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Old 01-14-2005, 11:35 AM   #21
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Originally Posted by Loren Pechtel
WTF?? Sounds like some lawyer managed to slip something through to break the measure.
I KNOW.

But it was in place for quite a while.

http://www.mcandl.com/colorado.html#VII

As I understand it, they started carving out little paths around it while the caps were in place, but even those added an extra burden of proof for the injured party to show that, in fact, they should not have to pay the doctor for accidentally sawing off their leg or whatever.

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I would think that in both cases there are economic damages. I don't think the fact that you are temporarily unemployed has anything to do with it.
OK. I was being lazy before, but I went and asked.

I guess what you have to do to determine future earnings is get a forensic economist or something to figure out earning potential based on various demographic factors. So, say a 2-year old is brain damaged and will be unable to earn a living for the rest of his life. They'll take into account factors such as socioeconomic status, the parents' education and employment, etc., and use those factors to determine what the child's likely earning potential would have been based almost entirely on averages for the relevant demographics, and those are considered economic.

Which is kind of scary and weird, because that seems to imply that the child of poor minority parents would automatically be deemed of lesser value than the child of wealthy Ivy League educated parents. For someone who is older and thus farther along in establishing their own life, those factors would be taken into account.

I'm sorry. I must be the laziest person ever, for not just walking down the hall to ask in the first place. If some forensic economist comes around asking questions, though, don't tell him about the laziness thing, OK?

Edit: I forgot to add that the reason I ask this is because of cases like Jesica Santillan, who got an organ transplant with the wrong bloodtype, and who was determined to have virtually no economic worth, as she was 17, unemployed, and poor. She eventually died, but if she had been grievously injured, I would hate to think that a young person is limited to some minimum economic value based solely on circumstances beyond their control. I might have something less of a problem if there were some kind of reasonable, and even reasonably optimistic, standard set for future economic damages.
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Old 01-14-2005, 12:34 PM   #22
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The 76% figure is, unsurprisingly, total bullshit and not scientific. It’s based on a survey sent out to a medical organizations membership—76% of those who responded said they had been sued.

Loren said:

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I also think we need to redefine the standard. The problem with too many malpractice cases is that there simply isn't the evidence to decide. I think such ambigious cases should go to the defense.
Wow, Loren once again posting in a thread about medical malpractice without evidence to support his position.

Loren, don’t you think it’s a bit too obviously hypocritical for you to criticize jurors for making judgments where there “isn’t the evidence to decide�? when you consistently do the same thing?
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Old 01-14-2005, 02:24 PM   #23
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Originally Posted by pug846
The 76% figure is, unsurprisingly, total bullshit and not scientific. It’s based on a survey sent out to a medical organizations membership—76% of those who responded said they had been sued.
And what's wrong with that? You think the doctors were lying about being sued??
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Old 01-14-2005, 02:48 PM   #24
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Originally Posted by Loren Pechtel
And what's wrong with that? You think the doctors were lying about being sued??
I'm no statistician, but it seems to me that this method could easily inflate the percentage without any dishonesty on the part of the doctors. Those who have been sued might be more likely to respond (and hence be counted) than those who have not been sued. I don't know the name, but I'm pretty sure that this is some sort of statistical fallacy. This is, of course, assuming that Pug's assessment of the study is accurate.
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Old 01-14-2005, 02:59 PM   #25
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Originally Posted by Loren Pechtel
And what's wrong with that? You think the doctors were lying about being sued??
Well, for those of us who like to base our opinions on things called facts, putting aside that it isn’t clear whether the survey was even a random sampling of the organization’s members, the 76% would not represent obstetricians as a whole unless you assume, without any evidence, that the members of the organization represent obstetricians as a whole. (There is an irony in your being appalled at the thought of doctors lying though: you constantly write—again, without factual support—that there are tons of meritless lawsuits. In those “meritless�? lawsuits, at least one expert witness—i.e., at least one doctor—would be willing to swear that malpractice had been committed. As a result, you must hold the position that those doctors are lying.)

As was pointed out to you here, simply going to google and linking to the first article you find with certain key words in it does not constitute legitimate support for your position. Although I must say that your attempt to back up your baseless assertions is rather encouraging. Perhaps one day you can take part in a discussion about issues, such as medical malpractice, by actually having an informed opinion.



As for the article linked in the OP, I’m not sure I have a problem with what the doctor did. If the doctor feels that his personal feelings about the patient might cause him to treat the patient less than what he expects of himself, then I think he did the right thing by refusing to work with the patient.

It’s also clear that something needs to be done to ensure that women receive the medical care they need when giving birth. Unfortunately, as has been argued over and over again in this forum, there is little evidence to suggest that “tort reform�? will help.
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Old 01-14-2005, 03:48 PM   #26
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Originally Posted by Barbarossa
Er--you mean JCAHO* and HIPAA,** right?


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*Joint Commission on Accreditation of Healthcare Organizations
**Health Insurance Portability and Accountability Act of 1996
Yes I do. And that is what I get for trying to type a cogent post at 5:45 in the morning before a long day at work. It was more a reflection of how we pronounce the acronyms at work (jay-ko) I guess.
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Old 01-14-2005, 04:19 PM   #27
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Originally Posted by mountain_hare
Still, the doctor is a professional, and should keep personal opinions/feelings locked away.
He shouldn't be forced to treat anyone he doesn't want to. Why should he be forced to treat a patient who could potentially destroy him, or at least be oblivious to that fact? If she doesn't care about him, why should he care about her?

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However, I can understand why some doctors are upset about the current situation, especially in America, where frivolous lawsuits are rife. Sometimes 'Mistakes of God' occur in medicine, where the doctor is not to blame. Yet he is always afraid of malpractice suits.
America is ridiculous with it's damage awards. John Edwards specialized in these kind of frivilous lawsuits. His main specialty was "proving" that lack of C-sections caused brain damage in babies, using gullible juries, junk science, and tragic cases which always make use of appeal to emotion. This "theory" has since been thoroughly falsified. The cost of medical care is driven up in this way because doctors had to perform more c-sections, protecting doctors from lawsuits but not protecting babies from brain damage.

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I would have more sympathy for doctors, if they didn't protect their own like some kind of secret society. It is virtually impossible to get a record of each doctor's past problems, issues, etc. And disciplining a doctor who has repeated and multiple breaches of professional conduct is unheard of, because the medical boards shield their members. It's similar to the way that Roman Catholic dioceses shield their pedophile priests.
No, thats not true. It's rather difficult to get a p.h.d in medicine first of all. Secondly, there are brigades of regulations and rules you have to go through to renew your license to practice medicine. Finally, patients have every right to choose their own doctors based on what they know. If they don't have enough information about one doctor they should seek another.

Besides, what evidence do you have to prove that medical boards shield bad doctors, besides unsupported assertion?

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I don't have a lot of sympathy for complaints about rising insurance costs, when the MDs aren't willing to help root out the 1-2% of their members that account for 95% of the lawsuits.
Which hospitals like to employ bad doctors? Let me know so I can avoid going to those ones.

To my knowledge, there is no hospital in the world which prefers bad doctors over good doctors, but let us know.

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I'm surprised that the 'conspiracy' is that bad. I always knew that doctors protected their own, but I obviously underestimated the seriousness.
Case in point: gullible liberals.

What reason do you have to believe that there is a conspiracy in the first place?

Quote:
Yes, Sauron, you are correct there are bad doctors in many fields, however the insurance companies (who I beleive are a major cause of all these problems) charge much higher premiums for obstetricians and surgeons and are telling them they will lower their premiums if tort reform comes about (prolly lying). Presumably because those fields often have a higher chance, naturally, of bad patient outcomes and more lawsuits.
Probably lying? I see no reason to believe that.

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I'd want to know how many people have been sued and lost, or ideally, how many were actually guilty of malpractice. The existence of suits doesn't prove malpractice...
To left-wing extremists it does. Read some of the thread titles around here.

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Limiting punitive awards (which are disallowed in my state) will not help OBGYNs at all. Juries are pretty conservative for noneconomic damages anyway, so the punitive damages are a red herring. The cases where you can get good punitive damages are the cases that should have large punitive damages. I don't know why people think that getting into a jury suddenly makes people lose all reason.
That implies that reason is the central motive behind a juries decision in the first place, which is often not true. Emotions play a much bigger role in American courtrooms, which is why we have people like Johnny Cochran, who are paid to play on the juries emotions.

Quote:
As someone who works in medicine, and aspires to be a clinician (most likely NP though, MD isn't what it used to be!) I think one of the biggest problems as identified by many doctors I work with and I concur with is that malpractice and/or punitive awards are often decided by a typical 'impartial' jury. A jury that usually knows nothing of standards such as JACHO and HIPPA and all it takes is a decent lawyer to convince the jury a doctor is guilty of malpractice, whether or not he is actually committing malpractice based on the scope of his practice and what current guidelines for treatment are. I'd argue that such a civil trial is not being tried by your peers, because the jury would need to have special training and knowledge in the field to objectively try. I'm not sure what the solution is, as having an all-doctor/medical proffesional jury may be tipping the bias to the defense; which isn't neccessarilly bad considering it should be the plaintiff's job to prove the affirmative coming into the case, not the defendent's job to prove a negative (as much as the media wants you to believe it is).
See, another medical person has just corroborated everything I said.
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Old 01-14-2005, 04:51 PM   #28
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Probably lying? I see no reason to believe that.
The last time we had this discussion, evidence was presented showing that states that inacted tort reform did not have a correlating drop in insurance premiums. :huh:
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Old 01-14-2005, 05:02 PM   #29
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I'd like to analyze that data more closely if you don't mind.
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Old 01-14-2005, 05:21 PM   #30
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I forgot to provide the link to the “76%�? study in my previous post, and I can’t currently seem to find a description of it anymore on the ACOG website, but here is an article discussing part of the scope of the survey (along with the current difficulty of being an OBYGN). Although this story does seem to describe the study as a random sampling of ACOG doctors, other links don’t seem to convey that message. (Regardless, it is clear that the study is of ACOG doctors and not a random sampling of all OBGYN doctors.)

Liberal writes:

Quote:
His main specialty was "proving" that lack of C-sections caused brain damage in babies, using gullible juries, junk science, and tragic cases which always make use of appeal to emotion. This "theory" has since been thoroughly falsified. The cost of medical care is driven up in this way because doctors had to perform more c-sections, protecting doctors from lawsuits but not protecting babies from brain damage.
His “main specialty�?? One case in his entire career dealing with c-sections and brain damage and that’s his main specialty? Moreover, unsurprisingly, your description of the case isn’t accurate.

Quote:
No, thats not true. It's rather difficult to get a p.h.d in medicine first of all. Secondly, there are brigades of regulations and rules you have to go through to renew your license to practice medicine. Finally, patients have every right to choose their own doctors based on what they know. If they don't have enough information about one doctor they should seek another.

Besides, what evidence do you have to prove that medical boards shield bad doctors, besides unsupported assertion?
I don’t think there’s a lot of disagreement that at the very least, some medical boards don’t do a very good job policing doctors. For example, here is an article describing some of the problems found in New Jersey. From the article:

Quote:
Last May, Dr. Richard Kaul went before the New Jersey Board of Medical Examiners to plead to keep his doctor's license.

Kaul had been convicted in England of negligent manslaughter after a dental patient died under anesthesia. His British license was revoked when he admitted that his "inattention" allowed the patient's blood oxygen to drop low enough to cause brain hypoxia and, finally, cardiac arrest.

But the New Jersey board allowed Kaul to keep his state license if he agreed to a six-month suspension.

Kaul, of Convent Station, N.J., believed the decision was too strict, so he appealed. "If anything, the six-month period of active suspension was lenient," the New Jersey Appellate Division ruled on Dec. 5. The discipline was especially lenient considering that Kaul had lied about the death on his applications to St. Clare's Health System, where Kaul is on staff, and Hackensack University Medical Center, the court noted.

The case, IMO Richard Kaul, M.D., while dramatic, nonetheless typifies the Board of Medical Examiners' attitude toward doctors who harm their patients. The board rarely bans doctors from practicing, even when they kill people, a review of the board's discipline records, dating back to 1972, shows.
Here’s another story detailing how lax some medical boards have been:

Quote:
Hundreds of doctors found guilty of sex-related offenses against their patients have been allowed to continue to practice, says a report from Public Citizen's Health Research Group published tomorrow in the Journal of the American Medical Association (JAMA).

The report studied 761 physicians disciplined for sex-related offenses and found that 75 percent of them (567) committed offenses against their own patients. "These violations include rape, sexual molestation and trading drugs for sexual favors," said Christine Dehlendorf and Dr. Sidney Wolfe, authors of the study.

The study also found that physicians disciplined for sex offenses are often allowed to practice with minimal and often unenforceable safeguards, such as having a chaperone present during examinations or having another physician monitor patient records. "Almost 40 percent of doctors disciplined for sex offenses before 1995 were still licensed to practice in March 1997," said the authors.

The specialties of psychiatry, child psychiatry, obstetrics and gynecology, and family and general practice were all significantly over-represented among the doctors disciplined for sex offenses. Although the number of physicians disciplined has increased from 42 in 1989 to 147 in 1996, recent studies show that the real number of offenses is likely to be much higher than those
reported, say the authors. The rate of discipline by state boards for sex-related offenses varied widely from 3.3 MDs disciplined per 1000 MDs to 0 MDs disciplined per 1000.
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