In the 50 years I have been practicing law, I have seen the pendulum of jury sentiment sway back and forth. When I began practicing juries were often sympathetic to injured people and willing to hold negligent parties responsible for the harm they caused. Over the last twenty years, however, that has been less true as juries have been skeptical about people suing to recover for personal injuries, especially if the alleged wrongdoer was a doctor or hospital. That may be changing.
Over the last twenty years, if you were a doctor or hospital and a malpractice case against you
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Recurring Problems in Medical Malpractice
For all the medical malpractice that is out there and all the different ways a health care provider can screw up, I still see many of the same things over and over. In light of how common some of these occurrences are, you would think the doctors and hospitals would do a better job of stopping them. On the other hand, since many of them are rooted in the foibles of human nature, they are going to be exceptionally resistant to change.
Communication Errors: Think of the old game of Telephone. As the message is passed from person to person,
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Bait and Switch
Many employers, who were trying to keep a lid on the cost of medical treatment for their employees, hired pharmacy benefit managers (PBM’s) to assist them. PBM’s market themselves as being an agent of the employer for whom they can negotiate prices with drug companies and keep down drug costs. Sounds really good in theory, doesn’t it? Someone who knows their way around the drug industry and can keep them from overcharging you.
As is so often the case in our convoluted and inefficient medical delivery system, “Not so fast.” In the view of many who want to improve our
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An Old Problem Finally Gets A Name
As health care becomes more complicated, the role of administrators becomes more important. Decisions made by administrators affect the decisions and activities of doctors and, by doing so, affect the patient care they deliver. Health care professionals have known this for years, but never had a name for the damage caused by administrative decisions. Now the problem has a name: Administrative Harm (AH).
One hundred years ago, doctors practiced by themselves or in small groups. They were independent of the hospitals to which they may have sent their patients. They and they alone made the decisions about what care their
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Exercise – The Wonder Drug
Mother Nature knows best. There is a lot of truth to that old adage. Our bodies are the result of a process of natural selection that has been going on for millions of years and is still going on today. Our bodies were optimized for a certain way of living. As we have changed our way of living (think junk food and sitting in front of the TV), our bodies are trying to catch up, but cannot keep up over the short run of only a century or two. Changing the way we live has had some very bad effects
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Another Ripple Effect Of Our Flawed Healthcare System
Our health care delivery system is deeply flawed. It is obscenely expensive, delivers spotty care that depends largely on where you live and how much money you have, and leaves many Americans out in the cold. These flaws create ripples that cause problems across society. One of the effects of the flawed system is exemplified by the very large malpractice verdicts arising out of birth injuries.
One of the great joys a person can experience in this life is the birth of a child. It is almost literally a miracle that there is a new person in the world who
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It Seemed Like A Good Idea At The Time
That is the story with Medicare Advantage plans. It seemed like a good idea at the time. The concept was given birth by the ideologues who believe that private industry can always do a better and more efficient job than the government can. Medicare was spending a lot of money paying for care for its senior enrollees. What if we let private industry in on the program? Surely, private industry could provide the same or better care for less money than those wasteful bureaucrats over at the Medicare offices. It didn’t turn out that way or come even close.
Hospitals Are At It Again
Recently I posted about deceptive techniques hospitals are using to enhance fees. Today I am writing about an article by Dr. Marty Makary, a professor at the Johns Hopkins School of Medicine and a frequent critic of the many failings of our health care delivery system. A recent column by Dr. Makary in the Washington Post discusses how Medicare’s payment system has unintentionally played a role in incentivizing hospitals to create these money-making schemes.
The starting point here is the fact that hospitals charge a great deal more for a procedure performed inside the walls of the hospital than the
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Healthcare Is Too Important To Be Left To The Marketplace
Free markets and the laws of supply and demand have been very good to us. We have a strong economy, good worker productivity and a huge variety of products available at affordable prices. In order for the laws of supply and demand to work efficiently, however, they require certain conditions such as transparency about prices and the absence of large barriers to entry. Both of those important factors are missing from the healthcare marketplace and we see the results all around us. Healthcare deserts, outrageous prices for drugs, widely different prices for the same service in the same local area,
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Artificial intelligence is coming to health care
There is a reason Artificial Intelligence (AI) is the next big thing. It holds the promise of being able to do so many things. It will make the computer revolution of the 60’s look like a mere ripple in the pond. It is probably not an overstatement to say that AI will change everything, including your medical care.
AI has already shown great promise in medical applications. It is far better, for example, than its human radiology counterparts in detecting early lung cancer in chest x-rays. It can do it better and faster than its human counterparts and it does
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Diabetes: What Doctors Don’t Know Can Kill You
Diabetes is a major health problem in the United States. Over 38 million Americans suffer from diabetes. That is 11% of the population. 20% of those with diabetes have yet to be diagnosed and don’t even know they have the disease.
There are two types of diabetes with very different causes and very different courses. The first is Type 1 diabetes. Type 1 is an autoimmune disease in which the body’s immune system attacks the cells that make insulin. Insulin is the hormone that enables the body to convert food to energy. Without it, you die. Type 1 diabetics must
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Defensive Medicine: Is It Really A Thing?
I recently posted about a former Surgeon General of the United States who was complaining about a large emergency department bill. Even though he admitted that all of the tests and treatment he received was necessary, he saw fit to complain that too often unnecessary tests and treatments are ordered because doctors are afraid of losing their licenses or being sued for malpractice. I observed that doctors like to complain about having to engage in defensive medicine even though it is unethical to order tests or treatments the patient does not need just for the sake of the doctor.
I
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Hospitals As Scam Artists
When you think of people who scam the public, you don’t normally think of hospitals. Sure you may think they charge too much or don’t live up to the promises they make to provide health care benefits to the community, but you don’t think of them as scammers. Maybe you should start.
Two recent stories about hospitals doing sneaky things in the pursuit of more money caught my eye. As anyone who has been reading this blog knows, our nation’s health care system is a disgrace. We pay more per person than any other nation on earth and get care
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Comforting Lies Doctors Tell Each Other
Doctors love to feel sorry for themselves when it comes to being held accountable to their patients. The system is so unfair and forces them to do things they don’t want to do. The story below is just the latest example.
I was recently reading a summary of medical news primarily intended for doctors when I came across an interview with a former surgeon general of the United States, Dr. Jerome Adams. The subject of the interview was the high cost of an emergency room visit he recently had in Scottsdale. Dr. Adams had been in Scottsdale for a conference
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Boarding – The Hospital Practice You Didn’t Even Know You Should Be Worried About
“Boarding” is the practice of leaving patients on gurneys in the emergency department while waiting for a bed to open up for them in the hospital. It is occurring frequently and its frequency is only getting worse. According to the statistics, those most likely to be affected are seniors.
It happens all the time. A patient is brought to the emergency department. After an examination and perhaps some tests, the emergency medicine physician concludes the patient needs to be admitted to the hospital for more care. Often, although the patient is ready to be transferred to the floor, the hospital
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The Importance of Good Communication
I have had a number of medical malpractice cases in which catastrophic injuries occurred after surgery because of lack of communication between the surgeon and the nurses. The immediate post-operative period is a critical period as the patient’s body attempts to return to normal from the trauma of the surgery and the effects of general anesthesia. Much can go wrong and that is why the patient is closely monitored during this period. However, even the closest and best possible monitoring is worthless, if the doctors in charge of the care are not notified of significant changes in the patient’s condition
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