Welcome to my first rambling post on our world of medicine. I like the medical field, but like all “industries,” the medical field has its wonders and failings.
My first topic is medical malpractice. Why? To be honest, I need to do some continuing education (CE), and I’m doing a CE course on Medical Malpractice. Since I need to learn about this topic for this exercise, I might as well write about it a little bit as well since I’m learning about it.
Let me just say upfront, I know very little about this topic. If you are looking for an expert opinion, you’ll need to look elsewhere. My information comes in part from the “Risk Management” course from netce.com … if you need some online CE, this seems to be a pretty decent and affordable source that you may want to check out.
Ok, enough disclaimer. What is Medical Malpractice? In theory, it’s when a doctor makes a mistake and injures a patient as a result. Medical malpractice can result in a Medical Malpractice claim … however, only 2% of negligent injuries result in claims. To put it another way, 98% of the time when a doctor makes a mistake and causes an injury to a patient, there is no lawsuit.
So where are the ~60,000 medical malpractice cases in the U.S. coming from each year? The reality is that most medical malpractice legal cases don’t involve an error made by a physician. According to a large Harvard study of malpractice claims and adverse effects by Localion et al (1991) only 17% of claims involved an injury caused by medical negligence.
If ~80% of medical malpractice claims don’t involve an injury caused by medical negligence, what is driving this system? Well, you don’t have to be a genius to figure out that there is a lot of money - about $3 billion per year - to be made by filing medical malpractice claims. It’s primarily a parasitic system to make money for personal injury attorneys, attorneys who defend doctors, and lots of people who work at those law firms as well as the courts that deal with these claims. In rare cases the system actually does what it was theoretically designed to do - hold physicians, dentists, and others financially accountable for the quality of care that they provide to their patients. Mostly, however, the system does not accomplish this and it has become an extremely lucrative way for lawyers to earn a living while getting “jackpot” settlements for patients who were injured, whether or not it was the physician’s fault or not. Don’t get me wrong, I don’t have anything against lawyers. I certainly don’t have anything against injured patients being compensated financially if the physician did something negligent. I just wish lawyers had something more wholesome to put their energy into than our dysfunctional medical malpractice system - or that the system could be reformed so that it serves its intended purpose. Since we have no choice about whether to deal with this dysfunctional system, let’s try to understand it a bit better.
The first thing to know about the U.S. medical malpractice system is that the plaintiff (the injured patient) must prove the case by a “preponderance of the evidence,” i.e., the plaintiff needs to give enough evidence that there is at least a 51% chance that the doctor harmed them due to a medical error. This seems to be the first problem with the system … that we are allowing a 49% chance the doctor did not harm the patient due to negligence. Clearly this is too approximate to be the basis of giving out $3 billion.
If you are still reading this, you have an above average attention span or way too much time to kill. Either way, I’m going to end this blog post and possibly write about this or another random medical topic in the future. Thank you for reading my post and I hope you were amused, angered, or otherwise motivated to encourage reform of the medical malpractice system.
