Polite Dissent

Make no mistake about it, there is medical malpractice crisis coming. Medical liability insurance companies (the companies that provide malpractice insurance to doctors) are either raising their rates dramatically (500% or more, annually) or pulling out of states entirely. Some states have been hit harder than others; for instance, when I was living in Las Vegas 2 years ago, the only level 1 trauma center was shut down for several weeks, and no obstretricians in town were accepting new patients — you had to drive to Lake Havasu (more than an hour away) if you wanted to have a baby.

Now why is there a crisis? It depends on who you ask: the doctors, lawyers, or insurance companies. One undeniable fact is that many Americans are sue happy, and seemingly will sue anyone at the drop of a hat. It was repeatedly told to us in Medical School that no matter how good a physician we were, we could expect to be sued at least twice. The doctors for the most part blame the trial lawyers for filing frivolous lawsuits. The lawyers blame the insurance companies, saying that they are raising their rates due to failed investments. The insurance companies blame the lawyers again.

This round table blame game serves little purpose. While everyone is arguing about who is to blame, doctors are quietly closing up shop and retiring early or moving to friendlier states. Sooner than we realize, it will be harder than ever to find a good doctor, an inexpensive doctor, one who can fit you in to be seen, because soon there won’t be many doctors left. I’m not crying wolf here, I personally know several doctors who have closed up shop, or severely restricted their practice in both Nevada and Illinois (where I live now). I know more who are starting to consider it.

Now you might expect me to espouse a malpractice damage awards cap, and I do — but I don’t like them. I don’t think malpractice caps solve the main problem. It’s true that malpractice caps will limit the damages awarded in the lawsuits that come to trial, but that’s not where the issue really is. The main problem is that many physicians who are sued have NOT committed malpractice. The plantiffs and their lawyers know this, the insurance and their lawyers know this, too. The physician certainly know this, and wants to go to trial to clear his or her name. However, the insurance company decides to settle prior to court, figuring it is cheaper to settle than defend a lawsuit (even one they will likely win). Malpractice caps do not solve this problem, as insurance companies will have no reason to act any differently.

I also have a concern that damage caps will fail the patient who was truly injured and will require lots of money to survive, period. Medical care for the chronically ill/injured is extremely expensive.

The only long term solution is Tort reform. Not just medical malpractice law, but all law. It will be difficult, but necessary. We need to block frivolous suits, but be careful not to favor big business or to prevent the “little guy” from suing when appropriate. Unfortunately, I don’t see tort reform happening anytime soon.

Sadly, that brings us back to malpractice caps. They may be a poor “band-aid”, but the only one quickly available. They do drop the insurance rates, and ease the malpractice crisis. I stand by my statement that I do not like them, but unfortunately I see them as a necessary evil if we want to fix our current mess.