Medicare Advantage plans were intended to save money for taxpayers and to offer more flexible benefits to enrollees than Traditional Medicare. A win-win, if ever there was one. Perhaps not surprisingly, the plans have done neither as the insurance companies offering them have gamed the system to increase their profits. The taxpayers have been getting screwed as have the advantage plan participants.

Medicare Advantage plans often offer additional benefits not found in Traditional Medicare. This is a big selling point and is frequently cited by enrollees as the reason for their choice of a…
Continue Reading Another Disadvantage To Medicare Advantage

A thank you to the New York Times for this story.

Emergency Department physicians have seen it all. Broken bones, wounds, and accidents of nearly every type are all daily occurrences for them. Some things they see over and over are easily preventable and avoiding them may keep you out of their departments.

HASTY CUTTING. We have all been there. We are in the kitchen and we want to cut a bagel or an avocado and we are in a hurry. We take a knife, maybe not the sharpest one…
Continue Reading Six Things ER Doctors Wish You Would Avoid

I recently had a doctor’s appointment. My doctor was mentoring a new medical student and he joined us in the examining room. My doctor, knowing I represent patients in malpractice cases, asked if I had any advice for the medical student. One of the things I told him was to be careful with the electronic medical records.

Electronic medical record companies have a product they want to sell to hospitals and doctors. They almost always claim that their record keeping system is easy to use and will save the doctors and nurses a lot…
Continue Reading Cut And Paste Medical Records

It is a fact of life that we all must leave at some point. Many of our deaths will occur in hospitals or while we are under the care of a medical provider. Sometimes those deaths will be expected while at other times they may be completely unexpected. When there is an unexpected death of a loved one during medical treatment, you should ask yourself why and whether the death might be in some way related to the medical care. Maybe it was caused by the medical care. Maybe it occurred because the loved one did not receive the care…
Continue Reading What To Do Following A Possible Malpractice Death

Doctors love to complain that they are the victims of a legal system gone haywire. To hear them tell it, they practice great medicine, but are deluged with frivolous lawsuits provoked by greedy lawyers. In point of actual fact, the number of malpractice claims is far, far less than the instances of medical malpractice that seriously injure patients. Only a small fraction of the victims of medical malpractice ever make a claim, much less file suit.

The curtain was pulled back on the subject of medical malpractice by a group of respected researchers for…
Continue Reading How Much Malpractice Is There?

Outpatient care is any care received outside the hospital. It is a far more frequent occurrence than hospital care. On average, one in four Americans receives outpatient care each month. Like the hospital setting, it is a hotbed of malpractice. Just how much, some researchers in Massachusetts decided to try and find out.

CRICO is the insurance and risk management program for all of the Harvard medical institutions and their affiliates. This includes 32 hospitals and 325 other health care organizations. CRICO is very interested in reducing the risk of patient injuries and has…
Continue Reading Malpractice In The Outpatient Setting

The answer is money. The question is why is our health care delivery system so expensive and inefficient.

We are Number One. We are Number One in the world in the amount we pay per person for health care. Where we are not Number One is in our health care outcomes. Sadly, we are way down the list, despite how much we spend. The Commonwealth Fund, a non-profit dedicated to improving health care in the United States, is over 100 years old. It regularly compares our health care system to those of the rest of the developed world. One of …
Continue Reading The Answer Is Money

When a patient is admitted to the hospital, a lot of bad things can happen and often do. Many studies have been done to try and identify those factors that increase the risk of an in-hospital death. Some of the factors which have been identified are ones over which we have little control. For example, males have a higher risk of death as do lower income individuals. Older age and the presence of co-morbidities are also factors which increase the likelihood of an in-hospital death and over which we have no control. Perhaps unsurprisingly, being admitted to the hospital on…
Continue Reading Stay Out Of The Hospital This Weekend – Or Any Weekend, For That Matter

From time to time I analyze large medical malpractice verdicts to see what lessons can be learned. They usually have some common characteristics. Here is a recent one out of New York state that reinforces my belief about the elements necessary for a really large verdict.

The plaintiff was a 60 year-old man who worked full time as an electrical mechanic at a local airport on Long Island. He had been having back problems and was receiving what was intended to be a routine injection of a steroid into the epidural space…
Continue Reading Analysis Of A Recent Large Malpractice Verdict

On a daily basis, I review information about potential clients and their medical treatment for the purpose of determining if they have an economically viable case I can help them with. An economically viable medical malpractice case is one in which there is a good chance to be successful and to recover enough money to make the risks of suit worth taking. I have previously blogged about the elements necessary for an economically viable medical malpractice case. You can find some of those posts here, here, and here. See if you can apply those elements to this…
Continue Reading Case Or No Case?

It is a time-honored theme in science fiction and horror movies. The small, seemingly harmless creature that grows and grows until it is so powerful, no one can stop it and it wreaks damage far and wide. This is an apt description of where we find ourselves with our nation’s hospital system. It is an out-of-control behemoth that is too big to tame and is destroying everything in its path.

As any regular reader of this blog knows, we are the only industrialized nation in the world that does not offer universal health care…
Continue Reading The Monster In Our Midst

The Depression era bank robber, Willie Sutton, is famously reported to have said he robbed banks because, “That’s where the money is.” In today’s medicine, the money is in cosmetic surgery and the good doctors, the bad doctors, and the private equity investors are flocking to cash in.

Necessary medical procedures are usually covered by insurance while elective cosmetic surgery procedures are not. Insurance often caps the amount a surgeon can charge for a procedure. Since cosmetic procedures are usually paid for by the patient out of his or her own pocket, the only limit to…
Continue Reading Plastic Surgery Chains

In the over fifty years I have been practicing law, on a few occasions I have succumbed to the temptation to take a case in a field with which I was not familiar. I regret those decisions. I made mistakes due to my lack of familiarity. Thankfully my clients did not suffer any harm from my errors. I hope the lawyers among you learn from my mistakes.

Over the last 45 years, I have spent most of my time working in the area of medical malpractice litigation. I started out defending doctors…
Continue Reading Hey, Lawyers, Resist The Urge To Dabble