessmen), and I see a beggar outside my restaurant who wants some food because he is hungry, do you think I should be required by the government to cook him a meal, with money of out MY OWN pocket??? I think not. So what if I decide that, hey, I have some leftovers from yesterday, that I was going to throw anyways, I'll just give those to him. And it so happens that the leftovers were spoiled, and the beggar gets sick; should he be allowed to sue me??? I don't think so either. Why? Because the beggar did not pay for the services provided. Same with healthcare - beyond anything, the healthcare system is a business, that needs to make money, and YES that is why if you are poor and you think that you have been mistreated, you'd better make damn sure you have been wronged, otherwise you will go to jail.
Another thing that bother me about the logic of your argument juddson, is that you look only from the perspective of the "poor person" (aka drunk & crackhead). what about from the perspective of the doctor, who for every frivolous case has to fork out 60-70k in order to reach a settlement, because court expenses are so much higher, and not only that, but he has to do what his insurance company tells him to do. And after that, after it's been proven that the doc is innocent, he still gets on the "higher risk" category, and has to pay higher premiums! And by the way, I guess you don't know how malpractice lawsuits work. Let's say that a patient decides to sue for malpractice; what happens next, is that the lawyer takes the patient's chart, and absolutely all the doctors that are named in the chart (for whatever reason - usually for consult), are named in that lawsuit, with the hope that maybe one head will fall. As a consequence, the insurance companies have to come up with the money for the legal defense for each of the doctors, which usually range around 50k per doctor. Let's say that you have 4 doctors one a case (which is a good average), then you'll realize that for a frivolous lawsuit that a "poor person" (aka drunk & crackhead) starts, the insurance company needs to fork out about $200,000, just to defend the doctors. When it comes to this kind of money, I say that it is time to stop those stupid lawsuits, and put in place some systems that deter them. I think it is time that people in this country start being responsible for their actions, and be ready to pay (literarily) for them.
And as cjmpremed said in his earlier post, I think it is sad, and in poor taste for you to mention your concern for "the poor people" vis-a-vis the medical profession, when we all know how lawyers make their money...and how much they charge for their services...
 
Well, allow me to take this time to state that I categorically disagree with romed1's statements regarding poor people (i.e., what sorts of people comprise this group and how they should be treated). There are, in fact, many people who are not "druggies" or "alcoholics" and who have a decent enough work ethic who are still poor for various socioeconomic reasons (see: lack of jobs, lack of support structures, propagation of spurious values via entertainment etc.). These folks should not be penalized merely due to their status. If actual gross negligence can be found on the part of a doctor or hospital (which would have to be determined by competent medical professionals as mentioned prior), then the fact that those patients happened to procure these services at a reduced price, or for free, should have no bearing on whether they are compensated or not. People enter into contracts, and avail themselves of certain services, in good faith; one of the tenets of this faith is that the personnel administering said services will be competent professionals and not two-bit hacks unaware of the most basic preventative or restorative measures (and this is the only reason that a charge of gross negligence would be brought...in my universe, at least 😛).


As for your invocation of the business model to medicine, well, I agree and disagree; for myself, the three qualities which I believe should inform our actions in this sphere are temperance, humanity and common sense. Assessing such a scenario through the use of these three criteria, we have several "answers":

One, that humanity should trump financial considerations so far as that is feasible; while this would seemingly contradict my previous utterances about medmal policy, I do not believe this to be the case, as I do not feel that every person seeking damages is necessarily concerned with a humane and reasonable outcome for themselves, having been goaded by their lawyers into suing for astronomical sums rather than out of medical necessity with some substantial amount thrown in for pain and suffering (a purely subjective criterion, mind you; in light of this, there should be caps on all such damages in every state).

Secondly, that temperance dictates that we should seek to reign in some of the excessive abuses of the current system while still providing avenues for the redress of legitimate claims by ALL parties-- rich, poor, what have you.

Lastly, common sense tells me that in no universe should lawyers make more than doctors. 😀 Now, this common sense notion must take into account the realities of our day (i.e., it's not going to happen); I still feel, however, that we should seek to address the vast discrepancy in income between these two professions.


Unfortunately, due to the sophistry and posturing of certain factions (see: lawyers), the average person cannot seem to tease out the sensible aspects of our legal system from the nonsensical and disproportionate aspects. Such a situation, where people are kept blind to the pertinent issues by the activity of monied interests, behooves only those monied interests (see: lawyers; notice a trend? 😉), as sensible reform can only be proposed and implemented once one has a grasp on the all of the relevant issues, not solely the ones which lawyers and PR reps choose to make available to us. Regardless, at the very least, certain incommensurable aspects such as "pain and suffering" and punitive damages (being purely subjective) must be made explicit as far as possible. As cold and mechanistic as it seems on its face, a monetary scale must be drawn up for various sorts of injuries, along with the "pain and suffering" damages which would accompany each. In other words, a person who was rendered a quadriplegic due to clear medical error is entitled to a TON more than a person who lost, say, a finger. Though this strikes as intuitive, we often see in the court system people who were victims of clearly "lesser" tragedies (as far as such a thing is quantifiable) seeking more damages than those who were more grievously afflicted. One of my favorite examples of the absurdity of our current system as it relates to this previous point is the recent Staten Island Ferry disaster in NYC, where many died and many more were seriously injured. One woman was paralyzed from the waist down as a result of this (clearly avoidable) incident, and was suing for around $15M. Another lady, who suffered no serious physical injury, was suing for $35M because she was having trouble sleeping due to nightmares. Anybody else see anything wrong here?

Granted, the above is not a medmal case, but to assume that similar things don't occur in medmal is ridiculous; this underscores the need for systemic reform and the quantification and explicit codification of as many aspects of this out-of-control process as is philosophically reasonable. As it stands, we have far too many attorneys running around with dollar signs dancing in their heads, and too many suggestible and overly emotional people (understandable in many instances, but not all; this holds for juries as well as plaintiffs) all too willing to become their patsies in a high-stakes legal wheel of fortune.


It's out of control. That's not to say that lawyers are the sole reason for the ruination of the medical profession, as I happen to believe that insurance companies and their profit motive have had just as pernicious an effect, if not more so. But the nonsense has to stop. Immediately.


EDIT: Romed1, you never told me what country you were speaking of previously (where you presumably grew up).
 
There are quite a few ways to slay the lawsuit demon. I worked as an insurance adjustor for a major company, and we had methods for preventing lawsuits.

Here are my recommendations:

1. Open up your medical practice and designate it as "nonprofit." Nonprofit means that it serves community based needs and your accountants manipulate the books to show zero profit for the corporation. You can still make quite a bit of money but your corporation has to show a profit of "zero." It happens all the time.

2. Take medicaid and medicare to establish your nonprofit status as well as establishing a loose affiliation with the government.

3. Require patients to sign a waiver of liability before treating them. In other words, make them sign a form waiving all monetary rewards regardless of any consequences.

4. Just in case any provision of the waiver is struck down, require a mandatory arbitration clause (avoid the jury at all costs)!

Methods like these would decrease lawsuits exponentially and protect doctors. I'm going to do them myself.
 
*bump*

Also, check it out.

Kerry Picks Edwards as Running Mate

http://www.foxnews.com/story/0,2933,124740,00.html

" 'I am pleased to announce that with your help, the next vice president of the United States of America will be Senator John Edwards from North Carolina,' Kerry told a rousing group of supporters"


I've checked the AMA's website, but no word yet. Anybody want to guess if they'll endorse Bush-Cheney?

Gerg
 
It's unfortunate that Kerry has chosen a bloodsucking personal injury trial lawyer, but my vote still goes to Kerry. Bush CANNOT win.
 
Hey all...i have been quietly sitting back to reading some of the posts, and I find this forum to be fantastic!

It is due to the current medico-legal crisis that compelled me to do a joint degree (medicine and law). I am absolutely sick of frivelous cases and the fact that physicians sit there and become complacent and do not do enough to fight back!

I have done 2 rotations so far, and in both of them, I saw something peculiar. The physician, who just came out of saving a baby's life, became completely meek at the sight of the patient's mother's lawyer (BTW, the mom did not call in the lawyer, it was her brother who happened to be a lawyer).

I have seen same/similar situations a few other times too, when the other physicians ALL became weak and meek at the sight of the lawyer! WHY!?!?!?!

It is because of things like this that has made me go to law school also. I am vehemently opposed to UNcapped consequential damages (pain and suffering, loss of consortium, etc.), and as much as I don't like Bush, having Kerry in the office is worse!

I want to defend my brothers and sisters, my future colleagues! I want to teach others how NOT to "mess up."

I am watching this thread carefully to see what people have to say.

I AM COMPLETELY PRO PHYSICIAN, but I leave you with this counterargument:

if you were the lawyer, and you go to court representing a patient who was allegedly negligently treated by a physician, what would YOU ask the factfinder (judge/jury) for damages? Realize that if you ask too little, then the judge/jury MAY (although I use the term "may," it should say "likely" because that's what usually happens, but there is no empirical data/evidence to support that contention) think that your case IS frivelous, since why would you be asking for so little (put another way...why WOULDN'T you be asking for the top amount permitted) if it wasn't frivelous! These thoughts occur all the time when lawyers decide on what damages to ask for.

It's a vicious circle!!!

What are your thoughts!?!

I'll write more later on...
 
few other things that crossed my mind:

1) Are lawyers really to blame? it is the PATIENT that decided to GO to the lawyer initially. The lawyer did their job, one of which is to be a zealous advocate for their client.

2) What about the insurance companies that place certain limitations on the physician and their scope of practice. This becomes a sequential, domino effect since the insurance company has placed limitations--> these limitations for the most part negatively affect the manner in which the physician can care for the patient --> it leads to more incorrect Dx, Tx, etc
--> leads to more people "visiting their local friendly ambulance chaser" --> more malpractice claims --> the current state of affairs!

I realize that there are arguments and counterarguments for EVERYTHING that I have stated (heck...that's the backbone of law...arguments and counterarguments). I am merely providing these situations since there was someone who had mentioned "where are the lawyer advocates."

WHILE I MOST CERTAINLY AM NOT a lawyer advocate, I am simply playing devil's advocate! (BTW....the etiology of that term is this: it has been said that the only person who would represent Lucifer was a lawyer...I am not Christian, so I do not know this for a fact...jsut something that was told to me by a friend)


On a final note, what a wonderful profession we are going into. I wish physicians would have 3 arms:


THE PHYSICIAN'S HOLY TRINITY:

1 arm gets pulled by the damn lawyer trying to say why DIDN'T you order the test...and since you didn't, you were negligent in treating my client...

2nd arm gets pulled by the insurance company who is trying to say why DID you order the test...and since you did, we will not reimburse you...

3rd arm gets pulled by the patient/patient's family who is questioning your every step/move on why you DID OR DID NOT do something!


Isn't medicine great....

(sarcasm aside...even with all these issues, MEDICINE IS GREAT and even all this isn't going to stop me from helping atleast 1 patient out there who will look me in the eyes and genuinely say: "thank you, doctor!")
 
Aucdoctobe said:
There are quite a few ways to slay the lawsuit demon. I worked as an insurance adjustor for a major company, and we had methods for preventing lawsuits.

Here are my recommendations:

1. Open up your medical practice and designate it as "nonprofit." Nonprofit means that it serves community based needs and your accountants manipulate the books to show zero profit for the corporation. You can still make quite a bit of money but your corporation has to show a profit of "zero." It happens all the time.

2. Take medicaid and medicare to establish your nonprofit status as well as establishing a loose affiliation with the government.

3. Require patients to sign a waiver of liability before treating them. In other words, make them sign a form waiving all monetary rewards regardless of any consequences.

4. Just in case any provision of the waiver is struck down, require a mandatory arbitration clause (avoid the jury at all costs)!

Methods like these would decrease lawsuits exponentially and protect doctors. I'm going to do them myself.

Good luck with the IRS, and good luck with business development 🙄

#3 is legally invalid, and you are just likely to scare off patients with such a hardline stance. They'll just stroll over to the next doc down the street, who isn't attempting to force them to sign their life away. As if you are the first to think of such tactics... why don't you think they are in widespread use?
 
cjm,
i had to correct several items you mentioned. first off, peter singer is at princeton not harvard. his arguments regarding euthanasia are well developed even if you do not agree with his conclusions.

second, people seem to think that if you want to make money you get a mba or a jd and, boom, your set. if you look at average salaries for physicians, lawyers, mba's you will see that docs come out on top. yeah, there are some lawyers and mba's making obscene amounts of money, but they are the exception rather than the rule.

finally, your analogy regarding lawyers and contngency fees is absurd. i don't see anyopne complaining when lawyers work on contingency and lose a case, thus receiving no payment. this system allows people who would not normally have access to the court to be able to receive representation.
 
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