The Health Care Bill has passed...

[Kevin]

Originally Posted by AOII Angel

I thank you for explaining why this happens. Now, why don't they fix this. Just like with medicine, saying that "It's always been that way." doesn't make it right. The malpractice insurance premiums have driven a lot of physicians out of practice in states like Mississippi and West Virginia. OB/GYN and Neurosurgery can be cost-prohibitory to practice.

Trouble is, the only folks really shilling methods of 'fixing things,' are just shilling means to enriching their respective constituencies, not actually fixing anything, and in many cases, making things worse.

Obviously, there must be disincentive built into the system to keep docs from performing open-heart-surgery while tripping on painkillers (it happens). And the 'driving folks out of business' argument just doesn't play well with me. They tried that argument recently in my state, but ignored the fact that while some practices did close, more practices opened in their place, meaning that there was a net-gain in the number of practices opening. It's pure speculation on my part, but I imagine that's the case in Mississippi and West Virginia as well. Unfortunately, the 'tort reform' side of the argument relies a lot on what can objectively be called misinformation or outright falsehood. They don't want an honest answer, they just want to increase their clients' (not doctors, but malpractice insurers) bottom line.

Case in point, take any of the states which have passed major medmal reform legislation, e.g., Texas. Their rates continued to climb in lock-step with the rest of the industry (but of course, the insurers ended up with a lot more cash than before).

Docs, I think, are too quick to blame the legal system for their malpractice insurance rates. They might instead look to the folks who they keep writing those big checks to (hint: not lawyers).

I have to disagree with you here. The use of radiology services has jumped astronomically in the past 5 years with CT imaging increasing more than 60% since I started residency. This has actually decreased physicians' ability to utilize physical diagnosis (hands-on examination) skills which are FREE in exchange for high cost CTs which have a very REAL risk of CANCER! If you look at my PACS system (radiology archival system) there are patients that come to my ER that have had abdominal CTs for abdominal pain every month for 10 months that have NEVER found a single abnormality. That is $30,000 worth of medical imaging to cover an ER doctors butt that has provided to patient with over 1,000 x-rays worth of radiation. Not a good idea. More expensive is not always better!

I think I must have heard a study confirming that on NPR recently. But I don't see any way around that short of some sort of medical tribunal actually putting out standards for that sort of care. While that, absent a statute, probably wouldn't bind a court, part of what goes into winning a medical malpractice case is proving by a preponderance of the evidence (or more depending on the state) that the physician violated the standard of care. If all physicians had some sort of guidelines as to what would and wouldn't violate that standard, maybe they could get away from defensive medicine. I'm not an expert in that field, but something like that would probably have some serious pull if physicians would actually stick to those rules more-less.

What I definitely don't think should happen is that bad doctors get insulated from practicing bad medicine.